Summary: Cohen JA and Mannarino AP. "Predictors of treatment outcome in sexually abused children," Child Abuse and Neglect vol 24(7): 983-994. 2000.

Many factors influence what types of symptoms sexually abused children develop. Both children's attitudes and parents' attitudes and parenting practices have an effect on these children's symptoms. But what factors influence the outcomes of treatment for child sexual abuse? This article describes an experiment that sought to assess just that.

Forty-nine sexually abused children between the ages of 7 and 15 were studied. These children, along with a parent, had undergone one of two 12-week courses of therapy to address the psychological and behavioral problems brought about by the abuse. The treatment is described in Cohen and Mannarino's article, "Interventions for sexually-abused children: Initial treatment findings." This article reports on factors that may influence treatment outcome, rather than the content of the treatment itself.

In order to analyze factors related to treatment outcome, both the children and their parents were asked to complete a number of standard tests. Some of them measured children's behavior, trauma symptoms, self-perceptions, and psychological states. Others assessed each family's adaptability and cohesion; parents' reactions to the abuse their children had suffered; and their support for their children in the face of this abuse.

The study's results suggest that treatment outcomes for sexually abused children are significantly affected by children's and families thoughts and beliefs about the abuse. For example, one test revealed that children's trauma-related anxiety was linked to their feeling that other people did not believe them. This belief, as well as a feeling of self-blame, was related to children's depression. The level of family support also had a role in children's anxiety, although parent's emotional reaction to the abuse did not have a significant impact on treatment outcome. One particularly interesting aspect of the research was the finding that family adaptability contributed to children's anxiety. It is unclear why this is so, but it may be that sexually abused children need a high degree of structure and predictability in their family lives in the aftermath of the abuse they have suffered.

Since so many of the elements tied to treatment outcome have to do with children's and parent's beliefs about themselves and their perceptions, cognitive behavioral therapy-which targets these areas-has a n important role to play in treatment of this population.