Child Sexual Abuse

Vignette.
Amanda is a 9 year old and only child. Her school teacher has complained that Amanda does not play with other childen and often prefers to eat by herself. When the therapist talks to her one day and asks her about her social life and the other kids, she tells the therapist about the babysitter who watches her everyday after school. She beginnes to dicuss the “touching games” her baby sitter plays with her. These touching games involve the babysitter touching the girl on her chest and inside her underware. Amanda tells the therapist that the babysitter then has her touch her in the same way. She sais that the babysitter told her not to tell anyone, but that she does not rally like it.
Observations.
Amanda’s scenario is a clear case of child sexual abuse. In fact, according to the National Child Traumatic Stress Network (2000), child abuse is any interaction between a child and an adult (or another child)in which the child is used for the sexual stimulation of the perpetrator or observer. The babysitter is using Amanda to sexually stimulate her, adopting a persuasive and manipulative tactic which involves calling the abusive behavior a “game” to confuse the victim. Touching Amanda on her chest and inside her underware and asking her to do the same is cosidered a lewd act. The penal code 288 states that “lewd acts include the touching of the child by the perpetrator. Lewd acts are not limited to touching the child. The acts may include the perpetrator displaying him/herself or others or having the child participating in touching him/herself or others. These acts are done with the same specific intent to arouse the sexual desire of the perpetrator or the child”.
Amanda’s withdrawn behavior is one of the typical reactions of children who have experienced trauma. Moreover, not having disclosed her sexual abuse to anyone, other than the therapist, is as well a typical behavior of abused children. This behavior is commonly dictated by feelings such as fear (of not being believed), shame, or guilt. In fact, if the abuser is someone the child or the family cares about, such as the babysitter, Amanda may worry about getting that person in trouble. In addition, children often believe that the sexual abuse was their own fault and may not disclose for fear of getting in trouble themselves.
When a child discloses abuse, it is crucial to stay calm, listen carefully, and never blame the child. Furthermore, any mandated reporter must call a child protective agency immediately. The phone call should be followed by a written report within the next 36 hours. This is an essential first step towards the child recovery process. In fact, children are known to be quite resilient, and with the combination of support from their parents and effective therapy, they can recover fron such experiences. After reviewing Amanda’s case thoroughly, the therapist will make a report using the feminist decision making model. The feminist model calls for maximum involvement of the client at every stage of the process. Therefore, after making the clinical evaluation and assessment of the client’s problem, the therapist will discuss the need to report with the client, in this case Amanda’s parents, before making the report. This allows the client to feel equalized in the therapeutic relationship and maintain a strong alliance with the therapist. Avoiding intervention in a case of child sexual abuse could lead to irriparable consequences. Research suggests that “large numbers of adolescent girls with behavioral disturbances were the victims of sexual abuse during childhood. This becomes evident with regard to behavioral problems of a sexual nature, juvenile prostitution and sexual promiscuity having been shown to be strongly related to sexual abuse” (Van Gijseghem, Gauthier, 1994).
A number of other adolescent behavioral disorders may also be associated with sexual abuse: running away from home (Janus, Burgess & McCormack,