Uncertain Legacies: Resilience and Institutional Child Abuse - A Literature Review

Appendix 2: Details of Papers Used in this Review

1

Author: Bender D, Bliesener T and Lösel F

Title and Source: 'Deviance or resilience? A longitudinal study of adolescents in residential care', in Davies G, Lloyd-Bostock S, McMurran M, and Wilson C (eds) (1996), Psychology, law, and criminal justice: International developments in research and practice, Walter de Gruyter: New York, 410-423

Primary Research: Yes

Methods: Semi structured interviews, questionnaires, tests; longitudinal, two wave study

Participants: First wave: 144 teenagers in German residential institutions and education workers; second wave: 114 of the original participants.

Key Findings: The paper found that resilient adolescents saw themselves as less helpless, had a more positive self-image, and were proactive in problem solving. They were accepting of their residential situation, saw it in a positive light, and were satisfied with their school environments and achievements there. They were flexible and had a significant person outside of their family.

2

Author: Bogar C B and Hulse-Killacky D

Title and Source: Resiliency Determinants and Resiliency Processes Among Female Adult Survivors of Childhood Sexual Abuse, Journal of Counseling and Development, 84, (2006), 318-327

Primary Research: Yes

Methods: Semi structured interviews

Participants: 10 American women

Key Findings: The study identified five determinant clusters (interpersonally skilled; competent; high self-regard; spiritual; and helpful life circumstances) and four process clusters (coping strategies, refocusing and moving on, active healing and achieving closure) which facilitated resilience in participants' lives.

3

Author: Collishaw S, Pickles A, Messer J, Rutter M, Shearer C and Maughan B

Title and Source: Resilience to adult psychopathology following childhood maltreatment: Evidence from a community sample, Child Abuse & Neglect, 31, 3, (2007), 211-229

Primary Research: No

Methods: Secondary analysis of data from previous two stage, longitudinal study

Participants: General population sample in the Isle of Wight, England. First wave: 571 adolescents and their parents; second wave, 378 original participants.

Key Findings: Ten percent of participants had experienced childhood abuse, and there was a higher rate of adolescent psychiatric disorders as well as higher rates of adult mental health disorders. A "substantial minority", however, reported no mental health problems in adulthood. This was found to be related to perceptions of parental care, adolescent peer relationships, the quality of love relationships in adulthood, and aspects of personality.

4

Author: Colton M, Vanstone M and Walby C

Title and Source: Victimization, Care and Justice: Reflections on the Experiences of Victims/Survivors Involved in Large-Scale Historical Investigations of Child Sexual Abuse in Residential Institutions, The British Journal of Social Work, 32, 5, (2002) 541-551

Primary Research: Yes

Methods: Interviews

Participants: 24 survivors (22 male/2 female) in the UK

Key Findings: Paper explores the impact of participating in formal investigations of residential childcare abuse and explores participants' motivations for doing so, concluding that financial gain was not a motivating factor. Reactions to participation in formal investigations were varied among those who took part in this study, leading to conclusions that revisiting memories in these circumstance had unpredictable impacts on individuals, and that this calls for sensitivity and support when conducting public investigations.

5

Author: Daniel B, Wassell S and Gilligan R

Title and Source: 'It's just common sense, isn't it?' Exploring ways of putting the theory of resilience into practice, Adoption and Fostering, 23, 3, (1999), 6-15

Primary Research: Yes

Methods: Five half-day participative workshops

Participants: Eleven social workers in the UK

Key Findings: The study found that a framework of professional practice which recognised and incorporated resilience-enhancing practice - much of which was already in evidence - contributed to better outcomes for children in care. However adequate resources, including time, needed to be allocated to enhance resilience practice among social workers.

6

Author: Daniel B

Title and Source: Operationalizing the concept of resilience in child neglect: case study research, Child: Care, Health and Development, 32, 3, (2006), 303-309

Primary Research: Yes

Methods: Questionnaires and semi structured interviews

Participants: Eight children between the ages of 5 and 11 living in Scotland, and the social workers involved in their care

Key Findings: This exploratory project, drawing on case studies, found that the concept of resilience can be effectively applied in the field of social work, in relation to neglected children.

7

Author: Daniel B

Title and Source: The Concept of Resilience, Messages for Residential Child Care, in Kendrick A (ed) (2008), Residential Child Care, Prospects and Challenges, Jessica Kingsley : London

Primary Research: No

Methods: Conceptual discussion paper

Participants:

Key Findings: This book chapter offers a critical overview of the concept of resilience, relating it to a framework for social work practice.

