Counseling Sexually Abused Children

Cases of sexual abuse of children are being reported in increasing numbers. A large percentage of child sexual abuse occurs in or around the home. Family members, family friends, or known adults are most often the offenders. There are certain family factors likely to be operating in a child's sexual abuse and these factors must be explored with all family members. Sexual abuse can have many disturbing consequences for the child and the family. A counseling approach should be to help an abused child and the offender feel that they are still worthwhile individuals. Underlying issues in the family should also be explored. Paula Slager-Jorné is director of training at the Children's Center in Detroit, Michigan.     

Violence in College Students' Dating Relationships1

In a survey of 504 college students examining predictors of violence in heterosexual relationships, over half of both men and women had committed at least one physically violent act, and men more often than women reported having been the victims of such acts. Most respondents who reported some experience with violence had both committed and received it, were involved in relatively few different types of violence, and first experienced violence when a relationship had moved beyond the casual dating stage. Modest associations between physical violence and sexual aggression were uncovered. In a series of discriminant analyses, men who abused their partners were not readily distinguished from men who did not, but tended to be young, low in family income, traditional in attitudes toward women, abused as children, currently living with a woman, and from Appalachian areas. Women who abused were more readily discriminated and scored low in social desirability, were abused as children, and were from non-Appalachian areas. Men who were abused were likely to be living with a woman and tended to be low in family income; similarly, cohabitation was related among women to being a target of violence, as were having been abused as a child and scoring low in social desirability. Findings are related to those of other studies of dating abuse, as well as to the family violence and aggression literatures.     

Family Functioning Moderating the Effects of Childhood Sexual Abuse on Memory Specificity

The main goal of this study was to investigate if adults sexually abused as children who were raised in a functional family are more able to generate specific autobiographical memories and suffer fewer depressive symptoms than sexually abused adults who were raised in a dysfunctional family. We found that abused males retrieved fewer specific memories than nonabused males, abused females, and nonabused females. The three latter groups did not differ from each other. Further, childhood sexual abuse did not predict depression among males and females. After accounting for family functioning, there were no group differences regarding memory specificity. Functional families appear to have beneficial effects on the adjustment of male victims of childhood sexual abuse.     

The pastoral challenge of an abusive situation

This paper explores a ministerial response to congregants who have abused or neglected their child. I begin by distinguishing the three major secular responses to this kind of family problem: casework, counseling, and therapy, and go on to note how all of the above are limited in their effectiveness by the objective, causal, explanatory framework within which they operate. I suggest that a pastor can take the same family facts and help those involved to understand and respond to them concretely as they are experienced. The paper concludes with an exploration of this alternative approach within a religious vocabulary of prayer and increased inwardness.     

Help-Seeking Behaviors in Non-Offending Caregivers of Abused Children in the Philippines

The help-seeking process among non-offending caregivers (NOCs) of abused children particularly in the non-Western context has yet to be elucidated. The objective of the current study was to investigate what proportion of Filipino NOCs of abused children sought professional support services within 12 months following child abuse disclosure (T1) and at 12 months (T2) follow-up in the Philippines. Two further aims were to investigate NOCs’ preferred service providers and settings and to explore barriers to help-seeking. A comparison group of Filipino parents without an abused child were also recruited to compare preferences and potential barriers to help seeking for child and family problems. A total of 47 NOCs and 70 comparison parents/guardians completed questionnaires, which assessed help-seeking preferences and barriers as well as parental stress. The majority of NOCs reported seeking help, which was perceived to be helpful. Almost two thirds of NOCs indicated preference for in-person counseling relative to the comparison group of parents. The majority of NOCs preferred seeking help from social workers and psychologists. Almost one third of both parental samples reported being judged as an unfit parent as a key barrier to seeking help for family problems. The findings have implications for psychological and allied health service providers in facilitating the adjustment for families of recently abused children.     

