The purpose of this study was to conduct a randomized experimental evaluation of the effectivenes... more The purpose of this study was to conduct a randomized experimental evaluation of the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) by examining its ability to reduce trauma symptoms among adult female survivors of childhood sexual abuse. These survivors, who suffer a variety of symptoms that are persistent and at times debilitating, comprise a large target population for social workers.
Higher education is an important pathway to safety for survivors of intimate partner violence (IP... more Higher education is an important pathway to safety for survivors of intimate partner violence (IPV). Recent work documents tactics of school sabotage (behaviors aimed at sabotaging educational efforts) identified by school staff and IPV advocates. However, the perspectives of current students who are IPV survivors are unexplored. As part of a multiphasic study, 20 semi-structured qualitative interviews with community college students who reported current or recent IPV were conducted. Identified tactics included disrupting child care, emotional abuse tied to school, and using manipulation to limit access to campus or resources. Identified impacts include preventing focus, diminished academic achievement, emotional or mental health challenges, and instilling a desire to overcome.
This study sought to open the black box of services at rape crisis centers (RCCs), particularly r... more This study sought to open the black box of services at rape crisis centers (RCCs), particularly related to counseling, to better understand what is available to survivors in urban and rural settings. Findings from a survey of directors and counselors in Texas RCCs reveal a number of strengths: supporting services for survivors of sexual assault and insights that can help to further advance the implementation of evidence-based trauma treatments in this sector. Although many areas of congruence were found between urban and rural settings, differences were noted that have implications for implementation of evidence-based trauma treatments.
Counselors in Rape Crisis Centers (RCCs) provide crucial services to survivors of sexual violence... more Counselors in Rape Crisis Centers (RCCs) provide crucial services to survivors of sexual violence. However, little is known about RCCs, including the treatment goals and assessment strategies of counselors. Counselors in all Texas RCCs (n = 83) were invited to participate in a web-based survey. Participants were asked to indicate which treatment goals they frequently identified and assessed, as well as their usual assessment techniques. Counselors endorsed treatment goals around self-esteem, empowerment, and relational functioning, along with trauma and mental health. Fewer counselors endorsed goals around drugs/alcohol or school/work/sexual functioning. Few counselors reported use of standardized measures. Counselors in urban settings were more likely to endorse goals related to mental health. There are discrepancies between counselors’ goals and how often outcomes are assessed. Increased assessment could promote the provision of effective services and access to funding.
Community college (CC) students make up 45% of American undergraduates, but little is known about... more Community college (CC) students make up 45% of American undergraduates, but little is known about their experiences of intimate partner violence (IPV), or accompanying service use and needs. The current study used a sequential confirmatory mixed methods design among a simple random sample of female CC students (n = 435), of whom 112 have experienced IPV in the past 12 months. Of these IPV survivors, 20 participated in qualitative follow-up interviews. The study assess use and perceived usefulness of college and community based resources, extent of social support, and perceived need for and barriers to service access. Campus based resources were rated as more useful than community based resources. Faculty were identified as important supports for survivors. Those experiencing IPV reported lower rates of social support compared to other students. A range of supports and services were endorsed as possibly useful by survivors. Survivors need services to address life generated risks that compound barriers to college completion created by abuse. CC survivors often balance work and parenting with education, and may benefit from different services than survivors in other educational settings.
This study describes the process of adapting and implementing GAIN (Girls Aspiring toward Indepen... more This study describes the process of adapting and implementing GAIN (Girls Aspiring toward Independence), a trauma-focused, group-based therapy adapted from CBITS (Cognitive Behavioral Intervention for Trauma in Schools) for girls in child welfare. Descriptive data were examined on three outcomes: posttraumatic stress disorder (PTSD), depression, and social problem-solving skills among adolescent girls in the child welfare system. Qualitative and quantitative methods were utilized to inform the adaptation of the CBITS intervention, evaluate feasibility, treatment fidelity, and acceptability, and to test the effects of the intervention. Girls ages 12 to 18 (N=27) were randomly assigned to the experimental and usual care conditions. Participants' symptoms of PTSD and depression, and social problem-solving skills were evaluated at pre, post (3 months), and follow-up (6 months) assessments. Adaptations for GAIN were primarily related to program structure. Data indicated that the program was receptive to girls in child welfare, and that it was feasible to recruit, randomize, assess outcomes, and implement with adequate fidelity. Retention was more successful among younger girls. Descriptive initial data showed greater reductions in the percentage of girls with PTSD and depression, and modest increases in social problem-solving skills in the experimental versus usual care condition. Despite the growth of knowledge in dissemination and implementation research, the application of traumafocused empirically supported treatment to child welfare populations lags behind. A large-scale RCT is needed to determine if GAIN is effective in reducing mental health problems and social problem-solving in the child welfare population.
