The shackles of abuse: unprepared to work at the edges of reason

Abstract

The shackles of abuse: unprepared to work at the edges of reason Childhood sexual abuse is an international public health problem. Research suggests similar prevalence rates in both Western and non-Western societies. The long-term consequences of child sexual abuse include wide ranging mental health problems in adult life. Psychiatric services and, in particular, counselling has been highlighted as being the most helpful to those who have experienced child sex abuse. This evidence base should be informing mental health nursing education and practice. However, we argue there is a divergence between the discourse of evidence-based theory and practice reality. The aim of this paper is to explore the preparedness of mental health nurses to work with adults who have experienced sexual abuse during their childhood. It is the first part of a three-part research project and reviews the literature relating to how (and if) mental health nurses are prepared to work with those who have sexual abuse histories. An important issue considered in this review is the impact upon patient/nurse relationships as a consequence of the nurse themselves being survivors of sexual abuse. We argue that a number of conflicting discourses need to be addressed, if mental health nurses are to be appropriately prepared to offer cogent, sensitive care to those in their care who are shackled to their past sexual abuse through the confines of their current mental illness.

Jury Selection in Child Sex Abuse Trials: A Case Analysis

“…Juror reactions to sexual assault may be visceral and intense given that victimization of children is perceived as detestable and immoral (Weekes, Pelletier, & Beaudette, 1995) and that sex offenders are perceived as predatory, socially incompetent, or homosexual (Fuselier, Durham, & Wurtele, 2002). Prevalence estimates of child sex abuse range from 3% to 66 % depending on study and country, although it seems to be an equally frequent problem across cultures (Warne & McAndrew, 2005). Selecting a jury can be an arduous and challenging task for attorneys and trial consultants depending on the nature of the case.…”

Exploring stigmatisation among people diagnosed with either bipolar disorder or borderline personality disorder: A critical realist analysis

“…Beyond clinical interactions, BPD is marginalised at the levels of policy, planning, staff training and service delivery, perhaps representing social oppression (Kealy and Ogrodniczuk, 2010) or institutional abuse (Warne and McAndrew, 2005).…”

Passive patient or engaged expert? Using a Ptolemaic approach to enhance mental health nurse education and practice

“…Thus, in recognizing both the unconscious and conscious elements involved in such relationships, caution needs to be exercised with regard to ‘knowing’ (the unconscious) as it can corroborate what we already believe we know (the conscious) and in doing so reinforce our prejudices, behaviours and responses (e.g. see Warne and McAndrew's (2005) work on why mental health nurses are unprepared to therapeutically engage with those who may have been sexually abused in childhood). Zapparoli and Gilson (1999) suggest that patient's specific needs are easily denied when these differ greatly from the common and conventional therapeutically imposed goals of the professionals involved.…”