8

Author: Daniel B

Title and Source: Concepts of Adversity, Risk, Vulnerability and Resilience: A Discussion in the Context of the 'Child Protection System', Social Policy and Society, 9, 2, (2010), 231-241

Primary Research: No

Methods: Conceptual discussion paper

Participants:

Key Findings: This paper discusses the concepts of adversity, risk, vulnerability and resilience in relation to systems of child protection, and explores how the concepts of 'risk' and 'harm' are understood at different points in the lifespan, and across different groups. The paper discusses how different conceptualisations of these issues affect contemporary child protection systems in the UK.

9

Author: Davidson G, Devaney J, and Spratt T

Title and Source: The Impact of Adversity in Childhood on Outcomes in Adulthood, Journal of Social Work, 10, 4, (2010), 369-390

Primary Research: No

Methods: Review of existing studies

Participants:

Key Findings: A review of the research which examines the impact of childhood adversity on longer term adult outcomes and suggests that existing research is limited by a focus on specific forms of adversity - mainly abuse and neglect - and either specific populations and general outcomes; or general populations and specific outcomes. The paper argues that it is important for social work researchers to become involved in debates relating to the prevention of childhood adversity, and identifies a gap in the literature, namely interdisciplinary large-scale general population studies.

10

Author: Dearden J

Title and Source: Resilience: a study of risk and protective factors from the perspective of young people with experience of local authority care, Support for Learning, 19, 4, (2004), 187-193

Primary Research: Yes

Methods: Interviews

Participants: Fifteen 13-19 year olds in the UK

Key Findings: The study asked young people who had been in local authority care to identify factors which were most and least helpful to them in learning to adapt positively to stressful situations. Helpful factors included the presence of adults who listened to and believed in them, and who took their views seriously; a sense of hopefulness about the future; and access to resources. The paper concludes the study raised questions of how local authorities might routinely consult with young people in their care.

11

Author: Flanagan-Howard R, Carr A, Shevlin M, Dooley B, Fitzpatrick M, Flanagan E, Tierney K, White M, Daly M and Egan J

Title and Source: Development and initial validation of the institutional child abuse processes and coping inventory among a sample of Irish adult survivors of institutional abuse, Child Abuse & Neglect, 33, 9, (2009), 586-597

Primary Research: Yes

Methods: Interviews using standard assessment protocols

Participants: 247 Irish survivors of childhood abuse in institutions

Key Findings: This study sought to develop and evaluate a psychometric instrument to assess psychological processes relating to institutional abuse and individual coping strategies used to deal with it, the Institutional Child Abuse Processes and Coping Inventory. This was found to be effective and relevant, as the only scale developed to be applied in this population group.

12

Author: Gallagher B

Title and Source: The Extent and Nature of Known Cases of Institutional Child Sexual Abuse, British Journal of Social Work, 30, (2000), 795-817

Primary Research: No

Methods: Analysis of child protection referrals

Participants: 20,000 files searched across eight areas and regions of England and Wales between 1988 and 1992

Key Findings: The study reviewed ICA case referrals to social services departments or the police in eight local authority areas and noted that while cases were fairly rare, where they did occur they involved large numbers of victims and abusers. Similarities with familial abuse cases were observed, but so too were significant differences, and it was also found that abuse took place in a much broader range of institutions than reflected in media coverage of the issue.

13

Author: Gilligan R

Title and Source: Promoting resilience in young people in long-term care - the relevance of roles and relationships in the domains of recreation and work, Journal of Social Work Practice, 22, 1, (2008), 37-50

Primary Research: No

Methods: Practice discussion paper

Participants:

Key Findings: This paper explored how roles and relationships in the domains of recreation and work could enhance the resilience of vulnerable young people, particularly those in long term care. It highlighted practice implications for carers and professionals working with young adults in care which might enable them to more effectively benefit from participation in employment and recreational activities.

14

Author: Hall J M

Title and Source: Positive Self-Transitions in Women Child Abuse Survivors, Issues in Mental Health Nursing, 24, 6-7, (2003), 647-666

Primary Research: No

Methods: Secondary analysis of open-ended interviews

Participants: 55 American women

Key Findings: This paper assessed the positive life transitions of women who had experienced abuse as children. Findings identified two processes, epiphanies and maintaining momentum, and six elements relating to self-change - self-centring, ownership, interpersonal insulation, wilfulness, seeing options and spiritual connection - which were significant in participants' recoveries.

