Sexual Abuse: Seeking Help

This information was taken directly from Child Welfare Information Gateway

Seeking Help

Responding to the needs of a child who has been sexually abused may involve the whole family and will likely have an impact on all family relationships. Mental health professionals (for example, counselors, therapists, or social workers) can help you and your family cope with reactions, thoughts, and feelings about the abuse. It is important to seek a behavioral health professional with a background in child development, child trauma, and sexual abuse. Before agreeing to work with a particular provider, ask questions about the person’s background, experience, and approach to treating children. (There is growing evidence for certain types of interventions; see page 12 for more information.)

Impact of Sexual Abuse on the Family

Being a kinship caregiver or a foster or adoptive parent to a child who has experienced sexual abuse can be stressful to marriages and relationships. Parenting in these situations may require some couples to be more open with each other and their children about sexuality in general and sexual problems specifically. If one parent is more involved in addressing the issue than another, the imbalance can create difficulties in the parental relationship. A couple’s sexual relationship can also be affected, if sex begins to feel like a troubled area of the family’s life. If and when these problems emerge, it is often helpful to get professional advice.6

In addition, if one parent was more in favor of adopting, and the other parent merely complied, general stress can be added to the couple when children have a range of problem behaviors that require attention. Some parents develop resentful and angry or withdrawn feelings toward foster or adoptive children who take up a lot of time and energy (for example, children who need extra monitoring and supervision or transport to weekly therapy appointments).

Parents can also feel stress because the child’s siblings (birth, foster, or adoptive) may be exposed to new or focused attention on sexuality that can be challenging for them. If one child is acting out sexually, you may need to talk with siblings about what they see, think, and feel, as well as how to respond. Children may also need to be coached on what (and how much) to say about their sibling’s problems to their friends. If your children see that you are actively managing the problem, they will feel more secure and will worry less.

When one child has been sexually abused, parents often become very protective of their other children. It is important to find a balance between reasonable worry and overprotectiveness. Useful strategies to prevent further abuse may include teaching children to stand up for themselves, talking with them about being in charge of their bodies, and fostering open communication with your children.

Counseling for Parents and Children

Talking with a mental health professional who specializes in child sexual abuse as soon as problems arise can help parents determine if their children’s behavior is cause for concern. Specialists can also provide parents with guidance in responding to their children’s difficulties and offer suggestions for how to talk with their children. A mental health professional may suggest special areas of attention in family life and offer specific suggestions for creating structured, safe, and nurturing environments.

To help a child who has been abused, many mental health professionals will begin with a thorough assessment to explore how the child functions in all areas of life. The specialist will want to know about:

Past stressors (e.g., history of abuse, frequent moves, and other losses)

Current stressors (e.g., a medical problem or learning disability)

Emotional state (e.g., Is the child usually happy or anxious?)

Coping strategies (e.g., Does the child withdraw or act out when angry or sad?)

The child’s friendships

The child’s strengths (e.g., Is the child creative, athletic, organized?)

The child’s communication skills

The child’s attachments to adults in his or her life

How the child spends his or her time and how much he or she spends with TV, Internet, video games, etc.

After a thorough assessment, the mental health professional will decide if the child and family could benefit from therapy. Not all children who have been abused require therapy. For those who do, the mental health professional will develop a plan tailored to the child and to the family’s strengths and needs. This plan may include one or more of the following types of therapy:

Individual therapy. The frequency and duration of therapy can vary tremendously. The style of therapy will depend on the child’s age and the therapist’s training. Some therapists use creative techniques (for example, art, play, and music therapy) to help children who are uncomfortable talking about their experiences. Other therapists use traditional talk therapy or a combination of approaches. All types of individual therapy that are evidence-based also include a component for family or parent engagement.

Group therapy. Meeting in groups with other children who have been sexually abused or who have developed sexual behavior problems can help children understand themselves; feel less alone (by interacting with others who have had similar experiences); and learn new skills through role plays, discussion, games, and play. Group therapy for parents can also be extremely beneficial.

Family therapy. Many therapists will see children and parents together to support positive parent-child communication and to guide parents in learning new skills that will help their children feel better and behave appropriately.

Whether or not family therapy is advised, it is vital for parents to stay involved in their child’s therapy or other kinds of treatment. Skilled mental health professionals will always seek to involve the parents by asking for and sharing information.

There are several evidence-based programs that have been found useful for treating children who have been sexually abused and their families. The California Evidence- Based Clearinghouse for Child Welfare lists programs for the treatment of problem sexual behaviors in adolescents (http://www.cebc4cw.org/topic/sexual-behavior-problems-in-adolescents-treatment-of/) and in children (http://www.cebc4cw.org/topic/sexual-behavior-problems-in-children-treatment-of/). Most mental health professionals stay up-to-date on recent evidence-based and practice-informed trends in mental health. The National Child Traumatic Stress Network includes information about trauma-informed treatment for sexual abuse on its website (http://www.nctsn.org/trauma-types/sexual-abuse#q3). The Child Trauma Academy suggests that interventions for trauma and abuse be delivered in a “neurosequential” order and be responsive to children’s current functioning and problem history.7


