Residential Treatment Centers for Child Abuse

Abstract

Every year millions of reports are being held and cases regarding those reports in courts are carrying on about abusement and omission against children . Abusement against children has been seen throughout of the history. Significant and permanent impacts can occur upon child abusement and neglect on victim children. It is important to know the psychological dynamics which have been lived by the children by the mental health professionalsto protect the children after the abusement report has been written. Cognitive Behaviour Therapy and medications are being used commonly in the treatment of abusement cases. However in some cases it is necessary to send away the victims from environment, enable them to continue their education life, make sure that they are treated by the professional individuals in safe area. For this end there are many Residential Treatment Centers around the world. "Oğuz Kağan Köksal Social Care and Rehabilitation Center " was established in Adana as the first Residential Treatment Center in Turkey. In this report the historical dimensions of the child abusement, the definition of it, its psychological dynamics, the psychological disorders caused by it, treatment approaches and residential treatment centers have been reviewed.

Keywords

• Residential treatment, sexual abuse, PTSD

Çocuk İstismarında Rehabilitasyon ve Tedavi Merkezleri

Abstract

Her yıl çocuklara yönelik istismar ve ihmal konusunda milyonlarca rapor düzenlenmekte ve adli davalar yürütülmektedir. Çocuklara yönelik istismarın tarihin bilinen tüm dönemlerinde yaşandığını görmekteyiz. Çocuk istismarının ve ihmalinin mağdur çocuklar üzerinde önemli ve kalıcı etkileri olabilmektedir. İstismar bildirimi yapıldıktan sonra çocukların yaşadıkları ruhsal dinamiklerin ruh sağlığı profesyonelleri tarafından bilinmesi çocukları korumak adına önemlidir. İstismar olgularının tedavisinde Bilişsel Davranışçı Terapiler ve ilaç tedavileri yaygın olarak kullanılmaktadır. Ancak bazı olgularda; mağdurların ortamdan uzaklaştırılması, eğitim hayatlarına devam edebilmelerinin sağlanması, güvenli bir alanda profesyonel kişiler tarafından tedavi yöntemlerinin uygulanması gerekmektedir. Bu amaçla dünyanın birçok ülkesinde Rezidental Tedavi merkezleri kurulmuştur. Türkiye'de ise ilk rezidental kurumu olan "Oğuz Kağan Köksal Sosyal Bakım ve Rehabilitasyon Merkezi" Adana ilinde kurulmuştur. Bu yazıda çocuk istismarının tarihsel boyutu, tanımı, ruhsal dinamikleri, yol açtığı ruhsal bozukluklar, tedavi yaklaşımları ve rezidental tedavi merkezleri gözden geçirilmeye çalışılmıştır.

Keywords

• Rezidental Tedavi, Çocuk İstismarı, TSSB.

References

1. Radbill SX. Children in a world of violence: a history of child abuse. In The Battered Child, 4th Ed (Eds RE Helfer, RS Kempe):3-41. Chicago, The University of Chicago Press, 1987.
2. Wong ML, Chan RKW, Koh D, Tan HH, Lim FS, Emmanuel S, Bishop G. Premarital sexual ıntercourse among adolescents in an asian country: multilevel ecological factors. Pediatrics 2009; 124:44-52.
3. Finkelhor D, Hotaling G, Lewis IA, Smith C. Sexual abuse in a national survey of adult men and women: prevalence, characteristics, and risk factor. Child Abuse Negl 1990; 14:19-28.
4. Nurcombe B. Child sexual abuse I: psychopathology. Aust N Z J Psychiatry 2000; 34:85-91.
5. Bolger KE, Patterson CJ. Developmental pathways from child maltreatment to peer rejection. Child Dev 2001; 72:549-568. Burns BJ, Hoagwood K, Mrazek PJ. Effective treatment for mental disorders in children and adolescents. Clin Child Fam Psychol Rev 1999; 2:199-254.
6. Tuma JM. Mental health services for children: the state of the art. Am Psychol 1989; 44:188-199.
7. Stone L. A. Residential treatment. In Basic handbook of child psychiatry, 2th ed (Ed JD Noshpitz). New York, Basic Books, 19 Kazdin AE, Siegel JC, Bass D. Cognitive problem-solving skills training and parent management trains in the treatment of antisocial behavior in children. J Consult Clin Psychol 1992; 60:733-747.
8. Kepenkçi YK. Hukuksal açıdan çocuk istismarı ve ihmali. Katkı Pediatr Dergisi 2001; 22:263-275.