15

Author: Hauser S T

Title and Source: Understanding resilient outcomes: Adolescent Lives Across Time and Generations, Journal of Research on Adolescence, 9, 1, (1999) pp1-24

Primary Research: No

Methods: Secondary analysis of interviews conducted over 20 year period

Participants: 146 American adolescents and their families in the initial sample, 80% retained and revisited

Key Findings: Adopting a longitudinal approach, this study sets out to examine the process by which resilience is played out in the lives of young people who have encountered adversity. It explores connections between contexts, subsequent developmental trajectories and variable outcomes in adulthood, and identifies variables which influence these including reflectiveness, relationships and agency.

16

Author: Hauser S T and Allen J P

Title and Source: Overcoming Adversity in Adolescence: Narratives of Resilience, Psychoanalytic Inquiry, 26, 4, (2006), 549-576

Primary Research: No

Methods: As Hauser

Participants: As Hauser

Key Findings: Transcripts from interviews with resilient young adults were examined to indentify key themes which differentiated them from their less resilient peers. These included agency, quality of relationships and reflectiveness. This paper drew on the same study as paper 15.

17

Author: Heller S S, Larrieu J A, D'Imperio R and Boris N W

Title and Source: Research on Resilience to Child Maltreatment: Empirical Considerations, Child Abuse & Neglect, 23, 4, (1999), 321-338

Primary Research: No

Methods: Literature review

Participants:

Key Findings: A literature review focussing on existing research at that time relating to resilience and the maltreatment of children and adolescents, this paper identified factors associated with resilience and discussed them in a longitudinal context, before concluding that there is a need to move beyond factors towards process when considering resilience.

18

Author: Hobbs G F, Hobbs C J and Wynne J M

Title and Source: Abuse of Children in Foster and Residential Care, Child Abuse & Neglect, 23, 12,(1999), 1239-1252

Primary Research: No

Methods: Retrospective study of medical records

Participants: 158 children in England

Key Findings: The study focussed on the characteristics of physical and sexual abuse experienced by children in foster and residential care in Leeds, England. The authors concluded that children in these situations are at particular risk of abuse, and that their special circumstances require specific measures to protect them from abuse.

19

Author: Houston S

Title and Source: Building resilience in a children's home: results from an action research project, Child and family social work, 15, 3, (2010), 357-368

Primary Research: Yes

Methods: Participatory action research

Participants: Nine UK professionals

Key Findings: This study looked at how resilience could be developed among young people in a residential children's home, focussing on two core areas: practice which was felt to be effective; and constraints and limitations placed on social workers which limited their interventions. Participants were found to act creatively in order to make best use of resources and tools, impacting positively on young people's lives even within the constraints of their frameworks of practice.

20

Author: Jackson S and Martin P Y

Title and Source: Surviving the care system: education and resilience, Journal of adolescence, 21, 5, (1998), 569-583

Primary Research: Yes

Methods: Questionnaires and in-depth interviews

Participants: 256 adults who had spent more than five years in care in the UK sent questionnaires; subsample followed up with interviews

Key Findings: This study used educational achievement to identify resilient adults who had been in local authority care in their youth. A risk and resilience framework was used to establish which factors seemed protective, and which altered outcomes among the more resilient adults. The study concludes that adolescence is a time of particular risk but also of opportunities, and that educational success was critical in determining lifestyle outcomes in adulthood.

21

Author: Laursen E K and Birmingham S M

Title and Source: Caring Relationships as a Protective Factor for At-Risk Youth: An Ethnographic Study, Families in Society, 84, 2, (2003), 240-246

Primary Research: Yes

Methods: Open ended interviews

Participants: 23 young people in the USA

Key Findings: This study sought to investigate the importance of caring relationships with adults as a key factor in the development of resilience among young people, and found they did play a significant role, describing elements of trust, attention, empathy, availability, affirmation, respect and virtue which define them.

22

Author: Lev-Wiesel R

Title and Source: Beyond survival: Growing out of childhood sexual abuse , in Joseph S and Linley P A (eds), (2008), Trauma, recovery, and growth: Positive psychological perspectives on posttraumatic stress, Hoboken New Jersey: John Wiley and Sons Inc.

Primary Research: Yes

Methods: Two studies conducted in the USA:

1) qualitative interviews; 2) questionnaires

Participants: 1) 52 adult survivors of paternal abuse;

2) 246 female survivors of childhood sexual abuse; second questionnaire administered to 93 from this original sample

Key Findings: This study set out to explain why there are variations in adjusting in adulthood among different groups of adult survivors of child abuse. The paper argues of central importance is whether blame is internalised or externalised, and that the development of resilience depended not on denying the abuse or its impacts, but in accepting and incorporating these experiences into new self identities.

