Thursday, June 5, 2014

Sexual abuse treatment for victims, perpetrators, and their families

Sexual assault is a traumatic event from which many victims never fully recover. Victims often develop problems with post traumatic stress disorder (PTSD), depression, poor self-esteem, interpersonal difficulties, and sexual disorders. PTSD is overwhelmingly the most common disorder related to sexual abuse.

Children may have some symptoms that are different from adults such as agitated behavior, repetitive play involving trauma, frightening non-specific dreams, and reenactment of the traumatic event.

Long Term Treatment Goals
•        Ensure safety from further victimization.
•        Help client understand and control the feelings and behavior that accompany the assault.
•        Build self esteem.

Short Term Treatment Goals
•        Establish therapeutic rapport and open communication with client.
•        Assess the level of symptomology.
•        Obtain medical assistance (forensic examination).
•        Obey child abuse laws (mandatory reporting)
•        Assess for suicidal tendencies.
•        Have client tell their story.
•        Identify and express feelings about the abuse.
•        Decrease feelings of guilt and shame.
•        Increase feelings of empowerment.

Therapeutic Interventions
•        Write out what happened including feelings.
•        Play Therapy
        o        Angry tower: build tower, then verbalize while throwing things at the tower, watching it topple, to allow feelings to emerge.
•        Mutual Story telling
        o        Client and therapist take turns telling stories (may use puppets dolls or stuffed animals).
•        Art Therapy
        o        Associate color with feelings
        o        Draw different scenes for different feelings
•        Letter
        o        Have client write letter to perpetrator that describes feelings about the abuse. Process the letter.    
•        Develop personalized Safety Plan
        o        Self defense classes
        o        Safety escape routes.
        o        Who to call in cases of emergency
        o        Domestic violence safety plans can be searched for online.
•        Challenging Beliefs
        o        Discuss myths and realities
        o        Reduce feelings of shame and guilt
•        Encourage group work

Family Interventions
•        Encourage parents to reassure child that they are not angry at family member/victim.
•        The best things parents can do is believe the client.
•        Encourage the whole family to find support, as well as being a support for each other.
•        Establish safety for the whole family.
•        Have parents request and advocate.
•        Encourage the family to make sure client knows they are not to blame.
•        Discuss myths as a family.
•        Tell families to make sure they take care of themselves too during this difficult time. offers online prep for NASW. Unlimited access to practice exams, case studies, simulations, video, audio, and flash cards 24/7.