Title: Healing from Sexual Abuse Trauma : Model and Measure
1Healing 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
2Healing 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
4More than PTSD
- Besides symptoms of PTSD, survivors of pervasive
trauma seek help for - depression
- anger
- self destructive behavior
- feelings of shame
- self blame
- mistrust
5More 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
6Paradigm Shift
- Trauma has largely been overlooked in
-
- Explaining behavior
- Designing environments
- Designing policies
7Paradigm 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
8Collaboration 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
9Concept 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
11Dimensions 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
12Dimensions 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
-
13Dimensions 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
14Models 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
15Healing from Sexual Abuse Implications for
Systems
- Validation
-
- Safety
- Self Care
-
- Community
- Empowerment
16Healing from Sexual Abuse Mens concept map
17Healing from sexual abuse Womens concept map