Use of “Temas” with patients referred for sexual abuse: Case studies of Puerto Rican children

Resumen

Child sexual abuse is an area that has received considerable attention, but it is largerly underreported because of stigma. In addition, in the clinical setting, sexual abuse tends to be under detected because there is a paucity of valid assessment techniques. Effective treatment of the sexually abused victims requires an understanding of the underlying dinamics associated with the trauma and an adequate treatment planning which fully adresses those dynamics. In Puerto Rico there are difficulties in conducting adequate treatments because there is a lack of culturally sensitive/competent instruments to assess the impact of sexual abuse on children's personality cognitive, and emotional functioning. Based on these needs, we utilized the adaptation of the TEMAS (Tell-Me-A-Story), a culturally sensitive narrative/projective test as a screening instrument. Five (5) children, ages 7-9, were recruited during the early phase of this program from a sexual abuse program in San Juan. Results showed slow reaction times, lengthy total tiem narrations, limited understanding of conflict resolution, partial maladaptation in interpersonal relations, and inappropiate affects. Analyses of the TEMAS narratives revealed that childre present problems that are similar to the "damaged good syndrome" described in the literature.