23

Author: Liepold B and Greve W

Title and Source: Resilience: A conceptual bridge between coping and development, European Psychologist, 14, 1, (2009), 40-50

Primary Research: No

Methods: Theoretical/conceptual discussion paper

Participants:

Key Findings: The authors argue that the ability to maintain stability in spite of adversity is the result of individual coping processes, which are influenced by both personal aspects and external circumstances, and make a link between coping and development.

24

Author: Lösel F and Bliesener T

Title and Source: Resilience in adolescence: A study on the generalizability of protective factors, in Hurrellman K and Losel F (eds), (1990), Health Hazards in Adolescence, pp 299-320, New York: De Gruyter

Primary Research: Yes

Methods: Semi structured interviews and tests

Participants: 244 adolescents in Germany

Key Findings: This paper draws on the same data as paper 1, examining specific factors which differentiate between those deemed 'resilient' or 'delinquent'. It found self regulation was key, and that access to social and personal resources, as well as personality traits, acted as protective factors.

25

Author: O'Leary P J

Title and Source: Men who were sexually abused in childhood: Coping strategies and comparisons in psychological functioning, Child Abuse & Neglect, Vol 33, 7, (2009), 471-479

Primary Research: Yes

Methods: Questionnaires

Participants: Primary purposive sample of 147 Australian men; secondary random sample of 1231 men

Key Findings: This study examined the coping strategies of men who were sexually abused in childhood to establish the relationship with clinical diagnoses in adulthood. It found that coping strategies which include internalisation, acceptance and disengagement are more likely to result in a clinical outcome, compared with those which focussed on external engagement and self development. The author concludes that coping strategies play an important role in the likelihood of clinical outcomes in adulthood.

26

Author: Perkins D F and Jones K R

Title and Source: Risk Behaviors and Resiliency within Physically Abused Adolescents, Child Abuse & Neglect, 28, 5, (2004), 547-563

Primary Research: Yes

Methods: Self report surveys

Participants: 16,313 American school children in seventh, ninth and eleventh grade

Key Findings: This study examined a variety of relationships between risk factors, thriving behaviours and protective factors. It found that the majority of participants were not engaged in risk behaviours - with the exception of sexual activity - but of those who were, a significant number had suffered physical abuse.

27

Author: Perry J C, Sigal J J, Boucher S, Pare N and Ouimet M C

Title and Source: Personal Strengths and Traumatic Experiences Among Institutionalized Children Given Up at Birth, The Journal of Nervous and Mental Disease, 193, 12, (2005), 777-78

Primary Research: Yes

Methods: Interviews

Participants: 81 (41 women/40 men) Canadian adults who had been placed in institutions as children

Key Findings: This study focussed on the strengths and adverse experiences of orphans who had been adopted on or shortly after birth who grew up in institutional care. The older adults reported high levels of adverse or trauma experienced in childhood, which was mediated to varying degrees by individual strengths and attachment relationships.

28

Author: Roman M W, Hall J M and Bolton K S

Title and Source: Nurturing natural resources: The ecology of interpersonal relationships in women who have thrived despite childhood maltreatment, Advances in Nursing Science, 31, 3, (2008), pp184-197

Primary Research: Yes

Methods: Three in depth interviews per participant over a nine month period

Participants: 44 American female survivors of childhood abuse

Key Findings: This study looked at the role of relationships in the lives of women who defined themselves as thriving despite experiencing maltreatment. It found that two distinct forms of relationship were particularly important in contributing to participants wellbeing and stability: 'Saw something in me' and 'No matter what' relationships.

29

Author: Rutter M

Title and Source: Children in substitute care: some conceptual considerations and research implications, Children and Youth Services Review, 22, 9/10, (2000), 685-703

Primary Research: No

Methods: Discussion paper

Participants:

Key Findings: Discussion of the risk and protective factors which affect children in substitute care, and outlines suggested key challenges which relate to children in a variety of institutional care settings.

30

Author: Simpson C L

Title and Source: Resilience in Women Sexually Abused as Children, Families in Society, 91, 3, (2010), 214-247

Primary Research: Yes

Methods: Web-based survey questionnaire

Participants: 134 American women

Key Findings: This study set out to identify the protective factors which most accurately predicted resilience in women who had been sexually abused as children. It found a combination of individual protective factors - such as high levels of self control and self belief - were most indicative of resilience.

31

Author: Smith-Osborne A

Title and Source: Life Span and Resiliency Theory: A Critical Review, Advances in Social Work, 8, 1, (2007), 152-168

Primary Research: No

Methods: Conceptual discussion paper

Participants:

Key Findings: The author examines the historical and conceptual development of lifespan theory and resilience theory in the context of social work practice and education in human behaviour within social environments. It concludes that resilience theory might be particularly effective in refining evidence based developmental theory in the field of social work.

