AIFC 650B
Provide Therapy for Issues
Relating to Abuse and Trauma
Please turn off mobile phones
RESOURCES
CCFT Volume 8
Mark Yarhouse and James Sells
Family Therapies: A Comprehensive
Christian Appraisal (Chapter 13)
Recommended additional reading
Judith Herman – Trauma and Recovery
Clinton, Tim and Trent, John
Marriage and Family Counselling
Grant Martin - Counselling for Family
Violence and Abuse
Elements of Competency
(Learning outcomes)
Read from Handbook
ABUSE AND TRAUMA 
Many degrees of abuse and damage
CHILD ABUSE
- Physical abuse and neglect
- Emotional abuse
- Intellectual abuse
- Sexual abuse
- Spiritual abuse
SPOUSE/PARTNER ABUSE
ABUSE OF THE ELDERLY
CRITICAL INCIDENT TRAUMA
POSTTRAUMATIC STRESS DISORDER
CHILD ABUSE 
(Trauma, neglect, abandonment,
violence)
- Inflicting injury or allowing injury
- Anything less than nurturing
- Can be overt or covert
- Includes what is done and what is
not done (neglect)
MANDATORY REPORTING 
Mandatory reporting laws (2012) vary from state to
state and in the nature of the abuse – see Volume 8
Suspected cases of child physical abuse and neglect,
sexual abuse and in some states emotional abuse and
domestic violence must be reported
Generally those mandated to notify are doctors,
dentists, psychologists, nurses, teachers, police
officers, welfare workers, school counsellors, child care
providers, religious workers (SA), and others who in the
course of their professional work delivers health care,
education and welfare to children and their families
Ordinary counsellors are required to notify in ACT,
NSW, NT, Tas. and SA, but not in Qld. Vic. and WA
THERAPY FOR CHILDHOOD ABUSE
GENERAL PRINCIPLES 
- Careful and accurate assessment of the abuse
- Denial or minimisation of abuse is common
(see Abuse Questionnaire in Vol.8)
- Build good relationship so client will talk
- Therapy depends on the extent and damage
- Crisis, short-term, long term
- Deal with symptoms as they arise in children
- Repressed, recovered and false memories
- False guilt assessed (CBT)
- Forgiveness of the abuser essential but not
thrust prematurely on the victim (see Vol.4)
PHYSICAL ABUSE AND NEGLECT
- Physical injury due to excessive discipline
(beating, burning, punching, shaking, kicking...)
Also overfeeding → childhood obesity
- Neglect of child’s basic physical needs not
due to poverty (food, shelter, clothing,
medical, etc.)
Prevention and Counselling
As with all abuse, careful investigation of the
extent of the abuse
- Instruction in correct parenting
EMOTIONAL ABUSE
- Verbal assault, screaming, belittling
- Marital discord, negativism, inconsistency
- Interfering with the child’s peers
- Exposing the child to danger
- Parental inversion (parent’s intimate sharing
with a child because of poor marriage)
- Deprivation of love and attention (neglect)
Prevention and Counselling
Instruction in correct parenting
INTELLECTUAL ABUSE
- Belittling the child’s thinking
- You are stupid
- You are an idiot
- Not supporting intellectual development
- Depriving the child of reasonable
education
- Not teaching problem-solving
- Parents not sharing their own weaknesses
Prevention and Counselling
CHILD SEXUAL ABUSE
Child sexual abuse occurs when an
adult, older child or adolescent
involves a child in sexual activity
Most behaviors are criminal and
addictive
SEXUAL ABUSE INCLUDES
Physical – touching to intercourse (incest)
Non-physical – voyeurism, exhibitionism
Verbal – sexual joking, innuendos
Boundary violation – invasion of child’s privacy
Exposure - to inappropriate nudity, pornography,
allowing child to see or hear parents having sex
Emotional – parental inversion
Exploitation – child pornography, prostitution
Circumcision (except when medically indicated)
Neglect – Failure to give proper sex education
INCIDENCE
1:4 girls and 1:8 boys up to age 17
Just as common in the church
WHO ARE THE OFFENDERS?
