齋藤 梓

To clarify how victims of sexual violence consulted and reported the assault to the police, interviews were conducted with 31 survivors of sexual assault. Essential to survivors who reported the assault to the police and filed criminal proceedings were the determination and perseverance to report the crime, the willingness to express distress and receive support, and a strong sense of ethics and mission. We make the following suggestions to reduce the burden on victims who consult the police and file criminal proceedings. 1. Persons involved in handling criminal proceedings should take care not to cause secondary damage to the victim. 2. Persons who the victim consult should not impose incorrect information or his/her opinion on the victim. Appropriate information should be provided to the victim to support the victim's self-decision. 3. Information should be widely disseminated about what sexual violence is, what can be done after the assault (for recovery), and support organizations.

本研究では、性暴力被害が被害者に与えた影響を明らかにすること、および被害認識の形成と被害の影響の関係を検討することを目的とし、31 名の女性にインタビュー調査を実施した。テーマ分析の結果、『尊厳/主体性への侵害』および『親密な関係や性的関係への侵害』という二つの影響のテーマが語られていた。また、起きた出来事が分からない、被害のイメージと異なるなどの場合、『被害認識が形成されづらい』様子が見られ、そのあいだも被害の影響は生じていた。被害認識が形成されてから、回復への道のりが始まっていたため、被害認識の形成を助ける不同意性交は性暴力であるという啓発と、認識後の中長期支援確立が重要であると考えられた。In this study, interviews were conducted on 31 females with the aim of revealing how sexual violence affected the victim and to examine the relationship between the sexual violence damage perception process and the impacts of the violence. Our thematic analysis revealed that the impacts that the damage had on victims were narrated under two themes: "Encroachment to victimʼs dignity and independence" and "Encroachment on intimate relationship and sexual relationship with others". Further, in cases where victims did not perceived episodes as cases of sexual violence or had an image different from that of sexual violence, they exhibited the state of "incapable to perceive the damage as such", and impacts of damage persisted when there was no awareness of being victimized. The road to recovery beg an after perceiving the damage as such.

近年，各地に性犯罪・性暴力被害者のためのワンストップセンターが設立され，さらに民間の犯罪被害者支援センターや警察，検察，弁護士，医師，行政，心理等様々な機関，専門職が性犯罪・性暴力被害者に対し支援を行っている。しかし未だ十分とは言えず，支援の形を模索している場合も少なくない。そこで本調査では，性犯罪・性暴力被害者支援の特徴や工夫について明らかにするため，これまで支援に携わってきた支援者を対象とし，性犯罪・性暴力被害者支援および支援における連携の工夫や課題についてインタビュー調査を行った。11名の弁護士および民間被害者支援相談員に調査を行い，得られたデータを質的に分析した結果，【性犯罪・性暴力被害の背景】，【支援者からみる性犯罪・性暴力被害者の抱える困難と回復】，【性犯罪・性暴力被害者支援の特徴】，【連携の特徴】という4 つのメインカテゴリが生成された。性犯罪・性暴力被害者支援は，被害者の「精神的な不安定さが強い」，事件にまつわる「意思決定が揺らぐ」，支援の途中で「連絡が取れなくなる」といった支援の難しさがあることが語られた。支援者は，被害者に「人としての尊厳をもって関わる」「意思・意向を尊重する」ことをしながら，被害者に「連携先への信頼（を見せる）」，「ある程度の強引さ」をもって支援につなぐといった工夫をしながら，支援を行っていることがわかった。

BACKGROUND: Trauma-focused cognitive behavioral therapy is used to treat children who have experienced traumatic events and suffer from trauma-related disorders. Its effectiveness has been demonstrated in several randomized controlled studies. However, most of these studies have been performed in the United States, with few studies conducted in Asian countries. Therefore, we aimed to evaluate the feasibility of trauma-focused cognitive behavioral therapy in children who have experienced traumatic events and who suffer from trauma-related disorders in Japan. FINDINGS: Thirty-five traumatized children (mean age = 10.9 years; range = 3-17 years; 74.3% girls) who received trauma-focused cognitive behavioral therapy were included. The effectiveness of the program was evaluated in each case using the University of California at Los Angeles Post-Traumatic Stress Disorder Reaction Index for DSM-IV for trauma-related symptoms and the Children's Global Assessment Scale for social functioning. Pre- and post-treatment outcome measures were analyzed using two-tailed paired t tests. The results for 35 participants indicate that post-traumatic stress symptoms were significantly improved following therapy [t(35) = 8.27; p < 0.01], whereas the assessment of social functioning supported the effectiveness of the program [t(35) = -14.68; p < 0.01]. The pre- to post-treatment effect sizes (Glass's delta) were 1.24 for the University of California at Los Angeles Post-Traumatic Stress Disorder Reaction Index and 1.96 for the Children's Global Assessment Scale. CONCLUSIONS: Our findings indicate that trauma-focused cognitive behavioral therapy is feasible for treating traumatized children of an Asian population. We discuss the implications of this result for clinical practice and future research.

This pilot study aimed to refine a treatment approach for traumatic grief due to violent loss. Our Traumatic Grief Treatment Program, a modification of Shear's complicated grief treatment (Shear et al., 2005), comprises psychoeducation, in vivo exposure, imaginal exposure, discussion of memories about and imaginal conversation with the deceased. Thirteen of 15 Japanese women suffering from posttraumatic stress disorder (PTSD) due to traumatic grief completed 12 to 16 weekly individual sessions based on their therapists' recommendations. Assessment scales included the Inventory of Complicated Grief, the Impact of Event Scale-Revised, and the Center for Epidemiologic Studies Depression Scale. There was significant reduction in symptom severity at treatment end, and symptom levels remained low throughout the 12-month follow-up period. Based on Jacobson's Reliable Change Index, 46% showed change on all 3 measures. These findings suggest that our treatment model may be feasible for treating traumatic grief with PTSD in non-Western settings.

明田芳久先生追悼号

This pilot study investigated the feasibility of Prolonged Exposure (PE) treatment for Japanese patients with posttraumatic stress disorder (PTSD) due to mixed traumatic events. Among 12 participants in this study, 9 women and 1 man completed between 9 and 15 weekly individual PE sessions; 2 female participants dropped out in early sessions. Among completers, the authors identified a significant reduction of symptom severity scores from pretreatment to posttreatment in terms of PTSD and depression on therapist-rated and self-rated measurements. Symptom levels remained low in 3- and 6-month follow-up assessments. Our findings suggest that PE is feasible and can be accepted for PTSD patients not only in Western countries, but also for those in Japan.