03

Journal of Child Sexual Abuse



ISSN: 1053-8712 (Print) 1547-0679 (Online) Journal homepage: http://www.tandfonline.com/loi/wcsa20

School-Based Child Sexual Abuse Prevention Programs: Moving Toward Resiliency-Informed Evaluation

Ian G. Barron, David J. Miller & Timothy B. Kelly

To cite this article: Ian G. Barron, David J. Miller & Timothy B. Kelly (2015) School-Based Child Sexual Abuse Prevention Programs: Moving Toward  Resiliency-Informed  Evaluation,  Journal  of  Child  Sexual  Abuse,  24:1,  77-96,  DOI:    10.1080/10538712.2015.990175
To link to this article:   http://dx.doi.org/10.1080/10538712.2015.990175



Published online: 30 Jan 2015.

   Submit your article to this journal


Article views: 1047

    View related articles    View Crossmark data






Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=wcsa20


Journal of Child Sexual Abuse, 24:77–96, 2015 Copyright © Taylor & Francis Group, LLC  ISSN:  1053-8712  print/1547-0679 online
DOI:  10.1080/10538712.2015.990175


School-Based Child Sexual Abuse Prevention Programs: Moving Toward Resiliency-Informed  Evaluation

IAN G. BARRON, DAVID J. MILLER, and TIMOTHY B. KELLY
University of Dundee, Dundee, Scotland


Although recent years have seen an increase in the range  of  child sexual abuse prevention programs delivered in schools, there have been relatively few efficacy studies. Those conducted have focused primarily on intrinsic child factors and have often lacked an explicit theoretical framework. We  offer resiliency theory as  a useful and apposite theoretical framework for program eval- uation. Resiliency theory suggests that a wider range of factors should be considered, including intrinsic (personal characteristics) and extrinsic (environmental) factors. Such factors may increase risk or,  alternatively, protect children from the negative effects  of adversity. We argue that a resiliency perspective to efficacy  studies should recognize a long-term view on children’s capac-  ity to cope and can employ both standardized and contextual  resiliency-informed measures.

KEYWORDS      maltreatment, resilience, abuse, program   efficacy


Despite a rapid increase in the range of child sexual abuse (CSA) pre- vention programs delivered in schools, there have been remarkably few efficacy studies. Wurtele (2009) suggests this is partly due to the lack of adequate funding, whereas others have expressed the view that uncertainty of what constitutes an effective program has limited attempts at evaluation (Barron & Topping, 2010b). Where efficacy studies have been conducted, they have focused on a narrow range of intrinsic child outcomes. These

Received 28 October 2013; revised 25 August 2014; accepted 26 August 2014.
Address correspondence to Ian Barron, Old Medical School, School of Education, Social Work and Community Education, University of Dundee, Nethergate, Dundee, Scotland, UK DD1 4HN. E-mail: i.g.z.barron@dundee.ac.uk

77

78 I. G. Barron et al.

intrinsic child factors have included assessment of self-protective knowledge and skills (Telljohann, Everett, & Price, 1997), emotional gains (MacIntyre & Carr, 1999a), abuse disclosure (MacIntyre & Carr, 1999b), and awareness of inappropriate touch (Taal & Edelaar, 1997). A small number of studies have also explored children’s response to threat (Finkelhor & Dzuiba-Leatherman, 1995), their subjective experience of programs  (Pohl  &  Hazzard,  1990), and the unintended negative consequences of programs such as increased anxiety (MacIntyre & Carr, 1999a). Findings from systematic reviews and meta-analyses indicate CSA prevention programs lead to small gains in self- protective knowledge and skills as well as a small number of disclosures (Barron & Topping, 2010b).
Although the evaluation of intrinsic child factors indicates CSA  pre-  vention programs impact positively on child development, Wurtele  (2009)  argues prevention program evaluation needs to be set within a public health approach. Such an approach aims to benefit as much of the population as  possible, acknowledging the  role  of  education  and  the  wider  community.  The interdisciplinary perspectives that are characteristic of  a  public  health  model would also lead us to examine intrinsic child outcomes in the context       of the child’s environment. As we explain, this mirrors a resiliency approach that emphasizes the interaction of intrinsic and extrinsic factors. To date,  however, few  efficacy  studies  have  included  environmental  factors  as  part  of evaluating programs. A small number of studies have explored and found knowledge, skill, and attitude gains for parents (e.g. MacIntyre & Carr, 1999a)  and teachers (e.g. Herbert, Lavoie, Piche, & Poitras, 2001). More  recently,  Wolfe, Crooks, Chiodo, and Jaffe (2009), in  a  randomized  control  trial  of  1,722 grade 9 students, sought to evaluate the impact of a school date rape prevention program on  the  social  context  of  peer  relationships.  Following  the program, the authors found  significant  reductions  in  peer  physical  dat-  ing violence. The study, however, was limited by its reliance on self-report measures.
One possible reason for the overfocus on intrinsic child factors may      be the lack of theoretical clarity expressed within published efficacy studies.  In a systematic review of efficacy studies of CSA prevention programs, Barron and Topping (2010b) found most studies omitted, or vaguely described, the theoretical underpinning of the program. In the few studies where theory    was discernible, this was based on psychological rather than sociological perspectives. Not surprisingly then, the resultant focus of evaluation was on intrinsic child development. For example, programs showing a behaviorist influence were evaluated by assessing changes in child behavior (Taal & Edelaar,1997), programs by cognitive-behavioral theory included evaluation  of child knowledge and attitude change (Telljohann et al., 1997), and pro- grams underpinned by social learning theory focused on skills gains from modeling, role-play, and discussion (Herbert et al., 2001). All three theo-   ries, although not explicitly stated, were discernible from most of the   studies

