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Essay title - Sexual Abuse on Adolescents

Introduction

Sexual abuse is any sort of nonconsensual sexual contact. Sexual abuse can happen to men or women of any age.  Sexual abuse by a partner or intimate can include derogatory name calling, refusal to use contraception, deliberately causing unwanted physical pain during sex, deliberately passing on sexual diseases or infections and using objects, toys, or other items. Media portrayals of adolescents often seem to emphasize the problems that can be a part of adolescence (Brent M.D. et al. 2002). Gang violence, school shootings, alcohol-related accidents, drug abuse, and suicides involving teens are all too frequently reflected in newspaper headlines and movie plots. In the professional literature, too, adolescence is frequently portrayed as a negative stage of life a period of storm and stress to be survived or endured. Despite the negative portrayals that sometimes seem so prevalent and the negative attitudes about adolescents that they support the picture of adolescents today is largely a very positive one. Most adolescents in fact succeed in school, are attached to their families and their communities, and emerge from their teen years without experiencing serious problems such as substance abuse or involvement with violence (Brent M.D. et al. 2002). With all of the attention given to negative images of adolescents, however, the positive aspects of adolescents can be overlooked. Professionals can play an important role in shifting perceptions of adolescents to the positive. The truth is that adolescents, despite occasional or numerous protests, need adults and want them to be part of their lives, recognizing that they can nurture, teach, guide, and protect them on the journey to adulthood. Directing the courage and creativity of normal adolescents into healthy pursuits is part of what successfully counseling, teaching, or mentoring an adolescent is all about (Brent M.D. et al. 2002).

The problem of adolescent sexual abuse has attracted a great deal of attention in recent years. The media have reported numerous cases in which persons in positions of trust—including day care providers, clergymen, and scout leaders have been accused of molesting children and adolescents under their care. Many of these charges have been made by adults who claim to have recovered repressed memories of abuse they were subjected to as children (Brent M.D. et al. 2002). Other widely reported stories have involved children being abused and sometimes murdered by convicted child molesters newly released from prison. In addition, pedophiles have reportedly lured child victims into abusive situations via the Internet. Commentators point to such developments as evidence that the problem of sexual abuse is alarmingly serious. On the other hand, some researchers and social critics, while agreeing that adolescent sexual abuse is a horrendous crime, maintain that the extent of the problem has been exaggerated due to various causes. Media critics contend that intensive reporting of a few sensational cases has created a sense of panic among the public. Others question the validity of the recovered memories that are the basis of many child abuse accusations (Brent M.D. et al. 2002). In addition, the victimization of children and adolescents, society’s most vulnerable members, automatically provokes intense anger among parents and concerned citizens who demand action on the part of law enforcement. While such outrage is natural and understandable, some commentators argue that the public’s response to recent developments has been excessive and has created the impression that the problem is worse than it actually is (Brent M.D. et al. 2002).

Experts believe that most cases of child sexual abuse are never reported to authorities. In fact, the FBI has estimated that only 1 percent to 10 percent of adolescent’s sexual abuse cases are reported to the police. Adolescents often do not report being sexually abused because they are ashamed, are afraid of repercussions, or are reluctant to betray their abusers. In addition, many reports of sexual abuse are never substantiated, either because they are unfounded or because they cannot be proven (Eisenstat M.D. et al. 1999). Sexual abuse cases are frequently difficult to prove due to a lack of physical evidence especially if the abuse is reported a significant period of time after it occurred or due to unreliable testimony by the victim. For these reasons, estimates of the prevalence of child sexual abuse vary wildly. Some researchers contend that the high estimates of child sexual abuse reported by a number of studies are exaggerated, due in part to over reporting by professionals who work with children. Current law requires those who supervise, such as teachers and doctors, to report any and all possible cases of sexual abuse to law enforcement authorities. These professionals are immune from prosecution if they make mistaken allegations but are liable for criminal penalties if they fail to report a case. Critics contend that the problem of over reporting is compounded by the manner in which reports are handled by child protection agencies and investigators (Eisenstat M.D. et al. 1999). Social workers are frequently accused of being too eager to believe charges of abuse, to remove victims from their homes, and to subject parents to intensive scrutiny. Critics point to this and similar cases to substantiate their assertion that child protective service agencies are overly zealous in their investigation and prosecution of adolescents’ sexual abuse accusations, thereby exaggerating the scope of the problem. Many others counter that adolescents’ sexual abuse is an underreported problem. As noted previously, most experts agree that the majority of cases of abuse are never reported by the victim. Some centers maintains that many of those who are mandated to report suspected abuse “do not report serious cases because they do not believe the child protection or legal systems will follow up the case effectively. In short, according to the center, professionals are underreporting rather than over reporting the problem of adolescent sexual abuse (Eisenstat M.D. et al. 1999).

