1. Intra-family violence

2. Rape
 Two approaches to treat a rape victim are CBT and group
therapy. Most research to date shows that CBT has effective
recovery outcomes.
 The specific forms of CBT that are commonly used with rape
victims are: systematic desensitization, flooding, prolonged
exposure treatment, and stress inoculation training. These
approaches involve systematic exposure to traumatic
memories and cognitive reinterpretation of these events.
Helping clients to remember and visualize feared situations
can help them gradually reduce their anxiety.
 Cognitive techniques, such as challenging automatic thoughts,
may also be used to diminish guilt, fear, and depression.
 Review all past CBT sections.

3.  Group therapy can be very beneficial for rape
victims.
 Many rape crisis centers are based on crisis theory
and supportive psychotherapy groups. They rely on
dissemination of educational information, active
listening and emotional support. Group sharing of
experience may affect patients' numbness, isolation
and fear of isolation.
 Review all group therapy readings and slides.

4. Sexual Abuse
 Group therapy is a positive therapy for sexual abuse victims. Groups should
be conducted at the same time as other treatment modalities. Some
patients may need individual treatment before they are ready for group
therapy.
 Groups are appropriate for victims, siblings of victims, mothers of victims,
offenders, and adult survivors of sexual abuse. In addition, "generic"
groups that include offenders, parents of victims, and survivors of sexual
abuse have been found to be very powerful and effective for all parties
involved.
 Groups may be time-limited, long-term, or open-ended. They may deal
with specific issues (e.g., relapse prevention, sex education, or protection
from future sexual abuse), or they may deal with a range of issues. Some
programs have "orientation" groups for new clients, usually with separate
groups for children and adults.
 Victim's and offender's groups have been brought together for occasional
sessions. Models that have concurrent groups for victims or children and
their non-offending parents, where from time to time the two groups join
for activities, are very productive.

5. Trauma-Focused CBT
 TF-CBT is a conjoint child and parent psychotherapy
approach for children and adolescents who are
experiencing significant emotional and behavioral
difficulties related to traumatic life events.
 It is a components-based treatment model that
incorporates trauma-sensitive interventions with
cognitive behavioral, family, and humanistic principles
and techniques.
 Children and parents learn new skills to help process
thoughts and feelings related to traumatic life events;
manage and resolve distressing thoughts, feelings, and
behaviors related traumatic life events; and enhance
safety, growth, parenting skills, and family
communication.

6.  TF-CBT has proved successful with children and adolescents
(ages 3 to 18) who have significant emotional problems (e.g.,
symptoms of posttraumatic stress disorder, fear, anxiety, or
depression) related to traumatic life events.
 This treatment can be used with children and adolescents who
have experienced a single trauma or multiple traumas in their
life.
 Children or adolescents experiencing traumatic grief can also
benefit from this treatment.
 TF-CBT can be used with children and adolescents residing in
many types of settings, including parental homes, foster care,
kinship care, group homes, or residential programs.

7.  Multiple treatment outcome research studies and much
clinical evidence indicate that TF-CBT helps children,
adolescents, and their parents overcome many of the
difficulties associated with abuse and trauma. It is an
efficacious treatment.
 TF-CBT has proven to be effective in addressing
posttraumatic stress disorder, depression, anxiety,
externalizing behaviors, sexualized behaviors, feelings of
shame, and mistrust. The parental component increases
the positive effects for children by reducing parents' own
levels of depression and emotional distress about their
children's abuse and improving parenting practices and
support of their child.

8. Family Therapy for Sexual Abuse
 Stage 1: Creating a Context for Change In Stage 1, a context
of safety and hopefulness is created. The family members commit to
work toward change. A collaborative relationship between client
and therapist is built to assess the problem and determine the
therapeutic goals.
 Stage 2: Challenging Old Patterns and Expanding New
Alternatives The family is encouraged to creatively challenge
problematic thoughts, feelings, and behaviors which are no longer
useful, giving way to more adaptive healthier alternatives.
Therapeutic interventions are designed based on the family’s
strengths.
 Stage 3: Consolidation In this stage, the family consolidates the
positive, adaptive new behaviors they have made so that they will
sustain. The family prepares for future situations and plans how to
continue to make adaptive choices to insure that no further abuse
takes place in their life or future generations of their family.

9.  Family therapy chapters and readings should be
reviewed.