Clinically significant change after cognitive restructuring for adult surviviors of childhood sexual abuse

Brandt, Sheldon
Journal Title
Journal ISSN
Volume Title
Stellenbosch : Stellenbosch University
ENGLISH ABSTRACT: This study investigated the outcome of cognitive restructuring for adult survivors of childhood sexual abuse in terms of clinically significant change. Twenty-six participants were assessed for depression, State anxiety, State anger, State guilt and self-esteem before and after 10 weekly sessions of group Rational-emotive behaviour therapy and at follow-up after 8 weeks. In contrast to a previous analysis of the data in terms of statistical significance indicating significant improvements on all variables from pre- to post-treatment, an analysis based on clinically significant change showed a differentiated treatment effect. Cognitive restructuring was found to be highly effective in facilitating recovery on measures of anxiety, depression and anger, but less effective for guilt and self-esteem. Only 3 participants (11.54%) recovered on all five variables, while 10 participants (38.46%) showed recovery on at least four variables. Relationship to perpetrator and pre-treatment irrational evaluative beliefs (measured by means of the Survey of Personal Beliefs) were found to be the best predictors of treatment outcome. A poor response to treatment was associated with the perpetrator being a close family member and with more Otherdirected Shoulds, while recovery was associated with the perpetrator being a friend or stranger and with more Awfulizing, Self-directed Shoulds and Negative Self-worth beliefs.
AFRIKAANSE OPSOMMING: In hierdie studie is die uitkoms van kognitiewe herstrukturering, as behandelingsprosedure VIr volwasse slagoffers van kindermolesteuring, in terme van kliniese betekenisvolheid ondersoek. Sesen- twintig deelnemers is voor en na behandeling (10 weeklikse groepsessies van Rasioneelemotiewe gedragsterapie) en by opvolg na 8 weke in terme van depressie, Staat-angs, Staat-woede, Staat-skuldgevoelens en selfwaarde geassesseer. In 'n vorige analise van die data in terme van statistiese betekenisvolheid is betekenisvolle verbetering na behandeling op al die veranderlikes gevind. 'n Heranalise van die data in terme van kliniese betekenisvolheid toon egter 'n gedifferensieerde behandelingseffek. Daar is gevind dat kognitiewe herstrukturering hoogs effektief was om herstel in terme van angs, depressie en woede te fasiliteer, maar minder effektief was ten opsigte van skuld en negatiewe selfwaarde. Slegs 3 patiente (11.54%) het klinies betekenisvol op al vyfveranderlikes verbeter, terwyl 10 pasiente (38.46%) op minstens vier veranderlikes herstel het. Die pasient se verhouding tot die molesteerder en irrasionele kognisies voor behandeling (gemeet met die Survey of Personal Beliefs) was die beste voorspellers van behandelingsuitkoms. 'n Swak respons op behandeling het verb and getoon met 'n naby familielid as molesteerder en met meer Ander-gerigte Eise, terwyl herstel geassosieer het met 'n vriend of vreemdeling as molesteerder en met die irrasionele kognisies van Katastrofering, Self-gerigte Eise en Negatiewe Selfbeoordeling.
Thesis (MA) -- University of Stellenbosch, 2001.
Adult child sexual abuse victims -- Rehabilitation, Healing -- Psychological aspects, Dissertations -- Psychology