School-Based Child Sexual Abuse Prevention Program 79

in Barron and Topping’s systematic review. Similarly, the measures used to assess child outcomes were mostly decontextualized and standardized, such as personal safety knowledge and skill questionnaires.
With potential for a greater contribution to program evaluation, a small number of studies explored theories of child learning of complex personal safety concepts (Tutty, 2000). Findings indicated children in the elementary years needed personal safety knowledge and skills presented in a more concrete manner compared to adolescents, who have the capacity to com- prehend more abstract concepts, such as that someone they know could abuse them. Tutty concluded that efficacy studies need to assess personal safety concepts learned and retained at different periods of development in interaction with age-appropriate pedagogy. In short, however, within pub- lished CSA prevention program efficacy studies most programs appear to be atheoretical, and no studies to date have made explicit the theoretical orientation underpinning program efficacy outcomes.
The current analysis, therefore, seeks to address the omission of theory within school-based CSA prevention program efficacy studies. To achieve this, resiliency theory is identified as a critical framework for analysis. Resiliency theory was selected for a number of reasons. First, resiliency has demonstrated its usefulness in making a significant contribution to the assess- ment and intervention of children who have been sexually abused as well as to the wider field of child care and protection (Daniel, Wassell, & Gilligan, 2010). In fact, many authors state that child abuse is best understood in an ecological context (e.g. Belsky, 1980; Coulton, Crampton, Irwin, Spilsbury, & Korbin, 2007; Videka, Gopalan, & Bauta, 2014). Resiliency is an ecological concept.
Second, the application of a resiliency practice framework to program efficacy is congruent with Wurtele’s plea to embed program evaluation within a public health model of social context factors. As a result, an adapted version of the Daniel and colleagues (2010) public health resiliency practice framework, which includes resiliency, vulnerability, adversity, and protec- tive factors, is presented as a potential applicable framework for program evaluation. These four factors were utilized to provide part of the struc-      ture of this article. Because of a significant focus on risk in a small number   of abuse prevention efficacy studies and the complex relationship between risk, resilience, and vulnerability, risk has also been added to the proposed framework. Although there are various models of resiliency that could have been used (e.g., Gitterman 2001a; Gitterman & Sideriadis, 2014; Rutter, 1987), the Daniel and colleagues (2010) model was selected because it is already widely applied within the child care and protection field. Second, it provides  a framework that readily lends itself to the identification and integration of both standardized and contextualized measures for intrinsic and extrinsic factors in CSA prevention program  evaluation.

80 I. G. Barron et al.

In order to, therefore, present resiliency theory as a useful and appo-    site theoretical framework for prevention program evaluation, the current analysis (a) defines resiliency within the context  of  school-based  CSA  abuse prevention evaluation, (b) applies, throughout the paper, the Daniel’s resiliency framework to the efficacy studies within Barron and Topping’s (2010b) recent thorough and systematic review and meta-analysis, and (c) specifically identifies, from a resiliency perspective, a range of social context factors (in addition to child intrinsic factors) that could be utilized in future program evaluation.

RESILIENCY BACKGROUND AND  DEFINITIONS

Work  in  the  field  of  resiliency  started  with  empirical  studies  in  the  area   of  schizophrenia,  in  particular  studies  of  children  of  schizophrenic  moth-  ers (Luthar, Cicchetti, & Becker, 2000) as well as children of the holocaust (Moskovitz, 1983). The focus on childhood resiliency then expanded to look       at multiple adverse conditions, such as socioeconomic disadvantage, child maltreatment,  and  chronic  illness.  Although  attention  focused  initially  on  the individual characteristics of resilient children, subsequent studies  estab-  lished three sets of factors: the attributes of the individual child, the family setting, and the wider social environment. The former are labeled intrinsic  factors, being characteristics of the individual, and the latter two are usually referred to as extrinsic factors, since they are related to the child’s environ- ment. A resiliency-based approach, then, draws attention to the environment     and networks around the child as well as to the areas of strength or vulner-   ability within the individual. These two elements are  not  discrete,  and  the  focus  is  on  the  whole  system  surrounding  the individual.
Adopting a perspective that looks at  both  internal  and  external  fac- tors can substantially broaden the focus of outcomes for efficacy studies,       as resiliency increases when persons and environments are reciprocally supportive (Kelly, Berman-Rossi, & Palombo, 2001). Examples of extrinsic factors being taken into account in efficacy studies could include evaluation  of changes in family discussions about personal safety and the measurement  of changes in teacher ability to ask and respond to abuse in children’s lives. Given that this latter issue is a potential barrier to the effective delivery of  CSA prevention programs, it is remarkable it has received scant attention within program efficacy studies (Barron & Topping,  2010a).
If resiliency theory is to be applied to prevention program efficacy stud- ies, a clear definition of what resiliency means for sexually abused children and those at risk of abuse is required. Given the lack of recognition of the concept of resiliency in program efficacy studies, definitions of resiliency have been sought from wider literature. Generally, within the literature, defi- nitions of resiliency vary. For example, resilience can be defined as qualities

School-Based Child Sexual Abuse Prevention Program 81

possessed by the child (e.g., qualities that help children cope,  and  even thrive, when faced with hurt, disadvantage, or abuse; Gilligan, 1997). This focus on internal factors is complemented by a broader perspective provided by the International Resilience Project (IRP). The IRP defines resilience as “both an individual’s capacity to navigate to health resources and a con- dition of the individual’s family, community and culture to provide these resources in culturally meaningful ways” (Ungar, 2005, p. 6). It follows that adopting a resilience framework  requires  abuse  prevention  efficacy  stud- ies to include assessments of resources  within  families  and  communities and of the ability of the child to identify, communicate, and utilize these resources. Due to the messiness of real-life social environments, this is a chal- lenging task for program researchers. Examples of measures could include assessment of child and family awareness of personal safety resources (e.g., leaflets and videos on how to talk to your child about sexuality and abuse)  and child protection agencies (e.g., helplines, social work staff, or CSA sur- vivor groups). Furthermore, knowledge of how children and families engage and use such material and personnel could provide possible indicators of developing resiliency.
In a related concept to resource identification and use, Luthar (2003) highlights the capacity for adaptation as a core aspect of resiliency. The belief that resilience should be seen not simply as an outcome (emotional well-being against the odds) but also as a process (the ability to adapt and respond effectively to adversity) has implications for efficacy studies, most notably that evaluation needs to be over time to trace the nature of child adaptation. Assessment of adaptation, for example, might include pre- and posttest observation, self-report questionnaires and parent–teacher reports of an increased repertoire of child coping strategies, increased emotional robustness, and a higher sense of self-competence and confidence (Daniel et al., 2010). The inclusion of these assessments would be a significant devel- opment for efficacy studies, as longitudinal evaluation to date has focused primarily on the maintenance of personal safety knowledge and skills.