Immediate and delayed suggestibility among suspected child victims of sexual abuse

Children suspected of being victims of sexual abuse are often interviewed by police, but little is known about the effects of sexual abuse on their suggestibility. The aim of this paper was to investigate differences in ‘immediate’ and ‘delayed’ suggestibility between children being investigated as suspected victims of sexual abuse and other children and to compare the suggestibility scores of children allegedly abused by a family member versus a person from outside the family. The participants were 180 children aged between 7 and 16 years, who had been subdivided into ‘victim’ and ‘control’ groups; each group being comprised of 90 children and matched for IQ. All children completed the Gudjonsson Suggestibility Scale (GSS 2) and a non-verbal IQ test. The children in the victim group scores significantly higher on Shift and Yield 2 than the control group, after controlling for memory capacity. Children abused by a family member coped significantly worse with interrogative pressure (high Shift) than those abused by a non-family member. Immediate suggestibility showed much stronger effects than delayed suggestibility. The findings suggest that sexually abused children are very vulnerable during questioning where there is interrogative pressure and those abused by a family member are even more vulnerable.     

Resolving the trauma organized system of sexual abuse by confronting the abuser: A focal family therapy approach with a woman who was a childhood victim of sexual abuse

The longer-term emotional and interpersonal effects of sexual abuse in childhood are reviewed and approaches to treatment discussed. The notion of a 'trauma organized system' to account for the long-standing effects of abuse is described. A major potential issue in creating therapeutic change is confronting the abuser, and a case is described where a woman brought her family for therapy when it was feared that the father, who had abused her in childhood, might abuse his grandchildren. A focal family therapy approach was used: this takes into account the traumatic nature of abusive events and their long-term organizing effects on individual and family functioning. The process of therapeutic work is described, including the resolution of traumatic effects by confronting the abusive act.     

Transference and countertransference issues with sexually abused clients

Abstract

This paper explores some of the therapeutic issues which arise when working with sexually abused clients. It is suggested that both the client and the therapist may at moments take any of the three positions in the Oedipal triangle and that the mother, father and child status are interchangeable in the transference and counter-transference. It is also suggested that the Oedipus myth represents the failure of a family to contain sexual and murderous passions. I describe a Hindu myth which takes a similar triangle of passion but illustrates how containment is possible. It is proposed that this implies we need to re-evaluate the presence of the erotic in therapy in a more positive light. It is further suggested that the sexually abused client needs to experience the containment of passion if a healing process is to occur.     

Sexually abused girls and their Rorschach responses

Exner's scoring (1990) was used on the responses by 46 sexually abused girls (6 to 14 years old) and 46 nonsexually abused girls (6 to 14 years old). Subjects were matched for age, race, family income, and family constellation. Sexually abused children exhibited significantly more unusual content, e.g., sex and blood, in their protocols as well as more frequent coping deficits.     

Current Treatment Strategies for Sexually Abused Children

SUMMARY

Given the disturbingly high prevalence of child sexual abuse, the expertise of medical and mental health professionals in treating child sexual abuse victims is essential. Relevant issues in treating these children include the mindfulness of developmental considerations, incorporation of a multi-modal therapeutic evaluation approach, clarification of treatment goals, appropriate use of and integration of various treatment modalities, and effective treatment termination. This article provides an introduction aid overview of treatment of sexually abused children of all ages, from preschoolers to adolescents, with special emphasis on the importance of developmentally linked evaluation and treatment strategies. Treatment is discussed in terms of goals, stages from evaluation to termination, and formats and modalities including individual psychotherapy, family psychotherapy, group psychotherapy and hypnotherapy, to provide a comprehensive overview of current treatment strategies for sexually abused children.     

Histories of sexual abuse in adolescent male runaways

In this study, data on sexual victimization in the histories of 89 Canadian male runaways as well as information on physical victimization, family structure, family financial stability, delinquent and criminal activities, and reasons for running away from home were evaluated. The population of male runaways evidenced dramatically higher rates of sexual and physical abuse than did randomly sampled populations. Sexually abused and nonsexually abused male runaways shared characteristics noted in the literature as common to runaways: problem families, high rates of delinquency, depression, tension, low self-image, and history of physical abuse. Sexually abused male runaways differed from nonsexually abused runaways in their reactions to their runaway event, with sexually abused male runaways responding in highly avoidant patterns coupled with extreme withdrawal from all types of interpersonal relationships. These differences are explained as consistent with known sequelae of sexual abuse, and the implications for treatment by runaway shelters and for further research are suggested.     

Parenting behaviors of women who were sexually abused as children in their families of origin.

