Elias is a five year old Mexican American male who has recently been referred to the community counseling center due to the exposure of sexual abuse by his stepfather. Elias was a client of this community center approximately 18 months earlier. Elias had been referred for poor impulse control and hyperactivity. At that time he was diagnosed as having Attention Deficit Hyperactivity Disorder (ADHD). He also met with the agency psychiatrist who had prescribed Elias Focalin. His cased was closed after only a few sessions due to the family’s inconsistency and withdrawal from services. At this point in time Elias has been attending his sessions with his mother and baby brother. Stepfather’s whereabouts are unknown and he has not had any contact with the family since the abuse was exposed. Elias has returned to taking Focalin, since he failed to continue taking his medication after withdrawing from services. However, there have been no changes noted in his behavior since he has begun to take the medication. The psychiatrist believes that this may be due to the low dosage he has prescribed Elias and because of such, the psychiatrist has opted to slowly increase the dosage and closely monitor any changes. The clinician notes that Elias is extremely hyperactive and exhibits minimal impulse control. Other than his high levels of restlessness, Elias shows no observable signs or symptoms of reaction to the sexual abuse. When clinician has attempted to process with Elias about the abuse or his feelings about the abuse, Elias has changed the subject or ignored the clinician all together. Mother states that she has noticed no changes in his behavior since the abuse was discovered. Practice Effectiveness Questions
The special population in discussion is children, the social problems in focus are sexual abuse and attention deficit hyperactivity disorder (ADHD), which leads the target client group to be children who have experienced sexual abuse and have been diagnosed with ADHD. Our client is Elias who is a child, who has experienced sexual abuse and is diagnosed with ADHD. For the purposes of this discussion our practice effectiveness questions are: 1) What are effective interventions for children who have been sexually abused?, and 2) What are effective interventions for children who have been diagnosed with ADHD? Search Description
The databases utilized for this search were: Google Scholar, Social Work Abstracts, Child Welfare Information Gateway, Academic Search Complete, Professional Development Collection, PsycARTICLES, PsycINFO, SocINDEX with Full Text Sociological Collection, Academic Search Premier, and JSTOR. It was also helpful to review the journal entitled Sexual Abuse: A Journal of Research and Treatment for relevant articles.
While searching the aforementioned databases, the following keywords were utilized: ‘sexual abuse and ADHD’, ‘sexual abuse and interventions’, sexual abuse and co-morbidity’, ‘ADHD and co-morbidity’, ‘children and sexual abuse’, ‘sexual abuse and interventions.’ All articles selected were peer reviewed, found in scholarly journals, and published within the last ten years.
In searching for relevant articles regarding treatment of sexual abuse, most articles addressed interventions designed to treat perpetrators of child sexual abuse; a few articles were uncovered that discussed treating adult survivors of childhood sexual abuse. Fewer still were articles that identified interventions for children who are recent or current victims of sexual abuse. In order to find information relevant to our target client group, we began pulling sources from reference pages of relevant articles which provided more focused research relevant to treatment of children who have experienced sexual abuse. Results
The result of our exhaustive search of available literature led us to identify eight articles to focus on. Out of these articles, four...