Examining How the Mental Health Needs of Children Who Have Experienced Maltreatment Are Identified and Addressed In Ontario: A Focus on Childhood Sexual Abuse

Abstract

This two-study dissertation aimed to develop a comprehensive understanding of mental health need identification, service referral process, availability of services, and type of mental health services in Ontario for children who have experienced maltreatment with a specific focus on childhood sexual abuse (CSA). The first study was descriptive and involved an email questionnaire completed by Directors of Service in each of the 53 Ontario Children’s Aid Societies (CAS). While the primary purpose of study 1 was to inform the sample for study 2, it also provided information about the identification of mental health needs and the referral process to mental health services for children who have experienced maltreatment. Based on the finding that the majority of mental health service referrals are made to community-based psychologists (80%), study 2 was designed to assess the availability, type, and empirical support of treatments provided by Ontario psychologists and psychological associates to children who have experienced CSA. Through the first provincial census of child and adolescent psychology clinicians registered with the College of Psychologists of Ontario, this study addressed the following questions: (1) What are the demographic, work setting, and treatment provision characteristics of these clinicians? (2) Within this population, what is the proportion and distribution of clinicians who provide treatment to children who have experienced CSA?; (3) To what extent do these treatment services map onto empirically-supported treatments (ESTs) for children who have experienced CSA?; and (4) How do clinicians’ demographic, work setting, treatment provision characteristics, and attitudes toward ESTs predict their approach to intervention? Results indicated that clinicians who worked with children who have experienced CSA differed significantly from other clinicians in terms of age, work setting, self-reported theoretical orientation, and clients’ primary presenting problems. Moreover, clinician age, self-reported theoretical orientation, time devoted to clinical training activities, and general attitudes toward ESTs predicted the use of ESTs among clinicians who work with children who have experienced CSA. Limitations and implications for future research are addressed within each study.