Uncovering survival abilities in children who have been sexually abused

ABSTRACT

The author combines the strengths perspective in social work with the resiliency literature in developmental psychopathology as guidelines for uncovering the survival strengths of children who have been sexually abused. Their survival abilities are often submerged beneath pain and discomfort and are difficult to elicit if the practitioner does not view their protective strategies as strengths. The essential elements of the strengths perspective and the resiliency literature are presented to reveal creative ways to work with children who have been sexually abused.

Children who are sexually abused are coerced into sexual activity before they are cognitively, emotionally, or physically able to manage the experience (Sgroi, 1982). But by engaging in creative behaviors, such children are able to adapt to an extremely negative situation and environment (Chandy, Blum, & Resnick, 1996). Without these creative survival methods, the child's mental health and will to live would be seriously jeopardized (Maltz & Holman, 1987). Honoring children's survival skills is an important element in treatment because such skills help them establish power over past experiences in which they were rendered powerless. In learning to respect their own survival skills, children begin to view themselves positively.

Children are likely to need assistance during treatment to identify their survival abilities because recalling their trauma will heighten their pain. Social work practitioners can help children uncover and build on their survival strengths by focusing on children's resiliency and ability to cope with the sexual abuse. With this approach, the practitioner and the child consider the interplay of and triumph in coping with sexual abuse.

The professional literature has few guidelines to assist practitioners in assessing children's survival abilities, distinguishing between their strengths and deficits, and using this information to develop an intervention plan (Chaffin, Wherry, & Dykman, 1997). Without adequate information regarding the methods children use to manage their sexual abuse, practitioners may attempt to change or eliminate problem behaviors that actually are essential strengths and coping strategies that are critical to children's survival. Survival strategies are often discussed in the professional literature in association with psychological impairment rather than being recognized as important tools for children to gain relief from their trauma (Chaffin, et al., 1997; Johnson & Kenkel, 1991). Many children use wishful thinking such as fantasizing and daydreaming to distance themselves emotionally from the anguish of their sexual abuse. Children report that using wishful thinking is helpful to them even though professionals associate it with creating significant psychological distress for the child (Johnson & Kenkel, 1991). Instead of eliminating this survival strategy because the use of wishful thinking is viewed as avoiding the problem, the practitioner can help the child become aware that it is an important measure that he or she used to cope and that it can be shaped into managing other adverse situations for the child. Consequently, it is essential to formulate specific and clear guidelines for treatment that center on survival abilities because gathering this information helps children to take pride in their accomplishments. Rebuilding self-esteem and pride is extremely important for children who have been sexually abused because the trauma permeates their identity and may leave them lacking in feelings of self-worth (Beitchman, Zucker, Hood, DaCosta, & Akman, 1991; Chaffin et al., 1997; Hiebert-Murphy, De Luca, & Runtz, 1992; Hotte & Rafman, 1992; McGain & McKinzey, 1995; Mennen & Meadow, 1994; Verleur, Hughes, & Dobkin de Rios, 1986).

This article combines the strengths perspective in social work and the resiliency literature in developmental psychopathology as guidelines for uncovering the survival strengths of children who have been sexually abused. Their survival abilities are often submerged beneath pain and discomfort and are difficult to elicit if the practitioner does not view these protective strategies as strengths. These two bodies of literature open up the possibility of eliciting the child's strengths while simultaneously dealing with the anguish resulting from the sexual abuse (de Young & Corbin, 1994).

Although the strengths perspective and the resiliency literature are grounded in different disciplines, both emphasize the children's ability to cope with traumatic situations. Both recognize that children's ability to live well in the present depends on their ability to recognize and uncover their strengths (Barnard, 1994; Saleebey, 1997). Both areas of literature understand that children are doing the best that they can with the resources available to them (Saleebey, 1997; Wolin & Wolin, 1993). Finally, both recognize that children may lose sight of their strengths and abilities because the trauma and pain are too great and that the practitioner's role is to assist in recovering their submerged survival abilities (Barnard, 1994; Saleebey, 1997).

Strengths Perspective

The strengths perspective in social work uses a paradigm that recognizes and appreciates people's abilities and potential for growth (Saleebey, 1996). Sexually abused children may not achieve their treatment goals because they are unable to actualize their coping abilities (Saleebey, 1996; Weick, Rapp, Sullivan, & Kisthardt, 1989). The pain and hardships children from sexually abusing families experience may obscure their skills, talents, and competencies (Saleebey, 1996, 1997). The helping process needs to focus on uncovering these lost strengths and to build on them in order to help the child achieve his or her treatment goals.

