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This chapter describes the case of two adolescent girls who were living in foster care with their maternal aunt and her family, the Kraller family. The girls and their aunt and uncle participated in Project SAFE, a university-based program for sexually abused children and their nonoffending caregivers, which is described in detail in the Course of Treatment section. The Kraller family was referred to Project SAFE by the local Child Advocacy Center. Miriam Kraller contacted the Child Advocacy Center when she learned that her two nieces (her younger sister’s daughters), Gina (age 14) and Suzy (age 13), had been sexually abused and were moving in with her and her family due to their mother’s inability to care for them. Both Gina and Suzy reportedly had experienced sexual abuse while living with their mother (Abigail Smith) in Alabama. Mrs. Kraller sought help because she was concerned about the impact of the sexual abuse on her nieces.
Childhood sexual abuse presents a variety of stressful challenges to the victims and their families. Treatment of sexually abused children has received increased attention in research domains and clinical practice as improved incidence studies in recent decades have revealed disturbing information about its occurrence (National Center on Child Abuse and Neglect, 1996; U.S. Department of Health and Human Services, 2000). Group treatment has been recommended as one of the preferred modalities in working with child victims of sexual abuse (e.g., Hansen et al, 1998; Reeker et al, 1997), and the involvement of nonoffending caregivers in treatment has been identified as an integral part of positive treatment outcome for sexually abused children (e.g., Celano et al, 1996; Damon & Waterman, 1986). In addition to its therapeutic benefits, a time-limited, standardized group treatment protocol is a promising option in managed care environments. The present chapter documents a parallel group treatment for Gina and Suzy and their nonoffending caregivers, Mr. and Mrs. Kraller.
The current case study suggests several directions for future clinical practice and research. The importance of thorough assessment is indicated by the different presentation of symptoms for Gina and Suzy, as well as by the diverse constellation of emo-tional and behavioral symptoms found in literature on sexually abused children. Future research should use such comprehensive assessment data to improve understanding of symptom profiles associated with sexual abuse and related contextual factors, and the relation of these profiles to treatment approach and response. The complex needs and positive responses to treatment of Gina, Suzy, and Mr. and Mrs. Kraller argue strongly that future research and practice should continue efforts to better understand and improve the adjustment of victims and families following disclosure of sexual abuse. Additionally, it is important to comprehensively evaluate standardized treatment protocols for sexually abused children and their families that may be broadly disseminated and replicated.