9. Topaloğlu B. İslamda Kadın, 6. Baskı. İstanbul: Yağmur Yayınları, 1975.
10. Schetky DH, Green AH. Child Sexual Abuse: A Handbook for Health Care and Legal Professionals. New York, Brunner-Mazel, 19 Hastings J. Encyclopedia of Religion and Ethics, 4th ed. New York, Charles Crisbner’s Publ, 1961.
11. Avcı A, Tahiroğlu AY. Cinsel istismar. In Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları (Eds A Aysev, YI Taner):721-736. İstanbul, Golden Print, 2007.
12. Aral N, Gürsoy F. Çocuk hakları çerçevesinde çocuk ihmal ve istismarı. Milli Eğitim Dergisi 2001; 151:3.
13. Garbarin J, Gilliam G. Understanding Abusive Families. Lexington, Lexington Books,1980.
14. Hancı İH. Adli Tıp ve Adli Bilimler. Ankara, Seçkin Yayıncılık, 2002.
15. Bilgin NG, Toros F, Çamdeviren H, Şaşmaz T, Mert E. Evde fiziksel ve sözel olarak cezalandırılan çocukların sosyodemografik özellikleri: prevelans çalışması. Yeni Symposium 2004; 42:131-139.
16. Finkelhor D. Childhood Victimization: Violence, Crime, and Abuse in the Lives of Young People. New York, Oxford University Press, 2008.
17. Aksoy E, Çetin G, İnanıcı MA, Polat O, Sözen MFİ, Yavuz F. Çocuk istismarı ve ihmali. http://www.ttb.org.tr/eweb/adli/icinde.html (18.11.2010 tarihinde ulaşıldı).
18. World Health Organization. Child Abuse and Neglect by Parents and Other Caregivers. Geneva, World Health Organization, 200 Tercier A. Child abuse. In Emergency Medicine, 4th Ed. (Ed JA Maer):1108-1118. St. Louis, Mosby, 1998.
19. Hobbs CJ, Hanks H, Wynne JM. Child Abuse and Neglect: A Clinician’s Handbook. Edinburg, Churchill Livingstone, 1993.
20. Putnam F.W. Ten-year research update review: child sexual abuse. J Am Acad Child Adolesc Psychiatry 2003; 42:269-227. Fleming J. Childhood sexual abuse: an update. Curr Opin Obstet Gynecol 1998; 10:383-386.
21. Çetin F. Çocuk ve Ergen Psikiyatrisi Temel Kitabı. Ankara, Hekimler Yayın Birliği, 2008.
22. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4th Ed. Washington, American Psychiatric Association, 1994.
23. Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stres disorder in trauma-exposed adults. J Consult Clin Psychol 2000; 68:748-766.
24. Charney DS. Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress. Am J Psychiatry 2004; 161:195-216.
25. Birmaher B, Heydl P. Biological studies in depressed children and adolescents. Int J Neuropsychopharmacol 2001; 4:1491
26. Peleikis D, Mykletun A, Dahl A. Long term social status and ıntimate relationship in women with childhood sexual abuse who got outpatient psychotherapy for anxiety disorder and depression. Nord J Psychiatry 2005; 59:31-38.
27. Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol 2006; 27:24-31.
28. Sparato J, Mullen PE. Impact of child sexual abuse on mental health. Br J Psychiatry 2004; 184:416-421.
29. Aktepe E, Işık A, Kocaman O, Eroğlu FÖ. Bir üniversite hastanesinde değerlendirilen cinsel istismar mağduru çocuk ve ergenlerin demografik ve klinik özellikleri. Yeni Symposium 2013; 51:115-120.
30. Birmaher B. Longitudinal course of pediatric bipolar disorder. Am J Psychiatry 2007; 164:537-539.
31. Brown GR, McBride L, Bauer MS, Williford WO, Cooperative Studies Program 430 Study Team 2005. Impact of childhood abuse on the course of bipolar disorder: a replication study in U.S. veterans. J Affect Disord 2005; 89:57-67.
