Executive Defense Technology, LLC

Below is an example of how CPTCSA designed an issue-based counseling approach by adapting and integrating two helping approaches: The 12 major issues in counseling sexually abused children (a thematic approach) and the Healing, Teaching and Caring intervention model by taking into account the reported effects of sexual abuse by the clients. The 12 major issues are:

1. Physical - The focus of the counseling within this issue surrounds the child's fear of physical damage and pregnancy, hence, a physical exam by an empathic doctor can be extremely helpful to rule this out and assist the child to deal with the findings. Most often physical findings indicate favorable results that relieve the child from worrying.

2. Psychiatric - Depression is a common reaction in victims. Clinically, it is necessary to look for signs of depression, to anticipate suicidal thoughts, and to support and protect the child from hurting himself / herself (self-inflicted wounds) and others. The signs could be lingering sadness, sleep disturbance, poor appetite, and unusual aggression. No amount of counseling could remove these symptoms, thus psychiatric intervention by way of medication is needed to treat the depressed child.

3. Legal - Though this issue is not included in the children's list of child sex abuse consequences, CPTCSA consciously included this because it is also vital for children to consider the legal process as one of their healing options. CPTCSA’s legal intervention is done through its Teens and Kids Court awareness program where children are guided in discussing the legal and justice system and its implications not only for victim safety but also for safety of other children at risk to be abused by the same offender. Counseling also deals with helping a child make a decision about whether they are capable of dealing with a court case.

4. Safety - This pertains to the emotional, psychological as well as physical safety of the child commonly derived from the child's fears. The fears often take the form of nightmares or sleep disturbance and other somatic complaints. The child is also afraid of future harm from possible reprisal from the perpetrator(s). Thus in the course of counseling, sources and contexts of fears are identified and processed with the child, ensuring child safety from further abuse or re-victimization. In most instances, the child is referred for protective custody to remove the perpetrator's access to him / her, as well as emotional safety strategies.

5. Sexual Identity - Homophobia is the most common issue of sexually abused boys in our experience. Behavioral manifestations of this problem can be seen through the boy's aggressive behaviors as a way of re-establishing their perceived loss of masculinity, one probable reason why the majority of the sex offenders are men. Higher level of anxiety and identity confusion are also commonly displayed by boys who experience "homosexual" abuse. This identity confusion generally stems from the boys concern over both the reasons for their selection as victims and their inadequate resistance to stop their abusers.

6. Believability - Most often the child was not believed when she/he first reported the abuse. Instead she / he was told to keep the abuse quiet, otherwise, she/he and her family would be stigmatized. A problem of trust could then be expected. Frequently, this is linked to low self-esteem and a feeling of being betrayed, and problems in forming close and intimate relationships with others.

7. Shame, Guilt & Responsibility - Shame and guilt feelings are commonly formed from the child's own physical responses to the sex abuse and by the perpetrator's portrayal of the child as seductive or as a willing participant. The child then could feel responsible for the abuse and other consequences, such as family disruption and family stigmatization. Consequently, charges against the offender(s) are often dropped so that the child can unburden herself from these feelings.

8. Powerlessness - Victims commonly feel a sense of personal powerlessness. This feeling can arise in response to the victim's inability to stop the repeated invasion of their bodies. A sense of loss is also experienced by the victims, loss of their family, loss of their innocence and loss of their normalcy.

9. Anger/Hostility - Victims are often angry not only with the perpetrators but also with family members who did not protect them and at others like the community that did not respond to their disclosure about the abuse. In some cases repressed anger could lead into severe depression.

10. Body Integrity/Sexualized Behavior - In counseling it is not uncommon for counselors to encounter children who exhibit highly eroticized behavior. This behavior is developed as a way of coping with the inappropriate early sexual experiences of the young child. Likewise, children can hate sex and protect their bodies by not bathing and making themselves ugly for protection.

11. Interpersonal Relationships - Victims often experience a sense of isolation. They isolate themselves from others, friends, families, even including the service providers. They isolate themselves for fearing that they would be recognized as victims and be ostracized by others. Behaviorally, isolation could be in a form of withdrawal and aggression to avoid development of intimacy and bonding. Fear of intimacy is one of the common issues among female victims of sex abuse