The strengths perspective focuses on identifying the individual and environmental strengths of each child (Kisthardt, 1997). Emphasizing the unique skills and competencies of a sexually abused child individualizes the helping process for the child. The child's strengths are drawn upon to formulate an intervention plan that is specific to the child's situation. Children will achieve positive treatment outcomes when their individual abilities are validated and mobilized into an action plan (Saleebey, 1997). Operating from a strengths orientation guides social work practitioners to unleash the potential in children who have been sexually abused.

A strengths assessment is used to explore the life domains of family, school, health, leisure, daily living, and social supports. The individual and environmental strengths available to the child are examined within each area (Kisthardt, 1992). Although the assessment explores coping in six life domains, children may not always have difficulty in these areas. For children who have been sexually abused, trauma is another life domain that needs to be explored. Such an exploration addresses the positive aspects of themselves that evolved from their attempts to overcome their childhood adversities. The survival abilities of children are enduring strengths that develop in relationship with their trauma as a means of self-preservation (Wolin & Wolin, 1993) rather than deriving from the life-domain areas specified in the strengths assessment.

Incorporating survival strengths into the assessment process creates a broader perspective for identifying sexually abused children's coping abilities. The resiliency literature in developmental psychopathology provides an in-depth exploration of protective strategies that emerge from managing an adverse childhood. Such information can be assimilated into the strengths perspective to assist social work practitioners in uncovering the survival strengths of children exposed to sexual abuse. Exploring these survival skills can then be used to develop an intervention plan that builds on children's ability to manage a traumatic childhood (Chaffin et al., 1997; Geffner, 1992; Spaccarelli & Kim, 1995).

Resiliency Literature

The resiliency literature emerged from studies in developmental psychopathology focusing on adverse conditions that placed children at risk for developing adult pathologies (Byrd, 1994). Initially, the term "resilient" referred to so-called "stress resistant" or "invulnerable" children. These children were characterized as unusually competent and capable. They not only survived, they thrived under adverse circumstances (Kauffman, Grunebaum, Cohler, & Gamer, 1979). Resiliency research focused on uncovering the attributes that helped at-risk children resist stress (Werner, 1989). Protective factors in the children, their families, and their external support systems were found (Garmezy, 1991). This research identified protective mechanisms in these three areas; the studies did not show, however, how these mechanisms interacted to produce invulnerability in children.

The studies progressed from defining the attributes of resiliency to exploring the processes over time that protect one from risk. Instead of viewing resiliency as the avoidance of stress factors, researchers recognized that resiliency was a process whereby risk was successfully engaged. The protective factors evolved from the adaptive changes that occurred when children successfully coped with stress (Rutter, 1987). Successfully engaging in risk fostered outcomes of adaptation and competence (Cohler, 1987).

The dominant focus of the resiliency research during the past 25 years has been on competence (Luthar & Zigler, 1991). Resilient children are characterized as being socially, behaviorally, and academically competent despite living in adverse circumstances and environments as a result of poverty (Werner & Smith, 1992), parental mental illness (Beardslee & Podorefsky, 1988), interparental conflict (Neighbors, Forehand, & McVicar, 1993), inner-city living (Luthar, 1993), and child abuse and neglect (Farber & Egeland, 1987). Children who are functioning well despite enduring hardships often do not receive treatment services because they find ways to be successful despite their troubled environments. To base resiliency on definitions of competency is restrictive because it applies only to children who escape risk with relatively few problems. Sexually abused children do not consistently exhibit competence in major areas of functioning (Nash, Zivney, & Hulsey, 1993). Yet, children who have been sexually abused are resilient (Chandy et al., 1996; Spaccarelli & Kim, 1995) even though their survival capacities may be either diminished or expressed as dysfunctional behaviors, for which standard measures of competency would not address their resilience. Instead, the qualities of their resilience are reflected in their ability to manage the sexual abuse and its effects. For example, somehow as children they not only endure the sexual abuse but find ways to go on with their lives. They have the burden of not revealing that anything has happened to them (Maltz & Holman, 1987). This prevents them from seeking assistance, and they are left to develop strategies for surviving the trauma on their own. Their capacity for self-repair takes tremendous energy, preventing them from accomplishing important developmental tasks. Because their survival abilities are overshadowed by the trauma, these strengths may be overlooked during treatment if the practitioner limits the definition of resiliency to the exhibition of competency.