32

Author: Thomas S P and Hall J M

Title and Source: Life Trajectories of Female Child Abuse Survivors Thriving in Adulthood, Qualitative Health research, 18, 2, (2008), 149-166

Primary Research: Yes: same study as Roman et al

Methods:

Participants:

Key Findings: This narrative study examined how thriving adult female survivors of childhood adversity had achieved success. Healing journeys varied from slow and consistent to chaotic and unpredictable. While many participants did suffer ill effects into adulthood - such as depression - they had achieved in the field of work and education, and were especially effective in parenting and working as mentors to young women who had also been subject to abuse.

33

Author: Ungar M

Title and Source: The social construction of resilience among 'problem' youth in out-of-home placement: a study of health-enhancing deviance, Child & Youth Care Forum, 30, 3, (2001), 137-154

Primary Research: No

Methods: Secondary analysis of original study: double interviews

Participants: 43 youths in care in Canada

Key Findings: This study set out to examine the ways in which resilience is constructed by young people who have had contact with child care and protection agencies, and their carers. It found that experiences of entering and leaving care can shape identities, positively or negatively, and that care providers have an impact on the construction of both positive and negative identities of youth in their care.

34

Author: Ungar M

Title and Source: Pathways to Resilience Among Children in Child Welfare, Corrections, Mental Health and Educational Settings: Navigation and Negotiation, Child & Youth Care Forum, 34, 6, (2005), 423-444

Primary Research: No

Methods: Case studies conducted in Canada

Participants: One male, one female case study

Key Findings: This paper examines the impact of social service delivery systems on children's development of resilience. Case studies are used to illustrate resilience enhancing and challenging patterns of service delivery and utilisation among young people. Finally, the paper outlines what services children themselves felt they needed to achieve resilience, and how the structure of service provision affects the ability of children to access health resources necessary to develop resilience.

35

Author: Werner E E

Title and Source: The Children of Kauai: Resiliency and Recovery in Adolescence and Adulthood, Journal of Adolescent Health, 13, (1992), 262-268

Primary Research: Yes

Methods: Longitudinal study including review of medical and school records, and interviews

Participants: 698 children born on island of Kauai, Hawaii, in 1955

Key Findings: This article outlines the longitudinal study undertaken by Werner and colleagues which tracked the life narratives of participants from birth to adulthood in order to determine what aided recovery from adversity. The paper outlines a range of factors which contribute to resilient outcomes in adulthood, and established a link between these and successful longer term adaptation.

36

Author: Wolfe D A, Jaffe P G, Jette J L and Poisson S E

Title and Source: The impact of child abuse in community institutions and organizations: Advancing professional and scientific understanding, Clinical Psychology: Science and Practice, 10, 2, (2003), 179-191

Primary Research: No

Methods: Conceptual synthesis using case studies, clinical experience, and consultative panels

Participants: Panels consisted of abuse survivors, practitioners and researchers

Key Findings: The paper proposes a conceptual framework, developed from child abuse studies, the authors' own clinical experiences, and two panels of survivors, practitioners and researchers involved in the field of abuse, which identifies abuse-related factors associated with negative outcomes, and corresponding dimensions of harm.

37

Author: Wolfe D A, Francis K J and Straatman A-L

Title and Source: Child Abuse in Religiously-Affiliated Institutions: Long-Term Impact on Men's Mental Health, Child Abuse & Neglect, 30, 2, (2006), 205-212

Primary Research: Yes

Methods: Clinical interviews and psychological tests

Participants: 76 men who had experienced physical/sexual abuse in Irish institutions with religious affiliations

Key Findings: This study looked at the long-term impact of sexual and physical abuse of boys in a non familial setting. It found adult survivors suffered high rates of a range of psychological disorders, alcohol misuse, criminal behaviour and chronic sexual problems. The authors note a need for awareness, prevention and treatment for those who have been subject to ICA.

38

Author: Wolters M G

Title and Source: Counselling Adult Survivors of Childhood Institutional Abuse: A phenomenological exploration of therapists' perceptions and experiences in Ireland, Person-Centred and Experiential Psychotherapies, 7, 3, (2008), 185-199

Primary Research: Yes

Methods: Interviews

Participants: 10 practicing counselling therapists in Ireland

Key Findings: This study explored therapists' perceptions and experiences of working with adult survivors of ICA, compared with working with adult survivors of childhood abuse in non institutional settings. It found that those who grew up in institutional settings might have particular difficulty taking part in therapy, and this is related to trust issues.