Treatment of childhood sexual abuse

Do children really need therapy?

Not a week goes by that I don’t hear this question asked by parents. It’s a question that originates not out of skepticism or denial, but from the protective place in a parent’s heart that does not want his or her child to hurt anymore. “She’s young; if we don’t talk about it, maybe she’ll forget it ever happened.” “Maybe it’s better if we don’t make a big deal about it.”

Certainly, these thoughts have merit when referring to common childhood mishaps such as scraped knees and small accidents. A minor injury that affects only the physical body heals readily enough. The child promptly forgets about it or incorporates it into her memory as an event with unpleasant consequences. But indeed, the child moves on, and probably does so with renewed appreciation for the principle of cause and effect. However, sexual assault is much more encompassing, affecting the body, mind and soul. Its impact can shake a child’s foundation and alter her beliefs about the world, the people within it and reality as she knows it.

Children are growing, developing beings. Not a day goes by that they do not embrace a new learning. Every human interaction impacts them, and they learn from each contact. They encounter, experience, absorb, and incorporate. When a perpetrator assaults a child, he deliberately alters the child’s known world. From offenders, children learn what it means to be hurt by people they know and trust; they encounter feelings of shame, degradation and fear; they experience devastating emotional pain; and they plumb the depths of powerlessness. The symptoms parents see on the outside are the child’s attempt at coping with the flood of information that runs contrary to all of her prior life experiences.

The trauma perpetrated upon a victim begins far earlier than the physical assault upon a child’s body. In order for a child to become a victim, the offender uses adult persuasion and tactics of deceit to develop a relationship that the child will interpret as trust and love. The offender isolates the child from other family members in order to have enough time to commit the offense. Offenders manipulate those in the child’s life who are natural protectors by grooming them into their deception. “You work so hard, you need a break, let me watch the children tonight.” “Your children need a strong male role model in their life.” In addition, the offender hides the offense by continued deceit coupled with methods of coercion. “If you tell, no one will believe you.” “If you tell, your family will hate you.” It is this sequence of abuses that characterizes the trauma of sexual assault.

Thus, the answer to the question, “do children really need therapy?” is obvious. Counseling sessions can be a safe haven to process the tangled thoughts and feelings which are a result of victimization. The child begins to learn new lessons about love and trust, and through positive relationships begins to experience feelings of security, happiness and self confidence. And yet, counseling is just one piece of the puzzle that will result in the whole picture of treatment that supports healing.

For treatment to be complete and effective, it must not be confined solely to individual counseling. Treatment that counteracts the encompassing trauma of sexual abuse must include an effective and supportive criminal justice system; competent medical treatment; familial support; a compassionate and empathetic community; and quality counseling that allows children the time and opportunity to process the impact of the trauma with someone who can hear the unbearable and believe the unbelievable.

And while not every child may need formal therapy, every child needs the opportunity to tell their story and receive positive support and guidance to counter the distorted lies of the offender. Therapy can be one component of a comprehensive treatment plan. When this system of treatment is available to victims of sexual assault, the outcome for healing is both positive and hopeful.