Working with Adolescent Girls who have been Sexually Abused

Abortion and Unwanted Pregnancy as a Consequence of Rape; Psycho-dynamic Groupwork; Teenage Mothers: An Attachment Enhancement Intervention


This part of the book explores the wider contexts and impact of intersecting harms (child sexual abuse [CSA], family violence and gender inequality) in regard to adolescent girls and teenage mothers. Our entry to the topic is the story of Melissa (not her real name). Ecological systems theory, as a basis for practice, would have us acknowledge that children are nested within family systems, which in turn are nested within community and societal systems, and that interventions that explore the inter-relationship of system dynamics can be particularly effective. We agree with and have written extensively about this, but Melissa’s story reminds us too that sometimes children are embedded in systems that are so destructive to their well-being that they must, for their survival, find themselves un-nested. Melissa represents the child whose family is so dangerous to her safety that she cannot remain a part of it or at most who lives on its periphery and therefore new systems of support need to be created.


Sexual Abuse Sexual Violence Attachment Style Insecure Attachment Teenage Mother 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Ainsworth, M. D. S., Bell, S. M., & Stayton, D. J. (1971). Individual differences in strange situation behavior of one-year-olds. In H. R. Schaffer (Ed.), The origins of human relations (pp. 17–56). London: Academic Press.Google Scholar
  2. American Psychological Association. (2008). Report of the task force on mental health and abortion. Washington, DC: American Psychological Association. Accessed August 4, 2012.
  3. Bailey, H. N., Moran, G., & Pederson, D. R. (2007). Childhood maltreatment, complex trauma symptoms, and unresolved attachment in an at-risk sample of adolescent mothers. Attachment and Human Development, 9(2), 139–161.CrossRefGoogle Scholar
  4. Bakermans-Kranenburg, M. J., van IJzendoorn, J., & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129, 195–215.CrossRefGoogle Scholar
  5. Battle, J. (2002). Culture-free self-esteem inventories, Examiner’s manual (3rd ed.). Austin: Pro-ed – An International Publisher.Google Scholar
  6. Belsky, J., Rosenberger, K., & Crnic, K. (1995). The origins of attachment security. In S. Goldberg, R. Muir, & J. Kerr (Eds.), Attachment theory: Social, developmental, and clinical perspectives (pp. 153–183). Hillsdale: Analytic Press.Google Scholar
  7. Berlin, L., Zeanah, C. H., & Lieberman, A. F. (2008). Prevention and intervention programmes for supporting early attachment security. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications. New York: The Guilford Press.Google Scholar
  8. Bifulco, A., Figueiredo, B., Guedeney, N., Gorman, L. L., Hayes, S., Muzik, M., et al. (2004). Maternal attachment style and depression associated with childbirth: Preliminary results from a European and US cross-cultural study. The British Journal of Psychiatry, 184(46), s31–s37.Google Scholar
  9. Book, H. E. (1998). How to practice brief psychodynamic psychotherapy: The core conflictual relationship theme method. Washington, DC: American Psychological Association Press.CrossRefGoogle Scholar
  10. Bowlby, J. (1973). Attachment and loss (Vol. 2). Separation: anxiety and anger. New York: Penguin Books.Google Scholar
  11. Bowlby, J. (1980). Attachment and loss (Vol. 3). Loss: sadness and depression. New York: Penguin Books.Google Scholar
  12. Bradshaw, Z., & Slade, P. (2003). The effects of induced abortion on emotional experiences and relationships: A critical review of the literature. Clinical Psychology Review, 23(7), 929–958.CrossRefGoogle Scholar
  13. Brown, R. P., & Gerbarg, P. L. (2005). Sudarshan kriya yogic breathing in the treatment of stress, anxiety, and depression: Part II-clinical applications and guidelines. Journal of Alternative & Complementary Medicine, 11(4), 711–717.CrossRefGoogle Scholar
  14. Cassidy, B., & Zoccolillo, M. (1996). Psychopathology in adolescent mothers and its effects on mother–infant interactions: A pilot study. Canadian Journal of Psychiatry, 41(6), 379–384.Google Scholar
  15. Chaffin, M., Hanson, R., Saunders, B. E., Nichols, T., Barnett, D., & Zeanah, C. (2006). Report of the APSAC Task Force on attachment therapy, reactive attachment disorder, and attachment problems. Child Maltreatment, 11, 76–89.CrossRefGoogle Scholar
