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Ethical Dilemmas in online research & treatment of sexually abused adolescents

Door Interapy Nederland | 12-07-2012, Samenvatting
Background: Although the prevalence of sexual abuse is high among adolescents, many victims do not seek treatment. Internet therapy may provide a low‐threshold alternative to regular care.

Objective: To evaluate an internet treatment protocol for adolescent victims of
sexual intimidation, violation and rape.

Methods: The effects of the treatment protocol were evaluated in two studies. The first study was an uncontrolled pretest‐posttest pilot. The second study was a baseline‐controlled trial, using repeated measurements. To control for spontaneous improvement, participants reported their symptoms both during a baseline control period and during treatment.

Results: In the pilot study, treatment completers (n=7) reported substantial decreases in trauma symptoms (effect size: .9 < d < 1.1). However, there was a large pre‐treatment dropout rate (90%) among the potential participants aged between 14 and 18 years old. Dropout appeared to result from the request for biographical information and parental consent during the screening. The second (controlled) study (n = 24) confirmed the impact of treatment. Yet, despite attempts to reduce pre‐treatment dropout, it remained high (77%).

Conclusions: The findings raise important ethical dilemmas. On the one hand it
is appealing to allow anonymity in this vulnerable and undertreated population. On
the other hand, responsible care providers may need biographical data in order to
act if crises occur. The paper discusses the impact of the questions that may arise in
online treatment, but also in online self‐help programs, but does not claim to have
clear‐cut answers.

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