Book Review
Sexual Abuse 
Sexual Abuse of Males:
The SAM Model of Theory and Practice Josef Spiegel. New York (NY): Brunner-Routledge; 2003. 545 p. US$60.00
Reviewer
rating*: Excellent
Review by: Harvey Armstrong
Toronto, Ontario
This book is a most thorough and complete presentation and discussion of sexual abuse of males (SAM). I found it both excellent and exhaustive. It is clinically useful and scholarly, with 84 pages of references and resources. Every important statement is referenced to literature on the subject or related subjects. In some places, there are so many references to a statement that reading is difficult. The references are reliable and current. The acceptance of the psychopathology as originally adaptive but currently maladaptive is an outstanding feature.
Josef Spiegel takes an ecologic, biopsychosocial approach to the cause, impact, silence, dismissal, and treatment of, as well as recovery from, SAM. Spiegel presents a broad range of topics, from neurophysiology and neurotransmitters to the roles of social norms and beliefs. Psychopharmacology is an exception because it is barely mentioned. Spiegel also chastises the legal system for minimizing the importance of this crime against children, adolescents, and society.
His sources are eclectic but well rounded. Spiegel illustrates his theoretical and clinical opinions with the first-person case histories of 6 male patients, he has assessed and treated for SAM. Each case has features that distinguish it from the other 5. This underscores the lack of uniformity of male abuse victims. The descriptions are vivid and are presented in the victims’ words. Spiegel avoids DSM-IV diagnoses.
Spiegel points out the differences and similarities between abused female patients and abused male patients, as well as the social, psychological, and physical issues that join and separate them. There is some repetition as the author moves from assumptions to dynamics to treatment objectives, and then to practical exercises. These exercises would be useful for any practitioner. Spiegel clearly states that the relationship between patient and practitioner, combined with clearly defined goals and techniques, is what heals the sexually abused male patient and allows him to deal with his pre-, during, and postabuse experiences, as well as his current adaptations.
This book should be essential reading for all practitioners because the percentage of patients who have suffered sexual abuse is much higher than most realize. Male patients with mental health, physical, social, sexual, marital, family, or legal difficulties have an increased likelihood of having suffered sexual abuse.
This book is also useful for those who assess and treat female victims. Increasingly, male victims, like female victims, are coming forward in civil suits against institutions that have not paid heed to the complaints of young victims. Cases are increasing and settlements are rising. This book is a gem for those of us who assess these victims and suggest treatment.
This book is easy to understand and to read. The few illustrations, consisting only of black and white charts and tables, are useful.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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