- From all socio-economic classes
- Men abuse 95% of girls and 80% of boys
- Stepfather 5x more likely to abuse than father
- Older children (esp. an adolescent sibling)
WHY ABUSE?
- Abuser comes from dysfunctional background
and probably been abused himself
- Pornography
Sexual
abuse can
commence
early - by
older boys
CHARACTERISTICS OF ABUSER
- Often from helping professions, youth worker
- Often charming, intelligent, rigid, legalistic
- Deep self-hatred, anger, resentment
- Insensitivity to the hurt imposed
REACTIONS WHEN CAUGHT
- Denial, minimization, rationalization
- Accusation – even of the victim
THERAPY FOR THE ABUSER
- As for sexual addiction (See Vol. 7)
- Possibility of reporting
- Right attitude towards abuser
EFFECTS ON THE VICTIM (varies)
EARLY CHILDHOOD
Anxiety, sleeplessness, personality changes
PRIMARY-SCHOOOL AGE
In addition - guilt, shame, low self-esteem,
decline in school work, fear of being alone with
men, poor hygiene, inordinate modesty,
bedwetting, poor communication
ADOLESCENCE
In addition - school absenteeism, drugs and
alcohol, promiscuity, going to bed fully dressed,
obesity, suicidal thoughts
ADULTS
In addition – depression, powerlessness, victim
mentality, relationship problems, sexual
dysfunction, addictions, mistrust, nightmares
INDICATORS OF CHILD ABUSE
- Behavioral, physical, medical (See Vol.8)
CONFIDENTIALITY AND REPORTING
CRISIS MANAGEMENT- Protection of child
VALIDATION OF ABUSE (See Vol.8)
INTERVIEWING THE CHILD (See Vol.8)
- Children don’t normally lie about abuse
DAMAGE FACTORS
As with all abuse careful initial investigation of
the extent of the abuse and damage factors is
essential
- Relationship to the abuser
- Was force or violence used?
- Degree of non-violent coercion
- Extent and nature of the abuse
- Duration
- Number of instances of abuse
- Accidental? Unintentional?
- Age of victim and stage of development
- Reaction of significant adults
THERAPY FOR THE VICTIM
- Depends on extent and damage
- Crisis, short-term, long term
- Deal with symptoms as they arise in children
- First step is for victim to talk about the abuse
to someone they can trust – breaks shame
- Repressed, recovered and false memories
- Damaged Goods Syndrome
- False guilt (abuser totally to blame)
- Forgiveness (see next slide)
- Relationship and sexual issues
- Victim to victor
- Family therapy
FORGIVING THE ABUSER
- Forgiveness of the abuser essential for
healing
- But it must not be done prematurely (see
process of forgiveness in Volume 4)
- The victim must come fully to terms with the
extent of the hurt, anger and even hatred of
the abuser, before they are in a position to
rightly forgive
- This will normally be after several sessions of
therapy
PREVENTION OF SEXUAL ABUSE
- Parent’s job to protect their child from abuse
Why don’t they?
