Chapter 14 By: Griselda Valdes, Heidy Fajardo, Enisa Alicea, Lita Wimbley, Tamaya Davis

Treatment: Sexual Abuse

Issues surrounding treatment:
Societys tendency to isolate both family and worker, combined with the familys secretiveness and will to bond in an effort to ward off intruders makes treatment difficult Negative of positive influence with family The helping system continues to struggle with how and who in the family to treat

Professionals advance new theories and treatment methods but long term testing and evaluation is either nonexistent or just beginning Not many community services address the needs of children abused outside the home Familial abuses cases are handled by a social services handled by Social Services Extra familial comes under the jurisdiction of the criminal justice system Services for extra familial abuse cases approve but lack of resources remain a problem

Treatment models (child sexual abuse treatment program):

Of all types of child maltreatment, sexual abuse is seen foremost as a criminal offense. Intervention too often focuses on prosecution and not on treatment for the whole family system.

Child Sexual Abuse Treatment Program: has three components: professional staff, volunteers, and self-help groups. o The professionals orchestrate the treatment plan o Volunteers provide support o Self-help groups, such as Parents United, Daughters and Sons United, provide support and group therapy Types of therapy: Individual or group therapy, couples counseling, family therapy, and groups for victims, offenders and non-abusive parents.

Treatment Methods (issues addressed in family treatment)

Family is a system that is composed of subsystems, therefore it needs to be worked with as a whole as well as individually. As a whole the family has some specific tasks

1. Realignment of generational boundaries and roles (incestuous families parents are split and children hold parentifies roles therefore there needs to be a realignment of roles)

Chapter 14 By: Griselda Valdes, Heidy Fajardo, Enisa Alicea, Lita Wimbley, Tamaya Davis

2. Teaching the family members how to communicate effectively (so that all might get their needs met) o Teaching adults parental skills o Helping the adults to create not only boundaries but also healthy rules for the family to live by Phases of Treatment 1. Disclosure-Panic: Initially family is defensive, angry and on denial. They project their blame onto others. o Phase lasts several weeks to several months o Worker empathizes and shows support to each member o Child needs to be assured that s(he) is believed and that s(he) will be protected o Mothers often denies the abuse and assumes child in lying o The children who are victims blame themselves for the abuse 2. Assessment-Awareness: occurs when the family members accept the reality of the abuse and assess what they actually have in the way of family relationships. o Roles of parents and children must be redefined so that members recognize their appropriate roles in the future. o Marital therapy and strengthening mother-child bond is necessary o Fathers future role is considered 3. Restructure: Gradually the family will adopt a more functional pattern of life. The family is reunited and have more open and honest communication o With therapy the family has gained skills and are capable of better understanding when to ask for help in the future. o Parents have learned to maintain boundaries, to communicate effectively and to give nonsexual stimulation and affection to their children. o The child recognizes that he or she has the power to resist and to ask for help if the molestation recurs. o All members of the family should feel great self-worth and empathize with the feelings of others Types of Therapy Used With Children Effective treatment gives the children an opportunity to express their negative feelings about themselves. (325) some of the kind of therapy that works with children are the following: o Group therapy- is especially effective with adolescent victims. This allows the victims to ventilate anger in a safe environment and develop new socialization skills. o Art therapy- is useful in assessment and in treatment. For example; by drawings portray the victims reactions to the abuse, and their self-image. Art therapy includes music, dance, movement, mime, drama, and poetry. Also Journal and story writing o Individual therapy- is useful in developing a trusting relationship on which the child can model other relationships. This therapy often begins when the child is in crisis over disclosure. o Play therapy- with younger children play therapy enables them to express themselves in a manner that less threatening. Victims enjoys games or projects, over which they can talk while seeming to put their attention elsewhere.

Chapter 14 By: Griselda Valdes, Heidy Fajardo, Enisa Alicea, Lita Wimbley, Tamaya Davis

o Mother- daughter therapy- this type of therapy helps strengthen the bond, improves communication, and ensures protection for the child in the future. Goals and issues in treatment for specific family members: the child victim, the nonabusing parent, the perpetrator

Child Victim Goals - 4 1. 2. Child will be able to deal with feelings more effectively (Individual Therapy) Integrate abuse as a life occurrence in order to continue on with their life

3. Assuring the child that they are entitled to protection within the family unit (Family Therapy) 4. Family members, along with child, lean to express needs in future (Family Therapy) Issues - 10 1. 5. 7. 9. 10. Feeling like damaged goods 2. Guilt 3. Fear 4. Depression

Low self-esteem leading to poor social skills 6. Repression anger/hostility Difficulty trusting 8. Blurred generational boundaries, role confusion

Pseudomaturity, failure to complete appropriate developmental stages Control, mastery over self

Non-Abusing Parent Goals 8 1. 2. 3. 4. 5. 6. 7. 8. Strengthen their role in the family so that in future can provide protection for child Unconditional acceptance and encouragement, in order to take control of their life To recognize their own feelings and share them with others Increase ability to enforce boundaries Learn to trust Anger /rage must be dealt with Recognition they fail to protect child from abuse Cultural sensitivity to clients culture Issues 6 1. Parent often a victim of abuse themselves

Chapter 14 By: Griselda Valdes, Heidy Fajardo, Enisa Alicea, Lita Wimbley, Tamaya Davis

2. 3. 4. 5. 6.

Feelings of inadequacy, dependence needs Expect others to perceive their needs and fulfil them Denial of state of marriage Anger, expressed in negative manner Lack of trust, in relation to others

The Perpetrator Goals 7 1. Accept personal responsibility for abuse

2. Understand the sequence of feelings, events, stimuli, circumstances that led to sexual abuse 3. 4. 5. 6. 7. Learn to break pattern at first sign leading to abuse Learn appropriate tools and mechanisms to break pattern, to control behavior Develop positive self-concept Have an opportunity to test new skills in a safe environment Post-treatment support to prevent recidivism

Issues 3 1. 2. 3. Risk public must be protected from their actionsincarcerate offender Risk Invention to be effective, must receive treatment for individual pathologies Testing for strengths to determine what must be remediated