Macmillan
Publishing Company Description: Sgroi's name is given as the author of this book. There is no indication that it is an edited volume yet eight of the fourteen chapters are by people other than Sgroi. Of the remaining six chapters, two have coauthors listed along with Sgroi. Only four chapters are written by Sgroi alone. However, this disparity does not seem to affect the quality of the chapters. All constitute speculative opinion with few references and rely on subjective claims of clinical judgment and clinical experience. Chapters 1 through 4 present material on the treatment of sexually abused children and adolescents. Play therapy is offered as a treatment modality for young children in Chapter 1. Chapter 2 describes inpatient treatment for children. Chapter 3 presents a description of a time-limited group therapy program for adolescent females. Chapter 4 discusses therapy of adolescent male victims. Chapters 5 through 7 deal with adult survivors of childhood abuse. In effect, this discussion is limited to female adults. Hypothesized stages of recovery are presented in Chapter 5. A program of peer group therapy for adults claming childhood abuse is described in Chapter 6. Chapter 7 discusses an often overlooked facet of treatment, the spiritual dimension of personal life and possible contributions to recovery. The special problems of mentally retarded persons, both as victims and as perpetrators of sexual abuse, are the focus of Chapters 8 through 10. A prevention program for retarded persons is presented in Chapter 8 and Chapter 9 is the curriculum for the educational component of the prevention program. The evaluation and treatment of retarded sexual abuse perpetrators is outlined in Chapter 10. Chapter 11 does not fit in any section but consists of a description of the program of evaluation and treatment offered at the privately funded Chesapeake Institute outside Washington, D.C. The final section of the book contains three chapters, 12
through 14, addressing treatment for adult offenders. Conceptions of the
behavior of sexual offenders are described in Chapter 12. The relationship and
some possible implications of being abused and later becoming an abuser are
explored in Chapter 13. In Chapter 12, a program being offered for nonprison,
community based treatment programs is presented as a possible alternative. Discussion: This is an arrogant book that has little relevance to anyone who honestly seeks to improve the methods of evaluation and treatment for both victims and offenders. It is an arrogant book because it shows no interest or even awareness of any thought or work outside the narrow little group clustered around Sgroi. The total number of references for all chapters is 214. Of the 214 references about 20 are to empirical studies. Two chapters, 4 and 7, have over half (118) of the total references, including 14 of the 20 references that are empirical in nature. Many of the references are repeated citations of Sgroi's other books and the writings of Groth and Burgess. There are startling omissions of significant research studies. An example is Groth and Oliveri's chapter dealing with the behavior of sex offenders. Groth and Oliveri simply rehash Groth's earlier conceptualization of regressed and fixated pedophiles. There is no mention of Knight's (Knight, 1989; Knight, Carter, & Prentky, 1989) attempt to replicate the regressed/fixated conceptualization and the failure of the concept to be supported. When there is empirical data that falsifies an hypothesis, those advancing the hypothesis ought at least mention that fact. Marvasti discusses children's play and the use of children's play behavior as if there were no questions to be asked about that approach. There is no mention of the years of research on children's play and the use of a sign approach to make a diagnosis. When people are sent to prison on the basis of evidence coming from children's play in sand tables or with dolls, interpreted by some mental health professionals to demonstrate abuse and to identify the perpetrator, there ought at least be a nod to the large body of empirical data showing the lack of validity, the unreliability, and the subjectivity of such interpretations. The chapters discussing therapy, whether with children, adolescents, or adults, and whether with victims or perpetrators, show no knowledge of the research data relating to therapy. The kind of therapy recommended is feeling-expressive, insight-oriented therapy. There is little support for the efficacy and utility of this therapy model with anyone, much less with young children. Art therapy, for which there is no empirical support, is touted as effective. There is a consistent emphasis in all the chapters on self-esteem as a major factor in both the problem (where it is low) and the solution (whereby it is to be increased). This emphasis places the therapy described and advised in this book in the "feeling good" domain. The assumption is that feeling (emotion) good (or bad) about oneself is primary. What one does (behavior) is secondary or at best derivative. The progenitor of this approach is Norman Vincent Peale. Freud never discussed self-esteem and did not even claim that his patients got better, just that they understood more. All the therapy programs described and advocated in this book are repetitions of the nonempirical, analytically-oriented, pop-psychology nostrums that do not accomplish anything better than a spontaneous remission rate. There is no empirical data offered for any of them. There is no evaluation and no information on the outcomes. Apparently the authors are so persuaded of the rightness and effectiveness of what they do that they have no questions about it nor do they have any interest in what empiricism may contribute to the venture. The chapter dealing with the spiritual life dimension is an exemplar of the instrumental approach to religion in which religion is valued because it somehow assists in getting to some other goal. Since William James, empirical research in religion has shown instrumental religiosity to be superficial, ineffective for any other goal, and generally associated with ethnocentrism and prejudicial, authoritarian attitudes (Strommen, Brekke, Underwager, & Johnson, 1972). The chapters on retarded victims and perpetrators show compassion and a recognition of the strengths and the needs of this population. However, the approaches recommended continue the infantilization of this group. The curriculum advised for use with retarded persons is simply the transfer of prevention material and concepts from those programs used with young children. Once again there is no awareness, or at least no mention, of the accumulating research data showing sexual abuse prevention programs to be ill advised, potentially damaging to children, and ineffective in preventing abuse. Adults who may be retarded, in spite of the concept of mental age, are not children. To treat them as children is demeaning and insensitive. The emphasis of this book solely on experience and clinical
judgment as the source and support for the ideas advanced makes it not only
unhelpful to those persons who want to do a better job of dealing with child
sexual abuse but may make it harmful (Dawes, 1989). Misinformation and
unsupported dogmas are worse than no information at all. Misguided policies,
unintended consequences, and the perseveration of ignorance and folly are the
most likely result of attending to this book and its concepts. References Dawes, R. M. (1989). Experience and validity of clinical judgment: The illusory correlation. Behavioral Sciences & the Law, 7, 457-467. Knight, R. A. (1989, June). As assessment of the concurrent validity of a child molester typology. Journal of Interpersonal Violence, 4,131-150. Knight, R. A., Carter, D. L. & Prentky, R. A. (1989). A system for the classification of child molester: Reliability and application. Journal of Interpersonal Violence, 4, 3-24. Strommen, M., Brekke, M., Underwager, R., & Johnson, A.
(1972). A Study of Generations ( Reviewed by Ralph Underwager, Institute for Psychological Therapies, Northfield, Minnesota.
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