Caring for Sexually Abused Children: A Handbook for Families & Churches

(Dr. R. Timothy Kearney)

The author has a Ph.D. in Clinical Psychology from the Graduate School of Psychology at Fuller Theological Seminary.
In 1998, he joined the Community Health Center behavioral health staff at the University of Massachusetts Medical School, Worcester.
In addition to administrative and clinical leadership of the Behavioral Health programs at CHC, Dr. Kearney supervises and trains postdoctoral psychology residents, co-leads psychotherapy groups with students and younger staff to train them in the provision of child group therapy, and provides direct client care with the clinical focus of providing care to children and adolescents and their families, especially those impacted by medical illness, trauma, and abuse. He is a licensed psychologist in Connecticut, New York, and California.

Counselors can use the material in this book to teach their clients:

1. How to properly define child sexual abuse: "Any kind of sexual act between a child and an adult or between an infant or young child and a significantly older child." (P. 16-17)

2. The scope of sexual abuse of children: "one out of every four females and one out of every seven males has been sexually abused by an adult before the age of eighteen." (p. 18)

3. The warning signs of child sexual abuse --

Physical warning signs:
(1) Torn, stained, or bloody underwear.
(2) Pain, swelling, or itching in the genital area.
(3) Pain in urination or defecation, or urinary or anal bleeding.
(4) Sphincter control problems.
(5) Pregnancy and venereal disease.
(6) Increase in physical complaints.

Behavioral warning signs:
(1) Age-inappropriate sexual behavior (knowledge of words, sexual activities, or role-playing adult sexual encounters).
(2) Use of names for genitalia (other than the names taught by their parents).
(3) Changes in performance at school (wandering thoughts, difficulty concentrating, daydreaming, sleep problems, sudden phobias).
(4) Delinquency or running away.
(5) Sleep disturbances (nightmares, fear of monsters, bed-wetting, and difficulty with going to bed).
(6) Changes in eating patterns.

Emotional and related signs:
(1) Poor peer relationships
(2) Fear of formerly comfortable people or places.
(3) Regression (i.e. reverts to pre-toilet trained behavior)
(4) Anxiety-related illness
(5) Secretive talk in relationships (i.e. "I can't talk about that.")
(6) Poor self-concept
(7) Depression
(8) Signs of decompensation (inability to function at home or school, suicide attempts, psychotic episodes).

Spiritual Signs:
(1) Anger at God
(2) Refusal to pray for a specific person
(3) "Flight into religion" (becoming extremely concerned about religious rites and practices in order to please God).
(4) Belief that one is uniquely and specifically sinful (the child sees himself as the most bad, most dirty, and most sinful of all people).
(5) Misconstrued theology (taught by the molester to the child).

4. How to respond when a child reports having been sexually abused. What to do after hearing this report. How to insure for the safety of the child. With whom will the child be going home? Who else knows about the alleged abuse? Is there a history of irrational or unsafe behavior on the part of the parent or the guardian or whoever has access to the child? What does the child think will happen next now that he or she has disclosed the abuse? Can you or someone you can specify be available as a support person? How and by whom should the parent or guardian be informed of what the child has said?

5. How to make the initial call to child protective services. These workers will investigate the validity of the allegations by meeting with the child and family to determine: (1) Is the child in immediate danger and in need of immediate removal from their home? (2) Is the child in short-term danger, perhaps because of parental substance abuse, and require temporary placement with a relative or foster home? (3) Is the child safe at the moment, but the family needs supportive services. Child protective services may require the child to undergo a sexual abuse medical examination, a diagnostic interview with a mental health professional, and possible a psychiatric interview for family members.

6. How to cooperate with police intervention and ensuing involvement from either family court or criminal court.

7. How churches can help with child sexual abuse by combating isolation, labeling, gossip, and shame and guilt.

8. How to know when to refer a child or family member for professional help.

9. How to address theological questions, such as
(1) Why does God allow a child to be sexually abused?
(2) Is God punishing the child or the family members?
(3) How come I can't trust God anymore?
(4) Has God abandoned me?
(5) Is God angry at me? Can He forgive me for feeling this way?
(6) Will it ever get any better?