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Healing from Sexual Abuse Trauma : Model and Measure

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Title: Healing from Sexual Abuse Trauma : Model and Measure


1
Healing from Sexual Abuse Trauma Model and
Measure
  • NASMHPD Research Institute
  • 13th Annual Conference on
  • Services Research and EvaluationDeveloping an
    Evidence-Based Culture to Reform Systems
  • February 9-11,2003
  • Supported in part by the Center for the Study of
    Issues in Public Mental Health NIMH Grant
    2P50MH51359

2
Healing from Sexual Abuse Trauma Model and
Measure
  • Mary Jane Alexander, Ph.D.1
  • Jeanne Dumont, Ph.D.
  • Kristina Muenzenmeier, M.D.2
  • Mary Auslander, M.S.W.3
  • 1Nathan Kline Institute for Psychiatric Research
  • 2Bronx Psychiatric Center
  • 3Maine Department of Mental Health, Mental
    Retardation, Alcohol and Substance Abuse Services
  • Supported in part by the Center for the Study of
    Issues in Public Mental Health NIMH

3
Trauma Exposure and Distress
  • General Users of Public Mental
    Population Health Services
  • Any Exposure 50 51 98
  • 3 Events or More 15 50
  • PTSD/Distress,
  • Impairment 8 42
  • Common Events witness bad injury/death
    sexual assault - adult
  • fire, flood, natural disaster
    sexual assault - child
  • car or work accident
  • attack with weapon

4
More than PTSD
  • Besides symptoms of PTSD, survivors of pervasive
    trauma seek help for
  • depression
  • anger
  • self destructive behavior
  • feelings of shame
  • self blame
  • mistrust

5
More than PTSD
  • Complex Post Traumatic Stress changes a persons
  • Ability to regulate their affective arousal
  • Attention and consciousness
  • Perception of oneself and the perpetrator
  • Relationship to others
  • Systems of meaning
  • Experiencing somatic distress

6
Paradigm Shift
  • Trauma has largely been overlooked in
  • Explaining behavior
  • Designing environments
  • Designing policies

7
Paradigm shift Increasing awareness of the
impact of trauma
  • Federal Support 1994 present
  • NASMHPD Resolution 1998
  • State Agency Support 11 States with Trauma
    Initiatives
  • Consumer voices 1994 - present

8
Collaboration Consumer/survivors, Clinicians,
Researchers
  • Develop a model of healing from childhood sexual
    abuse based on concept mapping
  • Develop a measure of healing using the model and
    concept map data
  • Develop a roadmap for healing
  • Validate the measure and further develop the
    theory
  • Participant survivors collaborate with study team
    to
  • Generate items
  • Interpret maps name dimensions of healing
  • Review draft measure

9
Concept Mapping Method
  • Brainstorm statements
  • Sort statements
  • Rate statements
  • Analyze sorted statements
  • (Multi Dimensional Scaling Cluster Analysis)
  • Name clusters and interpret maps

10
Healing from Sexual Abuse Trauma
  • Awareness validation
  • Confidence in judgments
  • Skills and safe environments to
  • identify triggers
  • diminish dissociation
  • experience and manage the whole range of emotions
  • Build reconnect with community, normalization
  • Optimism and hope, look to the future
  • Placing the abuser
  • Reach out, help others, advocate

11
Dimensions of Healing Women
  • Personal Empowerment
  • Power and control to say no effectively
  • Challenge authority
  • Positive Struggle Zone
  • Self acceptance Self love
  • Minimal needs
  • Fill in the gaps of time and events
  • Reconstruct sexuality
  • Enjoyment Choice, Diminish Guilt
  • Competence as a parent
  • Trust self to make choices
  • Competence in social roles Identify triggers
  • Cope with Emotions
  • Acknowledge that abuse happened
  • Diminish substance abuse
  • Self Acceptance Confidence
  • Stopped self-blame
  • Confidence in distinguishing internal from
    external reality

12
Dimensions of Healing Women
  • Awakening and self validation
  • Believing that sexual abuse happened
  • Building support/ self help
  • I surround myself with positive, nurturing
    people
  • No hole anymore in my heart or body
  • Gaining wisdom
  • I believe I can make good judgments
  • I acknowledge my feelings, even at times of joy
  • Forgiving the perpetrators

13
Dimensions of Healing Men
  • Awareness, beginning understanding
  • Identify as survivor, not as victim
  • Stop self blame for abuse
  • Change thoughts and feelings
  • Experience and express vulnerability
  • Diminish self abuse
  • Learn understand about sexual abuse
  • Mourn the loss of childhood
  • Process of normalization
  • Abuse as a pathway to mental illness
  • Diminish victim behavior
  • Identify and cope with triggers
  • Stop self pity
  • Accept love trust from self others
  • Re-establish family ties
  • Experience connection to others
  • Self Care
  • Support personal achievements
  • Diminish self harm in crisis
  • Overcoming fulfillment
  • Personal empowerment
  • Motivation to help others
  • Diminish fear increase assertiveness
  • Advocacy

14
Models of Recovery
  • Mental Illness
  • Anguish
  • Awareness insight
  • Action plan
  • Determination to be well
  • Well being / recovery
  • Reestablish social roles decision making
    capacity through social support
  • Complex PTSD
  • Safety
  • Remembrance Mourning
  • Reconnection with ordinary life
    commonality

15
Healing from Sexual Abuse Implications for
Systems
  • Validation
  • Safety
  • Self Care
  • Community
  • Empowerment

16
Healing from Sexual Abuse Mens concept map
17
Healing from sexual abuse Womens concept map
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