  16. Child Trends Data Bank. (2014). Teen pregnancy. Accessed September 8, 2014.
  17. Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2006). Fostering secure attachment in infants in maltreating families through preventive interventions. Development and Psychopathology, 18(03), 623–649.Google Scholar
  18. Cincotta, N. F. (2002). The journey of middle childhood: Who are “Latency”-age children? In S. G. Austrian (Ed.), Developmental theories through the life cycle. New York: Columbia University Press.Google Scholar
  19. Cohen, A. J., Adler, N., Kaplan, S. J., Pelcovitz, D., & Mandel, F. S. (2002). Interactional effects of marital status and physical abuse on adolescent psychopathology. Child Abuse and Neglect, 26(3), 277–288.CrossRefGoogle Scholar
  20. Cohn, J. F., Campbell, S. B., Matias, R., & Hopkins, J. (1990). Face-to-face interactions of postpartum depressed and nondepressed mother-infant pairs at 2 months. Developmental Psychology, 26(1), 15–23.CrossRefGoogle Scholar
  21. Cox, A. D., Puckering, C., Pound, A., & Mills, M. (1987). The impact of maternal depression on young children. Journal of Child Psychology and Psychiatry, 28, 917–928.CrossRefGoogle Scholar
  22. DeGarmo, D. S., Patterson, G. R., & Forgatch, M. S. (2004). How do outcomes in a specified parent training intervention maintain or wane over time? Prevention Science, 5(2), 73–89.CrossRefGoogle Scholar
  23. Denholm, R., Power, C., Thomas, C., & Li, L. (2013). Child maltreatment and household dysfunction in a British birth cohort. Child Abuse Review, 22(5), 340–353.CrossRefGoogle Scholar
  24. Dozier, M., Lindhiem, O., & Ackerman, J. P. (2005). Attachment and biobehavioral catch-up: An intervention targeting empirically identified needs of foster infants. In M. Dozier, O. Lindhiem, J. P. Ackerman, L. J. Berlin, Y. Ziv, & L. Amaya-Jackson (Eds.), Enhancing early attachments: Theory, research, intervention, and policy. Duke series in child development and public policy (pp. 178–194). New York: Guilford Press.Google Scholar
  25. Durrant, J. E., Trocme, N., Fallon, B., Milne, C., & Black, T. (2009). Protection of children from physical maltreatment in Canada: An evaluation of the Supreme court’s definition of reasonable force. Journal of Aggression, Maltreatment & Trauma, 18(1), 64–87.CrossRefGoogle Scholar
  26. Egeland, B. (2004). ‘Attachment-based intervention and prevention programs for young children’ in Encyclopedia on early childhood development [online] (pp. 1–7). Montreal: Centre of Excellence for Early Childhood Development.Google Scholar
  27. Engelhard, I. M., van den Hout, M. A., Kindt, M., Arntz, A., & Schouten, E. (2003). Peritraumatic dissociation and posttraumatic stress after pregnancy loss: A prospective study. Behaviour Research and Therapy, 41(1), 67–78.CrossRefGoogle Scholar
  28. Feldman, J. B. (2012). Best practice for adolescent prenatal care: Application of an attachment theory perspective to enhance prenatal care and diminish birth risks. Child and Adolescent Social Work Journal, 29(2), 151–166.CrossRefGoogle Scholar
  29. Field, T., Healy, B. T., Goldstein, S., & Guthertz, M. (1990). Behavior-state matching and synchrony in mother-infant interactions of nondepressed versus depressed dyads. Developmental Psychology, 26(1), 7–14.CrossRefGoogle Scholar
  30. Furnivall, J. (2011). Attachment-informed practice with looked after children and young people. IRISS Insight no. 10. Glasgow: IRISS, Accessed July 10, 2013.
  31. Gaudin Jr., J. M., Polansky, N. A., Kilpatrick, A. C., & Shilton, P. (1996). Family functioning in neglectful families. Child Abuse and Neglect, 20(4), 363–377.CrossRefGoogle Scholar
  32. Goldberg, S., Muir, R., & Kerr, J. (2013). Attachment theory: Social, developmental, and clinical perspectives. London: Routledge.Google Scholar
  33. Grace, S. L., Evindar, A., & Stewart, D. E. (2003). The effect of postpartum depression on child cognitive development and behavior: A review and critical analysis of the literature. Archives of Women’s Mental Health, 6(4), 263–274.CrossRefGoogle Scholar
  34. Guttmacher Institute. (2012). Facts on abortion in Latin America and the Caribbean. Accessed September 8, 2014.
  35. Hoffman, K. T., Marvin, R. S., Cooper, G., & Powell, B. (2006). Changing toddlers’ and preschoolers’ attachment classifications: The circle of security intervention. Journal of Consulting and Clinical Psychology, 74(6), 1017–1026.CrossRefGoogle Scholar
