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Sexually Abused Children | Importance Of Case Management And Teaming Part II
Posted on 10-8-2011

The child is given a choice to tell about her molestation experience whenever she wants within the first three appointments. Open acknowledgment of the molestation by the therapist helps. The time limit helps. The choice helps. These children have experienced blurred boundaries and few choices. Not one child I have seen (including teenagers) has refused to cooperate in sharing the details and emotional side effects of the molestation within this three appointment time frame. The goal is to assess the child's perception of the event, her emotional reaction to it, and her current guilt, fear, and anxiety about the molestation.

Tremendous energy must be expended in listening intently to the children's stories, drawings, play acting, dreams, and the like. Sexually abused children are rarely listened to,' much less understood. A child can tell if someone listens to what she has to say. Art Kraft, in his book Are You Listening to Your Child? (1973), clearly addresses this issue. "I remember when you said this or told me that story" will frequently bring a surprised look and then a grateful smile.

It is especially important in dealing with a young child to keep interpretations to a minimum. Children need shared, positive experiences, not insight. The preschooler tends to use denial to deal with upsetting experiences, to try to make them go away, and others have pointed out that often the very act of drawing without therapist intervention is a powerful expression that helps a child to establish self identity and provides a way of expressing feelings. Often the sheer enjoyment of the activity and the nonverbal release of the feeling through a painting or "scribble" may open the child up and facilitate the sharing of some deep feelings. With the young pre schooler, sometimes it is a major accomplishment to express feelings through a picture or a story; she expresses in her own way what she needs or wants to communicate at a given time.

At other times, a child may be engaged in dialogue through telling and discussing a story. For example, in discussing the story of a bunny looking for her mother, the therapist might say, "Does that ever happen to you?", in an attempt to make a connection between the character in the story and the child's own experiences. However, the process of making those connections occurs slowly over time and with caution. This awareness opens the door gradually to examining options and choices available, and may mean dealing with the fear the child has tried to keep hidden.

It is important for the therapist to move at the child's pace and know when to speak and when to keep silent. Similarly, the therapist must appreciate the child's natural activity level, and must vary treatment interventions and techniques accordingly. It is vital to get to know the child and to use this knowledge to move from structured task to free playas it seems appropriate. Each therapist must find his or her own style in maintaining the delicate balance between following the child's lead on the one hand, and directing and guiding on the other.

Two rituals are helpful in this endless and creative process. One is giving prizes. Children love a small container with prizes such as stickers, gum, candy, and other small items. In order to get the prize, the child must "work hard," which means talking about things that are hard to talk about; such topics may include the molestation, the child's sadness and hurt, and so on. The prize can also be a reward for the child's struggle in sticking to a subject or completing a task.

The other ritual is making notations on a chart during each appointment, helping the child to see that what happens to her is important enough to be noted. The mother is invited in at the beginning of the session. The child and mother are asked about the latest news or important events, either successes or problems. Sometimes snacks are given to the needier and more emotionally deprived children. This further nurturance is consistently given, regardless of behavior. The children need to have some fun when they come in to work, yet must also know they are expected to work on their issues. If the therapist has the expectation that the child will grow, the child rarely disappoints.

About The Author
David Crawford is the CEO and owner of a Male Enhancement Products company known as Male Enhancement Group which is dedicated to researching and comparing male enhancement products in order to determine which male enhancement product is safer and more effective than other products on the market. Copyright 2011 David Crawford of Top Male Enhancement This article may be freely distributed if this resource box stays attached.

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