32. Otto MW, Perlman CA, Wernicke R, Reese HE, Bauer MS, Pollack MH. Posttraumatic stres disorder in patients with bipolar disorder: a review of prevalence, correlates, and treatment strategies. Bipolar Disord 2004; 6:470-479.
33. Baldassano CF, Marangell LB, Gyulai L, Nassir GS, Joffe H, Kim DR et al. Gender differences in bipolar disorder: retrospective data from the first 500 STEP-BD participants. Bipolar Disord 2005; 7:465-470.
34. Kennedy BL, Dhaliwal N, Pedley L, Sahner C, Greenberg R, Manshadi MS. Post-traumatic stress disorder in subjects with schizophrenia and bipolar disorder. J Ky Med Assoc 2002; 100:395–399.
35. Carballo JJ, Harkavy-Friedman J, Burke AK, Sher L, Baca-Garcia E, Sullivan GM et al. Family history of suicidal behavior and early traumatic experiences: additive effect on suicidality and course of bipolar illness? J Affect Disord 2008; 109:57-63.
36. Lieb K, Zanarini MC, Schmahl C, Linehan MM, Bohus M. Borderline personality disorder. Lancet 2004; 364:453-461.
37. Fossati A, Madeddu F, Maffei C. Borderline personality disorder and childhood sexual abuse: a meta-analytic study. J Pers Disord 1999; 13:268-280.
38. Sansone RA, Sansone LA. Borderline personality disorder: the enigma. Primary Care Reports 2000; 6:219-226.
39. Lavan H, Johnson JG. The association between Axis I and II psychiatric symptoms and high-risk sexual behavior during adolescence. J Pers Disord 2002; 16:73-94.
40. Aktepe E. Çocukluk çağı cinsel istismarı. Psikiyatride Güncel Yaklaşımlar- Current Approaches in Psychiatry 2009; 1:95-119. Roland J, Summit, MD. The Child Sexual Abuse Accommodation Syndrome. Child Abuse Negl 1983; 7:177-192.
41. Broden MS, Agresti AA. Responding to therapists’ sexual abuse of adult incest survivors: ethical and legal considerations. Psychotherapy (Chic) 1998; 35:96-104.
42. Herman JL. Father–Daughter Incest. Cambridge, Harvard University Press, 1981.
43. Russel DEH. The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children. Child Abuse Negl 1983; 7:133-146.
44. Finkelhor D. Risk factors in the sexual victimization of children. Child Abuse Negl 1980; 4:265 -273.
45. Shengold L. Child abuse and deprivation: soul murder. J Am Psychoanal Assoc 1979; 27:533-599.
46. King K, Bagley C. Child Sexual Abuse the Search for Healing. London, Tavistock/Routtedge,1991.
47. Taylor JE, Harvey ST. Effects of psychotherapy with people who have been sexually assaulted: a meta-analysis. Aggress Violent Behav 2009; 14:273–285.
48. Glaser D. Emotional abuse and neglect (psychological maltreatment): a conceptual framework. Child Abuse Negl 2002; 26:697-714.
49. Litz BT, Engel CC, Bryant RA, Papa A. A randomized, controlled proof-of-concept trial of an internet based, therapistassisted self-management treatment for posttraumatic stress disorder. Am J Psychiatry 2007; 164:1676-1684.
50. Sinici E, Maden Ö, Ak M, Bozkurt A, Özşahin A. Bir cinsel tecavüz vak’asında EMDR uygulaması: vak’a sunumu. Yeni Symposium 2012; 50:58-60.
51. Shapiro F. Eye movement desensitization and reprocessing (EMDR): clinical and research implications of an integrated psychotherapy treatment. J Anxiety Disord 1999; 13:35–67.