Broadening the Definition of Resilience

Wolin and Wolin (1993) broadened the definition of resilience to include the individual attributes that develop as a result of finding ways to survive childhood adversity. They recognize the capacity of self-repair for anyone who must endure hardship. Wolin and Wolin emphasize that resiliency is not limited to people who escape risk with few problems. People who have survived traumatic childhoods are considered resilient because they have enduring strengths that developed as a means to protect themselves from their troubled families. Their resilience is based on their survival abilities, which are not captured on standard measures of competency. For sexually abused children, resiliency is grounded in how they managed the traumatic experience-often with little assistance from others (e.g., family).

Wolin and Wolin (1993) discuss seven themes of resilience-insight, independence, initiative, relationships, morality, creativity, and humor. These areas represent clusters of strengths that interact with one another to help people survive adverse experiences. The development and maturation of each resiliency occurs in three life stageschildhood, adolescence, and adulthood. Although not every child exposed to sexual abuse has all seven areas of resilience, the practitioner can identify each child's particular configuration of them.

The seven themes of resilience provide a conceptual framework for practitioners who are interested in uncovering strengths in sexually abused children while validating and discussing their trauma. The facilitation of resilience emanates from the practitioner's therapeutic orientation rather than the application of a specific intervention (O'Connell-Higgins, 1994). In order to affirm and support a child's survival abilities, the practitioner must be prepared to view a child's coping tactics as strengths. In the following discussion of the seven resiliencies only the first two stages-childhood and adolescence-are addressed as they relate to sexually abused children, particularly incest victims. Using these resiliencies as guidelines helps social work practitioners to identify and support the strategies children use to manage their sexual abuse. The recovery process for each abused child is highly individualized (Nash, Zivney, & Hulsey, 1993); however, such information helps children recognize the positive actions they took in order to survive and validates their resources for managing the trauma.

Insight

Insight allows the child to question the distorted reflections of a troubled family; that is, the child begins to understand that his or her family is "not what it's supposed to be" (Wolin & Wolin, 1993, p. 73). During the first stage of insight, children may sense the flaws within their families. Families may give messages blaming them for the sexual abuse or may deny its occurrence. Although they receive these distorted messages when they are young, children nevertheless sense that something is wrong with their family. However, they are not mature enough to verbalize it (Maltz & Holman, 1987).

Insight continues to develop throughout adolescence, as individuals identify the underlying reasons for the problems in the family (Wolin & Wolin, 1993). Through changes emotionally, intellectually, and in social interactions with others, adolescents are able to grow from sensing what is wrong in their family to giving a name to the problem. For example, children who are incest victims may figure out that the sexual activity is not an "expression of affection." They begin to understand that not all fathers interact with their daughters sexually (Valentine & Feinauer, 1993).

Independence

Independence refers to the child's ability to distance him- or herself emotionally or physically from a troubled family (Wolin & Wolin, 1993). Such distancing is difficult to sustain in sexually abusing families because the tendency in such families to pull together in order to maintain the family secret. During childhood independence and distancing are achieved by finding a protective place-psychologically through fantasizing or dissociating (Ceresne, 1995; Dinsmore,1991; Johnson & Kenkel, 1991) or behaviorally by maintaining a low profile in the family (Ceresne,1995).

They understand that they are not going to get the appropriate recognition from their parents. Consequently, they immerse themselves in satisfying activities with others in order to gain affirmation. School can be an important resource in that involvement in extracurricular activities allows them to spend less time at home (Byrd, 1994).

Initiative

Initiative occurs through taking risks to make one's life controllable despite the sexual abuse. During childhood exerting initiative takes the form of experimenting and learning what parts of a sexually abusing family environment are controllable and realizing what is not (Wolin & Wolin, 1993). They may figure out ways to try to protect themselves from the sexual abuse, for example, by wearing extra clothes to bed, faking illness, or sharing a bed with a sibling (Ceresne, 1995; Dinsmore, 1991). They may not always be successful in their attempts. Nevertheless, their actions show how active they are in trying to protect themselves and in trying to divert the sexual abuse.

In adolescence, initiative is shown through children's ability to take hold of their lives in the midst of family problems (Wolin & Wolin, 1993). These children maintain hope that the sexual abuse will end and that they can find ways to persevere until this time comes. Focusing on their future helps them separate from their current trauma and allows them to begin planning for life after the sexual abuse. Belief in God or a sense of spirituality can help these children find faith in their ability to prevail (Ceresne, 1995; Scalzo, 1991; Valentine & Feinauer, 1993).

