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CanadianPharmacy

Sexual Abuse Counselling

Social and psychological assistance to children affected by various types of sexual abuse includes working with the child’s traumatic experience, assessing family risk factors, resolving security and confidentiality issues, and coordinating actions between various specialists and services to help the child and his/her family. When providing counseling, it is important to focus on the following principles.

Introduction to General Principles in Counseling

Focus on injury

  • A psychologist should focus on the trauma experienced. To postpone the study of injury for a longer period is one of the most ineffective rehabilitation options. The injury will not go away on its own;
  • Each child’s experience is unique, despite the trauma he or she has experienced.

Assessment of the level of risk factors

  • It is necessary to determine the level of family dysfunction and the availability or inaccessibility for the child of protection from a non-violent adult.
  • The nature of assistance should be focused on reducing the risk of violence by family members and on those personality characteristics of the child that make him or her particularly vulnerable.
  • A dysfunctional family may reduce the effectiveness of therapeutic care for the child.

The relationship of the child with the offender

  • The child needs to know that all the feelings he or she experiences with an adult who has experienced violence are acceptable to a specialist.
  • If the child’s attention is fixed only on one of the senses, it is important to gradually direct the child to other possible emotional reactions.
  • The main goal of helping a child affected by sexual violence is to reduce and overcome the effects of traumatic experiences. It is known that trauma itself is never the only component of the post-stress disorder. Its share is approximately 50%, the remaining 50% is determined by the life of the child after an injury and, above all, the effectiveness of the assistance provided to him or her.

General Guidelines

When organizing the first meeting of a specialist with an injured child, it is necessary to follow some key recommendations

1. Make contact with the child

At the first stage of counseling for sexually affected children, it is extremely important for the psychologist to establish contact with the child, and the emphasis must be placed on a sincerely caring and supportive attitude towards him or her. When interacting with a child, one must remember that his or her level of confidence in adults can be very low, his or her emotional state is depressed, his or her behavioral reactions can be protective.

The room in which the psychologist meets the child should be comfortable, it should not be perceived as official. It is important that when contacting a child outsiders do not enter the room, the telephone does not ring. The presence of parents depends on whether they are supportive for the child and how much the child trusts them. In general, the presence of parents is not desirable, as they can influence the reactions of the child.

Children who have experienced sexual abuse, as a rule, have a rather low motivation to meet and work with a specialist, as this entails a return to the traumatic situation. Therefore, in order to establish contact with the child and to create a sense of trust and security, it is important to correctly build the beginning of the conversation – to get to know each other, to talk a little about yourself and what your work as a specialist is. You can offer the child to move freely around the room, consider equipment or toys. When making contact, it is recommended to ask questions on neutral topics that are not related to the traumatic situation:

  • What’s your name?
  • How old are you?
  • Do you go to school or kindergarten?
  • What do you like or dislike there?
  • Do you have any friends?
  • What do you like to do?
  • Tell me about your family?
  • What makes you happy? Why are you sad?

The smaller the child’s age, the less effective the purely question-answer form of conversation will be. For children of preschool and primary school age, to reduce stress, you can suggest “draw what you want,” ask questions on the drawing or on the test of M. Lusher.

2. Focus on violence

If a safe atmosphere is reached and the child knows why they brought him or her here, it is necessary to gradually turn to questions related to the past violence: “Tell me please, what happened to you?” When planning a conversation, it is important to take into account the child’s readiness for such a conversation. It happens that during the first conversation the child does not feel ready to talk about violence, especially in cases of sexual abuse, when it is very difficult for the victim to reveal his or her “secret”. If a specialist knows about the fact of violence, then during a 2/3 meeting, you can tell the child that there are good secrets (for example, a prepared gift) and bad secrets (an insult that can be told to the adult you trust so that he or she can help you).

The main reasons for children refusing to talk about cases of violence include the following: distrust of adults, the expectation of new troubles on their part, shame, fear that others will feel worse about them, fear or attachment to the offender, fear of upsetting parents, etc.

When a child or teenager reports a fact of violence, it is important to control your own emotions. A child’s story about a tragic event can cause a gamut of our own feelings (from shock and denial to anger and disgust), this is a difficult test. Professional knowledge of the situation requires the specialist to be calm and ready to continue the dialogue. Stay calm and open to the conversation, do not transfer your emotions to the child. Remember that the child can be attached to the offender and experience opposite feelings. It is important for him or her to feel that all the feelings that he or she has towards the offender are acceptable to the psychologist.