EXPANSION OF INTRINSIC CHILD  FACTORS

Barron and Topping (2010b) reported that only the  resiliency-related  con-  structs of self-esteem (MacIntyre & Carr, 1999a), locus of control  (Casper,  1999), and feeling safe (Pohl & Hazzard, 1990) were assessed within efficacy studies in their systematic review. However, the application of resiliency to efficacy studies brings the promise of a substantial increase in the range of intrinsic child factors, including the assessment of a child’s qualities of sur- viving, coping, utilization of resources, and adaptation to adversity over time. Literature into children’s resiliency identifies a range of relevant constructs      to  consider  and  measure:  self-esteem  (Gilligan,  1997),  self-efficacy (Masten,

82 I. G. Barron et al.

Best, & Garmezy, 1990), positive expectations (Wyman, 2003), a sense of autonomy (Grotberg, 1997), capacity for humor (Zide & Kelly, 2000), and holding a sense of something greater than themselves (Gitterman 2001b). Other personal characteristics identified include feeling secure (Gilligan, 1997), seeing oneself as loved (Grotberg, 1997), and appreciating one’s talents and social competency (Daniel & Wassell,  2005).


RESILIENCY ACROSS THE AGE RANGE

While a small number of efficacy studies have focused on the age and stage impact of programs on knowledge, skills, and a narrow range of emotional gains, none have assessed the impact of prevention programs on children’s changing resiliency across different periods of development. Efficacy studies need to attend not only to a wider range of children’s intrinsic qualities asso- ciated with resiliency but also assess how these qualities develop across the life course. Werner  (1990), from a review of international research includ-  ing age comparative studies, identified that resilient children in early  to middle childhood (5 to 11 years) tend to be sociable, demonstrate reflec-    tive thinking, cope flexibly with stresses, and can positively influence the world around them, including enabling adults to  support  them.  On  the  other hand, resilient adolescents tend to be  more  aware  of  their  values, have a greater internal locus of control, are more socially responsive, and    are more optimistic about themselves and the future. It is suggested, there- fore, that program efficacy evaluation in response to child resiliency research may need to assess differential resiliency outcomes for children at different periods  of development.
Within wider resiliency literature, a range of standardized measures, with known validity and reliability, have been used to assess children’s developing resilience across childhood. We would argue that these have the potential to  be utilized and adapted for program evaluation. The age range with fewest measures available, however, is the preschool years. One such measure, however, is the Devereux Early Childhood Assessment (DECA; LeBuffe & Naglieri, 1998), which is based on resilience and protective factors, assesses preschoolers’ self-control and communicative initiatives, parent–child attach- ment behaviors, and external supports. Lengthy at 62 items, the DECA provides screening, intervention planning, and the assessment of progress. Although an older measure, the DECA has had more recent support for        its application (Stewart-Brown & Edmunds, 2007). For children in elemen- tary school and older, the Resiliency Scales for Children and Adolescents (Prince-Embury, 2006) addresses three global scales of resiliency: mastery, emotional reactivity, and relatedness (including trust, support and tolerance). A personal resiliency profile is constructed from over 60 items for each  child.

School-Based Child Sexual Abuse Prevention Program 83

Although good reliability data is available, there is, however, a minimal focus on social context.
A more recent and socially context-focused tool is the Child and Youth Resilience Measure (Ungar & Leibenberg, 2009). Developed through the International Resiliency Project as a screening tool,  the CYRM  consists of  58 items, inclusive of intrinsic child as well as family, community, and cul- tural factors. It is a useful pre- and posttest measure for individuals and  groups and has good applicability to cross-cultural contexts. The Assessing Developmental Strengths (Donnon & Hammond, 2007) questionnaires cover  a wide age range (9–24) including the assessment of family resources and social supports. Further work is needed, however, on assessing  the  reli- ability and validity of this measure. Finally, the Adolescence Resilience Questionnaire (Gartland, Bond, Olsson, Buzwell, & Sawyer,  2011) assesses   a range of intrinsic and extrinsic factors for child, peer, family, school, and community connectedness. This list of measures does not aim to be exhaus- tive; rather, the aim is to suggest that relevant standardized measures of resiliency are available for use and adaptation for CSA program evaluation. While many other resiliency measures exist, there is an unfortunate bias toward  the  adolescent population.

GENDER ISSUES

Resiliency studies across  the  age  range  also  suggest  that  a  wider  range of gender issues need to be considered for program evaluation. Although  some efficacy studies have explored gender differences, most have a nar-   row focus on knowledge and skills with little difference in gender being  found (Finkelhor & Dzuiba-Letherman, 1995). Resiliency research, on the other hand, suggests that program efficacy studies may need to incorpo-     rate measures that take into account differential aspects of development for girls and boys. For example, factors that have high validity and are impor- tant for girls in middle childhood include risk-taking and emotional support, whereas the assessment of emotional expression and response to supervi-  sion, encouragement, and structure may be more significant for boys (Daniel et al., 2010). The application of resiliency theory and research to program efficacy not only introduces new, gender-oriented concepts  to  assess  but may help in identifying previously unrecognized differential gender effect   for programs across different periods of   development.

VULNERABILITY  FACTORS

As a factor within the Daniel and colleagues (2010) resiliency practice frame- work, signs of vulnerability have been traced across childhood.   Vulnerability

84 I. G. Barron et al.

has been defined as including both internal child characteristics (e.g., devel- opmental or temperamental difficulties) and vulnerabilities imposed on the child by adult expectation (e.g., being the “wrong sex”; Daniel et al., 2010). It appears that children in early to middle childhood can display learning or behavioral difficulties or be scapegoated at home, whereas adolescents may experience peer-relationship difficulties, disrupted schooling, and a wide  range of emotional and behavioral problems. As part of assessing resiliency, program efficacy researchers, therefore, need to consider the assessment of child and situational vulnerability and the interaction of these factors across the different periods of child development. Examples of vulnerability out- come measures for adolescents might include assessment of parental and teacher expectations of adolescent capacity to keep safe or the quality of adolescent peer relationships, whereas for elementary school children the focus would be on the quality of parental support and child response.


