Working with Child Survivors of Sexual Abuse- Workshop
Child Sexual Abuse
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Types of Abuse- contact vs non-cantact
o Penetrative (vaginal, anal, oral) vs non-penetrative (some form of contacttouching, fondling, no insertion happening)
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Powero Imbalance of power (eg- done to a 5 yo by an older person by someone in a
position of authority, trust, family, vulnerability, physical dominance)
o Consent
 Done with consent of child, child was okay, did not scream, etc- not a
valid
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Tactics- Can be difficult for a child to come to an understanding, may not be able to
articulate, and it is important to understand the psychological effects
o Grooming manipulation by perpetrator to build trust,
 more emotional sense and sense of comfort with older children
 material gifts with younger children
 Works within family too- creation of trust by the perpetrators
 3 S’s- secrecy, silence, shame
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Secrecy: Younger children- special game, do not tell anyone,
older children- online spaces, meeting in places, asking them
not to tell their friends
Silence- if you tell someone, I will harm someone close to
them, having videos or pictures of them, finding ways to
silence them
Shame (May be of others finding out)
Boundaries and Violationo No longer know who to trust, breach of safety and boundary, difficult to
understand if the abuser is wrong, especially if the person is very close and
trusted like a parent, etc.
o May feel emotionally safe, sometimes not- difficult to grapple with what has
happened
o Attention- Providing it when they follow what they want and not providing it
when they don’t listen to them, creates confusion for the child.
Why kids don’t tell:
- Shame
- Guilt
- That person told me not to tell anyone
Do’s:
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Remain calm, believe the child and allow them to talk
Provide support
Do not panic and blame them, the child might go into a shell and never reach out
How to embody: Day 2
Impact of CSA:
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Immediate signs- physical and emotional changes
Unexplained injuries
No concrete answers- I don’t know
Bruising in private body parts
Constant bruising
Difficulty walking or sitting
May cry more than telling what happened or where it hurts
Pregnancy
Pain and itching in genital areas
Fatigue and difficulty sleeping- constantly tired, sleepy all day, not sleeping at
night
o Behaviour changes- Identify premorbid vs post behaviours
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Accumulation of gifts or money
Regressive behaviours- thumb sucking, wetting pants
Too much/too little attention to appearances
Sudden dislike of certain places or people
Withdrawal
Short-term impacts- psychological, behavioural, body
o Younger children (2-8 yo)
 Sexualised games/ self stimulating behaviours
 Nightmares
 Being clingy
 Fearfulness, anxiety
 Emotional outbursts- crying, anger, irritation, frustration, depression
 Guilt and shame- stays after the abuse too
 Hyperfocus, hyperactivity- not able to contain themselves
 Lack of bodily boundaries and privacy- like being naked in the house,
even when someone is in the house
o Older children (9+ yo)
 Self-harm
 Disgust of sexuality, gender
 Sense of fear when thinking about sex
 Confusion of sex with love due to grooming during abuse
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Long-term- psychological, behavioural, body
o Loss of safety due to constantly being in a space of not being space and being
unable to speak up
o Inability to differentiate between safe and unsafe
o Loss of intimacy- even safe touch by partner feels unsafe
o Engaging in sexual acts in order to receive the attention they received as a
child
o Dissociation due to constant stress on body- immunity is on the edge,
overwhelm, the body is unable to manage everything- can happen anytime
around abuse
o Loss of physical connection with body
o Loss of sense of self
o Re-enactment- Re-creating the scenarios, getting into abusive relationships
and repeating the past
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Play behaviours- curious play vs sexualised play
o Touching themselves or others inappropriately
o Add pic from ppt
o Parents may have difficulty differentiating between the 2, important to take
note of other markers of abuse
o Social media can also play a role
Mind body impact of CSA
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Complex traumatic experience affecting mind and body
Often verbal narratives taken into consideration- too much attention to it
Needs more focus on bodily manifestations
Memory of it is also stored in somatic memory- muscles, fascia, nervous system, and
brain
Entire body remembers- from your head to your toes, not only visual memory
It means that the body is going to show signs, become a source or storage of memory
Need to rely on the body’s truth too- flashbacks, nightmares, anxiety, denial of bodily
needs (food, water, hygiene, moving, singing, anything that makes them happy),
certain touches might feel very weird (pushing away, clenching), may pass forward as
an adult
Body is confused whether what they are experiencing is normal or not, constant
juggle of complexity or confusion
A touch that may not be of sexual intent, like a mother bathing the child, can feel
confusing
Psychological impact should include the bodily experience
Understanding how Abuse Hides
Four aspects
- Community (Police, mental health
practitioners, teachers, principal)
- Parents
- The offender
- The child
Keep piece of paper and sketch pens or colours for
tomorrow
Difficulty with reporting abuse:
- Failure to ask as a community by
everyone around (labelled as throwing a tantrum)
- Fear of not being believed
- May not feel safe enough to talk to someone
- Grooming
- Fear of the perpetrator
- Reliving the trauma, may not even want to talk about as it may become to much for
the body to handle
- Fear that it might get worse if someone interferes
Day 2
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Practices as a mental health practitioner
Role of a therapist
Techniques to work in this space
How to talk to the children
Journey of healing
Play-based and expressive arts methods
Safety
- The child needs to know about the safety, trust and boundaries offered in the session
with you.
