How to proceed

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When dealing with disclosure the worker must have a clear idea of what they are hoping to achieve.

The worker is trying to help the child disclose the assault in as supportive an environment as possible. She/he is attempting to give the child and caregiver a framework for dealing with this crisis. This includes giving them sufficient information to make informed choices as well as letting them what procedures are to come. The worker will also wish to enable the child and caregiver to express their concerns and feelings and so should positively reinforce the constructive behaviours that have been employed in coping with the situation so far. To successfully achieve these goals the worker must be very aware of his or her own values and reactions.

When an assault is disclosed, it is sometimes necessary to carry through a number of procedures such as medical examinations and court interventions, very quickly. However, at other times there is unnecessary haste involved which is due to the worker's own needs and anxiety rather than any external realities. When the latter occurs it may appear to the child and caregiver that the situation is escalating very quickly beyond their control and they may feel confused, frightened or angry. Wherever possible the pace of events should be such that the child is not overwhelmed and both child and caregivers have enough time to gain their bearings and take in what is happening to them.

To minimise confusion any interview should be calm, orderly and as predictable as possible. The worker should spend time with all present, explaining his or her role, the agency's role and giving an overview of the session and its purpose.

As the caregiver is a critical person for the child's future welfare, it is vital that the counsellor interviews in a way which affirms his or her importance and that encourages this person to nurture and care for the child. Where appropriate this means that the worker's initial contact with the child may be in the caregiver's presence and that the worker may expressly get that person's permission before seeing the child alone. The caregiver should be encouraged to take on any reassuring or support functions during the interview.

The caregiver's feelings of powerlessness will be reduced when he/she understands what is to happen at that point and in the future. The worker needs to provide appropriate information in a simple and concrete way. Diagrams showing the roles of different agencies or detailing things such as court procedures are useful ways of helping both the caregiver and the child to get oriented. The worker needs to check that important information has been truly understood and many points may need to be repeated.

When dealing with the child the worker must recognise the sexual assault is difficult to talk about. Consequently, a considerable amount of time may be spent in engaging with the child. When talking about difficult things children often need to take a break and play for a while. They like to have something such as a blackboard or drawing to focus on while they talk. Creativity needs to be used to help children find the medium to express themselves more easily, such as drawing, clay work, writing or using the anatomically correct dolls.

Children are often reluctant to express their worries spontaneously and so it is appropriate at times for the worker to ask direct questions based on their assessment of the child's situation. Such questioning establishes the worker's experience in the situation and reassures the child that the worker will not be shocked. A direct questioning may be framed as follows:

'Other children sometimes think that it's their fault this happened, did you worry about that?'

When the child is not able to express their concerns directly, the worker may need to ask indirect questions. For a variety of reasons children sometimes prefer to test out the worker's reactions obliquely. An indirect question would be framed as follows:

'Sometimes other children are scared to say what has happened to them, what kind of things do you think they might be worried about?'

The information gained this way will give the worker greater insight into the child's situation and will give him/her greater scope for addressing appropriate responses and information to the child.

Figures 6 and 7 restate the issues from the child and caregiver's perspective and summarise suggestions for early interventions.

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