Unfortunately, sexual abuse is a significant threat to children, especially to vulnerable children, and caregivers should know what to do if a child discloses abuse. A friend and colleague, Dr. Maria Sauzier, is an expert in child sexual abuse and offers ten “things to do” when sexual abuse is suspected. The first five suggestions are given in this posting, and I will post the second five next week.
Maria Sauzier MD
- The victim is identified as ‘she’, although the number of abused boys is not insubstantial.
- The abuser is identified as ‘he’ given that 90% or so of abusers are male.
- He is an ‘alleged abuser’ until a court has found him guilty.
- These points are written both for caregivers who are family members and those who are not.
1. Don’t panic: finding out about sexual abuse can trigger profound reactions in caregivers: outrage, disgust, shame, fear that the damage is irreversible, fear of retaliation, denial or minimization, blaming the victim, resurgence of PTSD symptoms based on their own past abuse, etc. Make a mental map of who is around you: who can you trust to help you and your family in this crisis.
2. Safety first: assess the need for immediate medical intervention, immediate removal of the child and family to prevent further violence—–for ex if there is a threat to punish the child for disclosing, from the offender or from a family member. The alleged offender is the one who should leave the home.
3. Compose yourself, watch your reactions: the child is trying to make sense of what has been happening to her, is easily influenced by the clues she is picking up. Issues of shame and blame are particularly critical. Be calm and empathetic, do not jump to conclusions, do not pepper the child with questions, particularly leading questions, do not imply ‘how could you let this happen’, do not minimize, do not make promises you cannot keep (‘everything will be alright’).
4. Think developmentally: how old is the child chronologically and developmentally? This will guide your approach to finding out what happened and how to intervene.
5. Think of the family as a system: all members are in crisis, including the siblings and other dependents. Their reactions may help or impede the evaluation and the psychologic progress of the victim. You need to know what they know about the abuse and about the current crisis (why has father left?). This family system is embedded in a sociocultural structure, know as much as you can about cultural norms and expectations.