Sexual Abuse

If there are unexplained bruises, broken bones, and even cigarette burns, that is physical abuse. Physical abuse can also cause death. No adult has a right to beat anyone, no matter what. There are many reasons why a parent or an adult uses physical abuse on an adolescent. The parent(s) or adult could have come from an abusive home himself or herself. If that is all that the adult was taught growing up, then that is all he or she is going to know (Basson M.D., Rosemary. 2006). So it will be passed down to his/her children and their children will pass it down to their children. It is an endless chain of abuse. Alcohol and drugs play a big rule in sexual abuse. The parent(s) or caregiver is already stressed out by a variety of social conditions and when he/she get home from work she/he can start drinking or using drugs, if not both, This can trigger the violent behavior. Children are even sexually abused. A parent, guardian, relative, or a family friend can sexually abuse them. The age doesn't even matter. There are adolescents that have been sexually abused as well as teenagers. Some adolescents cannot or will not tell another adult that they are being sexually abused (Basson M.D., Rosemary. 2006). It is up to adults to look for signs of sexual abuse, such as physical complaints, fear of certain people or places, withdrawal from family and friends, discipline problems at home or school, self-destructive behavior, depression, and getting involved with alcohol or drugs just to mention a few. Adolescents that are being sexually abused frequently will display certain behavior such as copying adult sexual behavior, having sexual contact with other adolescents or themselves, and showing sexual knowledge through language or behavior. Other signs an adult can look for are unexplained swelling, bleeding or irritation of the mouth, genital, or anal area (Basson M.D., Rosemary. 2006).

Adolescents that have been sexually abused will have all kinds of emotions that they will be dealing with such as fear of the abuser, fear of causing problems, fear of being taken away from their home, and fear that people will look at them differently. They will also feel anger towards the abuser and feel angry with themselves for allowing it to happen. We as adults need to listen to our siblings. If they come to us and tell us that they are being sexually abused, you need to remain calm and listen to what the child is saying. Let him/her know that it is not her/his fault that this sexual assault has happen to him/her, he/she are the innocent victims of this tragedy (Basson M.D., Rosemary. 2006). We need to respect the child's privacy and not go telling everybody that doesn't need to know what has happened. It will only make it worse for the child, and the child will lose trust in you. Don't pressure the adolescents to talk about it if he or she is not ready. He or she will talk when he/she is ready. It will only make it worse for the victim if you force him or her to talk. Be patient with her/him. And never blame the victim for what has happened to him or her. Parent(s) or caregivers also mentally abuse their children, such as yelling, threatening the child, and degrading or humiliating him or her. It may not leave bruises or any physical evidence, but it does lower his/her self-esteem and will scar her/him mentally for the rest of his/her life (Basson M.D., Rosemary. 2006). The parent(s) or caregiver may not realize he/she is mentally abusing the victim; the parent or caregiver may think it is funny, but when it is humiliating and hurtful to the victim, it is mental abuse. The old saying, "sticks and stones may break my bones, but names will never hurt me" is so untrue. They do hurt, and they do leave scars. Mental abuse is all about control. Mental abuse can and will carry over to adult life, and the child that is being mentally abused will pass it down to his/her children. Neglect of a child happens more often than we realize. The mother can neglect her unborn child by drinking or doing drugs and by not taking care of herself when she is caring for the child. When the child is born it can be addicted to the alcohol or drugs the mother was using when she was pregnant with the child. The baby can have complications after he/she is born if the mother doesn't take care of herself while she is pregnant. The parent(s) or caregivers can neglect his/her children by not providing proper medical care, such as if the child gets sick and keeps getting worse and the parent doesn't seek proper medical help for the child. Not spending time with your child is neglect (Basson M.D., Rosemary. 2006).

