Jackson-Cherry ch 10
Women
15-20% of reported CSA cases are perpetrated by _________.
Bessel van der Kolk
A scholar in the field of traumatic dissociation, hypothesized that the psychic stress resulting from various traumas may exceed a child's ability to cope. As a result, the child dissociates from the abuse for survival. Therefore, if children have been traumatized by their abuse, counselors should allow for a period of stabilization, safety, and normal routines before attempting to facilitate treatment that directly addresses the abuse.
Morally indiscriminate
Abuse all or many types of individuals, so the sexual abuse of a child is less a specific preference for children than the result of a sociopathic level of indiscriminate abuse of people, regardless of their age or background.
Darkness to light
An organization that seeks to educate multiple sectors of the community about CSA trends, prevalence, warning signs, child advocacy, prevention, and interventions under the presumption that it takes a whole community to keep children safe and protected from perpetrators.
Child Sexual Abuse
Any sexual contact, behavior, or exposure for the purposes of sexual gratification of another individual that involves a child who is unable or unwilling to give consent.
Play therapies
Appear to be most successful with children who have deficits in social functioning, the modality should be tailored to the specific needs and characteristics of the child.
Group counseling
Appears to be most successful with those children with low self concept or depression
Informed intention
Applied to the verbal and nonverbal responses made directly to survivors as well as the steps taken in the aftermath of the disclosure to respond appropriately.
Manipulative perpetrators
Are compulsive and driven by fantasies about their victims; they may participate in behaviors that groom their potential targets.
Regressed
Are driven by a precipitating stressor and may find a readily available child to serve as a sexual substitute for a preferred adult partner.
Manipulative perpetrators
Are more likely than opportunist perpetrators to sexually abuse children or adolescents.
Trauma focused cognitive behavioral therapy
Are most successful when combined with play therapies and other similar psychodynamic interventions as well as with supportive therapies such as group therapy and parent attachments therapies
Inadequate
Are typically perceived as nonmainstream, perhaps with preexisting mental or emotional problems, who may sexually abuse a child our of insecurity or curiosity about sexual behavior.
Approach coping strategies
Can be characterized by reaching out to others for support, disclosing the abuse, or discussing the abuse with friends, family, and/counselors.
Avoidant coping strategies
Can be characterized by verbal or psychic denial of the abuse, withdrawal from one's social network, dissociation, or dissociative forgetting of the abuse.
Opportunist perpetrators
Commit sexual abuse because they are driven by basic sexual and nonsexual needs. The preferred sexual partner may or may not typically be a child. Thus, the child serves as a sexual substitute and may be part of a larger pattern of abusive behavior.
Physical cues of CSA
Complaints of genital or anal itching, pain, or bleeding Blood or discharge on undergarments Frequent psychosomatic illnesses Pregnancy at young age Sexually transmitted infections at young age Older, more sexualized appearance than peers Sleep disturbances, nightmares, night terrors.
Cognitive Behavioral Therapy
Continues to be the most common approach used in working with CSA clients. _____________ approaches have been the most widely used therapies in treating children adn adolescents with post traumatic symptomology, therefore, such strategies may be most beneficial to children and adolescents who are struggling specifically with post traumatic stress, anxiety, or depression after being sexually abused.
Autonomy
Crisis counselors should empower and respect the _____________ of the adult CSA survivor while also taking necessary steps to protect any children or adolescents who might be at risk as outlined by the laws of their practicing state.
Paraphilia
Defined in the DSM as a strong sexual preference for nonhuman objects, nonconsenting individuals, or the suffering and/or humiliation of themselves or their partners.
Behavioral cues of CSA
Difficulty in walking or sitting Frequent vomiting Sexually explicit drawings/writing Sexual interaction with others In-depth sexual play with peers Sexual interactions with animals/toys Exceptionally secretive behavior Extreme compliance or withdrawal Overt aggression Extremely seductive behavior Sudden nonparticipation in school activities Crying without provocation Regressive behaviors Sudden onset of wetting or soiling Sudden phobic behavior Suicide attempt
Parent child interaction therapy
Draws from play and operant therapy techniques and focuses on the psychoeducation and training of parents in the use of play therapy--type strategies to increase the stability, trust, and communication in the parent-child relationship
Cognitive cues of CSA
Drop in school performance Suicidal ideation More sexual knowledge than is appropriate Fear of males or fear of females.
Psychological cues of CSA
Feelings of low self worth Depression Anxiety Guilt Shame Hostility Flashbacks Nightmares
White children
Had a slightly higher proportion of reported sexual abuse at the hands of biological parents than did children of other racial or ethnic backgrounds.
Play therapy
Has also been integrated in to the treatment of children who have experienced CSA. Although ______________ may lack the widespread acceptance of CBT, reviews of meta-analyses undertaken over the last few decades have consistently shown that play ____________ significantly improved treatment outcomes in children across a diverse spectrum of issues.