This study examined provider perspectives on school sabotage. Service providers participated in s... more This study examined provider perspectives on school sabotage. Service providers participated in semi-structured interviews exploring these questions: Are service providers aware of instances of school sabotage occurring? What are the tactics that service providers have observed? What do service providers identify as the key impacts of school sabotage? The following are the themes: (1) tactics of abusive partners include disruption of financial aid, physical violence or stalking at school, and disrupting academic efforts; (2) survivors experience consequences, including emotional and academic impacts; (3) abusers display emotions including jealousy, resentment, and insecurity; and (4) many survivors use education as a pathway to safety and opportunity.
Sexual violence is pervasive and generates significant trauma symptoms that can last a lifetime f... more Sexual violence is pervasive and generates significant trauma symptoms that can last a lifetime for survivors. Rape crisis centers provide critically important services for survivors of child sexual abuse and adult sexual assault, including individual and group counseling. Eye movement desensitization and reprocessing (EMDR) has been found to be an effective treatment for a wide array of trauma symptoms in both children and adults. This study sought to determine the extent to which rape crisis centers use EMDR therapy, practitioners’ perceptions of EMDR, and the provider characteristics that might support or hinder implementation of EMDR in this setting. A statewide web-based survey generated responses from 76 counselors working within 47 rape crisis centers. Results indicate that there is a low-use rate of EMDR (8%) in this setting, perceptions of EMDR were predominately marked by uncertainty, reflecting a lack of familiarity, but there is strong interest in receiving training. The...
This study compares the association of histories of childhood emotional, physical, and sexual abu... more This study compares the association of histories of childhood emotional, physical, and sexual abuse, and physical neglect with revictimization among adolescent girls, and investigates the role of posttraumatic stress and symptoms of depression as mediators. Participants were 234 girls aged 12 to 19 years, who have been involved with the child welfare system in a Midwestern urban area. Data were collected from baseline surveys of a trauma-focused group program to which the participants were referred. The majority of participants were youths of color (75%) who were primarily African American (70%), and the remaining participants were White, non-Hispanic (25%). Data were collected through surveys that assessed histories of child abuse and neglect, symptoms of posttraumatic stress and depression, and experiences of physical, verbal, and relational revictimization in the last 3 months. All types of abuse and neglect were significantly associated with higher frequencies of revictimization...
Background and Purpose: Histories of childhood maltreatment have been linked to poor mental healt... more Background and Purpose: Histories of childhood maltreatment have been linked to poor mental health and health outcomes in adulthood. The Adverse Childhood Events Study (ACES) has provided strong evidence that childhood abuse is significantly associated with poor health behaviors and poor health outcomes, such as diabetes, heart disease, cancer, and HIV/STD’s in adulthood. Most of the research in this area has examined adults who retrospectively reported childhood abuse, yet little is known about adverse childhood events and health risk factors among adolescents who have substantiated histories of childhood abuse. To better understand this problem, we investigated the relationship between child maltreatment and four health risk factors in adolescent girls who are involved in child welfare. The following question was explored: What is the association of child maltreatment types (emotional abuse, physical abuse, and sexual abuse) with current health risk factors, such as poor eating, r...
Histories of childhood maltreatment such as physical abuse (PA), sexual abuse (SA) and emotional ... more Histories of childhood maltreatment such as physical abuse (PA), sexual abuse (SA) and emotional abuse (EA) have been linked to interpersonal violence. A recent report from SAMHSA reveals that over one fourth of adolescent girls have engaged in a violent act over the past year. Few studies have examined the association of different types of child maltreatment with violence, and the pathways to aggressive behaviors as perpetrators and victims. To address this gap, the following questions were addressed: What is the association of types of childhood abuse and current aggressive behaviors (as victims and perpetrators) among adolescent girls, and do PTSD and depression mediate this relationship? The subjects consisted of 112 girls, 12-18 years old (mean age=14.8, SD=1.6), who have been involved with the child welfare system. The subjects were African American (59%), bi-racial (20%), white (15%), and Hispanic or Asian (5%). Interviews assessed EA, PA, SA, PTSD, depression, and frequency ...