This research explored links between a childhood history of family sexual abuse and current parenting behaviors of mothers of school-age children, using observations of family interaction and interviews with the mothers. Videotaped family interaction tasks, analyzed with Benjamin's Structural Analysis of Social Behavior, showed that women who had been sexually abused in their childhood families were more self-focused, rather than child-focused, compared to nonabused women. In interviews, the women who had been abused gave strong evidence of greater reliance on their children for emotional support. These findings lend support to theoretical and clinical impressions of highly permeable intergenerational boundaries, including parent-child role reversal, in family systems marked by child sexual abuse, even when the abuse occurred in the previous generation.     

Nonfatal Suicidal Behavior Among Chinese Women Who Have Been Physically Abused by Their Male Intimate Partners

Three hundred fifty‐three women (median age = 32 years) admitted to the emergency rooms of nine general hospitals serving rural areas in China were interviewed for nonfatal suicidal behavior. Spousal conflict was the most commonly reported cause for their suicidal behavior and one third of respondents reported being victims of physical abuse by their spouses. Compared to non‐abused women, abused women were younger, had more disturbed family relationships, and experienced less financial hardship and more divorce. No differences were found between the groups in the proportion who reported psychiatric symptoms or in the level of suicidal intent; however, abused women were less impulsive and expressed more sadness at not having been successful in ending their lives.     

The Development,Process, and Evaluation of Group Psychotherapy With Sexually Abused Preschool Girls

The development, process, and evolution of group psychotherapy specifically designed for sexually abused preschool aged females is presented. Utilization of male and female cotherapists, group structure, individual and family dynamics, the role of children's mothers in treatment, and process of treatment are examined. Issues regarding countertransference phenomena, cotherapy relations, in-depth involvement of the children's mothers, and specifics related to structuring of a time-limited group are beyond the initial intent and scope of this paper, and are not discussed here.

The cotherapists conclude that group psychotherapy for children of this age group is both clearly valuable and highly indicated as an adjunct treatment modality. In future group psychotherapy with sexually abused preschool aged children, based upon clinical experience and evaluation, the cotherapists advocate a time-limited approach whereby each session would focus upon specific issues as illustrated in Table 1, and include structured and purposeful involvement of the girls' caretakers.     

Dynamics of Psychotherapy,Vol. III by Percival M. Symonds

This article presents a model for the group treatment of young children who are victims of physical or sexual abuse using the basic socialization unit, the family, as the analogue model. Components of the model include male–female cotherapists, a peer group of abused children, periodic home visits, a consultative rather than therapeutic relationship with the caretakers, and group supervision of the therapists. Seven therapeutic goals are identified which highlight therapeutic issues unique to the abused child within a developmental framework. A case example illustrates the process.     

The case against the routine provision of psychotherapy to children/adolescents labeled “sexually abused”

Whether symptomatic or asymptomatic, children labeled sexually abused are routinely offered treatment at considerable financial cost. One result of this is that mental health professionals are being charged with exploiting the problem of child sexual abuse (CSA). Is the routine provision of psychotherapy for children and adolescents labeled sexually abused warranted? In this paper, it is argued that the evidence indicates it is not warranted. Further, its provision is not in the best interests of either the children or mental health professionals. A number of recommendations are given which follow from the evidence.     

Counseling the incest offender

The Center Against Sexual Assault in Phoenix, Arizona is currently treating 50 incest offenders in its Offender Group treatment program. The average age range is 31–45 years old, and 80 percent were sexually or physically abused as children. These men have been found to be extremely self-centered, exhibit poor impulse control, and possess a strong denial of reality. The treatment program includes several intake sessions to ascertain suitability of the offender to this type of therapeutic approach and a stated self-admission of at least the possibility of incestuous involvement. The offenders work in groups, as well as individual sessions.     

Expectancies for Sexually Abused Children: Evidence of Perceiver Bias

We investigated perceiver bias in relation to children labeled as sexually abused. Building on recent research indicating that adults perceive children with such a label as having more behavioral problems and lower achievement, we replicated and expanded upon an earlier study. We tested undergraduate students (N = 699), who judged a six-year old child's aggressive behavior in vignettes that varied on severity of the aggressive behavior, child gender, and family history (sexually abused, mother dying of cancer, normal). Perceiver bias was related to family history label for internalizing behavior problems and competence issues and child gender for internalizing behavior problems and externalizing behavior problems. Implications for educators and practitioners are discussed as well as routes for future research.