Healing from Sexual Abuse Trauma : Model and Measure

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Healing from Sexual Abuse Trauma Model and
Measure

• NASMHPD Research Institute
• 13th Annual Conference on
• Services Research and EvaluationDeveloping an
  Evidence-Based Culture to Reform Systems
• February 9-11,2003
• Supported in part by the Center for the Study of
  Issues in Public Mental Health NIMH Grant
  2P50MH51359

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Healing from Sexual Abuse Trauma Model and
Measure

• Mary Jane Alexander, Ph.D.1
• Jeanne Dumont, Ph.D.
• Kristina Muenzenmeier, M.D.2
• Mary Auslander, M.S.W.3
• 1Nathan Kline Institute for Psychiatric Research
• 2Bronx Psychiatric Center
• 3Maine Department of Mental Health, Mental
  Retardation, Alcohol and Substance Abuse Services
  
• Supported in part by the Center for the Study of
  Issues in Public Mental Health NIMH

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Trauma Exposure and Distress

• General Users of Public Mental
  Population Health Services
• Any Exposure 50 51 98
• 3 Events or More 15 50
• PTSD/Distress,
• Impairment 8 42
• Common Events witness bad injury/death
  sexual assault - adult
• fire, flood, natural disaster
  sexual assault - child
• car or work accident
• attack with weapon

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More than PTSD

• Besides symptoms of PTSD, survivors of pervasive
  trauma seek help for
• depression
• anger
• self destructive behavior
• feelings of shame
• self blame
• mistrust

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More than PTSD

• Complex Post Traumatic Stress changes a persons
  
• Ability to regulate their affective arousal
• Attention and consciousness
• Perception of oneself and the perpetrator
• Relationship to others
• Systems of meaning
• Experiencing somatic distress

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Paradigm Shift

• Trauma has largely been overlooked in
• Explaining behavior
• Designing environments
• Designing policies

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Paradigm shift Increasing awareness of the
impact of trauma

• Federal Support 1994 present
• NASMHPD Resolution 1998
• State Agency Support 11 States with Trauma
  Initiatives
• Consumer voices 1994 - present

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Collaboration Consumer/survivors, Clinicians,
Researchers

• Develop a model of healing from childhood sexual
  abuse based on concept mapping
• Develop a measure of healing using the model and
  concept map data
• Develop a roadmap for healing
• Validate the measure and further develop the
  theory

• Participant survivors collaborate with study team
  to
• Generate items
• Interpret maps name dimensions of healing
• Review draft measure

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Concept Mapping Method

• Brainstorm statements
• Sort statements
• Rate statements
• Analyze sorted statements
• (Multi Dimensional Scaling Cluster Analysis)
• Name clusters and interpret maps

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Healing from Sexual Abuse Trauma

• Awareness validation
• Confidence in judgments
• Skills and safe environments to
• identify triggers
• diminish dissociation
• experience and manage the whole range of emotions

• Build reconnect with community, normalization
• Optimism and hope, look to the future
• Placing the abuser
• Reach out, help others, advocate

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Dimensions of Healing Women

• Personal Empowerment
• Power and control to say no effectively
• Challenge authority
• Positive Struggle Zone
• Self acceptance Self love
• Minimal needs
• Fill in the gaps of time and events
• Reconstruct sexuality
• Enjoyment Choice, Diminish Guilt
• Competence as a parent

• Trust self to make choices
• Competence in social roles Identify triggers
• Cope with Emotions
• Acknowledge that abuse happened
• Diminish substance abuse
• Self Acceptance Confidence
• Stopped self-blame
• Confidence in distinguishing internal from
  external reality

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Dimensions of Healing Women

• Awakening and self validation
• Believing that sexual abuse happened
• Building support/ self help
• I surround myself with positive, nurturing
  people
• No hole anymore in my heart or body
• Gaining wisdom
• I believe I can make good judgments
• I acknowledge my feelings, even at times of joy
• Forgiving the perpetrators

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Dimensions of Healing Men

• Awareness, beginning understanding
• Identify as survivor, not as victim
• Stop self blame for abuse
• Change thoughts and feelings
• Experience and express vulnerability
• Diminish self abuse
• Learn understand about sexual abuse
• Mourn the loss of childhood
• Process of normalization
• Abuse as a pathway to mental illness
• Diminish victim behavior
• Identify and cope with triggers
• Stop self pity

• Accept love trust from self others
• Re-establish family ties
• Experience connection to others
• Self Care
• Support personal achievements
• Diminish self harm in crisis
• Overcoming fulfillment
• Personal empowerment
• Motivation to help others
• Diminish fear increase assertiveness
• Advocacy

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Models of Recovery

• Mental Illness
• Anguish
• Awareness insight
• Action plan
• Determination to be well
• Well being / recovery
• Reestablish social roles decision making
  capacity through social support

• Complex PTSD
• Safety
• Remembrance Mourning
• Reconnection with ordinary life
  commonality

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Healing from Sexual Abuse Implications for
Systems

• Validation
• Safety
• Self Care
• Community
• Empowerment

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Healing from Sexual Abuse Mens concept map
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Healing from sexual abuse Womens concept map