Social science research with vulnerable populations is necessary in order to address social and h... more Social science research with vulnerable populations is necessary in order to address social and health problems among those in most need; yet, this research is fraught with inherent risks to its participants. Using the recent experience of conducting a study of Mexican immigrant women’s experience of intimate partner violence and help-seeking, the authors describe strategies used to prevent harm to participants. For this community of women, participation in research has the potential to expose them to physical, psychological, economic, and legal harm. Safety protocols are discussed in the areas of recruitment, interviewing, data management, and the report of findings. These foremost strategies inform the safe design of research with other similarly at-risk populations.
This phenomenological qualitative study examines intimate partner violence (IPV) experienced by a... more This phenomenological qualitative study examines intimate partner violence (IPV) experienced by a sample of 29 Mexican immigrant women residing in New York and St. Louis. The findings reveal important insights about culturally specific abuse tactics employed by batterers and the forms of abuse that are experienced as most hurtful to the survivors. Ten different abusive tactics emerged: verbal, economic, physical, sexual, and extended family abuse, social isolation, physical abuse of children, stalking and monitoring, stolen bride, and sex trafficking. Cultural values and expectations appear to be inextricably linked to how the participants characterized the severity of each of the abusive tactics as evidenced by which abusive behaviors the participants found most hurtful. The findings will help service providers have a better understanding of the role cultural context plays in the IPV experiences of Mexican immigrant women.
Journal of Religion, Spirituality & Aging, 2013
ABSTRACT Forty-three spiritually distressed older women (aged 55–83) who had survived multiple ty... more ABSTRACT Forty-three spiritually distressed older women (aged 55–83) who had survived multiple types of interpersonal trauma participated in a spiritually focused group intervention designed to address spiritual struggles related to earlier abuse and to enhance spiritual coping. It was hypothesized that the intervention would increase spiritual well-being and that religious/spiritual coping would mediate the relationship between the intervention and the outcomes of depression, posttraumatic stress, anxiety, somatic symptoms, and spiritual well-being. The results provide strong initial support for the importance of understanding the effect of negative religious/spiritual coping on depression and anxiety symptoms in older religious survivors of interpersonal trauma.
The purpose of this study was to conduct a randomized experimental evaluation of the effectivenes... more The purpose of this study was to conduct a randomized experimental evaluation of the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) by examining its ability to reduce trauma symptoms among adult female survivors of childhood sexual abuse. These survivors, who suffer a variety of symptoms that are persistent and at times debilitating, comprise a large target population for social workers.
Higher education is an important pathway to safety for survivors of intimate partner violence (IP... more Higher education is an important pathway to safety for survivors of intimate partner violence (IPV). Recent work documents tactics of school sabotage (behaviors aimed at sabotaging educational efforts) identified by school staff and IPV advocates. However, the perspectives of current students who are IPV survivors are unexplored. As part of a multiphasic study, 20 semi-structured qualitative interviews with community college students who reported current or recent IPV were conducted. Identified tactics included disrupting child care, emotional abuse tied to school, and using manipulation to limit access to campus or resources. Identified impacts include preventing focus, diminished academic achievement, emotional or mental health challenges, and instilling a desire to overcome.
This study sought to open the black box of services at rape crisis centers (RCCs), particularly r... more This study sought to open the black box of services at rape crisis centers (RCCs), particularly related to counseling, to better understand what is available to survivors in urban and rural settings. Findings from a survey of directors and counselors in Texas RCCs reveal a number of strengths: supporting services for survivors of sexual assault and insights that can help to further advance the implementation of evidence-based trauma treatments in this sector. Although many areas of congruence were found between urban and rural settings, differences were noted that have implications for implementation of evidence-based trauma treatments.
Counselors in Rape Crisis Centers (RCCs) provide crucial services to survivors of sexual violence... more Counselors in Rape Crisis Centers (RCCs) provide crucial services to survivors of sexual violence. However, little is known about RCCs, including the treatment goals and assessment strategies of counselors. Counselors in all Texas RCCs (n = 83) were invited to participate in a web-based survey. Participants were asked to indicate which treatment goals they frequently identified and assessed, as well as their usual assessment techniques. Counselors endorsed treatment goals around self-esteem, empowerment, and relational functioning, along with trauma and mental health. Fewer counselors endorsed goals around drugs/alcohol or school/work/sexual functioning. Few counselors reported use of standardized measures. Counselors in urban settings were more likely to endorse goals related to mental health. There are discrepancies between counselors’ goals and how often outcomes are assessed. Increased assessment could promote the provision of effective services and access to funding.