RISK FACTORS

Somewhat surprisingly, the assessment of children’s perception and response to risk were largely omitted from efficacy studies in the review (Barron & Topping, 2010b). However, given that a small number of studies incorpo- rated risk into assessment, as noted, risk was added to Daniel and colleagues’ practice framework, which was applied to efficacy studies. Although within the systematic review some studies assessed what children would do in spe- cific risky situations, there was little attempt to connect this to a theoretical understanding (Barron & Topping, 2010b). Perhaps this has in part been due to the contested nature of risk, the limited related research on children’s perception of different kinds of risks and the complexity of the relation-     ship between risk and children’s capacity to move to action. Pelcovitz, Adler, Kaplan, Packman, and Kreiger (1992) found an attitude-behavior discrepancy in which measuring what children say may not equate to what children do, particularly in situations as overwhelming as CSA. Further complicating the issue is the finding that what some authors construed as negative program outcomes, such as child heightened worry, may actually lead to positive out- comes. Finkelhor and Dzuiba-Leatherman (1995), for example, found that increased anxiety facilitated children’s utilization of strategies learned within programs into everyday life.
More widely within the context of resilience and public health, risk fac- tors have been defined as relating “to any event, condition, or experience  that increases the probability that a problem will be formed, maintained, or exacerbated” (Jenson & Fraser, 2006, p. 5). The implication here is not that the problem(s) will occur but that there may be an increased likelihood of difficulties. The adoption of resiliency within program efficacy studies, there- fore, places an understanding of risk at the center rather than the periphery

School-Based Child Sexual Abuse Prevention Program 85

of evaluation. Examples of assessment could include adult and child per- ceptions of risk compared to known and accumulated risks for children at home and in school and community (Jacobs & Hashima, 1995). Children’s efficacy and skills in managing, avoiding, and responding to risk alongside  the adult capacity to enable children to tell of risk and for adults to listen    and respond supportively could also be assessed (Barron & Topping, 2010a). Furthermore, the assessment of risk of abuse is not divorced from the assess- ment of child and adult perception, experience, intentions, and responses to other risks in life (Hothersall & Mass-Lowet, 2010). In other words, in assess- ing children’s growing resilience, efficacy studies could explore children’s capacity to learn to cope with a wide range of risks and opportunities in a  wide range of activities across school, home, and community    settings.


ADVERSITY FACTORS

The Daniel and colleagues (2010) adapted resiliency practice framework not only includes the interactive factors of resiliency, vulnerability, and risk but also adversity and protective factors. Examples of adversity in childhood     are wide ranging: witnessing or experiencing domestic violence, physical abuse and assault, rape, sudden unexpected loss or violent loss, parental mental illness, poverty, emotional abuse, substance misuse, parental  crimi- nal behavior, parental separation and divorce, multiple care placements, and CSA (Edwards et al., 2005). Adversity can include single events or cumula- tive traumatic experiences of the same and/or multiple types. The impact of adversity on children can be both acute and chronic, at multiple levels, and impact in both the short and long term. Neurobiological, social (e.g., attach- ments), emotional (e.g., self-regulation), cognitive (e.g., negative cognitions and beliefs), and health aspects (e.g., somatization) of child development     can all be affected (Van der Kolk,  2005).
Given the range of adversities children experience, it is remarkable that none of the program efficacy studies within the systematic review (Barron     & Topping, 2010b) conducted any assessment of the adversities in children’s lives. At best, a range of adversities were identified from children’s disclo- sures during the studies; however, analysis of these disclosures suggests children experience a narrow range of harm. Studies by MacIntyre and Carr (1999b) and Barron and Topping (2010a) would be exceptions to this, where  a broader range of harm was identified. As the wider literature into sexually abused children indicates, these children are typically abused in myriad other ways. It is suggested that the assessment of childhood adversity would be       a useful addition to program efficacy evaluation. Used as a pre-program assessment, such an approach may give some measure of the adversity chil- dren bring to programs which, in turn, may give a context to assess the differential impact of programs on cumulative harms. Such assessments  have

86 I. G. Barron et al.

their challenges, including children’s reluctance to disclose adversities prior to programs or the need to ensure children are properly supported during     and  following  questionnaire completion.

PROTECTIVE FACTORS

At a level of surface validity, protective factors appear to be closely related to adversity. The relationship, however, between protective factors and adversity, risk, resilience, and vulnerability is less than clear. Although, his- torically, the concepts of risk and protective factors have been understood as polar constructs, the evidence is yet to be found to link these as ends of the same continuum. As an alternative, Fraser and Terzian (2005) conceptualize protective factors as a buffer to risk and adversity exposure. Nurturing attach- ments and familial and/or community support, for example, are understood as minimizing, halting, or part of avoiding risk and adversity in a child’s life. The practice framework of Daniel and colleagues (2010) conceptual- izes protective factors in a broader sense. They consider that any of the aspects of resiliency, vulnerability,  adversity,  and protective environments by themselves or in interaction could lead to increased protective factors. For example, reducing a child’s vulnerability through increased personal safety knowledge and skills, removing a child from familial adversity into a care placement, reducing access to drugs, or increasing parenting capac- ity could all be considered as contributing to protective  factors. As such, they recommend a thorough assessment of each of these factors in inter- action over time. Specifically, in relation to efficacy studies, the aim would be to assess the effectiveness of programs to grow protective factors that appear to reduce  the  likelihood  of  CSA  and  other  harms (Fraser, Kirby, & Smokowski, 2004). Examples specific to risk/adversity/vulnerability and resilience/protective factors associated with CSA are summarized in Figure 1. The examples identified in Figure 1 indicate that an evaluation of the effectiveness of CSA program efficacy needs to sit within a wider context of life adversity and protective factors. The discovery that children who receive CSA prevention programs disclose a diversity of other harms and losses, some related to other forms of abuse (e.g., physical assault), others not (e.g., loss of a pet), seems to affirm this assertion (Barron & Topping 2010a). This suggests CSA program efficacy studies need to assess not only the disclo- sure of CSA but also other harms. To date, such recording and reporting of
disclosures is vague and inconsistent across studies.

