Sexual Abuse

Child sexual abuse has been described as the involvement of dependent, developmentally immature children and adolescents in sexual activity which they do not fully comprehend and to which they are unable to give informed consent. There are a number of offences under which a case in law may be brought, such as incest, rape, indecent assault, use of children in illegal photographs or filmed acts, exposure to pornography and so forth.

Child sexual abuse does not fall into any one social class, professional, occupational or ethnic group. The sexual abuse may begin with inappropriate touching or fondling through exposure to pornography or sex acts and lead up to sexual intercourse or rape. Child sexual abuse has factors in common with other forms of child abuse, such as physical abuse, neglect or the less-commonly recognised emotional abuse. The psychological effects of all these forms of abuse are similar and should be approached similarly.

Sexual abuse is often referred to in categories such as mild or severe. This usually involves looking at whether there was penetrative abuse or not, the frequency of the abuse, the duration, and the relationship between the abuser and the child. There has been slight differences in various studies regarding the importance of each of these factors in determining treatment procedures. The background of the child is also important, however, when examining the effects of the abuse experience. It is quite conceivable that a child fondled on only one occasion by a drunken adult can be psychologically traumatised to the same extent as a child with a much longer history of persistent abuse.

What are the effects of child sexual abuse?
There may not necessarily be any lasting or obvious physical effects of sexual abuse, but the psychological effects are much more prominent. These show themselves in many different ways. They can affect many areas of the survivor's life and they may not surface until the survivor reaches adulthood. Problems in adult relationships and sexual difficulties with partners may result. Some experience difficulties when they have a child themselves or reach other important times in their lives such as starting college. Issues may be triggered and they may suddenly find themselves unable to cope.

It has not been possible to identify the specific behavioural patterns which can only have been caused by child sexual abuse, although abnormal sexual attitudes and fantasies are often linked to earlier abusive relationships.

Common psychological effects which have been observed include low self-esteem, depression, withdrawal, self-injury, nightmares and flashbacks of abuse. There may also be a high level of guilt and repressed anger in the survivor of the abuse.

Recognising and assessing child sexual abuse

There are many behavioural signs which can alert to the possibility of sexual abuse having taken place. In young children these can include bed wetting and soiling, aggressive outbursts, over-sexualised behaviour, acting out the acts and talking about the abuse - where the child was touched and by whom. In older children, the behavioural signs may include running away from home, sudden or distinctive changes in school performance or attendance, withdrawal from friends and family, eating disorders and self-injury or violence towards other children. These signs may also result from other stressful situations that a child might encounter such as other forms of abuse, divorce or separation of parents or the birth of a sibling.

If child sexual abuse is suspected or identified, it is crucial that appropriate procedures and measures are taken immediately in order to stop the current abuse and protect the child from further abuse. Assessments are carried out for two main purposes:

• Legal proecudres
• Treatment

Assessments carried out for legal procedures may be concerned primarily with whether or not abuse has occurred, and will centre around procedures designed to encourage disclosure, and checking the reliability of the information.

Assessment for treatment purposes may be concerned less with the nature of the act and focus more on the psychological effects - which is of prime importance to therapists dealing with the survivors of abuse.

Treatment of child sexual abuse

Once a survivor of child sexual abuse seeks help or enters therapy, goals are devised between the survivor and the therapist. Coming to college may be the first time for a student who has been abused to feel safe to talk about the issue. These relate to the healing process the survivor will go through, and is dependent on the time available. The process will centre on realigning the blame for their own abuse. Different approaches may be used such as individual therapy, art therapy, group work and body work.

As feelings of guilt and shame are common among survivors, the feelings and emotions of the survivor will be a focus of the therapy. Once the client accepts that they were not to blame for the abuse, feelings of anger, rage and hatred towards their abuser may begin to emerge. They may want to seek revenge or see the abuser punished for the crime. They may want to report the abuse and prosecute the abuser. Counselling may help the client through this difficult legal procedure.

The focus of the therapy is to empower the person to deal with the issues relating to the abuse, and establish healthy, trusting and safe relationships with others.

There are also self-help techniques. An important avenue for healing is writing. Survivors can begin to help themselves by keeping a journal about their experience. This gives an opportunity to define one's own reality.. It is useful in figuring out how one feels, thinks and what one needs to do about the situation.

This process can also be helpful in facing unresolved feelings around abuse. The need to confront either the perpetrator of the abuse, or the parents for not protecting them from it, can be expressed in a letter. This may not necessarily be sent but it can be used to express what one wants without having to think about the possible repercussions. The purpose of the letter is to reattribute responsibility for the abuse as well as directing one's anger where it belongs.

Survivors can also help themselves by reading of other's experiences of abuse. Becoming aware of how abuse affected other people helps to normalise one's own feelings of rage, disappointment, betrayal, sadness and loss regarding one's own experience.

The National University of Ireland, Galway Student Counselling Service wishes to thank Student Counselling and Development in University College Cork for granting permission to reproduce this fact sheet.

Student Counselling Service
National University of Ireland, Galway, University Road, Galway, Ireland.
Phone: 353 (0)91 524411 ext. 2484
E-mail: fiona.kennedynuigalway.ie
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