Feminist Perspectives on Social Work and Human Sexuality

Mary Valentich, James Gripton

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317212300
• Edition: 1
• Topic: Social Sciences
• Subtopic: Feminism & Feminist Theory
• Index: Social Sciences

First published in 1985, this ground-breaking volume contributes to a largely neglected area of social work research, theory and practice. The collection of essays by internationally known social work educators and practitioners applies feminist perspectives to a wide range of issues influencing the social work profession and social work practice. In doing so, it demonstrates that a liberal feminist position is consistent with social work practice. Nearly all the chapters focus on direct practice issues, such as problems faced by women who have been sexually assaulted, the lack of adequate health care provided to lesbians from traditional health care systems, and sexist bias in sex therapy and family therapy models.

This book will be of interest to students and practitioners of social work.

Common Therapeutic Targets Among Women Who Were Sexually Abused in Childhood

Derek Jehu
Marjorie Gazan
Carole Klassen

ABSTRACT. The range of psychological problems that are most likely to require therapeutic attention in programs for women who were sexually abused in childhood are reviewed. In a series of 22 such women over three-quarters experienced low self-esteem, guilt, depression, and a variety of interpersonal difficulties. At least half these clients complained of some impairment in their sexual functioning. Therapeutic provision for suicide attempts and substance abuse is also very necessary with this client group.

What psychological problems are most likely to require therapeutic attention in any program for women who were sexually abused in childhood? Clearly, this is a vital question in planning such programs and the present article is an attempt to provide an answer in the light of the limited knowledge that is currently available. This knowledge is partly derived from the authors' clinical work with a consecutive series of 22 previously abused women who are being treated as part of a larger, ongoing project, and partly from the scarce literature on the topic.

Some important restrictions on the scope of the article need to be noted. First, no attempt is made to compare the incidence rates for certain problems in abused and non-abused women. This is not the purpose of this article, a few studies in the area have included a control or comparison group of non-victims (Jehu & Gazan, 1983).

A second restriction concerns the population being discussed. It is necessary to distinguish three overlapping groups of previously sexually abused women. First, there is the total population of such women, which in the United States and Canada is estimated to amount to between one-fifth and one-half of females (Finkelhor & Hotaling, 1983; Herman, 1981; Maney, 1983; Russell, 1983; Sexual Offences Against Children in Canada, 1984). Comparable figures are not available for other countries. Next, there is a sub-group of this total population consisting of previously abused women who experience psychological problems in adulthood. The size of this sub-group and the nature of their problems are essentially unknown. Finally, there is a further sub-group of previously abused women who have later difficulties and who seek treatment for these. Again the size of this sub-group is unknown and only limited information is available on the problems of its members. The current article is a contribution to this last issue, and it follows that the information presented on the occurrence of certain problems among previously abused women who seek treatment cannot necessarily be generalized to all abused women, or even to all abused women who experience difficulties in later life.

When such difficulties do occur it is impossible moreover, to be certain of the extent to which they are attributable to the earlier sexual abuse per se. There may well be contributions from other factors in their histories or current circumstances, often including discord and disruption in the family of origin, insensitive handling of the abuse by parents, police, courts, and social agencies, a self-destructive lifestyle, and exploitive relationships with partners.

Despite these limitations in the information available it is clear that previously abused women who are seeking therapy do commonly experience certain problems and that these are likely to be major therapeutic targets in treatment programs for these women. Thus, such programs will need to offer treatment for these problems or to have ready access to other facilities that can provide suitable treatment. A very wide range of psychological problems are experienced by previously abused women and only the most common are considered here. They are discussed in the general categories of emotional, interpersonal, and sexual problems, but allocation to these categories is somewhat arbitrary and there is considerable overlap across them.

Clients

Because of the nature of the therapeutic services being provided one of the criteria that potential clients are required to meet for acceptance into the project is an absence of any current crisis in their lives due to high risk of suicide or substance abuse. This criterion almost certainly reduced the prevalence of these problems as therapeutic targets in the series of clients reported here. There are some indications of this bias in that 16 of the 22 accepted clients had previously attempted suicide, nine had abused alcohol, and five had been addicted to drugs. Additionally, while the accepted clients were being assessed or treated, three attempted suicide, two revealed current alcohol abuse and one was found to be currently addicted to drugs. Other investigators have also reported substantial proportions of these problems among previously abused women. In a study of 67 such clients who were seeking counseling Briere (1984) found that 51 % had attempted suicide, 27% had a history of alcohol abuse, and 21% of drug addiction. Among 40 father-daughter incest victims in therapy Herman (1981) reports that 37% had attempted suicide, and 35% had been involved in alcohol or drug abuse. Thus, without the exclusion of certain potential clients because of current suicide risk or substance abuse it is highly probable that these problems would have been more common therapeutic targets in the series, and this has important implications in program planning for previously abused women.