Assessment of Parental Protective Factors
In contrast to the importance given to the parent–child dynamic in resiliency theory  (Basic  Behavioural  Science  Task  Force,  1996),  program   efficacy

School-Based Child Sexual Abuse Prevention Program 87
Resilience Temperament and self-esteem Secure attachment experience
Sociability and peers Problem-solving capacity (Daniel et al., 2010)

Adversity and risk
Poverty and homelessness

Protective factors
Parenting capacity

Parental substance misuse Supportive teacher(s) Separation biological parents Achievement oriented curriculum
Abuse and neglect Accessible community resources
(Laaksonen et al., 2011) (Green, 2011)


Vulnerability Family scapegoat Disability
Ethnicity and racism Poor attachment experience Lack of community supports
(Daniel et al., 2010)

FIGURE 1   Resiliency factor  examples.


studies have yet to explore the impact of programs on increasing the pro- tectiveness or adversity of parent–child attachments (see Figure 1). A small number of studies have sought parental views on programs and have found parents to be positive, reporting increases in parent–child communication on a range of sensitive topics (MacIntyre & Carr, 1999a). Related research on effective parenting, parent–child attachment, and abuse provides a range of frameworks that could be adapted and contextualized for program eval- uation (Daniel et al., 2010). Such an evaluative focus, however, implies active parental involvement in program delivery, including the recognition of how parents are part of creating physically and emotionally safe homes and community environments. Resiliency theory applied to efficacy studies

88 I. G. Barron et al.

then not only shifts the nature of evaluation but also brings the potential to develop the focus of program delivery itself (e.g., parent training components within CSA prevention programs on how to communicate with children in empowering ways).

Assessment of School Protective Factors
The context of schooling is another environmental factor identified in Figure 1, with the potential to increase protective factors in children’s lives or alternatively exacerbate adversity, risk, and vulnerability. According to resiliency theory, teachers are significant adults in children’s lives and offer relationships that are potentially protective or adverse in nature. The former could include empathic teaching and an attuned curriculum, whereas the lat- ter could be bullying by a teacher or a coercive teaching style. A recent study (Barron & Topping, 2010a) identified that teacher factors are related to CSA prevention program effectiveness. The study indicated presenters who hold a high level of child abuse knowledge utilize child-centered communication and demonstrate an emotional capacity to cope and respond to children’s disclosures, facilitating higher numbers of disclosures. In contrast, teachers who were more direct in communication and more concerned about behav- ior management received significantly fewer disclosures. While disclosures are sometimes reported in efficacy studies, the recording and analyzing of adult responses to disclosures, including the nature of communication, the accessing of support services, and the identification or the creation of a safe environment, is rare. A resiliency perspective, in contrast, conceptualizes these as core not peripheral issues.
Resiliency also views teacher factors as just one classroom-based aspect      of the wider school context that contributes to protective environments for children. In addition to teachers, the school environment  includes  a  com-  plexity of many other interactive factors  that  can  aid  a  child’s  resiliency  and be assessed within efficacy  studies.  Examples  of  these  factors  include:  the physical layout of classrooms and the school, appropriateness of the curriculum, the quality of peer relationships, the nature of pedagogy, home– school relationships, staff–pupil relationships, mentoring and other support services for students, school organization and management,  and  the  com-  munity in which the school operates (Jindal-Snape &  Miller,  2008).  All  of these factors potentially foster or undermine children’s resiliency and could     be assessed within efficacy studies. The following is a list of possible mea-    sures that could be utilized in program efficacy studies to assess the wider   school   environment:

● Evaluating evidence of a worth-enhancing ethos (reflected in empathetic relationships and activities designed to help children feel valued as indi- viduals) may provide information about how children’s sense of intrinsic worth is nurtured.

School-Based Child Sexual Abuse Prevention Program 89

● Specific examples of strategies and techniques that could be the focus  of assessment include: the application of behavior management policies based on humanistic (as opposed to behaviorist) principles, the encour- agement of pupil verbal contribution through techniques such as circle time and pupil councils, the use of peer-learning approaches that encour- age social relationships and enhance self-worth, and teachers planning for social and personal learning aims alongside academic targets. (For further examples, see Miller & Moran, 2012.)
● Mapping the extent and quality of school friendship groupings and   net-
works may yield helpful information on what supports exist or need to be developed for children beginning to disclose. Social network analy- sis (Wasserman & Faust, 1994) can be employed to gather such data, but information on friendship patterns can also be collected via simple socio- metric analyses (e.g., Remer & Finger, 1995). Information gained could be supplemented by accounts from teachers and others working with the children in school.
● Surveying student perceptions of bullying and peer conflict may help iden-
tify aspects of adversity within the school setting, which needs to be addressed systemically, especially for children made vulnerable by CSA who may be at risk of revictimization. Surveys of this kind are likely to have increased validity in schools where pupil autonomy and voice are encouraged and with teachers who are attuned to the needs of children.    An element of triangulation would also be valuable in such contexts.
● Evaluating the extent to which achievement and success are    celebrated
across a wide range of activities (as opposed to only the traditional “schol- arly” subjects) provides an indication of how individuals are helped to develop belief in their own   competence.
● Assessing student academic achievement may be an indicator of need or
growing self-confidence and competence; this is most valuable if eval- uation is conducted on an ipsative (self-referenced) basis. The value of ipsative assessment is that it adopts a developmental perspective on indi- vidual learning rather than measuring attainment against grade-related criteria or normative data. It can be seen that this is consistent with a resiliency perspective focusing on positive adaptation over   time.
● Monitoring of involvement in extracurricular activities and voluntary   work
may assess the development of necessary life skills.
● Evaluation of the quality of staff–student relationships may identify whether an abuse of power dynamic exists or if communication is empowering for children.