Child sexual abuse; it is not a topic that makes people comfortable. Discussing child sexual abuse, in fact, remains taboo even in this era of increasing openness about personal or family difficulties. While most Americans can understand, although not condone, how some forms of child abuse occur, it is almost impossible for them to consider the idea of sexual abuse. This is particularly true when the abuser is a parent or family member. Sexual abuse fuses those areas in which most people still experience discomfort: sexuality, power, gender domination, and the horrific exploitation of an innocent child. Sexual molestation, like so many forms of abuse, wounds not only its victim: it cuts through families and communities, destroying trust and the belief that some things simply do not happen in an enlightened society (Basson M.D., Rosemary. 2006).

Child Sexual Abuse: The Impact on Adolescent Development

Our culture demands that children mature from an egocentric to a socio centric focus. They are expected to participate in school, become involved in the community, and develop relationships outside their families. This is a challenging process even for the average young person; living with abuse makes the process incredibly difficult. During adolescence, youth are growing and changing in a range of ways that are affected by sexual abuse (Liebschutz, Susan et al. 2004):

Physiological Change

How tall they are or how much they weigh becomes a source of concern to young people during adolescence, particularly as they compare themselves with their peers. That comparison may produce feelings of anxiety or contribute to dampening their self-esteem. For youth who have experienced abuse or criticism by their parents, teasing about their looks may reinforce their perception that they are not valued abuse (Liebschutz, Susan et al. 2004).

Emotional Development

Young people in abusive situations must redirect their energy from emotional development to survival. When they are forced to focus on avoiding the violent or sexual advances of an adult caretaker, they do not make the same developmental progress as children who receive unconditional love, support, and guidance abuse (Liebschutz, Susan et al. 2004).

Cognitive Change

Young people develop their cognitive thinking ability, which means that they will reexperience and reframe abuse that occurred to them earlier, particularly if it began when they were young (Liebschutz, Susan et al. 2004).

Moral and Spiritual Development

During adolescence, youth begin to question the meaning of life and specifically to think about the larger world, the role they play in it, and the options and opportunities available to them (Liebschutz, Susan et al. 2004).

Sexual Development

For some young people, it is during adolescence that the real consequences of being sexually abused occur. When a child of 3 or 4 years of age is sexually abused, it is not a sexual event in the way adults may think. It is physically hurtful, confusing, and alarming, but they do not have a context for defining the abuse. When those children turn 12 or 13, they cognitively reassess the abuse as they begin to learn about or experience sexual feelings. While all young people's development is affected by both internal and external factors, each youth experiences growing up differently. For youth who are abused, however, that process is negatively affected, resulting in certain reactions or behaviors (Liebschutz, Susan et al. 2004).

The Abused Adolescent

While there is no clear profile of a sexually abused child, the research indicates that there are symptoms that present frequently in young survivors. These include the following (Ompad PhD et al. 2005).

Anxiety/Numbing

Young people who have been sexually abused often exhibit the polarity of anxiety/numbing behaviors. These youth are hyper vigilant, scanning the environment for threats to their safety; conversely they have learned to shut down their feelings. The chronicity of the abuse plays a part in the level of anxiety experienced by child victims. Youth who have been assaulted through most of their developmental phases have learned to maintain a defensive posture to protect them. They have learned the most debilitating lesson of child abuse: people who love you hurt you. For these children, the expression of caring is presumed to be followed by harm or danger (Ompad PhD et al. 2005).

Hypersensitivity

Young people growing up in violent or abusive environments tend to be hypersensitive to their surroundings. They flinch at sudden noises and are hyper aroused or over stimulated easily. They may experience acute fear in some situations and typically "stay on alert," which requires energy and takes a tremendous toll on their physical and mental well-being. They tend to carry a lot of tension in their bodies, so they may not move as fluidly as other children. Many of these youth present somatic concerns, such as always having headaches or stomach pains. Again, the chronicity of the abuse is an important factor in the degree to which young people develop hypersensitivity. If the abuse is an isolated incident, the child is better able to regroup. When the assault is frequent or long term, the child does not have respite to reorganize or stabilize and must develop highly refined defense mechanisms (Ompad PhD et al. 2005).

