Families Learning About Recovery
Strategies (FLARES): A group therapy
model for families facing sibling sexual abuse
M E G A N M . S C H A C H T, P H D
JERRY H. DUNN, PHD
© MoACTS
Sibling Sexual Abuse
 Estimated to occur in approximately 13% of the
population (Finkelhor, 1980)
 60% of psychiatric outpatients reported a history of
sibling sexual abuse (Bess & Jansenn, 1982)
 For our purposes, “siblings” are defined as children
who grow up in the same family.
© MoACTS
Sexual Abuse or “Typical” Sexual Play
(NCTSN, 2009)
SEXUAL ABUSE
“TYPICAL” SEXUAL PLAY
 Beyond the child’s
 Occurs between children of
developmental stage
 Involves threats, force, or
aggression
 Involves kids of widely
different ages or abilities
 Provokes strong
emotional reactions in
the child (e.g., anger,
anxiety, etc.)
© MoACTS





same general age/physical
size
Spontaneous and
unplanned
Infrequent
Voluntary
Occurs between kids who
know each other well
Easily diverted when
parents tell children to stop
and explain privacy rules
Factors that Contribute to
Sibling Sexual Abuse
 Older sibling given too much responsibility
 Witnessing or experiencing sexual abuse
 Access to pornography
 Neglect
 Lack of sex education
 Denial about family trouble/tensions
 Caregivers feeling overwhelmed
Family Services of Greater Vancouver, 1994
© MoACTS
Impact of Sibling Sexual Abuse
 Victim may feel pressured
 May feel betrayed by breach in sibling relationship
 Feelings of powerlessness to stop the abuse
 Feelings of shame or responsibility
 Offender may be protected by family secrecy
Family Services of Greater Vancouver, 1994
© MoACTS
No Easy Solution…
“I never imagined that someone would abuse my daughter
and I would end up responding by hiring him a lawyer.” (A
FLARES mother talking about her son)
© MoACTS
Impact on Families
 Court involvement (at times adversarial)
 Families separated as part of safety plans
 Many demands on families’ time for treatment and
other services
 Loyalty to children pulled in separate directions
 May have highly symptomatic children and
caregivers
© MoACTS
Benefits of Group
 Build social skills
 Overcome feelings of isolation and helplessness
 Hear a variety of viewpoints and can learn from
others
 Opportunities to practice skills
 Opportunity to help others
© MoACTS
© MoACTS
Intake Process
 Referral
 CAC, self-referred, family court
 Intake Assessment
 Brief child & caregiver interviews to assess symptoms, trauma
history & interest in group
 Symptom checklist (e.g., CBCL, TSCYC, or TSCYC)
 Orient to the group
© MoACTS
FLARES Group Model
Child Only
Groups
Conjoint Family
Groups
Caregiver Only
Groups
Psychoeducation
© MoACTS
Relaxation
& Affect
Cognitive
Coping &
Trauma
Narrative
Trauma
Processing
Safety &
Reunification
Psychoeducation
 Children
 Rationale for trauma therapy
 Myth Busters
 Caregivers
 Rationale
 Fact sheets: what, who, reactions, treatment, sexual behaviors,
etc.
 Conjoint Family
 Jeopardy style game
© MoACTS
Relaxation & Affect
 Children
 Feeling identification & expression; thermometers
 Taught focused breathing, PMR, guided imagery
 Caregivers
 Reflection & Active Listening
 Breathing, PMR, guided imagery ; importance of practice &
how to coach their children
 Conjoint Family
 Stressful activity  use relaxation  rate feelings
© MoACTS
Cognitive Coping & Trauma Narrative
 Children
 Thoughts/feelings/behaviors; positive self talk; automatic
thoughts (older children)
 Narratives  journaling or thought garden
 Caregivers
 Cognitive triangle; automatic thoughts; inaccurate/unhelpful
thoughts
 Read caregiver narrative & Prep for joint session
 Conjoint
 Meet as a family to share journal/thought garden & read 3rd
narrative
© MoACTS
FLARES Narratives
 Individual Therapy vs. Group Therapy narrative
 Risks of vicarious trauma
 Use of 3rd Party Fictional Narratives
 Tailor narrative content to group
 Ability to titrate intensity of exposure
 Use fictional narrative for caregivers as well
© MoACTS
Example of Child Narrative
My name is Jim and I am 9yo. When I was 7, I was
sexually abused by my older brother. His name is
Mike. Mike used to ask me to play video games with
him. He would have me sit on his bed and play.
Sometimes, while I was playing, he would start
rubbing my back. Then he would rub my leg. Then
he started rubbing my private. He told me it was a
different type of game and told me to rub his private
too. He said it was a secret game and I couldn’t tell
anyone. This made me feel nervous and
uncomfortable, even though he said it was a game.
© MoACTS
Example of Caregiver Narrative
We are a blended family of 7…After a weekend at her
mother’s, Rachel refused to come home with us.
After more questions, Rachel disclosed that Max had
gone into her room at night and touched her. Those
were the most wrenching words I had ever
heard…Coming to the realization that Max had
sexually abused his stepsister was an agonizing
process. We clutched at the possibility that Rachel’s
mother, a survivor of sexual abuse, might be putting
those ideas into our little girls mind. But the more
Rachel told us, the more we believed her. Doubt
quickly turned to shock, then to grief and anger.
© MoACTS
Trauma Processing
 Child
 Older kids – advice letters
 Younger kids – thoughts about abuse; what they would tell a
friend
 Caregivers
 Process focused groups
 Conjoint
 “Talk Show”
© MoACTS
Safety & Reunification
 Children
 Abuse prevention/safety skills
 Reunification & family safety plan
 Caregivers
 Family safety, managing holidays, etc.
 Reunification, apology sessions, court issues, etc.
 Conjoint
 GRADUATION!!
© MoACTS
For more information…
Megan Schacht, PhD
Clinical Manager
Assistant Clinical Professor
Children’s Advocacy
Services of Greater St.
Louis
University of Missouri – St.
Louis
(314) 516-7338
schachtm@umsl.edu
© MoACTS
Jerry Dunn, PhD
Executive Director
Associate Clinical Professor
Children’s Advocacy
Services of Greater St.
Louis
University of Missouri – St.
Louis
(314) 516-7324
dunnjer@umsl.edu