Assessment of Community Protective Factors
Schools, of course, do not operate in isolation but influence, and are influenced by, the communities, culture, and society in which they exist

90 I. G. Barron et al.

(Green, 2011). While some efficacy studies have identified demographic influences as moderating factors, typically age, gender, and socioeconomic status, resiliency places greater emphasis on a range of community protec- tive and adversity factors that have an impact on children. For example, program efficacy assessment of community protective factors could include accessible community services and resources for children as well as a  measure of community and familial support. Alternatively, evaluation of the growth in community safety could involve the  mapping  of  sex offenders  and any reduced criminal activity in the area. Comparative program and cross-community studies are rare in the program efficacy literature, although such studies potentially provide a means to disentangle the  differential  impact of programs on different schools in different communities (Barron     & Topping, 2010b). Furthermore, the evaluation of programs on a cross- cultural basis, an even rarer occurrence, could provide useful information about cultural specificity or sensitivity of programs as well as the potential  for generalization of findings.


LIMITATIONS

The current study is exploratory in nature and invites researchers to further explore and expand resiliency theory and practice in program evaluation. There are, however, a range of pitfalls in seeking to apply a resiliency framework. The definitions of the core concepts of resilience, risk, vul- nerability, adversity, and protective factors are all complex and contested. Any researcher would need to clearly define what they mean by these. Furthermore, within each of these factors, it is uncertain how researchers would decide what are the most important behaviors, attributes, contexts, and so forth, to assess.
While this study has exemplified one practice framework with its particular focuses, different frameworks may place greater emphasis on different factors leading to potentially different measures or types of mea- sures. Moreover, utilizing Daniel and colleagues (2010) as a framework in itself has its limitations. There can be a confusion of language and lack of clarity because of the interrelated nature of the four core factors. For exam- ple, the concepts of adversity and vulnerability both contain intrinsic and extrinsic factors. This can lead to confusion in which aspect of resiliency is being assessed. Daniel’s framework can also be criticized for being overly compartmentalized. While this may simplify complexity, it may mean the framework fails to fully represent the interactional nature of concepts under examination.
Operationalizing the assessment of many resiliency concepts will be a major challenge for researchers in terms of identifying what is important to assess, how to conduct the assessment (type of measures, etc.), how

School-Based Child Sexual Abuse Prevention Program 91

participants will respond to what are potentially intrusive assessments, and  the reliance on participant judgment with regard to self-reports and informa- tion on environments. For example, how will families respond to attachment patterns being assessed as part of program evaluation? How will schools respond to teacher–student relationships being assessed for coercive com- munication? Given that most sex offenders are unknown to authorities, how can the adversity of the prevalence of pedophiles be assessed? Likewise,        if children don’t disclose the harms in their lives, how can an accurate picture of situational adversity be achieved? Within this, assessment will   need to be stratified for a range of child and demographic factors in rela-    tion to resiliency (e.g., age, gender, ethnicity, and socioeconomic status). Assessment of adaptability to future adversity will also be challenging in relation to how adaptability is defined, what constitutes future adversity, and when can such assessments take place over    time.
Although this paper is arguing for embedding the theory of resiliency into CSA prevention program evaluation, what outcome factors to focus on, what to measure, and how to do this is a significant challenge. Although resiliency practice frameworks are available, there is currently little evidence to guide decision making in transferring these to CSA prevention program evaluation. Importantly, the power differential inherent in familial CSA needs to be considered in avoiding a naive application of resiliency theory to pro- gram evaluation. Resiliency is but one theoretical perspective to analyze CSA prevention program efficacy; indeed there is an argument for multiple lenses to be adopted in seeking to understand, intervene, and evaluate such com- plex problems. Furthermore, evaluation of resiliency is, by its nature, over time and therefore of limited value as a framework to guide short-term mea- sured outcomes. Against this, we have to set the increase in knowledge and understanding that will accrue over time to inform the development of good practice. While this article has focused on CSA prevention program efficacy, it is suggested that resiliency theory can be applied to efficacy stud- ies that focus on the prevention of a wider range of harms. Finally, there is a need to explore how resiliency theory not only influences program efficacy evaluation but also program development.

CONCLUSION AND RECOMMENDATIONS

Resiliency implies not only that children are able to cope better in present circumstances but also that they develop the capacity to cope and adapt,    even thrive, when faced with future adversities. This necessitates both a  short- and long-term view of program effectiveness, challenging the immedi- ate narrow outcomes of recent program efficacy studies. In order to capture the essence of resiliency (how children adapt to future adversities over time), a longitudinal view is required of children’s capacity to cope with the risks and  experiences associated  with  child sexual  abuse  and other harms.

92 I. G. Barron et al.

A resiliency perspective points toward significant paradigm-related developments for program efficacy studies. These include an increase in the identification and utilization of intrinsic and, particularly, extrinsic social con- text factors. There is also a need to learn more about the differential impacts of the interaction of these factors. Such developments will be enhanced  by a growth in the diversity of research methodologies, as found in the wider resiliency and school effectiveness literature. In this context, although standardized measures are available, much resiliency-based evaluation relies on contextualized assessment methods, such as observation in naturalistic settings, video analysis of interactions, and the qualitative assessment of subjective experience of participants. Although complex and multifaceted, such evaluation provides important information about the nested contextual factors that influence program outcomes and promises a vehicle for wider systemic home, school, and community change.
In summary,  the  recommendation  is  that  program  researchers  adopt  a resiliency perspective to CSA prevention efficacy evaluation. Such an approach will necessitate: (a) assessing a long-term perspective on children’s capacity to cope in the future; (b) consideration of intrinsic and extrinsic resiliency, vulnerability, risk, adversity, and protective factors in evaluat-    ing programs; and (c) the utilization of both standardized and contextual resiliency-informed  evaluative measures.


REFERENCES

Barron,  I.  G.,  &  Topping,  K.  J.  (2010a).  School-based  abuse  prevention:  Effect   on disclosures. Journal of Family Violence, 25(7), 651–659. doi:10.1007/ s10896-010-9324-6
Barron, I. G., & Topping, K. J. (2010b). School-based child sexual abuse prevention programs: Implications for practitioners. American Professional Society on the Abuse of Children, 22(2), 11–19. Retrieved from http://www.apsac.org/
Basic Behavioural Science Task Force. (1996). Basic behavioral science research for mental health: Vulnerability and resilience. American Psychologist, 51(1), 22–28. Retrieved    from   http://www.apa.org/pubs/journals/amp/index.aspx
Belsky, J. (1980). Child maltreatment: An ecological integration.  American  Psychologist, 35(4), 320–335.
Casper, R. (1999). Characteristics of children who experience positive or negative reactions to a sexual abuse prevention program. Journal of Child Sexual Abuse,      7 (4), 97–112. doi:10.1300/J070v07n04_07
Coulton, C. J., Crampton, D. S., Irwin, M., Spilsbury, J. C., & Korbin, J. E. (2007). How neighborhoods influence child maltreatment. A review of the literature    and alternative pathways. Child Abuse and Neglect, 31(11–12), 1117–1142.
Daniel,  B.,  &  Wassell,   S.   (2005).  Resilience:   A   framework   for   positive    practice.
Edinburgh, UK: Scottish Executive Social Research.
Daniel, B., Wassell, S., & Gilligan, R.  (2010).  Child  development  for  child  care  workers.  London,  UK:  Jessica Kingsley.