Depression

Even the youngest children who have been abused exhibit characteristics of depression. They may have a flat affect, not make eye contact, or not laugh. There are many manifestations of depression, including self-mutilation, substance abuse, and eating or sleeping disorders (Ompad PhD et al. 2005).

Alcohol or Drug Use

While some young people may experiment with drugs or alcohol as a rite of passage, youth who were or are abused use substances to numb their feelings (Ompad PhD et al. 2005).

Problem Sexual Behaviors

Children who were sexually abused may become involved in sexual acting-out behaviors, particularly when they reach adolescence, a time of increasing biological urges and exposure to sexual education. Under normal conditions, sexual behavior develops gradually over time, with youth showing curiosity and then experimenting with themselves and others. When children are sexually abused, however, they are prematurely exposed to material they do not understand and cannot make sense of. Moreover, children become conditioned to respond to certain things. In many instances, adults who interact sexually with children may reward them before or after the event. The children are conditioned to believe that if they engage in certain behaviors they will be rewarded. This is pure learning theory: children repeat acts for which they receive positive reinforcement. Some children who were sexually abused also may become sexually provocative, dressing and talking in a manner that puts them at risk of further sexual exploitation. Others merge sexual behavior and aggression and become the victimizers of other children (Ompad PhD et al. 2005).

Aggression

Eventually, most abused children get angry and some begin to act aggressively, typically with smaller children. This is the victim-victimizer dynamic; abused children learn that the bigger, stronger person hurts or takes advantage of the smaller, weaker person. Youth who have been victimized are conditioned to believe that when two people interact, one of them will be hurt. At each interaction with others, they may wonder who will be hurt this time. Some children adopt the victim role; others become the victimizers. In either case, they simply are playing out the roles that they have been conditioned to believe people play during interactions with others (Ompad PhD et al. 2005). The research would indicate that boys tend to adopt the role of aggressor more often than girls. They have a harder time tolerating the role of victim, which is in stark contrast to the cultural definition of masculinity. Girls tend to adopt the role of victim more often, which could be linked to the traditional social view of women as the weaker gender. Yet neither pattern holds true in all cases. Some boys take on the victim role; some girls become aggressive. Obviously, these behaviors and reactions are learned. Young people who have survived sexual abuse can just as easily learn more positive behaviors if communities choose to provide them with appropriate interventions and support. They need support in both working through the trauma and addressing the developmental stages they may have missed because of the abuse. This includes the critical step of developing an identity separate from their family or caretaker (Ompad PhD et al. 2005).

Identity Formation in Adolescence

Forming an identity is a major developmental issue during adolescence. This process of individuation, however, is one that begins when children are very young and crystallizes in adolescence. For positive identity formation to occur in any human being, some basic things have to be attained, including the following (Yeager MSC and Fogel PhD, Joshua. 2006):

All of these variables are severely compromised by child abuse and neglect. Abused children's sense of self and their future has been badly damaged. They may have learned that negative attention is better than no attention, and they act accordingly. Unfortunately, their behaviors, which result directly from the abuse, often lead significant people in their lives to react in ways that reinforce this negative self-image. This further damages young people's sense of virtue and feeling of being loved. To deal with these overwhelmingly negative feelings, some children develop an affect disorder, which results from a person compartmentalizing information about an abusive event separately from their feelings. They will describe an abusive event in great detail without emotion, as if it were happening to someone else. This dissociation is a defense mechanism that helps people block reality, especially when it is painful. Children who are being sexually abused use dissociation to separate from their own experiences. They talk about floating above their bodies or sitting on top of a lamp watching what happened (Yeager MSC and Fogel PhD, Joshua.2006).

