Treatment for Sexually Abused Children

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Abstract

Sexual abuse is one of the most common forms of child abuse. Its occurrence within the past decade has increased, thus creating a serious problem to the society as it threatens social dynamics. Additionally, the vice has dire effects on the future economic prospects countrywide if not dealt with appropriately and at the right time.

Children are part of the high-risk group for such abuse due to their innocence, which presents a form of vulnerability that perpetrators can exploit. Most governments have developed centers with specialized professionals where children, parents, and other caregivers can obtain help on how best to deal with the problem. Child abuse intervention is critical in setting the social and economic dynamics for future generations.

Introduction

Sexual abuse entails activities that involve forcing children or enticing children below the age of fifteen years to participate in activities of a sexual nature, including intercourse, exposure to sexual material such as pornography, and inappropriate contact with private parts. A child’s perception on the morality of the sexual act is irrelevant in sexual abuse cases, especially when there is adult participation in the act.

Treatment of sexually abused children is one of the many forms of intervention in dealing with child abuse in the society. Isolation of the problem from other forms of abuse is necessary as it enables intervening professionals such as psychologists and doctors to deal with the problem in the delicate manner that it deserves.

This paper explains some of the treatment options available for sexually abused children. It explores some of the factors that psychologists consider in determining the correct form of treatment for a child and what the various forms of treatment aim to achieve.

The diagnostic process

One of the factors that psychologists consider before prescribing treatment for a child is his or her age. A child’s age determines the level of understanding on what is right/wrong or normal/abnormal. It also determines the method of treatment best suited to the child. For instance, a five year old has a significantly higher level of awareness of the environment and understanding of right and wrong than a two-year-old child does.

Using therapy to help the five-year-old understand the problem and solutions is thus more appropriate in relation to the two year old. The second factor that comes in play in the diagnostic process is a child’s environment. A child’s surroundings play a big role in increasing or decreasing his or her vulnerability to sexual abuse (Gallagher et al., 2008).

Neighborhoods with low levels of security present a higher risk factor to children living in them than those with significantly higher security. The type of people living in a neighborhood may also raise or lower the risk factor for sexual abuse. For instance, a neighborhood with a high number of unemployed young men tends to have higher crime rates including sex related offences. Such a neighborhood would thus create a high-risk environment for children who are sixteen years and below (Coulton et al., 2007).

Thirdly, a psychologist also considers a child’s background in terms of relationships inside and outside the family setting. Relationships form part of a child’s social support system. Therefore, a faulty system would create a problem for the child during the recovery period (Tarabulsy et al., 2008).

The psychologist would thus need to establish a mechanism to repair the support system where possible or create a new one that a child can adopt by changing the social dynamics. One of the ways that childcare professional can achieve this goal is through prescribing out-of-home treatments, facilitating transfers to new schools, and recommending social activities geared towards the creation of new friendships. Another factor to consider in the establishment of a course of treatment is a child’s personality.

Treatment options for socially active children and introverts are different. Socially active children find it easier to associate with new people in their lives than children who prefer their own company (Finkelhor et al., 2007). Therefore, recommending a treatment method that involves many social activities for a socially conscious child would be futile. The role of a psychologist is not to alter a child’s personality, as that aspect remains a personal choice.

A child’s gender is also an important consideration as it dictates his or her role in society and some of the behavioral expectations that society considers as appropriate. For instance, society expects its female members to dress decently and cover up parts of the body that a male may consider sexually provocative. Male members on the other hand learn that they need to respect women and treat them as humanely as possible.

Males also learn that they play a protective role over females, and thus they should not use their physical strength for sexual abuse (Banyard & Williams, 2007). Lastly, a psychologist may consider previous episodes of abuse and some of the methods of intervention used.

This aspect helps him or her establish whether a certain course of treatment may work (Greenberg et al., 2008). It also enables him or her establish the kind of attitude a child may have towards certain courses of treatment. For instance, a child who has previously had a course of treatment that involved joint therapy with his or her parents may opt for personal therapy sessions instead.

Treatment goals

One of the goals of treatment of sexually abused children is to ensure that they overcome their abusive experiences as they grow into adulthood. Secondly, treatment aims at restoring a sense of normalcy in the child’s life. It helps the child understand that such a traumatic experience should not cause detachment from other experiences in life. Thirdly, treatment prevents transference, a phenomenon whereby the child carries the same experiences into adulthood and inflicts harm to other people in the same manner.