Relationships

In building relationships, one must seek people with whom to connect. In childhood, this may involve searching for opportunities to connect with family members. Children may build on family relationships during periods of calm and distance themselves during periods of chaos (Wolin & Wolin, 1993). Often their attempts are futile, which leads them to seek relationships outside the immediate family, sometimes with parents of their friends (Ceresne, 1995; Scalzo, 1991; Spaccarelli & Kim, 1995). Children may find great satisfaction in establishing close relationships with others. Dolls and pets can also serve as an outlet for their need for nurturance (Byrd, 1994; Ceresne, 1995; Dinsmore, 1991).

During adolescence, children actively seek relationships to fill the void in their own families (Wolin & Wolin, 1993). Adolescents thus are able to cultivate relationships over which they have a measure of control in contrast with the coercive relationships in their own families. For example, they choose friends whose parents they like or pursue relationships with a coach or a teacher (Byrd, 1994; Scalzo, 1991). These youth attempt to develop alternative families or seek out role models who can fulfill their needs (Valentine & Feinauer, 1993).

Morality

Morality is the expression of an informed conscience and is demonstrated through empathy, compassion, and caring toward others. Throughout childhood, children feel they have gotten a "bum deal" with their family but may channel their disappointment into trying to make a difference for others (Wolin & Wolin, 1993). Children may express their morality through their judgments of what is right and wrong in their own family. The abuser's "games" are cloaked in silence and secrecy, which makes the children question both the "games" and the abuser (Dinsmore, 1991).

During adolescence, children's morality may be channeled into fighting for justice at home by protecting younger family members and standing up to their perpetrators (Wolin & Wolin, 1993). They may sacrifice their bodies to prevent their siblings from being molested. Or they may rebel against the rules and demands of the perpetrator, such as curfew or dating restrictions. These adolescents demonstrate compassion toward others even though they have received little compassion themselves (Byrd, 1994; Ceresne, 1995).

Creativity and Humor

Expressions of creativity and humor channel pain and discomfort in imaginative ways. Anthony (1987) states that one "can extend the dimensions of the tasks to invent new and creative ways to manage the environment" (p. 149). A young child may manage adverse circumstances through play, using imaginative activities to cope with the real-life hardship of sexual abuse (Wolin & Wolin, 1993). Play helps children repair themselves emotionally and to endure the trauma. They may imagine or fantasize about a life in which they have power and cannot be hurt (Byrd, 1994; Ceresne, 1995; Scalzo, 1991).

Adolescents use their imagination as an important tool for handling difficult situations. Children's play is refined during adolescence into creative works or a highly developed sense of humor (Ceresne, 1995). Their creative abilities help them process their pain and grief (Dinsmore, 1991). Emotional pain may be channeled through writing, drawing, music, and so forth. A well-developed sense of humor not only helps them disconnect from their emotional pain, but helps them connect with others (Ceresne, 1995; Scalzo, 1991).

Implications for Social Work Practice

Treatment with sexually abused children focuses predominantly on ameliorating presenting problems, which may include depression (Koverola, Pound, Heger, & Lytle, 1993; Lanktree & Briere, 1995), anxiety (Dubowitz, Black, Harrington, & Verschoore, 1993; Lanktree & Briere, 1995), negative self-identity and self-blame (Chaffin et al., 1997; Mennen & Meadow, 1994; Verleur et al., 1986), poor social skills (McGain & McKinzey, 1995), loneliness (Hiebert-Murphy et al., 1992), selfdestructiveness (Battle, Battle, & Tolley, 1993; Chandy et al., 1996), and sexually acting out (Browne & Finkelhor, 1986; Corwin & Olafson, 1993; Friedrich, 1993). Although addressing the sequelae of sexual abuse is an essential treatment concern, it should not obscure the need to honor and develop children's survival strategies. If children's survival abilities are ignored in favor of an exclusive focus on their problems it may be difficult for children to relinquish a view of themselves as being damaged. Therapeutic paradigms that operate from a pathology focus are less likely to tap into areas of resilience because "we can only see and know that which our paradigms allow us to see and know" (Barnard, 1994, p. 137). A pathology focus encourages practitioners to perceive clients as having some disorder or deficit that creates negative expectations about their potential to address the stressors in their lives (Barnard, 1994; Saleebey, 1997). Identifying and building on the positive aspects of the self that helped the child survive trauma open up creative ways to work with children who have been sexually abused.