- At an environmental levelo Child-friendly space
o Sofas,
o Pets,
o Toys,
o Lower sitting,
o Keeping the door shut
o Having some infographics (in the waiting area)
- Ensuring and maintaining privacy- involve and inform them (ask the child before
enclosing, who to tell, what to tell)
- Use simple, clear language, use direct and appropriate words involved
- Needs to be a private, safe space, without parents
- If the child asks for a parent, ask parent to be there for 10-15 minutes and then ease
them into having the parent not being in the room
- Create an environment for the child to ask questions, answer them calmly and
reflected on body language as well
- Include structure, but include choices too (eg: let’s play a game, which one would you
like to play)
- Emphasise on safe space and boundaries, explain it to them, what it is, how it works,
give a lot of description of what safe looks like, ask the child what it looks like, ask
their preferences on what they would like in the room
- Avoid being alarmed, overprotective, advise (don’t do this, do this, avoid this person,
being scared when they talk about things)
How to talk at different stages
Add from PPT
Leading vs non-leading questions
From ppt
The Window Approach
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Create openings for each window one by one
Children- talk about body, then people safety (this mom, grandma, etc and
boundaries), protection and general safety, slowly transitioning
Adolescents- talk about attraction and love, needs and pleasures, consent and
boundaries, slowly transitioning to consent vs sexual abuse
Journey of Healing
- Helping the child understand what happened and making sense of it
- Teach themo Assertivenesso teach the child how to say no,
o voice their concerns,
o building self-esteem,
o making them aware that it was not their fault
o Emotion Regulation, guided imagery, maintaining a mood diary, normalization
and reintegration with society
Play and Expressive Arts Methods
- Creating an outline of the body, the child can mark body parts where they feel various
emotions or feelings, like where they feel safe/ unsafe, provide prompts
- Teaching good vs bad touch to children
- Conversation about body safety and body mapping
- Moving stories- talk about the elements of the story, what does it tell you how you can
take back home, etc
Day 3
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Legal obligations
POCSO
Duty of practitioners- confidentiality, gray areas, reporting
Safety Plan
Case study (video)
Rights of Children
- No child-specific laws for children
- Child needs to have strong safety measures, privacy
- Right to have a trusted adult or parent during recording statement
- Right to counselling, legal assistance, educational services, psychological recovery,
and provided with compensation.
POCSO- in 2012
- No laws before that outlined protection of children from CSA
- POCSO- Protection of Children from Sexual Offences
- Men and women can both be tried under this act
- Minor offender under the Child Juvenile Justice Act, major offender under the
POCSO
- Looking at how we can provide them proper psychological guidance to minor
offenders and reintegration with society with respect
- Dilemma of confidentiality vs how much to report by the counsellor
o Nothing can be exposed to the media, including their identity
o Make sure that the identity is protected, and charges if not done
o Special courts for POCSO cases, outside public not allowed, only the child,
family member or assistance and the offender
Offences under POCSO
Add from ppt- table with offenders, punishments, features
- Charges can be clubbed (like sexual assault + penetrative SA, the imprisonment time
and fine gets added up)
Confidentiality vs duty to report
- If client discloses incident of SA
- Wait for consent from parent and child before you report
- Sometimes they may not be ready to report, what to do in that case?
o Maybe because
 Legality
 Society's judgment concerns
 Offender in position of power
o Steps to take
 Talking to the child, record what is being said through documentation
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Discuss with family, take consent from the child first (If the child says
no, ask them about a safe or trusted adult they can discuss it with)
 Educate the child and the parent about POCSO and the law- what it is,
how the process looks, infographics, three points- protection, justice
and safety
 Reassure- you are not going to report unless they agree, no pressure
 Reporting may be necessary when:
 High chance of re-abuse
 No way of modifying the child’s environment
 Exception and grey areas come in here
 Need to assess severity, any modification possible
 Exploring the hesitations of the parent and child- why they are feeling
scared, ask about their reasons for not wanting to report + making them
understand the situation- empathy + reassurance, practical measures to
protect the child till you report- safety of the child is paramount
 I am not going to disclose any information to any media for the
safety and protection of the child
 Explain what will happen through the next steps
 If still not willing to report, look at practical measures
 Document all the 7 steps followed, in case the child goes on to report
in the future, to protect your practice, while showing the steps
followed. All documentation should be included. How was the child's
safety ensured?
 Whom to report to? Police, special juvenile police unit, child welfare
committee, district child protective unit, 1908 helpline, POCSO ebox
o Process of reporting
 Recorded by a woman police officer, not in uniform
 At the child’s home, in the presence of a safe adult
 In the language the child understands and speaks
 Frequent breaks
 Medical examination within 24 hours in the presence of parents or
trusted adults, results can sometimes be excluded if done a long time
after the incident
 Gentle conversation, not questioned too much
 In a child-friendly manner
 Audio recording of the statement, which is read out to the child and
parent
 Court hearing- the child is not expected to show up in court, may be
asked to meet the judge separately with a trusted adult, court visit is
selective and pre-informed, role of counsellor to prepare the child
Case dilemma
- If a child is ready to report but parents or guardians are not
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o Look at age of child
 7 or under, may not understand what it looks like
 Explain to them in the presence of an adult they are close or
comfortable with. Make sure they understand what the legal case
would be like
 Is the safety of the child jeopardised in any way? Is the parent still
going to support the child even if they choose to report?
 Can bring in a social worker to work with the child and the parent
o If done by a school teacher, report to the principal, and talk to the parent
o Responsibility of parent and school authorities to report further
o If the school does not take enough measures, the school may be involved in
legal proceedings for not taking steps
Constant risk, no way to change the surroundings, you as a therapist can go ahead and
report, the best thing to do- calling the child helpline 1098, which provides a social
worker for the case, talk to the parent that you will have to report
Steps for an offender who is a minor
o Getting more information on what is happening in the offender’s
surroundings, needs to be equally empathetic to both
o Understanding about their developing sexual curiosity vs abuse
o Take time to understand both their experiences
o Inform the parent that they will also be provided with support to get through it
Child safety steps
No consent, ensuring the safety of the child
Add from PPT