Community college (CC) students make up 45% of American undergraduates, but little is known about... more Community college (CC) students make up 45% of American undergraduates, but little is known about their experiences of intimate partner violence (IPV), or accompanying service use and needs. The current study used a sequential confirmatory mixed methods design among a simple random sample of female CC students (n = 435), of whom 112 have experienced IPV in the past 12 months. Of these IPV survivors, 20 participated in qualitative follow-up interviews. The study assess use and perceived usefulness of college and community based resources, extent of social support, and perceived need for and barriers to service access. Campus based resources were rated as more useful than community based resources. Faculty were identified as important supports for survivors. Those experiencing IPV reported lower rates of social support compared to other students. A range of supports and services were endorsed as possibly useful by survivors. Survivors need services to address life generated risks that compound barriers to college completion created by abuse. CC survivors often balance work and parenting with education, and may benefit from different services than survivors in other educational settings.
This study describes the process of adapting and implementing GAIN (Girls Aspiring toward Indepen... more This study describes the process of adapting and implementing GAIN (Girls Aspiring toward Independence), a trauma-focused, group-based therapy adapted from CBITS (Cognitive Behavioral Intervention for Trauma in Schools) for girls in child welfare. Descriptive data were examined on three outcomes: posttraumatic stress disorder (PTSD), depression, and social problem-solving skills among adolescent girls in the child welfare system. Qualitative and quantitative methods were utilized to inform the adaptation of the CBITS intervention, evaluate feasibility, treatment fidelity, and acceptability, and to test the effects of the intervention. Girls ages 12 to 18 (N=27) were randomly assigned to the experimental and usual care conditions. Participants' symptoms of PTSD and depression, and social problem-solving skills were evaluated at pre, post (3 months), and follow-up (6 months) assessments. Adaptations for GAIN were primarily related to program structure. Data indicated that the program was receptive to girls in child welfare, and that it was feasible to recruit, randomize, assess outcomes, and implement with adequate fidelity. Retention was more successful among younger girls. Descriptive initial data showed greater reductions in the percentage of girls with PTSD and depression, and modest increases in social problem-solving skills in the experimental versus usual care condition. Despite the growth of knowledge in dissemination and implementation research, the application of traumafocused empirically supported treatment to child welfare populations lags behind. A large-scale RCT is needed to determine if GAIN is effective in reducing mental health problems and social problem-solving in the child welfare population.
This study examined provider perspectives on school sabotage. Service providers participated in s... more This study examined provider perspectives on school sabotage. Service providers participated in semi-structured interviews exploring these questions: Are service providers aware of instances of school sabotage occurring? What are the tactics that service providers have observed? What do service providers identify as the key impacts of school sabotage? The following are the themes: (1) tactics of abusive partners include disruption of financial aid, physical violence or stalking at school, and disrupting academic efforts; (2) survivors experience consequences, including emotional and academic impacts; (3) abusers display emotions including jealousy, resentment, and insecurity; and (4) many survivors use education as a pathway to safety and opportunity.
Sexual violence is pervasive and generates significant trauma symptoms that can last a lifetime f... more Sexual violence is pervasive and generates significant trauma symptoms that can last a lifetime for survivors. Rape crisis centers provide critically important services for survivors of child sexual abuse and adult sexual assault, including individual and group counseling. Eye movement desensitization and reprocessing (EMDR) has been found to be an effective treatment for a wide array of trauma symptoms in both children and adults. This study sought to determine the extent to which rape crisis centers use EMDR therapy, practitioners’ perceptions of EMDR, and the provider characteristics that might support or hinder implementation of EMDR in this setting. A statewide web-based survey generated responses from 76 counselors working within 47 rape crisis centers. Results indicate that there is a low-use rate of EMDR (8%) in this setting, perceptions of EMDR were predominately marked by uncertainty, reflecting a lack of familiarity, but there is strong interest in receiving training. The...
