Akron Children's Hospital, Akron, OH 44504, USA.
J Interpers Violence. 2012 Jan;27(1):23-39. doi: 10.1177/0886260511416466. Epub 2011 Aug 22.
Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment.
(a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases.
Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity.
In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals.
儿童性虐待（CSA）通常需要进行心理治疗以解决受害者创伤的症状。进入和完成咨询服务的障碍会影响长期的幸福感。儿童倡导中心（CAC）的医疗和心理健康综合评估和治疗模式有可能减少心理健康治疗的障碍。
（a）描述接受与不接受心理健康治疗的 CSA 患者之间的特征差异，（b）确定与心理健康治疗目标成功完成相关的因素。设计/设置：对接受 CAC 评估后转介至心理健康服务的 CSA 患者（3-16 岁）进行回顾性队列研究。结果变量包括与治疗的联系和治疗的完成。自变量包括人口统计学特征、虐待特征和治疗师特征。数据从 CAC 和计费数据库中提取。
共评估了 490 名受试者。受试者如下：女性居多（74%），白人（60%），超过一半的人接受医疗补助（56%）。平均年龄为 8.4 岁。约有 52%的人联系了心理健康服务，而成功联系心理健康服务的患者中有 39%完成了治疗。成功联系与转介至其他咨询服务独立相关（AOR8.4[2.5,27.7]）。成功完成治疗与照顾者参与治疗（AOR3.2[1.8,6.0]）和患者是否转介至其他咨询服务（AOR4.1[1.9,8.5]）独立相关。在是否联系和/或完成治疗方面，与未联系和/或完成治疗的患者相比，在人口统计学特征或虐待严重程度方面没有差异。
与之前的报告相比，我们的 CAC 似乎克服了该人群的联系障碍。然而，在该人群中实现成功完成治疗目标仍然存在挑战。让照顾者参与治疗服务对成功实现治疗目标有积极影响。
