Resumen: El abuso sexual (ASI) constituye la victimización más frecuente en la infancia. Los efectos del ASI en la vida adulta pueden afectar al funcionamiento, físico, psicológico y social y generar alteraciones psicopatoló-gicas. El objetivo de este estudio fue evaluar un programa individual cognitivo-conductual, de 12 sesiones, en el tratamiento de mujeres adultas vícti-mas del ASI, llevado a cabo durante 20 años en un marco comunitario. La muestra constó finalmente de 121 sujetos que participaron voluntariamente en el estudio. Se utilizó un diseño de medidas repetidas con seguimientos de 1, 3, 6 y 12 meses. La tasa de éxitos en el tratamiento del trastorno de estrés postraumático fue del 90.7% en las víctimas que completaron el tratamiento. A pesar de la pérdida de pacientes en los seguimientos (25.58%), los resultados se mantuvieron en las pacientes evaluadas en los cuatro periodos establecidos (un 74.42% al cabo de 12 meses), con una alta reducción de las recaídas. Sin embargo, hubo un nivel más bien alto de rechazos y de abandonos. Una conclusión es que hay que desarrollar estrategias motivacionales para mantener a las víctimas en el tratamiento. Se comentan las implicaciones de este estudio para la práctica clínica y para la investigación. Palabras clave: Abuso sexual infantil; mujeres víctimas adultas del ASI; tratamiento psicológico; seguimiento a largo plazo.Title: Psychological treatment of adult female survivors of childhood sexual abuse: long term results. Abstract: Child sexual abuse (CSA) is one the most common forms of child victimization. The effects of CSA can extend into adulthood, impacting on physical, psychological, and social functioning and contributing to adult psychopathology. The aim of this paper was to evaluate an individual 12 sessions cognitive-behavioral programme in the treatment of female adult survivors of CSA after implementing it for twenty years in a community setting. The sample consisted of 121 subjects who voluntarily participated in the study. A design with repeated measures (pre-treatment, posttreatment and 1-, 3-, 6-and 12-month follow-up) was used. The success rate regarding posttraumatic stress disorder was of 90.7% in the treatment completers. In spite of the lost patients in the follow-ups (25.58%), the results were maintained in the contacted patients at follow-up (74.42% in the 12-month-follow-up), with a high impact on reducing recidivism. However, the rate of refusals and drop-outs of the treatment was rather high. Therefore it is necessary to develop strategies to improve motivation for treatment. Implications of this study for clinical practice and future research in this field are commented upon.
The current study aimed to test the clinical effectiveness of a cognitive-behavioral therapy (CBT) program for battered women in a community setting and to find out whether effectiveness of individual therapy can be improved in conjunction with group therapy. One hundred sixteen treatment-seeking battered women were assigned either to CBT on an individual basis or an individual and group basis. Psychological treatment, focused on post-traumatic stress disorder (PTSD), emotional discomfort, and impaired functioning, comprised a 17-session program, including emotional expression, psychoeducation, trauma re-exposure, coping skills, and problem-solving training. Although most treated patients in both groups improved in all variables (PTSD, emotional discomfort, and impaired functioning) at all assessments, the combined individual and group therapy did better than the individual therapy regarding PTSD symptoms and impaired functioning at follow-up assessments. These findings partially support the beneficial effects of group CBT as adjunctive therapy to individual CBT. Implications of this study for clinical practice and future research in this field are commented on.
The aim of this research was to test the comparative effectiveness of two therapeutic modalities in the treatment of chronic posttraumatic stress disorder in victims of sexual aggression: (a) self-exposure and cognitive restructuring and (b) progressive relaxation training. The sample consisted of 20 patients (victims of rape in adulthood or adult victims of childhood sexual abuse) selected according to DSM-III-R criteria. A multigroup experimental design with repeated measures (pretreatment, posttreatment, and 1-, 3-, 6-, and 12-month follow-up) was used. Most treated patients improved, but the success rate was higher in all measures in the exposure and cognitive restructuring group immediately on posttreatment and at follow-up. Implications of this study for clinical practice and future research in this field are commented on.
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