52. Çelik G, Tahiroğlu AY, Avci A. Pharmacological management of sexually abused adolescents with comorbid PTSD and bipolar disorder: a case series. Journal of Mood Disorders 2012; 12:37-46.
53. Albucher RC, Liberzon I. Psychopharmacological treatment in PTSD: a critical review. J Psychiatry Res 2002; 36:355-367.
54. Seedet S, Stein D, Ziervogel C, Middleton T, Kaminer D, Emsley RA, Rossouw W.Comparison of response to a SSRI in children, adolescents, and adults with PTSD. J Child Adolesc Psychopharmacol 2002; 12:37–46.
55. Mitka M. FDA alert on antidepressants for youth. JAMA 2003; 290(19):25-34.
56. Ravidran LN, Stein MB. Pharmacotherapy of PTSD: premises, principles, and priorities. Brain Res 2009; 1293:24–39.
57. Looff D, Grimley P, Kuller F, Martin A, Shonfield L. Carbamazepine for PTSD. J Am Acad Child Adolesc Psychiatry 1995; 34:703-704.
58. Davidson JRT, Stein DJ, Shalev AY, Yehuda R. Posttraumatic stress disorder: acquisition, recognition, course, and treatment. J Neuropsychiatry Clin Neurosci 2004; 16:135–147.
59. Kisiel CL, Lyons JS. Dissociation as a mediator of psychopathology among sexually abused children and adolescents. Am J Psychiatry 2001; 158:1034-1039.
60. Scholte EM, Van Der Ploeg JD. Residential treatment of adolescents with severe behavioral problems. J Adolesc 2006; 29:441-454.
61. Curry JF. Future directions in residential treatment outcome research. Child Adolesc Psychiatr Clin N Am 2004; 13:429-440. Friedrich WN, Baker AJL, Parker R, Schneiderman M, Gries L, Archer M. Youth with problematic sexualized behaviors in the child welfare system: a one-year longitudinal study. Sex Abuse 2005; 17:391-397.
62. Kools S, Kennedy C. Child sexual abuse treatment: misinterpretation and mismanagement of child sexual behavior. Child Care Health Dev 2002; 28:211–218.
63. Blackman M, Eustace J, Chowdhury T. Adolescent residential treatment: a one to three year follow-up. Can J Psychiatry 1991; 36:472-479.
64. Weiner A, Kupermintz H. Facing adulthood alone: the long-term impact of family break-up and infant institutions: a longitudinal study. Br J Soc Work 2001; 31:213-234
65. Brodie I. Children’s homes and school exclusion: redefining the problem. Support for Learning 2000; 15:25–29.
66. Shin SH. Building evidence to promote educational competence of youth in foster care. Child Welfare 2003; 82:615–632. Schiff M, Benbenishty R. Functioning of Israeli group-homes alumni: exploring the differences and in-care correlates. Child Youth Serv Rev 2006; 28:133–157.
67. National Council for the Child. Children in Israel: Statistical abstract. Jerusalem, Israel National Council for the Child, 2006. Zito JM, Craig TJ, Wanderling J. Pharmacoepidemiology of 330 child/adolescent psychiatric patients. J Pharmacoepidemiol 1994; 3:47–62. Serhat Nasıroğlu, Uzm. Dr., Van Bölge Eğitim Araştırma Hastanesi, Van. Yazışma Adresi/Correspondence: Serhat Nasıroğlu, Van Bölge Eğitim Araştırma Hastanesi, Van, Turkey. E-mail: [e-mail] Yazar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemiştir. The author reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol6/no1/ Çevrimiçi yayım / Published online 29 Ekim/October 29, 2013; doi: 10.5455/cap.20131231120555