This process enables a young person not to feel the pain associated with actually being present during the abusive event. Unfortunately, dissociation also creates a problem with a child's sense of identity and interrupts their sense of being anchored in reality. Children who have an identity problem or no sense of who they are may, for example, develop an insecure attachment disorder (Yeager MSC and Fogel PhD, Joshua.2006). Therapists experience this with young people who ask to see them every day or to come live with them. These young people do not feel real unless they are in another person's presence. Or they fear that the person they are with now will go away and not come back, leading to feelings of abandonment and despair. When children are not allowed to develop an identity, they may appear as if they are presenting a "false self." These youth simply may not have a good sense of self to present to the world. When with other groups of people, especially other youth with strong personalities, abused children may easily retreat into themselves or mimic those they are around. Helping young people go back through the developmental stages and rebuild a sense of self is critical to their overall emotional well-being (Yeager MSC and Fogel PhD, Joshua.2006).

Treating the Sexually Abused Adolescent

One of a therapist's most important tasks is to ensure that a child is living in a safe environment with a central, supportive, caring adult. Often, young people who have been abused or neglected experience incredible mobility in their lives as they move from one placement to the next. These youth begin to doubt that any adult will be with them for very long. A sense of security and safety in one place, therefore, is very important to the therapeutic process. Once the child is in a safe environment, the therapist can begin to develop a relationship with the child. Through that relationship, the therapist can begin to help the child understand why it is important to process what happened to them (Hornor RNC, MS, CPNP, Gail.2004). Most abused adolescents want a sense of control over their lives. Therapists can show youth how, by working through their earlier experience, they can eliminate some of their negative feelings and the resulting behaviors. Through that process, youth can develop a sense of control over their behavior. When a young person is ready, the therapist can help them begin affiliating with others and developing the ability to trust and have relationships with other people, both adults and peers. Often at this stage, a therapist will place a youth in group therapy (Hornor RNC, MS, CPNP, and Gail.2004).

By the time an adolescent receives the help they deserve, they may have been sexually or otherwise abused over a period of time. They have built up an array of defenses to protect themselves, and making contact with them may be difficult. To establish the trust of an abused child, a therapist needs to build a relationship with that child, which takes time. Therapists need that time to demonstrate that they are trustworthy, by action as well as words. In some communities, the new managed care systems are threatening this process by covering the costs of only short-term therapy. The trust of a severely abused child simply cannot be established in six to eight sessions. Under those circumstances, experts caution that therapists should work only on phase 1, or the establishment of the child's safety. It is inappropriate to encourage a child to talk about traumatic abuse if that child is not in a position to receive ongoing therapeutic support (Hornor RNC, MS, CPNP, and Gail.2004).

Working With Youth Who Have Been Sexually Abused

Helping youth explore past abuse is specialized work, requiring significant education, training, and expertise. The following key principles provide guidance for those working with youth who have been sexually abused (Okie M.D., Susan. 2007):

Remain Neutral in Your Early Interactions with Abused Children

When some youth sense that a therapist or other professional is paying attention to or trying to help them, they may withdraw because the circumstances feel risky to them. The very nature of counseling or therapy, which involves personal contact with another human being and focused, positive attention, can produce stress and anxiety for children who have been sexually abused. Youth who have been sexually abused also may associate nice behavior with seduction. In the past, people were nice to them when they wanted something. They may wonder what therapists or other adults expect from them in return for their help (Okie M.D., Susan. 2007)

Assist Youth in Understanding That They Are Not To Blame

Typically, left to their own resources, children make incorrect assumptions about why they were abused or neglected. When 100 youth in San Francisco were asked why they were in the foster care system, 98 of them said, "Because I am bad." And young people's behavior often reflects how they feel about themselves. If they think they are bad, they may act in ways that perpetuate that image (Okie M.D., Susan. 2007).

Be Nonjudgmental

Youth do not respond well to adults who want to tell them what to do or who are constantly critical.

Catch Youth Doing Something Good

Focus on telling young people what they are doing that is good. When they make a thoughtful decision and stick to it, for example, congratulate them on following through (Okie M.D., Susan. 2007).

Help Them View Their Feelings without Judgment

Feelings are not good or bad, they are just feelings. Help young people understand that it is all right to feel angry, and help them to learn to express their anger in ways that are healthy for themselves and others (Okie M.D., Susan. 2007).