Lastly, early treatment of sexually abused children ensures the occurrence of healthy social dynamics in the future. Social dynamics dictate gender roles and economic development in a community and a country in general. Economic development depends on the social stability and reduction on the crime rate. Therefore, by ensuring that victims of sexual abuse do not carry the vice forward, the treatment of sexually abused children fosters economic development.

Treatment options

Therapy

Therapy is a form of treatment that mainly deals with psychological health. Therapy involves an analysis of a patient’s state of mind, concerns, and perceptions of reality and a redirection of such perceptions in cases where the patient’s perceptions contradict reality. With regard to sexually abused children, one of the objectives of therapy is to enable the child make sense of his or her experiences.

A therapist assists the child to comprehend his or her feelings regarding the incidents of abuse, thoughts on what sexual activities entail, and elements that constitute appropriate behavior. A therapist also aids the child in establishing what comprises healthy interaction and relationships, which is especially important for children, as they tend to look up to adults for mentorship.

In order to establish a course of treatment that is appropriate for every child, therapists apply theoretical studies for the derivation of practical applications. One of the theories that assist therapists in establishing appropriate treatment is the moral development theory. The theory bases its foundation on the premise that a person’s cognitive ability depends on his/her stage of development. In essence, cognitive ability affects behavioral patterns.

The founder of the theory, Lawrence Kohlberg, presents the view that human moral development occurs in three stages, which are concurrent with growth from childhood to adulthood (Finkelhor et al. 2007). The first stage, the pre-conventional stage, applies between infancy and young adulthood. In this stage, children react to a system of reward and punishment in learning what comprises morality. They tend to do more of the activities that earn rewards and less of those that result in punishment.

The practical application of this theory is that it helps therapists establish the cause of sexual abuse, appropriate treatment, and prevention measures. For instance, if the form of abuse involves exposure to pornographic material, a therapist would need to explain to a child why such material is bad for him or her and consequences that such material may cause. The manner in which the therapist explains such issues depends on the child’s age and subsequent cognitive ability.

Another theory that therapists apply in the diagnostic process is the attachment theory. The theory suggests that a mother forms a bond with her child at infancy and such a bond may be secure or insecure in nature (Tarabulsy et al., 2008). The theory presumes parents as models of safety and sanctuary for a child. Secure bonds form when children can view their parents as their sanctuary while insecure bonds form when children lack the feeling of safety when with their parents.

The types of bonds are significant in a child’s growth. Secure bonds foster feelings of dependability while insecure bonds reinforce feelings of self-insecurity and low esteem. Such bonds extend to interactions with people outside the family unit. The theory helps a therapist establish the kind of treatment a child needs, especially regarding relationships.

If the perpetrators of the incidents of abuse on the child are his or her parents, therapist may find it necessary to recommend an out-of-home model of treatment that puts the child in a different environment. Such an environment may be necessary in enabling children reconstruct their perspective on what appropriate relationships constitute.

Therapy options also vary depending on the prevailing circumstances. In instances where insecure bonds are evident, a therapist may prescribe personal professional sessions with the child. This aspect helps a child open up about his or her experiences and creates a safe environment that fosters the healing process (Greenberg et al., 2008).

In cases of secure bonds, a child may opt to include his or her parent or parents in the sessions in order to reassure safety. In some instances, the therapist may choose an informal setting that puts a child at ease such as a park or playground, depending on the child’s age and preference. The aim is to create a relationship between the therapist and the child that serves as a model for appropriate relationships in the child’s life.

Getting the child to feel comfortable and safe enables the creation of rapport and easy discussion of traumatic events (Feiring & Cleland, 2007). Therapy sessions also enable the therapist pinpoint behavioral issues that a child may have that put him or her at risk of abuse and address them appropriately.

For instance, if the victim of abuse is a girl who likes to sit with her legs open thus exposing her private parts, a therapist may notice it and address it appropriately. For a boy who likes peeping under peoples’ clothes, a therapist can observe the same and explain why such behavior is inappropriate.

Therapists also support positive and productive relationships by counseling parents, teachers, and other relevant adults in a child’s life on how to deal with issues relating to the abuse. Sexual abuse tends to attract stigma and it is thus important to ensure the confidentiality of information relating to the abuse as part of the process of bringing normalcy to a child’s life.