When a child reports a fact of violence, especially sexual violence, it is ineffective and even harmful to:

  • ask if he or she provoked the offender by any action;
  • ask questions that increase guilt;
  • ask why the child did not show sufficient resistance or did not call for help;
  • talk about what you would do in a similar situation;
  • give advice and impose your own decisions;
  • say “calm down, do not worry…”, that is, deny the feelings of the child;
  • be cold and detached, not to show empathy;
  • say “I understand you…”;
  • be too deeply emotionally involved in the situation, which makes it difficult or impossible to provide assistance.

It is important to collect the information about the violence that is relevant to assessing the psychological state of the child and developing assistance strategies (a type of violence, its severity and duration, the nature of the relationship between the child and the offender, the feelings of the child, etc.).

3. Consider the level of personal development of the child

  • Speak a language that is understandable to the child, answer his or her questions honestly and simply. When building advisory work with young children:
  • Use short questions and sentences not exceeding 5 words;
  • Avoid special terms, double negation questions, abstract concepts;
  • Use the same words to name the intimate parts of the body that the child used;
  • Try to use less pronouns (he, they), use proper names;
  • Rephrase the question if the child does not understand it:
  • After receiving the answer, try to summarize what the child said, so you encourage him or her to better understand him-/herself and the situation.

4. Use active listening techniques

It is important to actively listen, using all the methods of active listening. Do not seek details and do not conduct an investigation since this is the responsibility of law enforcement agencies. It is unacceptable to put pressure on the child, to force him or her to show injuries, bruises. Respect the child’s right to speak as much as he or she sees fit. It is important for a specialist to find out if what the child felt.

5. Use physical contact with caution

Physical contact with the child – touching the knee, shoulder, hug, can remind him or her of the injury. It is known that friendly touch can be a form of support and care, but a child, in particular, who has suffered sexual trauma, does not adequately respond to physical contact, becoming numb and as if listening to his or her own feelings.

6. Give your child support

Support the child, tell him or her or her that it takes courage to talk about your experiences, and you appreciate the fact that he or she trusted you. It is important to support the child’s perception of his or her personal value, as well as help overcome the feeling of isolation. Children who have experienced violence, especially sexual, have a feeling of dissimilarity to their peers, with whom such things “never happened”. Tell the child that he or she is not alone in this situation, that this happens, unfortunately, with other children.

7. Evaluate child safety

  • Make sure the child understands how dangerous it is to interfere with violent relationships and adult fights;
  • Find out if there are adults next to the child whom he or she trusts and who will not allow the repetition of violent acts;
  • Is there a safe place where your child can go?
  • Do you, as a specialist, have the opportunity to contact a non-violent adult helping a child?

8. Explain to the child the further development of events

When advising a child who has suffered from violence, it is important not to make promises in which the specialist is not sure: “Your mother will help you”, “The one who offended you will be punished.” You also do not have the right to give a child a promise of complete confidentiality and consider his or her consent or disagreement decisive in planning further actions. The child should not be forced to take responsibility for the possibility of overcoming the situation of violence.
Concluding the conversation with the child, inform him or her about how further events may develop, for example: “I am going to talk with your mother about what happened to find ways to protect you.”

It should be noted that this scheme is of a relative nature: during the interview, the consultant should follow the child and support topics for which the child is ready to talk. It is important to adhere to the tactics of “soft conduct”, taking maximum care of the safety of the child. Initial contact with the child, built on a soft interaction with him or her, should help the specialist answer the following questions:

  • What traumatic events did the child experience?
  • At what level of age and personality development is the child, and what are his or her resources?
  • What negative psychological symptoms are inherent in a child’s behavior and how dangerous are they in the future?
  • What type of therapy is appropriate in this particular case?
  • Do family members have the motivation and resources to participate in the rehabilitation process?
  • How to connect a contact network (kindergarten, school, relatives, etc.) to participate in rehabilitation work?

In the case of sexual violence, the range of necessary information should be expanded:

  • At what age and when did sexual violence occur?
  • Who committed sexual abuse and who may have known about it?
  • The nature of the abuse: for example, the degree of coercion and use of force, the feelings experienced by the child?
  • What explanation did the child give to him-/herself, whom does he/she blame?

During the first meeting, it is important to convey to the child that child abuse is not the norm. It is important to make the following clear:

  • “I believe you”;
  • “I’m sorry it happened to you”;
  • “It is not your fault”;
  • “It’s good that you talked about this”.