NCJ Number
61193
Date Published
Unknown
Length
22 pages
Annotation
SOCIOEMOTIONAL ISSUES INVOLVED IN CHILD SEXUAL ABUSE ARE CONSIDERED, AND APPROPRIATE CRISIS INTERVENTION AND FOLLOWUP SUPPORT TECHNIQUES ARE DESCRIBED.
Abstract
BASED ON EXPERIENCES AT THE CHILDREN'S HOSPITAL NATIONAL MEDICAL CENTER, IN WASHINGTON, D.C., WHERE COMPREHENSIVE SERVICES ARE PROVIDED FOR CASES OF SUSPECTED SEXUAL ABUSE AND ASSAULT OF CHILDREN AND ADOLESCENTS 18-YEARS OLD OR YOUNGER, IT HAS BEEN FOUND THAT REGARDLESS OF THE TYPE OF ABUSE TO WHICH A CHILD IS SUBJECTED, THE INVOLVED FAMILIES ARE IN A STATE OF CRISIS. SINCE THE EFFECTS OF THE INCIDENT ON THE CHILD OF TEN ARE DIRECTLY RELATED TO THE CHILD'S PERCEPTIONS OF THE REACTIONS OF SIGNIFICANT ADULTS, THE STAFF HAS USED TRADITIONAL CRISIS INTERVENTION THEORY AND TECHNIQUES TO STABILIZE THE IMMEDIATE SITUATION. IT IS THE EMOTIONAL STATE (THE REACTION OF THE INDIVIDUAL OR FAMILY GROUP), IN COMBINATION WITH THE COPING PROCESS, AND NOT THE PRECIPITATING EVENT ITSELF, THAT DEFINES A CRISIS. THE GOAL OF CRISIS INTERVENTION IS TO HELP INDIVIDUALS REGAIN THE LEVEL OF FUNCTIONING THEY HAD PRIOR TO THE CRISIS. MAJOR PERSONALITY CHANGES ARE NOT SOUGHT. CRISIS INTERVENTION INVOLVES INTERVIEWING THE PARENTS AND THE CHILD SEPARATELY. IN THE INTERVIEW WITH THE PARENTS, THE PHYSICIAN SHOULD BE EMPATHETIC, SUPPORTIVE, AND NONJUDGMENTAL. IT IS USEFUL TO LABEL THE PARENT'S FEELINGS AS THEY ARE EXPRESSED. ANY MEDICAL ACTIVITIES RELATIVE TO THE CHILD SHOULD BE CLARIFIED, AND IT IS IMPORTANT TO EXPLORE PARTICULAR PARENTAL FEARS RELATED TO THE CHILD'S FUTURE PSYCHOSEXUAL DEVELOPMENT. IN INTERVIEWING THE CHILD, THE PHYSICIAN SHOULD ASSESS THE CHILD'S EMOTIONAL STATE AND UNDERSTANDING OF THE MEDICAL VISIT, TAKING CARE TO CLARIFY ANY MISPERCEPTIONS OR MISINFORMATION, WHILE PERMITTING THE CHILD TO VENTILATE FEELINGS ABOUT WHAT HAS HAPPENED. FOLLOWUP SESSIONS WITH THE CHILD AND FAMILY SHOULD BE SCHEDULED AS INDICATED BY THE DEGREE OF EMOTIONAL UPSET OF THE PARENTS, EMOTIONAL AND PHYSICAL CONDITION OF THE CHILD, AND THE COPING MECHANISMS OF THE FAMILY. IF THE PARENTS AND CHILD HAVE NOT RETURNED TO NORMAL FUNCTIONING WITHIN 6 TO 8 WEEKS, LONG-TERM INTERVENTION IS INDICATED. REFERENCES ARE PROVIDED. (RCB)