Lastly, therapists teach children the importance of personal care, ways of accomplishing it, and how to avoid future incidents of abuse. This approach empowers the child and diminishes feelings of worthlessness and helplessness. The overall effect is that it opens the child up to other experiences in life and allows him or her to grow beyond the traumatic experiences.

Relocation

Sometimes the best way to initiate the treatment process involves removing the child from an abusive environment, especially when the abuser is a parent (Macmillan et al., 2009). Although separating a child from his or her parents may prove counterproductive, keeping the child away for a certain period may help him or her create new experiences different form the abusive ones. Such relocation depends on the perpetrator of the crime.

For instance, in a case where a parent abuses his or her child sexually, relocating the child to a boarding facility away from the parent would be advisable.

However, it is important to consider the child’s wishes regarding contact with such a parent. In some cases, visitation right may apply. In a case where the perpetrator is the child’s teacher, then moving the child to another school is vital in breaking the chain of abuse. In essence, relocation aims at separating the child from the perpetrator and allowing him or her create new experiences in a different location.

Prevention

Prevention of future acts of sexual abuse is a form of treatment for sexually abused children as it alters the environment in which a child lives, thus making it secure for abused children and the future generations (Reading et al., 2009). Community education is one of the key elements in the prevention process.

It creates awareness of the problem, eradicates stigma related to sexual abuse, and provides an avenue for formulation of solutions including the removal of offenders from the community through imprisonment (Prinz et al., 2009). It also ensures that the social dynamics encourage growth of children in the community without the threat of victimization.

Conclusion

Sexual abuse causes trauma to any victim regardless of age or gender, but it is especially traumatic for children as it presents the likelihood of changing their perception of reality in terms of interactions with other individuals in society as they grow up.

Sexually abused children are likely to shy away from association with other members of society as they grow up, mistake abnormal sexual behavior for normal ones, and even affect the child’s view on gender roles in society. Treatment of the problem early in advance curtails the progression of such confusion and corrects a child’s perspective on human interactions, thus enabling him or her to grow physically, mentally, and emotionally.

Reference List

Banyard, V., & Williams, L. (2007). Women’s voices on recovery: a multi-method study of the complexity of recovery from child sexual abuse. Child Abuse and Neglect, 31(3), 275–90.

Coulton, J., Crampton, S., Irwin, M., Spilsbury, C., & Korbin, E. (2007). How neighborhoods influence child maltreatment: a review of the literature and alternative pathways. Child Abuse and Neglect, 31(12), 1117- 42.

Feiring, C., & Cleland, C. (2007). Childhood sexual abuse and abuse-specific attributions of blame over 6 years following discovery. Child Abuse and Neglect 31(11), 1169–86.

Finkelhor, D., Ormrod, K., & Turner, A. (2007). Poly-victimization: A neglected component in child victimization trauma. Child Abuse and Neglect, 31(1), 7–26.

Gallagher, B., Gradford, M., & Pease, K. (2008). Attempted and completed incidents of stranger-perpetrated child sexual abuse and abduction. Child Abuse and Neglect, 32(5), 517–528.

Greenberg, L., Warwar, S., & Malcolm, W. (2008). Differential effects of emotion focused therapy and psycho education in facilitating forgiveness and letting go of emotional injuries. Journal of Counseling Psychology, 55(2), 185-196.

MacMillan, L., Wathen, N., Barlow, J., Fergusson, M., Leventhal, M., & Taussig, N. (2009). Child maltreatment 3: Interventions to prevent child maltreatment and associated impairment. The Lancet, 373(9659), 250–266.

Prinz, R., Sanders, R., Shapiro, J., Whitaker, J., & Lutzker, R. (2009). Population-based prevention of child maltreatment: the US triple p system population trial. Prevention Science, 10(1), 1–12.

Reading, R., Bissell, S., Goldhagen, J., Harwin, J., & Masson, J. (2009). Promotion of Children’s rights and prevention of child maltreatment. The Lancet, 373(9660), 332–343.

Tarabulsy, G., Pascuzzo, K., Moss, E., St-Laurent, D., Bernier, A., Cyr, C., & Dubois-Comtois, K. (2008). Attachment-based Intervention for maltreating families. American Journal of Orthopsychiatry, 78(3), 322-332.

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