Approaches in Working with Sexually Abused Children
As a major counseling service provider to sexually abused
children and their families, CPTCSA has been utilizing various counseling
approaches in an integrated manner, from a general case management framework to
more specific client-centered and issue-based psycho-emotional and
psycho-educational counseling interventions. Considering the complexity of the
problem of sex abuse, it is a must for every service provider to develop a more
sex abuse-focused counseling program in order for both counselor and client to
have some sense of predictability as to the content and outcomes of the chosen
mode of intervention.
Focus can be achieved when cases are properly assessed
and goals for counseling are clearly defined by the client and counselor.
Moreover, a mentoring form of supervision would then be easier for both the counselor
and mentor provided that mentoring is being provided by someone who is
experienced and trained. A counseling program without the support and guidance
of a qualified mentor-supervisor is quite unethical.
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
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
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
Press HERE to read Tivona's Story about a 14 year old victim
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