Child Sexual Abuse

 
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CHILD SEXUAL ABUSE
What Is Cognitive Behavior Therapy?

Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.

Changes or goals might involve:

  • A way of acting: like smoking less or being more outgoing;
  • A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
  • A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
  • A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past. They concentrate on a person’s views and beliefs about their life, not on personality traits. Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families. Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.

HOW TO GET HELP: If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet. You may, or may not, find a competent therapist in this manner. It is wise to check on the credentials of a psychotherapist. It is expected that competent therapists hold advanced academic degrees. They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association. Of course, they should be licensed to practice in your state. You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations. You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"

The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition. These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.

What Is Child Sexual Abuse?

Child sexual abuse is defined as sexual contacts or interactions forced on a child by an adult or teenager (or by any person perceived as having greater power or authority). Sexual contact can be anything from touching breasts or genitals to oral, anal, or vaginal intercourse. The abuse may involve the adult touching the child or the child being coerced into touching the adult. Sexual abuse may be committed by a younger person when that person is either significantly older than the victim or is in a position of power or control over another child. Most often, sexual abuse involves some direct physical contact, for instance, sexualized touching and/or kissing; fondling, rubbing and/or penetration of the vagina or anus with the fingers; oral sex; simulated intercourse or penile penetration of the vagina or anus. Sometimes a sex offender might expose himself or herself (exhibiting the genitals or breasts) to a child; might have the child watch pornographic or sexualized films; or might film a child removing his or her own clothes.

Children are often lured into these sexually abusive activities by playful coaxing (e.g. "This will be our special secret, Jane...") or bribed with offers of money, candy, and favors. Sometimes they are bullied or threatened. Adults might use the authority they have by virtue of being “adults.” And, less frequently, physical force or violence may be used. Whether the child is actually "hurt" or not, whether the child objects or not, whether the child likes it or not, any such sexual stimulation, by an adult or a coercive or older child, is considered child sexual abuse and is potentially very psychologically dangerous to the child.

Who is the victim of child sexual abuse?

Child sexual abuse cuts across all social classes, races, and religions. Both boys and girls are victimized. Unfortunately, child sexual abuse is not rare. Our best estimates suggest that, by the age of 18, one of every three females and one of six males are subject to some physical form of sexual abuse. It's possible the percent of males is even higher, as male victims may be less likely to disclose abuse because of heightened embarrassment or shame or the fear they will be viewed as victims or homosexuals.

Who sexually abuses children?

Although a smaller percentage of sex offenders are women, the majority are male. Sex offenders are generally NOT "dirty old men" or strangers lurking in alleys. They are typically not obviously mentally ill or retarded. In fact, sex offenders are usually well known and trusted by the children they victimize, and frequently are members of the family, including fathers and stepfathers, brothers, aunts and uncles, grandparents, and cousins. There is no clear cut description or profile of a sex offender. Thus there is no way to recognize a potential abuser; and it's often hard to believe that a trusted individual would be capable of abusing children.

Many offenders had been physically or sexually abused themselves as children (about one in four sex offenders were sexually abused; many more were physically abused as children). Some may be unable to function sexually with adult partners and have many different encounters with children. Others do maintain sexual relationships with adults, but may turn to children for gratification, particularly during times of stress. A small percent of offenders sexually abuse children while under the influence of drugs or alcohol.

What are the consequences of sexual abuse for the child victim?

Sexually abused children may experience a wide range of emotional and behavioral reactions to the abuse. The nature and severity of these difficulties may depend upon the age of the child, the identity of the perpetrator, the circumstances of the abuse, and the family's reaction to the child's disclosure. Children may exhibit symptoms similar to anxiety and distress, such as wetting the bed, nightmares, difficulty in school, and running away, which are similar to problems exhibited by children who have experienced any kind of a trauma. Children may also exhibit symptoms that are more specific to inappropriate sexual exposure, such as repetitive sexual talk and play, and fears of specific situations or people that remind them of the abuse. Some children may not exhibit any difficulties as a result of their traumatic experience. And, sometimes, problems will not become apparent for years, when the child has grown up.

Once the abuse is disclosed, and stopped, some children return to relatively normal behavior and emotions. The support and protection of the people close to them is really important in helping children get back to normal. However, some children have symptoms that persist long after the abuse itself has ended. In fact, a significant number of sexually abused children suffer a serious and often chronic disorder known as posttraumatic stress (PTSD). That's why it's important for the sexually abused child to undergo a psychological evaluation and, if necessary, receive treatment. It is important that parents recognize that children may experience different problems related to their sexually abusive experiences as they go through different developmental stages. Therefore, although a child may have successfully completed therapy soon after the abuse was disclosed, or may not have had difficulties previously, he/she may need to go to counseling at some later time.

Where should you go for help?

If you suspect that a child has been sexually abused, you can contact a therapist, who can assist at any step in the following process. You can also contact the child protection agency in your community. You may remain anonymous but the caseworker will ask you important questions about the child, the possible abuser, and the circumstances. In all states, sexual abuse of minors is a crime, and you can file a report with your local police. In some states, the child protection agency will need to work in conjunction with the police. In other instances, the agency will investigate the sexual abuse allegation and provide guidance and help to the child and family. These strategies will often help to protect the child from further sexual abuse.

In addition, you should consider working with a therapist to protect the child’s emotional and psychological well being.

What kind of treatment is available for victims and nonoffending parents?

Many therapy formats have been applied to sexual abuse cases including individual, family and group therapy. Cognitive behavioral therapy, in both individual and group settings, effectively decreases the problems experienced by sexually abused children.

Both the sexually abused child as well as his/her nonoffending parent(s) can benefit from cognitive behavioral interventions. The cognitive behavioral therapist may help nonoffending parents cope with their own thoughts and feelings about their children's abuse, while also teaching parenting skills that will help them respond more effectively to their children's disclosures and abuse-related difficulties. Cognitive behavioral interventions for the child should be individually tailored to target the particular child's difficulties. However, educational, coping skills, and gradual exposure exercises are generally incorporated into the treatment plan. Gradual exposure refers to exercises that encourage children to confront memories, thoughts, and innocuous reminders (e.g. bathrooms, sleeping alone, undressing, showering, etc.) of the abuse in a gradual fashion over time. This may be done by guided imagery, doll play, drawing, reading, writing, poetry, singing, etc. By reducing the anxiety associated with abuse-related discussion, gradual exposure exercises help sexually abused children to express their thoughts and feelings more openly, thereby enhancing their ability to understand and emotionally process the abusive experience(s).

Survivors of sexual assault don't need to suffer in silence. Behavior therapists can offer effective treatments tailored to a survivor's individual problems.

 

For more information or to find a therapist:

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