Conclusion

Home: Workers: Useful Articles: Dealing with CSA

In an attempt to make disclosure a less traumatic event for both the child and caregiver, this paper has provided a model for understanding the crisis and assists workers to identify salient issues for each victim and caregiver.

The model considers two categories of information that must be assessed. The first of these are the situational factors and the second category are the common issues confronting sexual assault victims. We demonstrate how the information gained by using this model can be used to significantly increase the relevance of worker interventions. Only by gaining access to how the events of disclosure and sexual assault are perceived by the individual child and caregivers, can the worker hope to be truly useful.

We believe, the model, together with the suggestions on procedure and strategies will minimise the trauma of disclosure for all involved.

Figure 6: Range of common issues for the child and ways of dealing with them

Issue: Will they believe me?

Suggested responses:

• State your belief. 'I believe you'.
• Emphasise your authority 'I see lots of children that this happens to and I believe you'.
• If appropriate, encourage caregivers to state their beliefs.

Issue: Is it my fault? Am I in trouble?

Suggested responses:

• Check the child's reasoning 'What's the special reason you think it's your fault?'
• Work with simple logic to draw out and validate the strengths or positive actions the child displayed 'in coping with the situation, for example, 'What would happen if you didn't go into the room when he told you to' 'I would get into trouble'. Point out survival aspects of child's behaviour in going into the room. Emphasise the positive nature of child's choice.
• State your belief 'I don't think it's your fault'.
• If appropriate, encourage non-offending parent to do the same.

Issue: Can people tell what's happened to me?

Suggested responses:

• Encourage expression of feelings.
• Validate feelings expressed.
• Explore the child's perceptions of key people's reactions.
• Help child to understand these reactions.

Issue: I should have told earlier.

Suggested responses:

• Check the child's reason and validate 'It's scary to tell especially when you don't know what's going to happen' 'I understand why you didn't tell earlier, I'm glad you've told now I think you are being very brave'.
• Look for logical reasons for not telling in the child's story and affirm these. Positively reinforce the child for taking the risk of telling now.

Issue: Everyone is upset because of me I wish I hadn't got him/her into trouble.

Suggested responses:

• Try and get non-offending parent to be clear about their feelings and message to the child (if appropriate) for example, 'I'm angry at him but not at you' *Discourage child from being responsible for looking 'after grown ups, for example, 'If your mum cries, it's O.K. It might help her to feel better afterwards'.
• Identify for child who will look after grown ups 'When your mum is upset she can talk to Auntie or she can talk to me'.
• Explain to the child that you know grown ups have special issues and worries too, for example, 'Will my daughter be O.K.' 'I should have been able to tell' and that you or someone (named) will be helping them sort those things out.
• Again affirm the notion that the offender has caused this upset, not the child.

Issue: What will happen now? I didn't mean to cause so much trouble.

Suggested responses:

• Give appropriate and realistic information about procedure.
• Emphasise child's right not to be sexually assaulted.
• Focus blame where it belongs and draw a boundary around child and non-offending family members 'He is the one to blame. He has caused this trouble for all of you.'
• Using information obtained from above help child explore reality and emphasise that this is not something they did it's something that happened to them.

Issue: Is my body damaged? Will I have problems when I grow up?

Suggested responses:

• Use details of the disclosure to reassure child.
• Use medical examination to let the child know that they are 0. K. or how they are hurt and what it means.
• Allow the child to use the medical to the extent they need, for example, if a child has a major concern about AIDS and requests AIDS screening, this should be done even if it's only function is going to reassure the child.

Issue: But he said ... (Threats ... )

Suggested responses:

• Check whether the child has received threats from the perpetrator, for example. 'If you tell you'll go into a home/jail' 'No one will ever want you except for this (sex)' 'If you tell you'll break up the family.'
• Use this issue to reaffirm the offender as the person who has done wrong. Again use simple logic to show the child how threats are ways the offender uses to make the child do as they say or ways to make them feel less guilty.
• Where threats have some reality to the child, for example, 'If you tell, you'll break up the family' emphasise the difference between the behaviour and the telling. Use examples of other deviant behaviour and consequences.

Issue: What's the doctor for?

Suggested responses:

• Emphasise that he/she is there to make sure that the child is O.K. not to check if they are telling the truth.
• Prepare the child for what will happen, for example, by talking, showing the examination room, miming with the dolls.
• Make sure the child has control, 'if you want us to stop, we will'.
• Check if the child has any special questions or worries that she/he might like to check out with the doctor.

Figure 7: Range of common issues for the caregiver(s) and ways of dealing with them

Issue: Will she/he be alright? (Will she/he be ruined for life like X?)

Suggested responses:

• Give realistic assessment of how sexual assault and disclosure may affect child.
• Set limits to prophecies of doom. Help caregivers to think about differences concerning how sexual assault was dealt with in the past and now.
• Help caregivers to understand the child's thinking, for example, that many children think it' s their fault, etc.
• Encourage caregiver to think of specific ways to support and help their child.
• Help caregiver to see needs of child at this time particularly child's need to have some control over who gets told or involved, for example, should the school be told?

Issue: Why didn't she/he tell me earlier?

Suggested responses:

• Encourage caregiver to adopt child's perspective 'What do you think might have stopped X from telling earlier?'
• Help caregiver to see how realistic some of these reasons are, for example, protecting non-offending parent
• Provide relevant information 'I see a lot of children and very many of them don't tell anyone for a very long time'.
• Emphasise child's fear of rejection and disbelief.

Issue: I should have been able to tell.

Suggested responses:

• Provide relevant information such as the secret and planned nature of assault.
• Look at the clues that the caregivers feel they have missed.
• Validate the reasonableness of not understanding what the clues really meant.
• Acknowledge that most caregivers are not 'looking for child abuse' in their child's behaviour.

Issue: I feel like it happened to me.

Suggested responses:

• Allow and encourage expression of feelings.
• Validate these feelings but reflect them back as the 'caregiver feelings'.
• Reaffirm the caregiver's role as separate from child and help caregiver explore the ways they can support and help their child.
• Explore needs of their child at this time and the important role they have as supporting caregivers.
• Help caregivers identify their own adult support people.

Issue: Is it my fault?

Suggested responses:

• Place responsibility where it belongs.
• Explore particular reasons for thinking it is their fault.
• Use simple logic to demonstrate that their behaviour is not responsible for the child abuse and to reaffirm that the offender alone must accept responsibility for the offender's behaviour.
• If non-offending caregiver has prevented exposure in the past or made unsuccessful attempts to stop abuse, the worker should be:
• realistic about consequences.
• recognise person's reasoning and pressures.
• focus on the positive aspects of caregiver's behaviour.
• emphasise need for appropriate child protection behaviour now.

Issue: Perhaps there's been some mistake!

Suggested responses:

• Reinforce reality of child sexual assault.
• Predict and explore some of the pressures on the caregiver and acknowledge them.
• Be clear about the seriousness of sexual assault and the consequences if it is ignored, that is, the child will continue to be at risk.

Issue: What will happen now?

Suggested responses:

• Provide as much clear information as possible.
• Delineate areas of choice and non choice with respect to: safety of child, legal proceedings.

Issue: I feel so upset I'm afraid.

Suggested responses:

• Encourage caregivers to talk about their feelings. Acknowledge these feelings.
• Help them to identify if possible, someone in their social network that they can talk to.
• Assess whether professional or formalised support is required if so, offer it.

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