  36. Hook, D. (2009). Erikson’s psychosocial stages of development. In J. Watts., K. Cockcroft., & N. Duncan (Eds.), Developmental Psychology (2nd ed.). Cape Town: UCT Press.Google Scholar
  37. Hornor, G. (2010). Child sexual abuse: Consequences and implications. Journal of Pediatric Health Care, 24(6), 358–364.CrossRefGoogle Scholar
  38. Jones, A. D., & Maharaj, P. E. (2014). Evaluation report: Project R.I.S.E. Grenada/Toronto: The Sweet Water Foundation.Google Scholar
  39. Jones, A. D., Trotman Jemmott, E., Maharaj, P. E., & Da Breo, H. (2014). An integrated systems model for preventing child sexual abuse: Perspectives from Latin America and the Caribbean. Basingstoke/New York: Palgrave Macmillan.CrossRefGoogle Scholar
  40. Juffer, F., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (Eds.) (2012). Promoting positive parenting: An attachment-based intervention. London/New York: Routledge.Google Scholar
  41. Kisiel, C. L., Fehrenbach, T., Torgersen, E., Stolbach, B., McClelland, G., Griffin, G., et al. (2014). Constellations of interpersonal trauma and symptoms in child welfare: Implications for a developmental trauma framework. Journal of Family Violence, 29, 1–14.Google Scholar
  42. Knerr, W., Gardner, F., & Cluver, L. (2013). Improving positive parenting skills and reducing harsh and abusive parenting in low-and middle-income countries: A systematic review. Prevention Science, 14(4), 352–363.CrossRefGoogle Scholar
  43. Lagerberg, D. (2000). Secondary prevention in child health: Effects of psychological intervention, particularly home visitation, on children’s development and other outcome variables. Acta Paediatrica, 89(s434), 43–52.CrossRefGoogle Scholar
  44. Lev-Wiesel, R. (2008). Child sexual abuse: A critical review of intervention and treatment modalities. Children and Youth Services Review, 30(6), 665–673.CrossRefGoogle Scholar
  45. Lounds, J. J., Borkowski, J. G., Whitman, T. L., Maxwell, S. E., & Weed, K. (2005). Adolescent pregnancy and attachment during infancy and early childhood. Parenting: Science and Practice, 5(1), 91–118.CrossRefGoogle Scholar
  46. Luborsky, L., & Crits-Christoph, P. (1998). Understanding transference: The core conflictual relationship theme method (2nd ed.). Washington, DC: American Psychological Association Press.CrossRefGoogle Scholar
  47. Martz, E., & Lindy, J. (2010). Exploring the trauma membrane concept. In E. Martz (Ed.), Trauma rehabilitation after war and conflict (pp. 27–54). New York: Springer.CrossRefGoogle Scholar
  48. Marvin, R., Cooper, G., Hoffman, K., & Powell, B. (2002). The circle of security project: Attachment-based intervention with caregiver-preschool child dyads. Attachment and Human Development, 1(4).Google Scholar
  49. McCloskey, L. A., Figueredo, A. J., & Koss, M. P. (1995). The effects of systemic family violence on children’s mental health. Child Development, 66(5), 1239–1261.CrossRefGoogle Scholar
  50. Messman-Moore, T. L., Walsh, K. L., & DiLillo, D. (2010). Emotion dysregulation and risky sexual behavior in revictimization. Child Abuse and Neglect, 34(12), 967–976.CrossRefGoogle Scholar
  51. Mullers, E., & Dowling, M. (2008). Mental health consequences of child sexual abuse. British Journal of Nursing, 17(22), 1428–1433.CrossRefGoogle Scholar
  52. Murray, L., & Sinclair, D. (1999). The socioeconomic development of 5 year old children of postnatally depressed mothers. Journal of Child Psychology and Psychiatry, 40(8), 1259–1271.CrossRefGoogle Scholar
  53. Nash, M. R., Hulsey, T. L., Sexton, M. C., Harralson, T. L., & Lambert, W. (1993). Long-term sequelae of childhood sexual abuse: Perceived family environment, psychopathology, and dissociation. Journal of Consulting and Clinical Psychology, 61(2), 276–283.CrossRefGoogle Scholar
  54. Nicolson, S., Judd, F., Thomson-Salo, F., & Mitchell, S. (2013). Supporting the adolescent mother–infant relationship: Preliminary trial of a brief perinatal attachment intervention. Archives of Women’s Mental Health, 16(6), 511–520.CrossRefGoogle Scholar
  55. Novotney, A. (2009). Yoga as a practice tool. Monitor on Psychology, 40(10), 38.Google Scholar
  56. Posavac, E. J., & Miller, T. Q. (1991). Some problems caused by not having a conceptual foundation for health research: An illustration from studies of the psychological effects of abortion. Psychology and Health, 5(1), 13–23.CrossRefGoogle Scholar