School-Based Child Sexual Abuse Prevention Program 93

Donnon, T., & Hammond, W. (2007). A psychometric assessment  of  the self-reported youth resiliency: Assessing developmental strengths questionnaire. Psychological  Reports,  100,  963–978. doi:10.2466/pr0.100.3.963-978
Edwards,  V.  J.,  Anda,  R.  F.,  Dube,  S.  R.,  Dong,  M.,  Chapman,  D.  P.,  &     Felitti,
V. J. (2005). The wide-ranging health outcomes of adverse childhood experi- ences. In K. A. Kendall-Tackett & S. M. Giacomoni (Eds.), Child victimization: Maltreatment, bullying and dating violence prevention and intervention (pp. 8-1–8-12). Kingston, NJ: Civic Research Institute.
Finkelhor, D., & Dzuiba-Leatherman, J. (1995). Victimization prevention programs: A national survey of children’s exposure and reactions. Child Abuse and Neglect, 19, 129–139. doi. org/10.1016/0145-2134(94)00111-7
Fraser, M., Kirby, L., & Smokowski, P. (2004). Risk and resilience in childhood. In M.
W. Fraser (Ed.), Risk and resilience in childhood: An ecological perspective (pp. 13–66). Washington, DC: NASW Press.
Fraser, M. W., & Terzian, M. (2005). Risk and resilience in child development: Practice principles and strategies. In G. P. Mallon & P. McCartt Hess (Eds.), Handbook  of children, youth, and family services: Practice, policies, and programs (pp. 55–71). New York, NY: Columbia University Press.
Gartland, D., Bond, L., Olsson, C., Buzwell, S., & Sawyer, S. (2011). Development  of a multi-dimensional measure of resilience in adolescents: The Adolescence Resilience Questionnaire. BMC Medical Research Methodology, 11, 134. Retrieved   from   http://www.biomedcentral.com/bmcmedresmethodol
Gilligan, R. (1997). Beyond permanence? The importance of resilience in child placement  practice  and  planning.  Adoption  and  Fostering,  21(1),  12–20.
doi.org/10.1177/030857599702100104
Gitterman, A. (2001a). Social work practice with vulnerable and resilient populations. In A. Gitterman (Ed.), Handbook of social work practice with vulnerable and resilient populations (2nd ed., pp. 1–38). New York, NY: Columbia University Press.
Gitterman,  A.  (2001b).  Vulnerability,  resilience  and  social  work  with  groups. In
T. Kelly, T. Berman-Rossi, & S. Palombo (Eds), Groupwork: Strategies for strengthening resiliency  (pp. 19–34). Binghamton, NY: The Haworth  Press.
Gitterman, A., & Sideriadis, L. A. (2014). Social work practice with vulnerable and resilient populations. In A. Gitterman (Ed.), Handbook of social work practice with vulnerable and resilient populations (3rd ed., pp. 1–32). New York, NY: Columbia University Press.
Green, L. (2011). Understanding the lifecourse: Sociological and psychological perspectives. Cambridge, UK: Polity Press.
Grotberg, E. (1997). The international resilience project: Findings from the    research
and the effectiveness of interventions. In B. Bain et al. (Eds.), Psychology and education in the 21st century: Proceedings of the 54th annual convention of the International Council of Psychologists (pp. 118–128). Edmonton, Canada: ICP Press.
Herbert, M., Lavoie, F., Piche, C., & Poitras, M. (2001). Proximate effects of a child sexual abuse prevention program in  elementary  school  children.  Child  Abuse  and Neglect, 25, 505–522. doi:10.1016/S0145-2134(01)00223-X

94 I. G. Barron et al.

Hothersall, S., & Mass-Lowet, M. (2010). Need, risk and protection in social work practice. Exeter, UK: Learning Matters.
Jacobs, J., & Hashima, P. (1995). Children’s perceptions of child sexual abuse. Child Abuse and Neglect, 19(12), 1443–1456. doi:10.1016/0145-2134(95)00092-5
Jenson, J., & Fraser, M. (2006). Social policy for children and families: A risk and resilience perspective. Thousand Oaks, CA: Sage.
Jindal-Snape, D., & Miller, D. (2008). A challenge of living? Understanding the psycho-social  processes  of  the  child  during  primary-secondary  transition  through resilience and self-esteem theories. Educational Psychology Review, 20, 217–236.  doi:10.1007/s10648-008-9074-7
Kelly, T., Berman-Rossi, T., & Palombo, S. (Eds.). (2001). Groupwork: Strategies for strengthening resiliency. Binghamton, NY: The Haworth   Press.
Laaksonen, T.,  Sariola, H., Johansson, A., Jern, P.,  Varjonen, M., von der Pahlen,   B., . . . Santtila,  P.  (2011).  Changes  in  the  prevalence  of  child  sexual  abuse,  its  risk  factors,  and  their  associations  as  a  function  of  age  cohort  in a Finnish population sample. Child Abuse and Neglect, 35(7), 480–490. doi:10.1016/j.chiabu.2011.03.004
LeBuffe,   P.,    &   Naglieri,   J.   (1998).   The   Devereux   early   childhood    assessment.
Lewisville, NC: Kaplan  Press.
Luthar, S. S. (2003). Resilience and adversity: Adaptation in the context of childhood adversities (pp. 293–317). New York, NY: Cambridge University  Press.
Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71, 543–562. doi:10.1111/1467-8624.00164
MacIntyre, D., & Carr, A. (1999a). Evaluation  of  the  effectiveness  of  the  Stay Safe primary prevention program for child sexual abuse. Child Abuse &  Neglect, 23(12),1307–1325. Retrieved from http://www.journals.elsevier.com/ child-abuse-and-neglect/
MacIntyre, D., & Carr, A. (1999b). Helping children to the other side of silence: A study of the impact of the Stay Safe Programme on Irish children’s disclosures of sexual victimisation. Child Abuse & Neglect, 23(12), 1327–1340. Retrieved from http://www.journals.elsevier.com/child-abuse-and-neglect/
Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2, 425–444. doi:10.1017/S0954579400005812
Miller, D. J., & Moran, T.  R. (2012). Self-esteem: A guide for teachers. London, UK:   Sage.
Moskovitz, S. (1983). Love despite hate. New York, NY: Schocken   Books.
Pelcovitz, D., Adler, N. A., Kaplan, S., Packman, L.,  &  Kreiger,  R.  (1992).  The  failure of  a  school-based  child  sexual  abuse  prevention  program.  Journal  of  the American Academy of Child and Adolescent Psychiatry, 31(5), 887–892. doi:10.1097/00004583-199209000-00017
Pohl, J. D., & Hazzard, A. (1990). Reactions of children, parents and teachers to child sexual abuse prevention programs. Education, 110(3), 337–344. Retrieved from http://www.educationpublishing.com/ej.shtml