The strengths perspective in social work and the resiliency literature in developmental psychopathology focus on assessing the positive qualities of children who are exposed to sexual abuse. They move beyond focusing on damage as the most significant dimension in treatment and recognize that tapping into the child's survival abilities and strategies is at the center of good practice (Weick & Chamberlain, 1997). The social work practitioner guides the process through uncovering and identifying themes of resilience in the survival stories of children who have been sexually abused. For example, children often blame themselves for the sexual abuse because they feel that they should have stopped it. Although telling children that they are not responsible for the sexual abuse is reassuring to them, often they continue to blame themselves. If the practitioner probes into the ways that children tried to stop the sexual abuse (e.g., figuring out that sharing a bed with a sibling reduces the risk of being sexually abused), he or she helps the child uncover initiative and reenforces that active role the child played in his or her survival. Initiative becomes an important tool for change because it demonstrates the ability.to problem solve in difficult situations and may be applied to other areas of the child's life. The psychological scars will never disappear completely; however, focusing on the child's strengths and resiliency can help limit the power of sexual abuse over the child.

References

Anthony, E. J. (1987). Children at high risk for psychosis growing up successfully. In E. J. Anthony & B. J. Cohler (Eds.), The invulnerable child (pp.

147-184). New York: Guilford. Barnard, C. (1994). Resiliency: A shift in our perception? American Journal of Family Therapy, 22, 135-144. Battle, A. O., Battle, M. V., & Tolley, E. A. (1993). Potential for suicide and aggression in delinquents at juvenile court in a southern city. Suicide and Life Threatening Behavior, 23, 230-244.

Beardslee, W. R., & Podorefsky, D. (1988). Resilient adolescents whose parents have serious affective and other psychiatric disorders: Importance of selfunderstanding and relationships. American Journal of Psychiatry, 145, 63-69.

Beitchman, J., Zucker, K., Hood, J., DaCosta, G., & Akman, D. (1991). A review of the short-term effects of child sexual abuse. Child Abuse and Neglect, 15, 537-536.

Browne, A., & Finkelhor, D. (1986). A review of the research. Psychological Bulletin, 99(1), 66-77.

Byrd., R. (1994). Assessing resilience in victims of childhood maltreatment. Doctoral diss. Pepperdine University. Dissertation Abstracts, 5503. Ceresne, L. (1995). Reflections on resilience: Narratives of sexually abused women's coping and healing strategies. Master's thesis, Dalhousie University, 1995. Dissertation Abstracts, 3405.

Chaffin, M., Wherry, J., & Dykman, R. (1997). School age children's coping with sexual abuse: Abuse stresses and symptoms associated with four coping strategies. Child Abuse and Neglect, 21, 227-240.

Chandy, J., Blum, R., & Resnick, M. (1996). Gender-specific outcomes for sexually abused adolescents. Child Abuse and Neglect, 20, 1219-1231. Cohler, B. (1987). Adversity, resilience, and the study of lives. In E. J. Anthony & B. J. Cohler (Eds.), The invulnerable child (pp. 363-424). New York: Guilford.

Corwin, D., & Olafson, E. (1993). Overview: Clinical identification of sexually abused children. Child Abuse and Neglect, 17, 3-5.

de Young, M., & Corbin, B. (1994). Helping early adolescents tell: A guided exercise for trauma-focused sexual abuse treatment groups. Child Welfare, 73, 141-154.

Dinsmore, C., (1991). From surviving to thriving: Incest, feminism, and recovery. Albany, NY: State University of New York Press.

Dubowitz, H., Black, M., Harrington, D., & Verschoore, A. (1993). A follow-up study of behavior problems associated with child sexual abuse. Child Abuse and Neglect, 17, 743-754.

Farber, E., & Egeland, B. (1987). Invulnerability among abused and neglected children. In E. J. Anthony and B. J. Cohler (Eds.), The invulnerable child (pp. 289-314). New York: Guilford. Friedrich, W. (1993). Sexual victimization and sexual behavior in children: A review of recent literature. Child Abuse and Neglect, 17, 59-66.

Garmezy, N. (1991). Resiliency and vulnerability to adverse developmental outcomes associated with poverty. American Behavioral Scientist, 34, 416-430. Geffner, R. (1992). Current issues and future directions in child sexual abuse. Journal of Child Sexual Abuse, 1, 1-13.

Hiebert-Murphy, D., De Luca, R., & Runtz, M. (1992). Group treatment for sexually abused girls: Evaluating outcome. Families in Society, 73, 205-213.