Think Of Your Interactions with Youth as "Invitations" For Them to Do or Say As Much or As Little As They Choose

Youth need to learn to make choices about how they will participate, or not, in different situations. An offering youth option gives them a chance to practice making choices in a safe environment. If a young person does not complete an assignment, for example, consider talking with him or her about what the assignment might have looked like if they had finished it. Or, discuss what might have been the biggest problem in completing the task. Through this process, you might accomplish more than if you focus on the young person's failure to complete the task (Okie M.D., Susan. 2007).

Avoid Power Struggles with Young People

It generally is nonproductive to spend time arguing a point with an adolescent. Move on to other discussions that might prove more useful. Keep in mind that if a young person is feeling defensive, they are not feeling safe.

Remember That Abused Adolescents Have A Reason to Be Defensive

If you are hit enough, emotionally or physically, you learn to stand ready to protect yourself or even to ward off attacks by attacking first. Young people who have been abused need time and a trusted relationship to feel safe.

Understand How Easy It Is For Abused Children to Be Further Victimized

Without question, once abused, children become more vulnerable to further victimization. It is not just the abuse that leaves them exposed to exploitation; it is the concomitant loss of love, nurturing, and feelings of being safe and valued. Often adult predators provide, at least at first, the very things missing from an abused child's history: time, attention, caring, and a sense of belonging.

Be Aware That Some Behaviors Provide Youth with a Sense of Control

When children are treated well, nurtured, loved, and accepted, they learn to expect that treatment from others. When children are abused, they similarly expect others will abuse them. These children may engage in aggressive behavior as a defense mechanism; their behavior is a means of taking control of a situation they anticipate will occur anyway. When you work with youth to stop behaviors that place them at risk, it is important to be aware that those behaviors may be the only current means they have for mastery and control (Okie M.D., Susan. 2007)

Help Educate Others That Young People Are Never Responsible For Their Abuse

Often, people suggest that adolescents should have told someone or fought back. The expectation is that adolescents should be able to protect themselves. It is important to remember that many young people have long histories of abuse, which makes them vulnerable; they are not "normal" (nonabused) adolescents suddenly confronted with dangerous circumstances. Moreover, it is critical to remember that children are relating to their parents, the people they love and need most in the world. When asked, "Who is bad, you or your Mom and Dad?" children will always choose themselves. Children need to protect the idealized image of their parents; those are the people they long for.

Working with youth who have been sexually abused obviously requires special skills and expertise. For that reason, most youth agencies develop strong working relationships with therapists who are experienced in working with youth who have been sexually abused. In selecting a therapist, youth agencies should look for well-trained professionals who understand and apply the above-mentioned principles. They also should look for therapists who do the following:

Use Therapeutic Approaches Other Than Talk Therapy

Direct talk therapy generally is not the most effective approach with adolescents. Well-trained therapists will use art or play therapy in working with abused youth. They also might discuss news clippings or watch a video and let youth comment on another young person's situation. It may be easier for youth to talk about another person as a means of sharing how they feel. Moreover, helping young people develop empathy for others often can be the first step in developing self-empathy.

Help Youth Change Behaviors That Cause Negative Reactions in Others

Therapists examine a child's behavior, describe it, and then try to determine why the child is acting in this manner. A 12-year-old girl, for example, who threw temper tantrums, explained that she felt quiet inside when the tantrum was over. She said she felt calm because "everything inside had come out." This child had been beaten whenever she showed any emotion, so she had learned to keep her feelings bottled up inside. Every now and then, however, she had to let those feelings go. Until she entered therapy, the child had never been taught how to live with and manage real feelings; the result was tension, control, and then loss of control. Her therapist worked with her, using a tea kettle as a metaphor. They jointly developed a plan for the young woman to begin to let her "steam" out in ways that would not cause concern among the people around her or allow the kettle to "blow its lid." Through the process, the young girl learned affect tolerance: the ability to feel, absorb, and express her feelings appropriately (Kyriacou M.D. et al. 1999).

