This presentation analyzes a hypothetical case study of a young girl aged six and a half years who was taken for treatment by her mother, as a result of the girl’s sexual abuse by her mother’s boyfriend.
The court has ordered Melissa and her mother Asher to go for treatment after the judge and the social workers dealing with the case established that Melissa’s claims of being sexually abused were true. When the assessment began, Melissa was 6 years old, and her mother was 27 years old. Asher had been married at 20years but was divorced from Melissa’s father and had completely distanced herself from him.
At the time of the case, Asher had moved in with her boyfriend, Tony, for about year and half. He had started molesting Melissa around seven months earlier. At first Melissa could not open up to her mother because Tony had threatened to kill her if she told anything to her mother.
When Melissa decided to break the silence her mother could not initially believe her, and had brushed it off, but she later decided to investigate when she realized that her daughter’s behavior had really changed and she had become withdrawn and fearful, it was then that she discovered the shocking revelation of what had been happening to her daughter.
The therapists also came to learn that Melissa’s mother also had an abusive childhood, she came from a broken home whereby her mother had divorce with Asher’s abusive and alcoholic dad and worse of it had been sexually abused once.
The paper discusses that although the girl is the main patient, she is part of larger system that she is connected to; which is very relevant to her case and also course of treatment.
Process of the crisis
Urie Bronfenbrenner came up with an ecological systems theory explaining how all things in a child and the child’s surroundings have an impact on how the child grows. He examined levels of the environment that impact a child’s growth, which include the micro system, the immediate surrounding of a child such as the family relationships, the mesosystem, which describes how the various parts of a child’s micro system cooperate in order to help the child. The exosystem level consist of the others that the child may not be in contact with her but still affect her in a big way for example parents’ workplaces, and relationships
Bronfenbrenner’s final level is macro system; it’s the most remote set of things to a child but still has a great impact on the child. For example freedoms permitted by the government and cultural values. All these affect how a child develops positively or negatively.
Using Urie Bronfenbrenner’s ecological model, I will examine the context of Melissa’s case, the impact of the sexual abuse in her life, the preferred treatment for both the mother and child and how to avoid future abuse.
Encompassing the mesosystem is exosystem, the broader settings that define Melissa’s life, and the macrosystem, the cultural values that determine how she and those surrounding her are required to behave. Through the abuse, Tony violated the expected values, and Asher’s early refusal to believe what her daughter told her also cut off the girl from the covering that an individual is supposed to be given by the larger society. Nevertheless, the legal system, which is normally a part of the exosystem, has got into a closer circle of Melissa’s life and attempts to correct the violations of those close to her (Finkelhor, 1986). This has led to an ecological transition, a situation in which an individuals place in ecological environment is changed due to change in the role one plays, setting, or both. Although distressing for Melissa and her mother, the transition is an important, positive move in the healing of both individuals.
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Interestingly, therapists’ discovery that Asher was herself sexually abused leads to applicable considerations that will assist in the treatment both of them. These considerations are also important in explaining the current psychopathologies seen in Finkelhor (1986) where he explains that traumas and mal-adaptations during childhood reoccur many times in later generations; children from dysfunctional families mostly create their own dysfunctional families they go with the patterns they learned when growing up. Asher has given Melissa the only kind of childhood she herself knows.
Effects
When Melissa was taken for treatment the first time she looked afraid, depressed and uncertain. When we look at the effects of sexual abuse can be looked into with the conceptualization of Finkelhor, the traumatogenic impacts of sexual abuse is widely used. The effects are divided into four categories, as explained below;
Traumatic sexualization refers to ill disposed feelings about sex, and the sexual identity problems.
Stigmatization which is manifested in guilty feelings and feeling responsible for the abuse or of disclosure.
The other effect is betrayal, whereby it is downgrading the trust in people who are required to be protectors and nurturers of children.
Powerlessness includes a view of being vulnerable and a victim and the behavioral manifestations of anxiety consist of phobias, insomnia, and eating disorders;
Management of the case
In Melissa’s case management there are various considerations that need to be made. Hence, coordination is very important. The things that the team are required to put in mind at this stage of intervention are disconnection of the child /or the offender from the family, the part played by the juvenile court and the criminal court and also the plan for treatment of the family
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Before a treatment plan is developed, it is vital to understand the cause abuse; there are various models as explained by Finkelhor under Sexual Abuse Causal Models. In history there have been two major models namely the family-focused and the offender-focused perspectives. Efforts have been made to integrate the two by Finkelhor who developed a causation model that involves both the family-, and offender-focused perspectives.. Finkelhor explains four preconditions that must be involved for sexual abuse to take place, factors connected to the abusers force to sexually abuse; factors inducing the abuser to overcome internal obstacles; factors inducing the abuser to overcome external inhibitors and factors inducing to overcome the child’s resistance
Modalities of treatment
In treatment modalities, whereby the main goal in sexual abuse treatment is to deal with the impacts of sexual abuse, and decrease the risks of future sexual abuse.
Treatment Issues for the Victim that will have to be attended to be are; Trust whereby; there are devastating effects on children’s relationship, especially being able to trust o people. In family sexual abuse, the effect is worse as in the case of Melissa because her stepfather, who should be her protector, exploits and violates the limits of acceptable values. A non- offending parent like Melissa’s mother who could not believe her initially accelerates this damage.
The therapist is required to establish circumstances where the child has positive participation with trusted adults in order to correct the child’s ability to trust. Emotional Reactions to Sexual Abuse whereby the child feeling being victimized in that she feels as if she is responsible and starts feeling guilty, having a disorganized sense of self and low self-esteem because of being involved in sexual abuse. The therapist is required to help the child understand and accept that she was not responsible and also make her feel good again about herself.
Protection from future victimization
Protection from Future Victimization whereby the abused child needs taught future protection strategies. The child should be taught to say no and tell a trustworthy person may be useful.
Treatment Issues for the Mother
Treatment Issues for the Mother particularly in cases involving the mothers in interfamilial as in Asher’s case. Just like the victim Melissa her mother will need to undergo treatment in several areas such as areas connected to Sexual Abuse
It is hard for mothers of victims, to comprehend why a grownup may go sexual with a child. This is an issue that the clinician should address with the mother.
The therapist can offer professional explanation into the causes of abuse specific to the case. Another issue to be addressed believing the child’s disclosure of the sexual abuse. The therapist can explain makes her believe that the child is telling the truth or conclude that children do not make false allegations on such matters. Eventually the therapist will help the mother comprehend her duty in the abuse, if she had one. She is not to blame but in some way may have played a part to prolonged abuse as in the case of Melissa and Asher for not believing her initially
Improving the mother-child relationship is also very important because it is an important step in assisting the mother to be protective of her child in future.
In the case of intrafamilial abuse like Melissa’s case, the mother should decide if she wants to cut off her relationship with the abuser or salvage her relationship. Personal issues such as past trauma as having been sexually abused herself which is the case of Melissa. Such an experience has various impacts in on the mother’s ability to deal with her child’s abuse. The mother may be not being in a position to cope because she has not dealt with her own sexual abuse. Hence her abuse has to be addressed as in the case of Asher. She may not suspect risky situation quickly and her decisions of partners, playing part in moving in with a man who goes sexual with children.
Hence in conclusion, childhood sexual abuse is a very sensitive issue that has to be dealt with to avoid future destruction of the children’s lives
Reference
Finkelhor, D. (1986). The Effects of Sexual Abuse, in D. Finkelhor et al., Eds. Sourcebook on Child Sexual Abuse Newbury Park, CA: Sage.
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