Hotte, J. P., & Rafman, S. (1992). The specific effects of incest on prepubertal girls from dysfunctional families. Child Abuse and Neglect, 16, 273-283.

Johnson, B., & Kenkel, M. (1991). Stress, coping, and adjustment in female adolescent incest victims. Child Abuse and Neglect, 15, 293-30S.

Kauffman, C., Grunebaum, H., Cohler, B., & Gamer, E. (1979). Superkids: Competent children of psychotic mothers. American Journal of Psychiatry, 136, 1398-1402.

Kisthardt, W. (1992). A strengths model of case management: The principles and functions of a helping partnership with persons with persistent mental illness. In D. Saleebey (Ed.), The strengths perspective in social work practice (pp. 59-83). New York: Longman.

Kisthardt, W. (1997). The strengths model of case management: Principles and helping functions. In D. Saleebey (Ed.), The strengths perspective in social work practice (pp. 97-112). New York: Longman.

Koverola, C., Pound, J., Heger, A., & Lytle, C. (1993). Relationship of child sexual abuse to depression. Child Abuse and Neglect, 17, 393-400.

Lanktree, C., & Briere, J. (1995). Outcome of therapy for sexually abused children: A repeated measures study. Child Abuse and Neglect, 19, 1145-1155.

Luthar, S. (1993). Annotation: Methodological and conceptual issues in research on childhood resilience. Journal of Child Psychiatry, 34, 441-443. Luthar, S., & Zigler, E. (1991). Vulnerability and competence: A review of research on resilience in childhood. American Journal of Orthopsychiatry, 61, 6-22.

Maltz, W., & Holman, B. (1987). Incest and sexuality: A guide to understanding and healing. Lexington, MA: Lexington Books.

McGain, B., & McKinzey, R. K. (1995). The efficacy of group treatment in sexually abused girls. Child Abuse and Neglect, 19, 1157-1169. Mennen, E, & Meadow, D. (1994). Depression, anxiety, and self-esteem in sexually abused children. Families in Society, 75, 74-81.

Nash, M., Zivney, O., & Hulsey, T. (1993). Characteristics of sexual abuse associated with greater psychological impairment among children. Child Abuse and Neglect, 17, 401-408. Neighbors, B., Forehand, R., & McVicar, D. (1993). Resilient adolescents and interparental conflict. American Journal of Orthopsychiatry, 63, 462-471. O'Connell-Higgins, G. (1994). Resilient adults overcoming a cruel past. San Francisco: Jossey-Bass.

Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57, 316-331.

Saleebey, D. (1996). The strengths perspective in social work practice: Extensions and cautions. Social Work, 41, 296-305.

Saleebey, D. (1997). The strengths approach to practice. In D. Saleebey (Ed.), The strengths perspective in social work practice (pp. 49-57). New York: Longman.

Scalzo, J. (1991). Beyond survival: Keys to resilience among those who experienced childhood sexual abuse. Doctoral diss. Simon Fraser University. Dis

sertation Abstracts, 5404. Sgroi, S. (1982). Handbook of clinical intervention in child sexual abuse. Lexington, MA: Lexington Books. Spaccarelli, S., & Kim, S. (199S). Resilience criteria and factors associated with resilience in sexually abused girls. Child Abuse and Neglect, 19, 1171-1182. Valentine, L., & Feinauer, L. (1993). Resiliency factors associated with female survivors of childhood sexual abuse. American Journal of Family Therapy, 21, 216-224.

Verleur, D., Hughes, R., & Dobkin de Rios, M. (1986). Enhancement of self-esteem among female adolescent incest victims: A controlled comparison. Adolescence, 21, 843-854. Weick, A., & Chamberlain, R. (1997). Putting problems in their place: Further explorations in the strengths perspective. In D. Saleebey (Ed.), The strengths perspective in social work practice (pp. 39-48). New York: Longman.

Weick, A., Rapp, C. A., Sullivan, W. P., & Kisthardt, W. (1989). A strengths perspective for social work practice. Social Work, 34, 350-354.

Werner, E. (1989). High-risk children in young adulthood: A longitudinal study from birth to 32 years. American Orthopsychiatric Association, 59, 72-81.

Werner, E., & Smith, R. (1992). Overcoming the odds: High-risk children from birth to adulthood. Ithaca, NY: Cornell University Press.

Wolin, S., & Wolin, S. (1993). The resilient self. New York: Villard.

Kim M. Anderson Is assistant professor, Social Work Program, Social Sciences Department Avila College, Kansas City, Mssouri.

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