This study compares the association of histories of childhood emotional, physical, and sexual abu... more This study compares the association of histories of childhood emotional, physical, and sexual abuse, and physical neglect with revictimization among adolescent girls, and investigates the role of posttraumatic stress and symptoms of depression as mediators. Participants were 234 girls aged 12 to 19 years, who have been involved with the child welfare system in a Midwestern urban area. Data were collected from baseline surveys of a trauma-focused group program to which the participants were referred. The majority of participants were youths of color (75%) who were primarily African American (70%), and the remaining participants were White, non-Hispanic (25%). Data were collected through surveys that assessed histories of child abuse and neglect, symptoms of posttraumatic stress and depression, and experiences of physical, verbal, and relational revictimization in the last 3 months. All types of abuse and neglect were significantly associated with higher frequencies of revictimization...
Background and Purpose: Histories of childhood maltreatment have been linked to poor mental healt... more Background and Purpose: Histories of childhood maltreatment have been linked to poor mental health and health outcomes in adulthood. The Adverse Childhood Events Study (ACES) has provided strong evidence that childhood abuse is significantly associated with poor health behaviors and poor health outcomes, such as diabetes, heart disease, cancer, and HIV/STD’s in adulthood. Most of the research in this area has examined adults who retrospectively reported childhood abuse, yet little is known about adverse childhood events and health risk factors among adolescents who have substantiated histories of childhood abuse. To better understand this problem, we investigated the relationship between child maltreatment and four health risk factors in adolescent girls who are involved in child welfare. The following question was explored: What is the association of child maltreatment types (emotional abuse, physical abuse, and sexual abuse) with current health risk factors, such as poor eating, r...
Histories of childhood maltreatment such as physical abuse (PA), sexual abuse (SA) and emotional ... more Histories of childhood maltreatment such as physical abuse (PA), sexual abuse (SA) and emotional abuse (EA) have been linked to interpersonal violence. A recent report from SAMHSA reveals that over one fourth of adolescent girls have engaged in a violent act over the past year. Few studies have examined the association of different types of child maltreatment with violence, and the pathways to aggressive behaviors as perpetrators and victims. To address this gap, the following questions were addressed: What is the association of types of childhood abuse and current aggressive behaviors (as victims and perpetrators) among adolescent girls, and do PTSD and depression mediate this relationship? The subjects consisted of 112 girls, 12-18 years old (mean age=14.8, SD=1.6), who have been involved with the child welfare system. The subjects were African American (59%), bi-racial (20%), white (15%), and Hispanic or Asian (5%). Interviews assessed EA, PA, SA, PTSD, depression, and frequency ...
Social science research with vulnerable populations is necessary in order to address social and h... more Social science research with vulnerable populations is necessary in order to address social and health problems among those in most need; yet, this research is fraught with inherent risks to its participants. Using the recent experience of conducting a study of Mexican immigrant women’s experience of intimate partner violence and help-seeking, the authors describe strategies used to prevent harm to participants. For this community of women, participation in research has the potential to expose them to physical, psychological, economic, and legal harm. Safety protocols are discussed in the areas of recruitment, interviewing, data management, and the report of findings. These foremost strategies inform the safe design of research with other similarly at-risk populations.
This phenomenological qualitative study examines intimate partner violence (IPV) experienced by a... more This phenomenological qualitative study examines intimate partner violence (IPV) experienced by a sample of 29 Mexican immigrant women residing in New York and St. Louis. The findings reveal important insights about culturally specific abuse tactics employed by batterers and the forms of abuse that are experienced as most hurtful to the survivors. Ten different abusive tactics emerged: verbal, economic, physical, sexual, and extended family abuse, social isolation, physical abuse of children, stalking and monitoring, stolen bride, and sex trafficking. Cultural values and expectations appear to be inextricably linked to how the participants characterized the severity of each of the abusive tactics as evidenced by which abusive behaviors the participants found most hurtful. The findings will help service providers have a better understanding of the role cultural context plays in the IPV experiences of Mexican immigrant women.
Journal of Religion, Spirituality & Aging, 2013
ABSTRACT Forty-three spiritually distressed older women (aged 55–83) who had survived multiple ty... more ABSTRACT Forty-three spiritually distressed older women (aged 55–83) who had survived multiple types of interpersonal trauma participated in a spiritually focused group intervention designed to address spiritual struggles related to earlier abuse and to enhance spiritual coping. It was hypothesized that the intervention would increase spiritual well-being and that religious/spiritual coping would mediate the relationship between the intervention and the outcomes of depression, posttraumatic stress, anxiety, somatic symptoms, and spiritual well-being. The results provide strong initial support for the importance of understanding the effect of negative religious/spiritual coping on depression and anxiety symptoms in older religious survivors of interpersonal trauma.
Uploads
Papers by Tonya Edmond