Child Sexual Abuse: Critical Perspectives on Prevention, Intervention, and Treatment

Martine Miljkovitch is an associate professor of Psychology at
Laurentian University.

“The 12 papers in this volume were originally commissioned by the
Canadian government in 1987 as part of a continued exercise in trying to
understand the dimensions of the problem of sexual abuse of children.
This endeavour . . . began with the setting up of a committee of inquiry
(chaired by Dr. Robin Badgley) in 1980.” It represents a major
multidisciplinary effort.

“The theme of this volume is the prevention of child sexual abuse”
(CSA), but it covers other areas as well. Prevention is presented in the
introduction and the general literature review, followed by two chapters
on primary prevention and two chapters on tertiary prevention and
treatment outcome studies (one concerning victims of CSA; the other,
offenders). Other chapters cover psychopathology (the impact of CSA in a
developmental perspective); assessment of sexually abused children
(interviewing and medical); and epidemiological, risk, and outcome
studies.

This volume is well-researched and packed with data, achieving a good
balance between scientific findings and clinical acumen and perspective.
It is compassionate without being overly emotional. It is also
objective: at the same time showing the giant steps that have been made
in the last decades, and presenting sobering facts about the long-term
effects of some types of CSA and the low success rates in the treatment
of offenders.

The book’s value would have been enhanced by a concluding chapter
from the editors re-emphasizing such points as the fact that more
specialized material should be created for potential abusers—mostly
men—rather than for children. In particular, it seems, more needs to
be done to educate males: “In adult recall studies . . . between a
fifth and a third of those who sexually abuse children are aged 18 or
less.” Indeed, now that “we have a greater appreciation of the role
of cognitive processes in the commissions of these crimes,” it seems
that primary prevention efforts should not be geared to the same
populations as tertiary prevention efforts (those that focus on
treatment of victims). It also seems that tertiary prevention efforts
should focus more on specific populations such as runaways and young
prostitutes (CSA prevalence rates in female prostitutes are 52-73
percent) and on certain types of CSA (chronic, intrafamilial, or
involving the use of threats or force). Overall, this book represents a
remarkable achievement.