School-Based Child Sexual Abuse Prevention Program 95

Prince-Embury, S. (2006). Resiliency scales for children and adolescents: Profiles     of personal strengths. San Antonio, TX: Harcourt Assessments. Retrieved from http://www.resilienceproject.org
Remer, R., & Finger, V. S. (1995). A comparison of the effects of sociometry compo- nents on personal and interpersonal growth. Journal of Group Psychotherapy, Psychodrama, and Sociometry, 48, 114–117.
Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57 , 316–331. Retrieved from http://onlinelibrary. wiley.com/journal/10.1111/(ISSN)1939-0025
Stewart-Brown, S., & Edmunds, L. (2007). Assessing emotional intelligence in chil- dren: A review of existing measures of emotional and social competence. In
R. Bar-On, J. Maree, & M. Elias (Eds.), Educating people to be emotionally intelligent (pp. 241–257). Westport, CT: Praeger.
Taal,  M.,  &  Edelaar,  M.  (1997).  Positive  and  negative  effects  of  a  child  sex-    ual abuse prevention programme. Child Abuse and Neglect, 21, 399–410. doi:10.1016/S0145-2134(96)00179-2
Telljohann, S. K.,  Everett,  S.  A.,  &  Price,  J.  H.  (1997).  Evaluation  of  a  third  grade sexual abuse curriculum. Journal of School Child Health, 67 (4), 149–153. doi:10.1111/j.1746-1561.1997.tb03436.x
Tutty, L. M. (2000). What children learn from sexual abuse prevention programs: Difficult concepts and developmental issues. Research on Social Work Practice, 10(3), 275–300. Retrieved from http://rsw.sagepub.com/
Ungar, M. (2005). Introduction: Resilience across cultures and contexts. In M. Ungar (Ed.), Handbook for working with children and youth: Pathways to resilience across cultures and contexts (pp. 15–39). Thousand Oaks, CA:  Sage.
Ungar, M., & Liebenberg, L. (2009). Cross-cultural consultation leading to the development of a valid measure of  youth  resilience:  The  international  resilience project. Studia Psychologica, 51(2–3), 259–269. Retrieved from http:// psychologia.sav.sk/sp/
Van der  Kolk,  D.  (2005).  Developmental  trauma   disorder.   Psychiatric   Annals, 35(5), 401–408. Retrieved from http://www.traumacenter.org/products/ Developmental_Trauma_Disorder.pdf
Videka, L., Gopalan, G., & Bauta, B. H. (2014). Child abuse and neglect. In A. Gitterman (Ed.), Handbook of social work practice with vulnerable and resilient populations (pp. 248–268). New York, NY: Columbia University Press.
Wasserman, S., & Faust, K. (1994). Social network analysis. Cambridge, UK: Cambridge  University  Press.
Werner, E. E. (1990). Protective factors and individual resilience. In S. J. Meisels &
J. P. Shonkoff (Eds.), Handbook of early childhood intervention (pp. 97–116). New  York,  NY:  Cambridge University.
Wolfe, D., Crooks, C., Chiodo,  D.,  &  Jaffe,  P.  (2009).  Child  maltreatment,  bul-  lying, gender-based harassment and adolescent dating violence: Making the connections. Psychology of Women Quarterly, 33(1), 21–24. doi:10.1111/ j.1471-6402.2008.01469.x
Wurtele, S. K. (2009). Preventing sexual abuse of children in  the  21st  century:  Preparing for challenges and opportunities. Journal of Child Sexual Abuse, 18, 1–18.  doi:10.1080/10538710802584650

96 I. G. Barron et al.

Wyman, P. A. (2003). Emerging perspectives on context specificity of children’s adap- tation and resilience: Evidence from a decade of research with urban children in adversity. In S. S Luther (Ed.), Resilience and adversity: Adaptation in the con- text of childhood adversities (pp. 293–317). New York, NY: Cambridge University Press.
Zide, M., & Kelly, T. B. (2000). Guidelines for humour in social work education. Arête, 24(2), 30–38. Retrieved from http://discovery.dundee.ac.uk/portal/en/ research/guidelines-for-humor-in-social-work-education(9509b1fa-bb0d-49ff- a83f-aa8014a76711)/export.html


AUTHOR NOTES

Ian G. Barron, PhD, is a reader in the School of Education, Social Work and Community Education at the University of Dundee. His current research interests focus on school-based prevention programs of child sexual abuse and the evaluation of trauma recovery programs.
David J. Miller, DEdPsy, is emeritus professor in the School of Education, Social Work and Community Education at the University of Dundee. His research interests include the social and personal aspects of education, with    a particular focus on self-esteem and   resilience.
Timothy B. Kelly, PhD, is a professor of social work and dean of the School of Education, Social Work and Community Education at the University of Dundee. His current research interests focus on the care of older people in health and social care settings, supporting careers and group work practice.