Childhood sexual abuse: community‐based treatment practices and predictors of use of evidence‐based practices

Abstract

Background Cognitive behavior therapy with abuse‐focused components is empirically supported for children/adolescents who have experienced childhood sexual abuse (CSA). We examined the extent to which community‐based psychologists use evidence‐based practices (EBP) for CSA and identified predictors of EBP use. Method Psychologists (N = 231) providing CSA treatment services to children/adolescents in Ontario (Canada) were identified through the first census of child and adolescent psychology clinicians registered with the College of Psychologists of Ontario. Participants completed a questionnaire on treatment strategies, sociodemographics, work setting, treatment provision, and attitudes toward EBP. Data were collected between December 2009 and June 2010. Results The majority (78%) of psychologists providing CSA services reported never having received training in specific treatment approaches for this population. Only 5% of psychologists received training in the EBP of trauma‐focused cognitive behavior therapy. Multiple regressions indicated that age, theoretical orientation, continuing education, and attitudes predicted the use of an empirically based intervention for CSA. Conclusion Study findings show that few community‐based psychologists have received training in specific treatment approaches for CSA victims and very few are trained to deliver EBP for this population. There are ethical concerns about the practice of psychologists who are untrained and unsupervised doing this work. Research findings, which underline the need for training, supervision, and continuing education, need to be translated into clinical practice.

A survey of evidence-based practice, training, supervision and clinician confidence relating to post-traumatic stress disorder (PTSD) therapies in UK child and adolescent mental health professionals

“…This is important given that approximately half of clinicians received no trauma training, and almost a third received no supervision. These are better figures than the earlier study of psychologists by Czincz and Romano ( 2013 ), but their study focused exclusively on work with sexually abused children. Results identified noticeable differences between professions in the level of training and supervision received.…”

“…A number of barriers have been identified, including clinicians’ fear of increasing distress, lack of training and supervision, a lack of confidence, and beliefs relating to the restrictiveness of manualised approaches (Becker et al, 2004 ; van Minnen, Hendriks, & Olff, 2010 ; Whiteside, Deacon, Benito, & Stewart, 2016 ). Czincz and Romano ( 2013 ) surveyed psychologists in Canada working with children who had suffered sexual abuse and found that 77.5% of clinicians received no training in trauma approaches, and 66.2% reported never receiving clinical supervision.…”

Use of evidence-based interventions in child welfare: Do attitudes matter?

“…In particular, a provider’s openness to EBPs might be a critical factor in initiation of a practice. In a sample of psychologists providing treatment to child and adolescent survivors of sexual abuse, Czincz and Romano (2013) found that the Openness and Appeal subscales were associated with self-reported use of EBPs. Similarly, in a study of paraprofessional and professional staff providing treatment for youth with autism, the Openness subscale was associated self-reported use of EBPs (Paynter & Keen, 2015).…”

Institutional Care and Response to Victims of Child Sexual Abuse in India: The Role of Non-governmental Organizations & Public Hospitals

“…al, 2012). Czincz & Romano, (2013) studied the utility of trauma-focused cognitive behavioral therapy, an evidence-based intervention for children who have experienced CSA within community based treatment practices. Results from the study highlighted the pressing need for knowledge translation of evidence-based practices and its adoption in community settings and a service approach that is more focused on accountability and cohesion between the realms of research and practice.…”

“…In this era of increased demand for accountability and evidence-based practice, understanding current treatment practices, the extent to which they align with evidence-based practice, and the factors that influence the use of evidence-based practice are crucial for knowledge translation purposes in the field of CSA (Czincz & Romano, 2013. As suggested by Allnock et al, (2012), gathering more evidence about sexual abuse assessment and provision would form a useful extension to the data currently collected through any national mapping process undertaken.…”