Abstract
Sexual abuse trauma and chronic revictimization are central to the experience of many women diagnosed with severe mental illness. The high reported prevalence rates of sexual abuse trauma among these women necessitate that program planners and clinicians be prepared to adapt their treatment interventions for use with trauma survivors. This article describes how current treatment approaches for women diagnosed with severe mental illness can be adapted to accommodate the special needs and vulnerabilities of sexual abuse trauma survivors. A history of trauma added to the clinical picture of longstanding and severe mental illness poses new diagnostic and treatment considerations, which are discussed. The full range of rehabilitation services—case management, residential placement and supervision, inpatient hospitalization, medication management, network intervention, and socill skills training—must be grounded in an understanding of the trauma experience, informed by accurate assessment of the trauma, and accommodated to the woman’s specific history of sexual abuse trauma.
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References
Beck JC, van der Kolk B: Reports of childhood incest and current behavior of chronically hospitalized psychotic women.American Journal of Psychiatry 1987; 144:1474–1476.
Craine LS, Henson CE, Colliver JA, et al.: Prevalence of a history of sexual abuse among female psychiatric patients in a state hospital system.Hospital and Community Psychiatry 1988; 39:300–304.
Rose SM, Peabody CG, Stratigeas B: Undetected abuse among intensive case management clients.Hospital and Community Psychiatry 1991; 42:499–503.
Jacobson A, Richardson B: Assault experiences of 100 psychiatric inpatients: Evidence of the need for routine inquiry.American Journal of Psychiatry 1987; 144:908–913.
Muenzenmaier K, Meyer I, Struening E, et al.: Childhood abuse and neglect among women outpatients with chronic mental illness.Hospital and Community Psychiatary 1993; 44:666–670.
Herman J:Trauma and Recovery. New York: Basic Books, 1993.
Bachrach LL: Defining chronic mental illness: A concept paper.Hospital and community Psychiatry 1988; 39:383–388.
Bryer JB, Nelson BA, Miller JB, et al.: Childhood sexual and physical abuse as factors in adult psychiatric illness.American Journal of Psychiatry 1987; 144:1426–1430.
Harris M, Bergman HC (Eds.).Case Management for Mentally Ill Patients. Langhorne, PA: Harwood Academic Publishers, 1993.
Harris M, Bergman HC: Case management with the chronically mentally ill: A clinical perspective.American Journal of Orthopsychiatry 1987; 57:296–302.
Jacobson A, Herald C:The relevance of childhood sexual abuse to adult psychiatric inpatient care.Hospital and Community Psychiatry 1990; 41:154–158.
Bebout R, Harris M: In search of pumpkin shells: Residential programming for the homeless mentally ill. In: Lamb R, Bachrach LL, Kass FI (Eds.):Treating the Homeless Mentally Ill. Washington, DC: American Psychiatric Press, 1991, pp. 159–181.
Courtois CA:Healing the Incest Wound. New York: Norton, 1988.
Geller J, Harris M:Women of the Asylum. New York: Anchor Books, 1994.
Ehrenreich B, English D:For Her Own Good. New York: Doubleday, 1978.
Harris M, Bergman HC: Networking with young adult chronic patients.Psychosocial Rehabilitation Journal 1985; 8:28–35.
Harris M, Bergman HC, Bachrach L: Individualized network planning for young adult chronic patients.Psychiatric Quarterly 1986-87; 58:51–56.
Bebout RR: Contextual case management: Restructuring the social support networks of seriously mentally ill adults. In: Harris M, Bergman HC (Eds.):Case Management for Mentally Ill Patients. Langhorne, PA: Harwood Academic Publishers, 1993, pp. 59–82.
Harris M:Sisters of the Shadow. Norman: Oklahoma University Press, 1991.
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Harris, M. Modifications in service delivery and clinical treatment for women diagnosed with severe mental illness who are also the survivors of sexual abuse trauma. The Journal of Mental Health Administration 21, 397–406 (1994). https://doi.org/10.1007/BF02521358
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DOI: https://doi.org/10.1007/BF02521358