Conceptualization of Childhood sexual abuse and mental health psychological and sociological perspective
Universally defining child abuse is impossible. However as Desai (2010) pointed out, the dominant characteristics in any abuse is the central position of an adult that allows her or him to coerce or force a child into sexual activities. Child abuse includes masturbation, fondling the genitals of the child, digital penetration, oral genital contact and anal and vaginal intercourse. Child abuse can be physical and even non contact abuse such as voyeurism, exposure and pornography. On the other hand, mental health includes psychological, emotional and social well being. It affects how a person feels, think and act as they live daily. Furthermore, it helps in determination of how a person relates to others, handle stress and make choices (Kinnear, 1995).
On the psychological perspective, child abuse and mental health portrays behavior problems such as posttraumatic stress disorder and separation anxiety. The abused children undergo difficult time in their lives in addition to parental substance abuse. The aftermath of sexual abuse can form the start of a child’s negative behaviors and negative experiences. According to Sgroi (1982), sexual abuse to a child is a mental disaster as it can cause a child to become an irreversible, unforgettable, pain in the subconscious mind. Psychologically, mental illness can affect mood, thinking and behavior. MacFarlane et al (1986) observed mental health is important but the disorder can arise due to family history, history of sexual abuse, life experiences.
On the sociological perspective, Desai (2010) elaborates how social changes have affected child abuse problems. The children welfare and women’s movements has made the problem to rapidly rise in the public attention. Furthermore, patriarchal authority and socialization has resulted to the problems of mental health and child sexual abuse. The rising rate of divorce globally put the children at risk of these problems. However, Kinnear (1995) also suggest that it also assists the children to escape form intolerable and oppressive family situations. External controls erosion on sexual behavior and sexual revolution are also singled out as factors that have aggravated children sexual abuse and mental health.
Treatment models and intervention strategies currently used to address children sexual abuse and mental health.
Childs sexual abuse treatment is a complex process. One of the challenges is its occurrence in the larger intervention contexts. Treatment which forms part of intervention should handled with a team of professionals. A treatment approach as an intervention employed in a child sexual abuse should address the prerequisite and the contributing causes and the meet the treatment needs of the family and victim, individual, family, dyadic and group treatment interventions should be made available (Sgroi, 1982).
- Group therapy
It is the best treatment choice but usually offered concurrently with other treatment modalities. It is appropriate for siblings of victims, victims, mothers, adult survivors and the offenders. According to MacFarlane et al (1986), generic groups including victims parents, offenders and the survivors is effective and powerful for the parties involved.
Groups may be long term, time limited or open ended and dealing with specific issues such as sex education, relapse prevention, or future sexual abuse protection. Moreover, they may deal with many issues of wide range. Offenders and victims grouped may be brought together occasional for sessions. Furthermore, models consisting of concurrent children victims and their parents, where they join for activities from time to time are always productive (Desai, 2010).
- Individual treatment
It is suitable for offender, victim and the victims other as well as survivors and their siblings. Kinnear (1995) suggests that alliance building is the initial rule, moreover, trust on the therapist by the all parties and believing that change is desirable and possible. The parties may possess different commitment levels to therapy, but most investment should be made on the victim and least on the offender.
- Dyadic treatment
Is applied to repair or enhance mother- daughter relationship damage, and the daughter-father relationship.
- Family therapy
Is the treatment process culmination and is not taken usually until reunification determination has been there and is in the best interest of the victim (Sgroi, 1982).
- Multiple therapists
It is very helpful because it is close to impossible to administer all those complex intervention series only by one individual. Two therapists are good if possible even if one does the group work and the other does dyadic, individual and family work. However, MacFarlane et al (1986) pointed out that there exist many reasons of involving many therapists apart from the logistics reasons. These include:
- Families that are sexually abusive are difficult to offer services to, and therefore the clinicians need each other. Such families are multi problematic and crisis hidden, making it hard for an individual to exert total responsibility.
- It recreates when you assign a different therapist to the offender and the victim. It enhances safety and privacy for the victim. These are the two elements of the victim that was offended by the offender.
- Co therapy involving both female and male has therapeutic advantage considerably. It exposes the members of the family to role models of all the sexes. Moreover, co therapy enhances the clinician’s ability to affect change because of the allowed leverage, especially in group therapy.
- Lastly, some of the decisions that must be taken during treatment are complex and difficult, and mistakes can be devastating. Therefore, more than one head is better.
Two Empirical studies to support the effectiveness of these interventions
The Bureau international catholique de l’enfance (2001) did an empirical research to prove the effectiveness of dyadic therapy interventions. The program was done on 16 sexually abused victims aged 7-9 years. The children samples were gotten form Nebraska hospital. Investigation consisted of a therapy program for 3 months. From the results, 12 children were able to re unite with their families but 4 had difficulty given that the offenders were family members (Bureau international catholique de l’enfance, 2001).
Another study was done by Mars (2003) to test the effectiveness of group therapy on sexually abused children. In the study with her clinicians, they targeted the victims under the child welfare care aged between 10- 16 years, their siblings, family and the offenders. The therapy took 6 months. The therapy involved weekly counseling; inter group exchange, individual therapy. From the research, the approach showed 60 % success with the victims returning to normal life, family integration and cohesion (Mars, 2003).
Desai, M. (2010). A rights-based preventative approach for psychosocial well-being in childhood. Dordrecht: Springer.
Kinnear, K. L. (1995). Childhood sexual abuse: A reference handbook. Santa Barbara, Calif: ABC-CLIO.
Sgroi, S. M. (1982). Handbook of clinical intervention in child sexual abuse. Lexington, Mass: Lexington Books.
MacFarlane, K., & Waterman, J. (1986). Sexual abuse of young children: Evaluation and treatment. New York: Guilford Press.
Bureau international catholique de l’enfance. (January 01, 2001). Right to happiness: Prevention and intervention against sexual abuse and exploitation of children. Annual Report Bice.
Mars, J. (January 01, 2003). Sibling Abuse Trauma: Assessment and Intervention Strategies for Children, Families, and Adults by Caffaro & Conn-Caffaro; – From Surviving to Thriving: A Therapist’s Guide to Stage II Recovery for Survivors of Childhood Abuse by Bratton; – “I Never Told Anyone This Before”: Managing the Initial Disclosure of Sexual Abuse Re-Collections by Gasker; – Breaking the Silence: Group Therapy for Childhood Sexual Abuse: A Practitioner’s Manual by Margolin. Criminal Justice Review, 28, 164- 165.
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