Rachael Johnson - NSPCC

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• Rachael Johnson - NSPCC
• Aims
• To identify the impact of sexual abuse
• To identify the need for services
• To describe a model developed within NSPCC

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• The Impact of Sexual Abuse
• Psychological
• Social
• Behavioural

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• The Four Traumagenic Dynamics Model of sexual
  abuse
• (Finkelhor and Brown, 1986)
• Traumatic sexualisation The childs sexuality is
  shaped in a developmentally inappropriate way.
  Premature sexualisation lack of boundaries sex
  is associated with negative feelings and
  memories may struggle to form appropriate
  sexual/intimate relationships.
• Betrayal child is abused in a relationship in
  which they expect to be cared for and protected.
  Trust is violated.

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• The Four Traumagenic Dynamics Model of sexual
  abuse
• (Finkelhor and Brown, 1986)
• Powerlessness the child is made to feel helpless
  and powerless may blame self because they could
  not stop the abuse or did not actively resist
  child has no ownership over their body.
• Stigmatisation a sense of badness, shame and
  guilt may become incorporated into the childs
  self-image.

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Danya Glaser (1991) added two further factors

• Secrecy the need to deal with the secrecy
  surrounding the abuse prior to disclosure the
  fear and isolation this engenders for the child.
• Confusion the confusion arising from a child
  possibly experiencing pleasurable feelings bad
  behaviour initiated by a trusted adult
  conflicting feelings a child might have for the
  perpetrator of abuse the double life a child
  might have to live.
• These factors arent solely linked to sexual
  abuse but the combination of dynamics make this
  type of trauma unique.

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The Need for Services

• NSPCC research identified a gap in services
• Scarcity of evidence about what works leads to a
  lack of funding
• CBT is not suitable for all, particularly younger
  children.

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Letting the Future In Model

• Children and young people aged 4 to 17
• Child has made a disclosure of sexual abuse
• Where a joint investigation has taken place
• Child living with a safe carer

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• Letting the Future In Model
• Assessment of therapeutic need
• Individual work with child/young person
• Individual work with safe carer
• Joint work with child and carer

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• Therapeutic work with child/young person
• Socio-educative work around sexual abuse
• Identity and self-esteem power dynamics
• Helping child become aware of their feelings and
  manage feelings around their abuse
• Helping child tell their story.

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The Use of Symbolic Play with Children

• Play is the natural way for children to
  communicate about traumatic and emotional
  experiences.
• Symbolic play allows child to explore their
  experiences from a safe distance without getting
  re-traumatised.
• Most children re-enact the impact of their
  experience through play because it is foremost in
  their mind.
• Non-directive play - the role of the practitioner
  is to reflect the childs play, to tune into the
  childs feelings, to notice themes in childs
  play.

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Focussed Interventions with Children

• Eco Maps/Life Graphs/Life Maps to depict
  important people or events in childs life.
• Sand-tray work Ask the child to use figures to
  depict their family to depict scenes of before
  and after they told about their abuse.
• Picture cards to describe feelings childs
  view of themselves dynamics in relationships.
• Relaxation activities e.g. blowing bubbles
  tensing/relaxing muscles.
• Activities to help child express feelings e.g.
  punching through newspaper messy painting
  ripping paper.
• Create supportive messages e.g. it was really
  good to tell You are brave What happened was
  not your fault.

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Support for Safe Carers

• The most influential factor in children's
  recovery is the warmth and consistency they
  receive from their safe carer.
• We know that sexual abuse can lead to a
  deterioration in relationships between children
  and carers and also that compromised
  relationships can make children vulnerable to
  abuse.

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Individual Work with Carers

• Help carer process their thoughts and feelings
  about their child grief and loss they may be
  experiencing.
• Help carers feel more understood and less
  isolated.
• Socio-educative work about sexual abuse (impact
  of abuse, why its difficult for children to
  tell, perpetrators behaviour).
• Help carers think about how they can support
  their child (nightmares, managing behaviour,
  supportive messages).
• Increase warmth and consistency. Increase their
  ability to be in tune with childs feelings.
• Prepare for joint work with the child repair
  relationship.

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Evaluation

• Work is being evaluated by Durham and Bristol
  Universities
• There will be a focus on the role of the
  therapeutic alliance
• This research will involve the largest number of
  children.