Comportement des enfants et des adolescents

Abstrait

Design of a Comprehensive One-Year Program at the Be Brave Ranch to help Children who have been Victims of Sexual Abuse

Peter H Silverstone, Farrel Greenspan, Millie Silverstone, Hanelle Sawa and Jacqui Linder

Abstract Childhood sexual abuse (CSA) is frequent, but treatment remains variable. We have designed a novel, intensive, and comprehensive 1-year program for children aged 8-12. This involves 4 periods during which the children stay at a “camp-like” facility (with parents or guardian whenever possible) for an initial period of 4 weeks followed by 3 further 2-week periods (at 4, 8, and 12 months). During these periods they receive more than 200 hours of therapy and in-between the children and their family are supported by weekly outpatient group sessions. The goals are to improve symptoms of post-traumatic stress disorder, depression, anxiety, quality-of-life, self-esteem, and attachment. The primary therapeutic approach is trauma-focused cognitive behavioural therapy (TF-CBT) provided within a group session. Other therapeutic approaches include play therapy, art therapy, and animal assisted therapy. The program, at a facility called the “Be Brave Ranch”, has been designed to also provide a enjoyable activities in addition to the therapeutic sessions, including yoga, arts, games, music, animal interactions, as well as evening programming. Children who have been victims of CSA can have problems with cognitive development, and so receive daily cognitive training utilizing the on-line My cognition program to improve memory, attention, psychomotor speed, and executive functioning. We intend to determine the effectiveness of this program, compared to baseline, with each child acting as their own control. Outcomes will be measured in future research studies by changes in the Child Post-Traumatic Stress Disorder Symptom Scale, Kid-KINDL, revised Children’s Anxiety and Depression Scale, and questions on attachment. In conclusion, this novel and comprehensive program may offer a new approach to helping children with CSA, and it is intended that key elements will be adapted to outpatient environments to provide more widespread availability of best care for child victims of CSA.