Eye movement desensitization and reprocessing (EMDR)
Is a notable therapy for use with CSA populations because it has been shown to be effective both in the immediate aftermath of abuse as well as with adolescent and adult clients whose abuse is well in the past. Furthermore, recent studies have shown that _______ has been more effective than TF-CBT in reducing depressive symptoms in trauma survivors and may be a resilience building therapy that serves to prevent further accumulation of traumatic recall, which can lead to later developing disorders.
Trauma focused cognitive behavioral therapy
It employs eight components including psychoeducation, relaxation and stress management skills, cognitive coping and processing, and conjoint child-parent sessions. Any treatment using prolonged exposure therapy or cognitive restructuring must be careful to avoid interference with the child's story that could affect court testimony or the CPS investigation, and cause potential retraumatization of the sexual abuse.
Parent child interaction therapy
May be appropriate for children demonstrating problematic externalized behaviors following abuse or who have suffered an attachment break with a primary caregiver as a result of the abuse events.
Diverse
Offenders who fit the ___________ pattern are interested in sexual experimentation, and they choose a child target because of the novelty or taboo, or because the child is a more vulnerable partner with whom sexual experimentation can take place.
Seduction
Offenders who fit the _____________ pattern for the largest group of acquaintance child molesters. They are able to identify with children and engage in grooming potential victims.
Sadistic
Offenders who fit the ______________ pattern represent a small percentage of perpetrators, but they are the most likely to abduct or kill their victims. Are aroused by the infliction of pain, humiliation, and suffering victims.
Child sexual abuse
One of the most underreported crimes, with survivors facing a number of potential physical, psychological, cognitive, behavioral, emotional, and spiritual consequences.
Males
Perpetrators in 75 to 96% of reported child victimization cases.
Victim-perpetrator cycle
Recent research demonstrated that 40% of males with sexual assault or rape histories prior to 16 years of age later become offenders of sexual abuse themselves, while 60% did not.
Statutory rape
Refers primarily to a relationship between a juvenile and an adult that is illegal under the age of consent statues, but that does not involve the degree of coercion or manipulation sufficient to qualify under criminal statutes as a forcible sex crime.
Situational type perpetrators
Regressed Morally indiscriminate Inadequate
Four behavioral patterns of preferential type perpetrators of sexual abuse
Seduction Introverted Diverse Sadistic
CPS documentation
Should include the report made, the date and time the report was made, and the name of the individual to whom the report was made. It should be cautioned that by reporting anonymously, the only record of mandated reporting is from the counselor's notes, since CPS will not have on file the identity of the reporter.
48 hours
Statutes regarding abuse, generally a report must be made within the first ________ after these is reasonable cause to believe or suspect a child is being subjected to abuse.
Behavioral cues of CSA
Talk about being damaged Attempting to run away Cruelty to animals Fire setting Eating disordered behavior Self injurious behavior Use of sexual language Sexual victimization of others
Child Sexual Abuse
The employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or... the rape, and in cases of caretaker or inter-familial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children.
Trauma focused cognitive behavioral therapy
The most popular CBT treatment is _________________.
Sleeper effects
The tendency of symptoms to present over time and across many phases of life span development.
Family systems counseling
This systems oriented counseling may involve individual counseling for the child, the nonoffending parents, and the perpetrator; marital therapy; counseling with the nonoffending parents and child; counseling with the offender and the child; group counseling; and family therapy with the purpose of retaining or reunifying the family. It should be noted that family counseling with the offender and the child would need to be undertaken with great care.
Introverted
Those who fit the _____________ pattern lack the verbal and social skills to seduce children and may resort to the traditionally stereotypical behaviors of lurking around playgrounds or abducting children with whom they have no prior relationship.
Eye movement desensitization and reprocessing (EMDR)
Trained counselors use a standardized protocol that accesses client memories of traumatic events in the past as well as triggers any symptoms in the present, an then work to install more adaptive coping processes for trauma triggers that may be experienced in the future.
Externalized behavioral problems Increases in the caregiver's parenting self efficacy.
Two of the foremost presenting issues in families struggling to recover from abuse events.
Grooming
When ______________ children, the perpetrator will give potential victims gifts and positive attention, making them feel loved and understood to the point where they may willingly participate in sexual acts.
Teacher/lover
____________ female offenders have a more regressed pattern of behavior, have strained peer relationships, and perceive themselves as being in romantic relationships or as sexually mentoring their victims, therefore resisting the idea that their actions might be criminal in nature.
Affirmative responses
____________ to a child's disclosure of CSA include attentive body posture, empathic facial expression, nodding head with belief, and refraining from expressions of alarm or shock. When children receive affirmative responses such as these, they sense that they have done the right thing in reporting the abuse, feel trust that the adult they told will respond appropriately, and have hope that the abuse will cease.
Male-coerced
_____________ female offenders tend to abuse children in concert with a dominant male partner, and they may grant access to children out of a fear of abandonment by a dominant male partner.
Predisposed
_____________ female offenders typically act alone in victimizing their own children or other easily accessible young children. They are typically survivors of incestuous relationships with continued psychological problems and deviant or paraphilic sexual fantasies.
