This study is implementing the first controlled treatment outcome study of group therapy for sexually abused adolescent girls. About 105 girls currently in residential treatment will be members of these groups, ranging in age from 12 to 19. Approximately 70% of them will be randomly divided into either immediate treatment or a delayed treatment control group. The group treatment is a 20-week closed enrollment therapy group that is focused on sexual abuse and its ramifications. With a cognitive- behavioral trauma-processing model, it uses group dynamics to facilitate the girls' emotional processing of their victimization memories and its perceived effects. There will pre-treatment, post-treatment, and follow-up measures of problem behaviors, inappropriate sexual behavior, aggression, relationships with male and female peers, depression, anxiety, sleeping disturbances, running away, substance abuse, eating problems, self-esteem, suicide gestures, and PTSD symptoms. These measures are designed to assess the range of the traumagenic effects of sexual victimization. In addition to the usual statistical analyses for controlled treatment outcome studies, survival analyses will be used to investigate the tendency for members' problematic behaviors to get worse during treatment before they improve and to investigate the timing and extent of changes in problematic behaviors after crucial therapy experiences, such as extensively disclosing one's victimization. Other analyses will test whether certain kinds of clients are more likely to improve, such as those with more severe sexual victimization, those with more social support, or those with more optimistic attributional styles.
