Body Image Group Therapy for Female Adolescent Survivors of Sexual Abuse

197 Pages·2006·1.64 MB·English

ATHABASCA UNIVERSITY
UNIVERSITY OF CALGARY
UNIVERSITY OF LETHBRIDGE

BODY IMAGE GROUP THERAPY FOR FEMALE ADOLESCENT SURVIVORS
OF SEXUAL ABUSE
BY
ANGELA COULOMBE

A Final Project submitted to the
Campus Alberta Applied Psychology: Counselling Initiative
in partial fulfillment of the requirements for the degree of
MASTER OF COUNSELLING

Alberta
August 2006
DEDICATION
I would like to dedicate this final project to my husband, Greg, and my daughters, Caitlin,
Emily, and Jessica for their time, patience, and unwavering support, encouragement, and
love. Also, to my Oma who became my guiding angel as I completed this project, for always
saying I could do it.
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ABSTRACT
A 12-week group manual for adolescent survivors of sexual abuse with body image issues is
presented. Metamorphosis was developed following a literature review of the topics of body
image, adolescence, sexual abuse, group therapy, and ethical, legal, and medical
considerations. It is based on the concept of embodiment, or the experience of one’s body,
and the complex interplay of how adolescent survivors of sexual abuse might experience
their bodies. Metamorphosis was developed from a holistic approach, in which the mind,
body, and spirit are considered as interconnected within interacting biological, psychological,
social, and spiritual systems. It is supported by an empowerment approach, focusing on client
strengths and resources, within a developmental framework with the goal of health and
wellness promotion.
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ACKNOWLEDGMENTS
I would like to thank Dr. Shelly Russell-Mayhew for her ongoing support and encouragement
through each step of this final project. Dr. Russell-Mayhew’s guidance helped make my
vision of this final project a reality, and for this I am grateful. Thank you also to Janice
Shigemi, Shirley Howarth, and all of the staff at the Sexual Assault Centre of Edmonton for
their unwavering dedication to working with survivors of sexual abuse. I am indebted to
them for their ongoing support and guidance as I continue to learn in the counselling field.
Thank you to the many survivors I have had the privilege to meet for sharing their stories and
providing the impetus for this project. Finally, thank you to my friends and family who
graciously offered their love and support to help me make one of my dreams come true.
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TABLE OF CONTENTS
DEDICATION...........................................................................................................................i
ABSTRACT.............................................................................................................................iv
ACKNOWLEDGMENTS.........................................................................................................v
LIST OF TABLES....................................................................................................................x
CHAPTER I..............................................................................................................................1
Introduction...........................................................................................................................1
Statement of Problem........................................................................................................1
Rationale for Project..........................................................................................................1
Potential Implications........................................................................................................3
Project Overview...............................................................................................................3
CHAPTER II.............................................................................................................................5
Literature Review..................................................................................................................5
Introduction.......................................................................................................................5
Body Image.......................................................................................................................6
Historical and Contemporary Understandings of Body Image.....................................6
Body Image Defined.....................................................................................................7
Prevalence of Unhealthy Body Image...........................................................................8
Risk Factors for Unhealthy Body Image.....................................................................10
Individual risk factors..............................................................................................10
Sociocultural risk factors.........................................................................................11
Abuse and trauma experiences................................................................................12
Consequences of an Unhealthy Body Image...............................................................13
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Summary.....................................................................................................................15
Adolescent Body Image Development............................................................................15
Body Image Across the Lifespan................................................................................16
Objectification theory..................................................................................................17
Other Individual and Sociocultural Risk Factors........................................................18
Sexual Abuse...............................................................................................................21
Summary.....................................................................................................................22
Child Sexual Abuse.........................................................................................................22
Child Sexual Abuse Variables.....................................................................................23
Possible Outcomes of Child Sexual Abuse.................................................................23
Sexual Abuse, Embodiment, and Body Image............................................................25
Summary.....................................................................................................................27
Group Therapy................................................................................................................28
Theoretical Orientation...............................................................................................28
Types of Groups..........................................................................................................29
Group Stages...............................................................................................................30
Group Therapy with Adolescents................................................................................35
Group Therapy with Survivors of CSA.......................................................................37
Limitations to Group Therapy.....................................................................................38
Summary.....................................................................................................................38
Interventions....................................................................................................................39
My Theoretical Orientation.........................................................................................40
Theoretical Models from the Literature......................................................................41
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Group Therapy Topics................................................................................................44
Summary.....................................................................................................................47
Ethical, Legal, and Medical Considerations....................................................................48
Competence.................................................................................................................48
Informed Consent........................................................................................................49
Confidentiality.............................................................................................................50
Other Ethical, Legal, and Medical Issues....................................................................51
Summary.....................................................................................................................52
Conclusion...........................................................................................................................52
CHAPTER III..........................................................................................................................54
Procedures...........................................................................................................................54
Conducting the Literature Review..................................................................................55
Group Manual Development...........................................................................................57
CHAPTER IV.........................................................................................................................60
Group Manual for Adolescent Survivors of Sexual Abuse with Body Image Issues.........60
INTRODUCTION...................................................................................................................63
What is body image?...........................................................................................................63
Theoretical Orientation.......................................................................................................63
Using this Manual...............................................................................................................64
Why Metamorphosis?.........................................................................................................64
GROUP PROPOSAL..............................................................................................................65
Rationale for Group.............................................................................................................65
Group Purpose.....................................................................................................................65
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Group Policy.......................................................................................................................65
Practical Considerations......................................................................................................66
Procedures...........................................................................................................................66
Group Development............................................................................................................66
Guardian and Adolescent Information Meeting..............................................................66
Pre-group Assessment.....................................................................................................67
Session Format....................................................................................................................67
Evaluation Procedures.........................................................................................................67
Recruitment.........................................................................................................................68
CHAPTER V.........................................................................................................................162
Synthesis and Implications................................................................................................162
Strengths of Project...................................................................................................162
Limitations of Project................................................................................................162
Recommendations for Future Research....................................................................164
Conclusion.........................................................................................................................164
References.............................................................................................................................166
Table 1...................................................................................................................................181
Table 2...................................................................................................................................184

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