Therapy for Children and Teens Who were Sexually Abused

While some young people find relief from the traumatic events by telling a professional therapist what happened during the abuse, others are not helped by this.The therapist must be able to tell the difference and lead each client along his or her unique path to recovery.

Most children and teenagers want to do well in school, want to be loved by their parents, and want to have friends. If therapy aims to help them accomplish these goals, many do not find it necessary to relate details of the abuse. They will have gained sufficient self-confidence to be able to function well in their lives. This makes them less vulnerable to subsequent exploitations.

Sometimes the most important help we give to children and to teenagers is the help we give their parents in learning more effective parenting skills. 

It is  important to understand that recovery for young people often occurs in stages such that at each new developmental stage, the person will have to digest what happened to them over again. That is because as children grow they are able to understand other aspects of the traumatic event and their needs change. For example, a five-year-old child cannot understand sexual abuse in the way a fifteen-year-old will. For this same reason, adults may need to return to therapy even if they felt as children that they healed from what was done to them.

These are not therapy approaches, but rather, tools that can be applied by therapists working from a variety of therapy of schools of therapy. They are well regarded within the trauma therapist community.

There are several tools for trauma resolution. Some have been scientifically tested to explore how effective they may be and others have not. While it may give greater confidence to therapists, and perhaps to parents as well, to know that academic research has shown a particular method to be helpful, it is important to remember a few facts:

For these reasons, while research is important, it only can give the therapist partial answers. Therapists, especially sex trauma therapists, need a great deal of experience to know which clients will likely benefit from a particular tool and when and how to use them.

Cohen, Deblinger and Mannarino, developed the most researched approach to trauma therapy for children and teenagers. It is a short-term process that includes relaxation exercises, telling the story of the abuse, explanations for victims and their parents on sexual abuse and its effects, parent guidance and parent-child sessions. I was critical of their one-size-fits-all approach and now am happy to see that they have begun to explore the multifaceted and complex issues that face sex abuse victims/survivors and their families.

Their most recent study explores the relative importance of the various aspects of therapy and they show what many therapists have known for a long time - that the most important part of therapy for many children after being safe from abuse is not telling the story of the abuse, but rather learning important coping skills for functioning better in school and among peers.

They were able to show that different therapy approaches are necessary for different symptomatic presentations of children of different ages and they promise future studies will provide more answers to clinicians who seek to provide the best therapy possible to each individual client.

Their latest article:

Deblinger, E., Mannarino, A.P., Cohen, J.A., Runyon, M.K. & Steer, R.A. (2011). Trauma-focused cognitive behavioral therapy for children: Impact of the trauma narrative and treatment length. Depression and Anxiety, 28, 67-75. 

Family therapy can take different forms. The therapist may see all the family together, may work with the parents only, or may alternate between seeing members individually or in pairs and in larger groups.  The purpose of family therapy is to help family members communicate more effectively and develop healthier and more satisfying interactions.

An important part of family therapy when there has been child abuse is parenting education and parenting skills development.

When the abuser is a member of the nuclear family, it is more likely that family members will be seen individually until they are ready to acknowledge the abuse, the abuser takes responsibility and the nonabusive parent knows how to help the children in light of the abuse having gone on unstopped.

Siblings need special attention in order to help them vent their feelings. Their feelings toward the abuser, the nonabusive parent/s and the victim/s will be complex and cause a great deal of confusion. 

Family reunification aims to enable parents to provide a safe and healthy environment in which to continue raising their children.

All My Articles on the Internet
Here you can find the growing list of articles I publish in various places around the Web. It includes all topics and you will see that the list of sex abuse articles will grow faster than the others.

I have been working almost exclusively in this for over 25 years. In 1999, I established the first multidisciplinary clinic in the country (Israel) treating children, teenagers and adults who were sexually abused and their families. We did couples therapy when one or both partners were survivors of abuse and offered parental guidance when a child or youth was abused or was found to have sexually acted out against another minor. I directed the clinic until 2010, when I turned my energies toward establishing a two-year specialist training programme for therapists who want to work in this area.

I have presented at international conferences in Israel and abroad. My first book on therapy for adults survivors and their therapists was published in 2006 and I have published numerous professional papers in English and Hebrew.

One of my current goals is to share all that I have learned over my career - for survivors, their loved ones and professionals working with them.

I will answer questions, personal and professional, and make articles around the questions asked so that others can benefit as well.