  57. Pritchett, R., Kemp, J., Wilson, P., Minnis, H., Bryce, G., & Gillberg, C. (2010). Quick, simple measures of family relationships for use in clinical practice and research: A systematic review. Family Practice, cmq080.Google Scholar
  58. Puckering, C., McIntosh, E., Hickey, A., & Longford, J. (2010). Mellow Babies: A group intervention for infants and mothers experiencing postnatal depression. Counselling Psychology Review, 25(1), 12.Google Scholar
  59. Purcell, W. J. (1996). The attachment-trauma complex. The American Journal of Psychoanalysis, 56(4), 435–446.CrossRefGoogle Scholar
  60. Quinlivan, J. A., Tan, L. H., Steele, A., & Black, K. (2004). Impact of demographic factors, early family relationships and depressive symptomatology in teenage pregnancy. Australian and New Zealand Journal of Psychiatry, 38(4), 197–203.CrossRefGoogle Scholar
  61. Riggs, S. A., Paulson, A., Tunnell, E., Sahl, G., Atkison, H., & Ross, C. A. (2007). Attachment, personality, and psychopathology among adult inpatients: Self-reported romantic attachment style versus adult attachment interview states of mind. Development and Psychopathology, 19(01), 263–291.CrossRefGoogle Scholar
  62. Robbins Broth, M., Goodman, S. H., Hall, C., & Raynor, L. C. (2004). Depressed and well mothers’ emotion interpretation accuracy and the quality of mother–infant interaction. Infancy, 6, 37–55.CrossRefGoogle Scholar
  63. Shaffer, D. R., & Kipp, K. (2014). Developmental psychology: Childhood and adolescence (9 ed.). California: Cengage Learning.Google Scholar
  64. Slack, K. S., Holl, J. L., McDaniel, M., Yoo, J., & Bolger, K. (2004). Understanding the risks of child neglect: An exploration of poverty and parenting characteristics. Child Maltreatment, 9(4), 395–408.CrossRefGoogle Scholar
  65. Stith, S. M., Liu, T., Davies, L. C., Boykin, E. L., Alder, M. C., Harris, J. M., et al. (2009). Risk factors in child maltreatment: A meta-analytic review of the literature. Aggression and Violent Behavior, 14(1), 13–29.Google Scholar
  66. Summers, R. F., & Barber, J. P. (2012). Psychodynamic therapy: A guide to evidence-based practice. New York: Guilford Press.Google Scholar
  67. Tarabulsy, G. M., Pascuzzo, K., Moss, E., St-Laurent, D., Bernier, A., Cyr, C., et al. (2008). Attachment-based intervention for maltreating families. American Journal of Orthopsychiatry, 78(3), 322–332.Google Scholar
  68. UNICEF. (2009). Children in Barbados and the Eastern Caribbean: Child rights – the unfinished agenda. Accessed September 21, 2014.
  69. Van Der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking.Google Scholar
  70. van IJzendoorn, M. H., Juffer, F., & Duyvesteyn, M. G. C. (1995). Breaking the intergenerational cycle of insecure attachment: A review of the effects of attachment-based interventions on maternal sensitivity and infant security. Journal of Child Psychology and Psychiatry, 36, 225–248.CrossRefGoogle Scholar
  71. van Roode, T., Dickson, N., Herbison, P., & Paul, C. (2009). Child sexual abuse and persistence of risky sexual behaviors and negative sexual outcomes over adulthood: Findings from a birth cohort. Child Abuse and Neglect, 33, 161–172.CrossRefGoogle Scholar
  72. Wan, M. W., & Green, J. (2009). The impact of maternal psychopathology on child–mother attachment. Archives of Women’s Mental Health, 12(3), 123–134.CrossRefGoogle Scholar
  73. Webster-Stratton, C., Reid, M. J., & Hammond, M. (2004). Treating children with early-onset conduct problems: Intervention outcomes for parent, child, and teacher training. Journal of Clinical Child and Adolescent Psychology, 33(1), 105–124.CrossRefGoogle Scholar
  74. Williams, S. G., Brown, J., & Roopnarine, J. L. (2006). Child rearing in the Caribbean: A literature review. Barbados: Caribbean Child Support Initiative.Google Scholar
  75. World Health Organization (WHO). (2011). Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008 (6 ed.). Geneva: WHO.Google Scholar
  76. Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy. New York: Basic Books.Google Scholar
  77. Yalom, I. D. (2012). Love’s executioner: And other tales of psychotherapy. New York: Basic Books.Google Scholar

Copyright information

© The Author(s) 2016

Authors and Affiliations

  1. 1.The University of HuddersfieldHuddersfieldUK
  2. 2.Florencena ConsultingBridgetownBarbados
  3. 3.Sweet Water FoundationGrenadaGrenada
  4. 4.The Alpine ProjectLa RomaineTrinidad and Tobago

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