Your Child Welfare Agency

If you are a kinship caregiver or foster parent, or if you are seeking to adopt a child, you may wish to talk with your social worker about what you discover about your child’s history and any behaviors that worry you. Sharing your concerns will help your social worker help you and your family. If your child exhibits problem sexual behaviors toward other children, be aware that you may also be required to report these to child protective services in order to comply with mandated reporting laws in your jurisdiction.8

Many adoptive parents also call their local child welfare agency to seek advice if their child shows troubling behaviors. Child welfare workers are often good sources of information, can offer advice, and are familiar with community resources. Adoption agencies may also be able to provide additional postadoption services or support to adoptive parents who find out about their child’s history of sexual abuse after the adoption is finalized. For more information about postadoption services, see the Child Welfare Information Gateway web section: https://www.childwelfare.gov/adoption/adopt_parenting/

What to Look or in a Mental Health Professional

Finding a knowledgeable and experienced mental health professional is key to getting the help your family needs. Some communities have special programs for treating children who have been sexually abused, such as child protection teams and child advocacy centers. You may also find qualified specialists in your community through the organizations noted below.

Child advocacy centers (see http://www.nationalcac.org/locator.html)

Rape crisis or sexual assault centers

Local psychological or psychiatric association referral services

Child abuse hotlines (See Information Gateway’s Child Abuse Reporting Numbers: https://www.childwelfare.gov/pubs/reslist/rl_dsp.cfm?rs_id=5&rate_chno=11-11172)

Information Gateway’s Selecting and Working With a Therapist Skilled in Adoption at https://www.childwelfare.gov/pubs/f_therapist.cfm

Child protective services (CPS) agencies

The National Child Traumatic Stress Network maintains a list of its members that specialize in research and/ or treatment at http://www.nctsn.org/about-us/network-members

Nonprofit service providers serving families of missing or exploited children

University departments of social work, psychology, or psychiatry

Crime victim assistance programs in the law enforcement agency or in the prosecutor’s or district attorney’s office

Group private practices with a specialization in trauma services

Family court services, including court-appointed special advocate (CASA) groups or guardians ad litem

American Academy of Child & Adolescent Psychiatry at http://www.aacap.org/cs/root/child_and_adolescent_psychiatrist_finder/child_and_adolescent_psychiatrist_finder

American Psychological Association at http://locator.apa.org/

Therapy for children who have been sexually abused is specialized work. When selecting a mental health professional, look for the following:

An advanced degree in a recognized mental health specialty such as psychiatry (M.D.), psychology (Ph.D. or Psy.D.), social work (M.S.W.), counseling (L.P.C.), Marriage and Family Therapy (M.F.T.), or psychiatric nursing (R.N.)

Licensure to practice as a mental health professional in your State (Some mental health services are provided by students under the supervision of licensed professionals.)

Special training in child sexual abuse, including the dynamics of abuse, how it affects children and adults, and the use of goal-oriented treatment plans

Knowledge about the legal issues involved in child sexual abuse, especially the laws about reporting child sexual victimization, procedures used by law enforcement and protective services, evidence collection, and expert testimony in your State

A willingness to work in a coordinated fashion with other professionals involved in your family’s care


Conclusion

Many people want to help children who have been sexually abused, but they often struggle with feelings of confusion, concern, anger, and disgust as they learn more about the abuse. You may need help in order to resolve these struggles and to move toward acceptance of your child’s background.

If you were (or suspect you may have been) sexually abused as a child, dealing with your own child’s difficulties may be particularly challenging, and reading this factsheet may have brought up difficult thoughts and feelings.9 Your courage in facing these issues and tackling a personally difficult and painful subject can actually be helpful to your children by demonstrating to them that sexual abuse experiences can be managed and overcome.

Creating a structured, safe, and nurturing home is the greatest gift that you can give to all of your children. Seek help when you need it, share your successes with your social worker, and remember that a healthy relationship with your children allows them to begin and advance the recovery process. It is in the context of your parent-child relationship that your child learns trust and respect, two important building blocks of your children’s safety and well-being.

Return to Special Needs

Acknowledgment

Child Welfare Information Gateway would like to acknowledge the contributions of Eliana Gil, Ph.D., Gil Institute for Trauma Recovery and Education, LLC, in Fairfax, VA, and a nationally known lecturer, author, and clinician specializing in working with children and families in which child sexual abuse has occurred as well as children with sexual behavior problems and their families. This is an update to an original publication written in partnership with Susan A. Rich, Ph.D.

Reference

Child Welfare Information Gateway. (2013). Parenting a child who has been sexually abused: A guide for foster and adoptive parents. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.

Citations

6 For more information about sustaining a healthy marriage, visit the National Healthy Marriage Resource Center website: http://www.healthymarriageinfo.org/index.aspx

7 For more information on the neurosequential model of therapy, see http://childtrauma.org/nmt-model.

8 See Child Welfare Information Gateway’s Mandatory Reporters of Child Abuse and Neglect at https://www.childwelfare.gov/systemwide/laws_policies/statutes/manda.cfm.

9 A list of resource organizations for adults who were abused as children is available on the Child Welfare Information Gateway website: https://www.childwelfare.gov/pubs/reslist/rl_dsp.cfm?subjID=41&rate_chno=11-11136.