Sexual abuse

Which children need support?

Whilst not all children who have experienced sexual abuse will require a therapeutic intervention, that is not to say that the child will not need some level of reparative support. There are many factors that need to be considered and these include mitigating factors such as;

Parental support, reciprocity and the presence of a secure attachment pattern.
Family functioning.
Support networks.

Then the resilience factors of the child which may include;

The child having a positive or relaxed temperament.
Having a secure attachment pattern.
Having been able to disclose the abuse soon after it took place.
The disclosure having been believed and responded to swiftly, sensitively and in a calm manner.

Factors that increase vulnerability include;

Parental mental health issues including depression.
Insecure or disorganised attachments.
Presence of abuse, neglect, low warmth - high criticism.
Multiple transitions.
Amount of loss.

The duration of the abuse period, type of abuse, numbers of abusers will also compound the negative impact on the child but that is not to say that one type of abuse is worse than another. for example a child with low resilience factors may be more affected by a non-contact offence than a resilient child who experienced a contact offence who had all the familiy support systems in place.

What services will children need?

Therapy

A creative therapy like play therapy is developmentally appropriate. It allows the child to regain a level of control and to communicate within their chosen medium. It will help them to address; fear, anger, loss, distress, guilt, embarrassment, trust, safety, abandonment amongst others but also avoids toxic shame.
However, play therapy alone will not necessarily enable the child to make sense of the messages they have been given about themselves, blame, responsibility or outcomes or physical sensations that have been left unmetabolised or assuaged within their bodies and this may benefit from a Sensoimotor approach.

Psycho-education

Whilst popular in treatment services; self-protection is not a good message to give harmed children. Vulnerable children do not need to believe that they are responsible for their abuse, and that is the danger if they are subsequently revictimised; It is an adult's responsibility to protect children - not for children to protect themselves. Children need a developmentally sensitive programme that aims to help them understand what victimisers, say, do and make the child believe. They need to understand how their experiences impact on their emotions, beliefs about themselves and why their bodies subsequentely feel/not feel the way that they do.