- Progressive from about age 3
- Parents need to meet the child’s emotional
needs and build a good relationship so the
child will readily come to them and share
- Parents need to explain privacy of child’s
body, setting boundaries and being assertive
(See Volume 8)
SPIRITUAL ABUSE (child and adult)
- Product of a dysfunctional church
- Interfering with spiritual nurture (parent/sect)
- Authoritarianism, rigidity, legalism, control
- Teaching a distorted image of God
- Conforming to rules  pretense and unreality
- Demanding perfection
- Promoting the “quick fix”
- Generating undue guilt, shame and fear
- Insisting on child being in an extreme sect/cult
- Confusion and cut off from God’s grace
Neglect - Failure in proper spiritual nurture
THE DYSFUNCTIONAL CHURCH 
Similar to dysfunctional family
CHARACTERISTICS
Control, authoritarianism, legalism,
perfectionism, misogyny, cheap grace, sexual
repression, doctrinally unsound beliefs
Promotes spiritual abuse and religious addiction
Rules - many - to be rigidly kept
Roles - persecutor, active enabler, passive
enabler, victim, protester
RECOVERY FROM SPIRITUAL ABUSE
Talking, feeling, trusting
Giving up denial and pretense – honesty
Dealing with resentment and guilt
Learning the true character of God
Cognitive restructuring (faulty beliefs)
Perseverance and endurance (no “quick fix”)
Learning grace
Spiritual renewal
Finding a suitable church
DOMESTIC VIOLENCE 
(Spouse Abuse, Partner Abuse)
TYPES
- Physical
- Emotional (threats, using children, betrayal)
- Sexual
- Spiritual
- Economical
- Social
INCIDENCE
1:3 women sometime – 1:10 significant injury
Husband abuse also common
Incidence in church also high
Domestic
violence is
criminal
assault and
cannot be
tolerated in
any
circumstance
Apprehended
violence orders
have reached
epidemic
proportions
EFFECTS ON SPOUSE
Denial, confusion, anger, fear, shame, low
self-esteem, breakdown in trust
INDIRECT SYMPTOMS
Bruises, emergency treatment, miscarriages,
drugs, alcohol, anxiety, depression,
marital/sexual conflict, codependency,
isolation, unrealistic hope
CHARACTERISTICS OF THE ABUSER
Misogyny and codependency
Authoritarian patriarchy
Rage-aholism (addictive personality)
Alcohol involved in about half of cases
PHASES
Tension building→violent episode→remorse
INTERVENTION
Arrest, safety, AVO, therapy
THERAPY ISSUES FOR VICTIM
- Breaking through denial
- Assertiveness
- Codependency
- Dealing with anger, resentment, guilt, shame
THERAPY ISSUES FOR ABUSER
- Codependency and misogyny
- Anger management – group therapy
ABUSE OF THE ELDERLY 
Scriptures (See Volume 8)
TYPES
Physical, emotional, social, financial ,medical
INCIDENCE 1:10 and increasing
REASONS
- Dependency
- Care-giving stress and other stress
- Negative attitudes towards elderly
THERAPY ISSUES
- For abused and abuser (see Volume 8)
Abuse of
the elderly
is not
uncommon
CRITICAL INCIDENT TRAUMA 
DEFINITION
Serious exposure and stress from a sudden
event
INCIDENCE
Two thirds will experience it in their lifetime
INCLUDES
Natural disasters, war, terrorism, violence,
rape, sudden death, serious accidents, etc.
CRITICAL INCIDENT TRAUMA
THOSE AFFECTED
Directly, witnesses, helpers, family, community
EMOTIONAL REACTIONS
1. Shock
2. Impact
3. Resolution
INTERVENTIONS
DEFUSING
- Initial shock, disbelief, disorientation
- Within a few hours of event
- Well-being and safety of the client (and others)
- Allow expression of emotions, etc.
- Reassurance
- Helping clients cope
- Clarification of therapy required and referral
DEBRIEFING
(CISD - Critical Incident Stress Debriefing)
- 1-3 days after incident when necessary
- Single one-off group session
CRISIS COUNSELLING
- If necessary
- For those who do not want, or who are
unable to have, group CISD
- Anxiety Disorders (eg. Panic attacks,
Acute stress disorder -  1 month after)
- Client encouraged to share feelings
- Denial, confusion, anger, bitterness, shame,
guilt, fear are evaluated
- Need for marriage/family therapy evaluated
POSTTRAUMATIC STRESS DISORDER
(see Volume 8)
Definition (DSM-5)
- Re-experiencing an extremely traumatic event
for more than a month (8%?)
- Acute, chronic, delayed onset
Symptoms
- Intrusive memories, dreams, flashbacks
- Severe distress, panic-like attacks
Therapy
- Stress management
- Anxiety therapy (desensitisation, CBT)
ACUTE STRESS DISORDER (1-6 months)
Form groups of 5-6 so each in turn can
share insights they received from the
teaching of this unit