Monthly Archives: September 2011

How to handle sexual abuse allegations Part 2

Here is Part 2 – Points 6-10. To read Points 1-5, How to handle sexual abuse allegations Part 1.

6. Who, what, when, where and how: talk with the child in a private setting, if possible not in the very room where the abuse occurred. You want to know: who is/are the alleged perpetrator(s)?what happened?, what level of sexual intrusion, what level of violence? how long has this being happening, when was the last time? where did it happen? How did the alleged perpetrator enforce silence? With threats of violence to the child or the family, with manipulation and bribes? Does the child feel that he is the one who loved her the most? Were others also abused? Are there witnesses who saw/heard or should/could have known? Are others at risk?

7. Help the child’s mother/primary caretaker: she is crucial to the child’s development towards health or pathology. Her support for the child is the most important predictor of psychological outcome. She may be dependent on the alleged offender, or afraid of him. The abuse disclosure may trigger memories of her own childhood abuse. Do not be judgmental, be supportive and help her be the best mother she can be at this time of personal and familial crisis.

8. The alleged offender does not fit into any one profile: he may look ‘innocently normal’, needy and immature, looking to children to meet his needs, he may be a nurturant parent, or even the more nurturant one, he may be a substance abuser, he may be psychotic, or a family tyrant, or a psychopath with a criminal record, or a pedophile who will bow out and move on to the next family with children of the same age, etc. Whatever profile he fits into, he too may be in crisis, and may be at risk for violence against the family or himself. And, whatever his profile, the victim and the other children may suffer from losing him, financially or emotionally. Family reunification is a later issue that requires thoughtful assessment.

9. The victim does not fit into any one profile or follow any one path. Depending on many variables, she may or may not be headed towards psychologic problems. The family needs to know that their reactions are the most critical variable.

10. Long term outcomes cover a broad range of possibilities, influenced by many factors: the child’s biologic and temperamental disposition towards resilience or vulnerability; the child’s early history of nurturing and attachment; the level of stress in the child’s early life, as it affected her and her caregivers; the child’s character development and capabilities; the child’s mental health; the particulars of the child’s experience of abuse and violence. In addition, there are many factors that caregivers can influence after the abuse has been disclosed: the immediate and long term level of support within the family; the immediate and long term availability of psychologic counseling for the child and the family; the relationship with the non-offending parent; in cases of incest, the child and the family’s relationship with the offending parent; acceptance and support within the larger family and the community; the absence of blaming the victim; the social circumstances and security of the family; living in a safe environment; the availability of education, etc

Read this blog in Spanish.

Threat of Loss and Change

Leave a reply

Conversation Between “S” of the Home and Sarah Measures

9-9-2011

Sarah spoke to S on Friday about the two ten-year-old twin brothers. Recently the boys have been acting up more at school, but not at home. Behavior issues include: not listening, swearing, disrespect of other children. Although the boys are in different classes, the behavior seemed to begin with one boy, F. and spread to K. At home they continue to do their homework quite well and are able to complete it independently, once they get started. When asked about these behaviors the boys tend to become defensive and say that other people instigate it.

Both boys are skilled and passionate about soccer. They have trained and played in a local team at the park for the past year. K wanted to switch to the school team, but logistically this was not possible for the home. They also like to play computer games. They are less interested than other children in the home in other activities such as going to the park or skating.

There is a correlation between the timing of these behaviors and children beginning to leave the home. Two girls, M and N, are scheduled to leave in a month. The boys are particularly close to N, a slightly older girl. The boys are unlikely to leave the home themselves because their placement was the result of court action. When asked about the increase of visiting days to twice instead of once a month the boys appeared neutral.

S and Sarah discussed talking with them about their feeling around the changes going on in the home, and the departure of their friends. In addition to the emotional loss this embodies, they may also be feeling anxious about their own futures. This may also be discussed within a small group of children.

S plans to talk further to the boys’ two teachers concerning:

a) Their existing strengths, interests and connections and how to foster them.

b) Possible reasons why the twins may be more troubled than usual at the moment.

S might then follow this conversation by offering the teachers contact and brainstorming opportunities with me by e-mail or phone. (The boys have two teachers, one English speaking, the other Spanish speaking. This is likely to be useful to the English speaker.)

An intervention, might begin by understanding the root of their feelings, the reasons for their actions, and then helping them to understand their feelings and replace their negative behavior with more positive, self affirming actions. Eventually, after gathering more information about causes and supporting success we could discuss some positive behavioral strategies.

Read this blog in Spanish.

How to handle sexual abuse allegations, Part 1.

1 Reply

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.

September 2011

Maria Sauzier MD

Caveats:

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.

Go on to How to handle sexual abuse allegations Part 2

Read this blog in Spanish.

VILLAGE STAFF IN ACTION

Leave a reply

A team member, Susana, is featured in her agency newsletter.

Village Staffer Shares New Expertise Locally and Internationally

Just over a year ago, The Village’s Co-Founder and Chief Operating Officer, Irma Seilicovich, approached therapist Susana Fragano, ASW, with a unique opportunity: a chance to participate in an innovative, yearlong postgraduate certificate program featuring a multidisciplinary approach to infant-parent mental health. The program also happened to be housed at the University of Massachusetts. Without hesitation, Susana, who works with parents of children from birth to 18 years and supervises our MSW student interns, made the commitment to spend one weekend a month in Boston. We’re glad she did!

The course attracts professionals from around the country and is led by some of the most respected pioneers in the field of child development. Students gain firsthand experience with the latest research on how to train parents and caregivers to build strong and healthy attachments to the children in their lives—identified as the linchpin in helping children thrive. Susana not only mastered skills that are now enhancing The Village’s services but, as one of the few bilingual clinical social workers in the program, she was invited to accompany faculty member Dr. Alexandra Harrison on her field work to an orphanage in El Salvador. There, Susana co-facilitated workshops for caregivers on building relationships with severely traumatized children, who must contend not only with issues of abandonment but with the effects of poverty and war. In addition to providing much-needed services, Susana returned with new insights that will be invaluable in working with the many Salvadoran families The Village serves.

Read this blog in Spanish.

Parallels in Resiliency

Leave a reply

In my conversation with F (names have been initialized and changed to preserve confidentiality), a member of the Leadership Team (LT), I caught up on the important subject of the court hearings for the children. The Home has received court letters regarding the children from four families so far, and the court has begun to hold hearings, which the Leadership Team from the Home has attended. Because of the new law, there is now a powerful initiative to take children out of children’s homes and return them to their biological families. LT is concerned that the families feel threatened by the courts when they hesitate to take their children back; LT thinks that the families are afraid they will be sent to prison if they don’t accept their children. At present, the court requires children to stay in a children’s home for a maximum of two years. Of course, most of the children in the Home have lived there for many years, some for most of their childhood, and the Home has offered a functional family for them – providing security, nurturing, quality education, and important relationships. Therefore, leaving the home, while in some cases allowing them to repair a rupture with their biological families, will always entail a significant loss.

Continue reading →