Appreciate That Children Sustain Injuries Differently

Some young people are more resilient than others. A therapist needs to assess how well the young person has survived the abuse, what they think about themselves, and how they manage to reach out to others. Through this process, it is important to help the youth build a history of accomplishment by emphasizing the young person's strengths and successes (Kyriacou M.D. et al. 1999).

Help Youth Process Traumatic Material

Young people need support to deal with what happened to them, discharge their feelings, and develop a sense of mastery about that process. Unless this happens, images similar to those associated with the abusive event may trigger a posttraumatic stress reaction. A youth may blow up or go into trancelike behavior for no apparent reason. This is an indication that they have unresolved traumatic material and they need help in processing that material in a structured way that creates feelings of empowerment (Kyriacou M.D. et al. 1999).

Work With Youth to Assimilate the Information and Feelings Associated With Their Prior Abuse

By processing traumatic material, therapists can help youth talk about the event and feel the associated feelings at the same time (Kyriacou M.D. et al. 1999).

Recognize That While Abuse and Neglect Have the Potential to Be Traumatic, Not Every Abused Child Is Traumatized

Traumatized children are a subset of abused children. Factors that distinguish the two groups tend to include the child's relationship to the abuser, age at the onset of abuse, and biology, and the chronicity and severity of the abuse. All abused children are hurt and exploited, but, depending on a broad set of variables, some children continue to live in the climate of the trauma (Kyriacou M.D. et al. 1999).

Help Youth Learn How to Manage Their Feelings in Settings in Which It Would Not Be Appropriate To Act Upon Them

Some youth need to learn affect regulation, which is the ability to control feelings in certain situations. Adults, for example, who had a fight with a spouse prior to making a presentation at work, are able to refocus themselves. They are able to control the feelings they are experiencing as a result of the fight while they make the presentation (Kyriacou M.D. et al. 1999).

Work with Youth to Develop Impulse Control

Children growing up with abusive parents did not have impulse control modeled for them. Many abusive parents think and act at the same time; when they are angry, they strike their children. Nonabusive parents also get angry at their children; they simply have the impulse control not to act on every thought. Children who grew up with abusive parents may need to learn that thoughts and action can be distant on the time spectrum. They need help in determining how to go through a series of steps to make decisions about what they will do in response to their thoughts (Kyriacou M.D. et al. 1999).

That All Children Are Different

Some children act out in ways that continue the climate of trauma through behavioral reenactments that keep the victim dynamic present in their life. Others want to talk constantly about the abuse and will do so even with strangers. Still other youth refuse to talk about the abuse; they say it is over and they do not want to deal with it. A good therapist will develop a plan for working with a young person on the basis of that child's behavior, presenting problems, personality, and coping style (Kyriacou M.D. et al. 1999).

References

Basson M.D., Rosemary. (2006). Sexual Desire and Arousal Disorder in Women. New England Journal of Medicine, 354 (14), 1498-1506.

Brent M.D. et al. (2002). Adolescent Depression. England Journal of Medicine, 347 (9), 667-671.

Eisenstat M.D. et al. (1999). Domestic Violence. New England Journal of Medicine, 341 (12), 886-892.

Hornor RNC, MS, CPNP, Gail. (2004). Ano-Genital Warts in Children: Sexual Abuse or Not? Journal Pediatric Health Care, 18 (4), 165-170.

Kyriacou M.D. et al. (1999). RISK FACTORS FOR INJURY TO WOMEN FROM DOMESTIC VIOLENCE. England Journal of Medicine, 341 (6), 1892-1898.

Lee, Henry et al. (2004). Blood Evidence: How DNA is revolutionizing the Way We Solve Crimes. England Journal of Medicine, 350 (3), 313-316.

Okie M.D., Susan. (2007). Sex, Drugs, Prisons, & HIV. England Journal of Medicine, 356 (2), 105-108.

Ompad PhD et al. (2005). Childhood Sexual Abuse and Age at Initiation. American Journal of Public Health. 95 (4), 703-709.

Yeager MSC and Fogel PhD, Joshua. (2006). Male Disclosure of Sexual Abuse and Rape. Advanced Practice Nursing eJournal. 6 (1), 1-5.

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