Of the 22 accepted clients, 11 were aged 20-29 years, nine were aged 30-39, and two were aged 40-49. Their marital status was seven married, two separated, four divorced, two living as married, and seven never married. One client was living in a homosexual partnership. Educationally, one attained grades five to eight, seven grades 9 to 12, four technical/vocational training, and 10 university education. In ethnic background, 17 were Caucasian, two native Indian, two Metis, and one Inuit.

The age at which the sexual abuse commenced was between zero and five years for eight clients, six to nine years for 12 clients, and 10-14 years for two clients. The duration of the abuse was less than one year for one client, one to three years for three clients, four to six years for four clients, seven to nine years for six clients, 10 to 12 years for five clients, and 13 years or more for two clients, and for one client this information is missing. For acceptance into the project the women were required to meet the criterion of having been abused on more than one occasion. The frequency of abuse was two to 99 occasions for five clients, more than 100 occasions for 16 clients, and this information is missing on one client. A wide range of activities were involved in the abuse, with manual stimulation and/or erotic fondling of the client by the offender occurring in over 70% of cases, and penile penetration of the vagina in over 50%. The relationships of the offenders to the clients appears in Table 1.

Table 1
Relationship of Offenders to Client (N of clients = 22)

Relationship	N of offenders
Father
Natural	7
Others	6
Brother
Natural	13
Step	2
Adoptive	1
Grandfather	1
Great uncle	1
Brother-in-law	1
Male cousin	1
Male acquaintance	12

Note. For inclusion in this table (a) if the victim was aged 12 years or under when the abuse commenced then the offender must have been at least five years older (b) if the victim was aged 13 to 16 years the offender must have been at least 10 years older. Many clients were abused by more than one offender.

Emotional Problems

Low Self-Esteem

This problem was identified in 19 of the 22 clients. It was evident in the assessment interviews and from the number of clients who endorsed certain Belief Inventory (Jehu, 1983) items as shown in Table 2. Another indication is the distribution of the clients' scores on the Culture Free Self Esteem Inventory for Adults (Battle, 1981) as shown in Table 3, although it should be noted that the norms on which this classification is based are derived from college students which is not an entirely comparable population to the clients in the series.

Other investigators have also identified low self-esteem as a common problem among women who were sexually abused. For instance, among 30 women victims of incest who volunteered to be interviewed in a research study conducted by Courtois (1979), 87% reported their sense of self as having been moderately to severely affected. Similarly, among 40 father-daughter incest victims in psychotherapy, 60% had a predominantly negative self-image and the investigator comments that "With depressing regularity, these women referred to themselves as bitches, witches, and whores. The incest secret formed the core of their identity" (Herman, 1981, p. 97).

Guilt

Guilt associated with the earlier sexual abuse was identified in 18 of the 22 clients. This was evident in assessment interviews and from the clients' responses to certain items on the Belief Inventory (Jehu, 1983) as shown in Table 4. Clearly, many of the women continue to blame themselves for having been sexually abused in childhood and this misattribution is an important source of guilt which requires therapeutic attention.

Depression

Not surprisingly in view of the prevalence of low self-esteem and guilt some degree of depression was also present in 18 of the 22 clients. As one indication of this, the distribution of their scores on the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979) is shown in Table 5. Similar findings by other investigators include reports of a diagnosis of depression in 35% of 26 father-daughter incest victims in psychotherapy (Meiselman, 1978), and of major depressive symptoms in 60% of another series of father-daughter incest victims in psychotherapy (Herman, 1981).

Table 2
Number of Clients Endorsing Items Indicating Low Self-Esteem (N = 21)

Item	N
I ...

Table of contents

• Cover
• Title
• Copyright
• Original Title
• Original Copyright
• Contents
• About the Editors
• Contributors
• Foreword
• Introduction
• On the Diversity of Love Object Orientations Among Women
• Common Therapeutic Targets Among Women Who Were Sexually Abused in Childhood
• A New Look at Mothers of Incest Victims
• Social Work, Traditional Health Care Systems and Lesbian Invisibility
• Feminist Issues in Sex Therapy
• The Sexual Component in Family Therapy: A Feminist Critique
• Human Sexuality and Feminism: A New Approach to Perinatal Social Work
• Women's Responses to Abortion: Implications for Post-Abortion Support Groups