Taking care of children who have been abused

If you are a parent or caregiver of a child who has been sexually abused, it is natural for you to feel shocked and numb about the incident. However, it is important to be calm and remind yourself that your support and reassurance can significantly alleviate the impact of the abuse on the child. Child psychiatrist Dr Preeti Jacob of NIMHANS, shares some pointers that can help you effectively offer support to a child who has survived abuse.

Dos:

• Believe the child and help them feel safe again.

• Encourage the child to share their feelings. The child must be made to understand that there are no right and wrong feelings, and that it is helpful to share feelings with trusted people. Understand that children may have contradictory and ambiguous feelings towards the abuser, especially in cases of intra-familial abuse. From early on, it is important for children to be taught to identify and express their feelings in an appropriate manner.

• Find support for yourself. It is not easy to assimilate such a terrible experience. There may be a number of practical issues that also need to be resolved. Being overwhelmed is natural and it is important to find an able supportive network for yourself and seek professional help, if necessary.

Dont’s:

• Do not catastrophize the abusive experience and its impact. For example, mothers may feel that the experience might prevent the child from getting married. As children may base their perceptions of the abusive experience(s) based on parental perceptions, it's important for parents to identify any negative thoughts within themselves. This is vital so that parents can help the child in the "NOW" and model effective methods for the child to cope.

• Do not avoid the topic of abuse, especially if the child wants to talk or share about it. Most children want to talk about an aspect of the abuse or the fallout of the abuse. For example, a child may be anxious about going back to school and facing their classmates. The parent can discuss this aspect by allowing the child to express their concerns and fears, and discuss ways they can tackle the problem together. While dealing with their own loss and grief, parents might either display anger or reluctance to talk about the experience; might feel that talking about it will remind the child of the horrific experience(s) or​ feel at a loss for what to say and how to react to the child and may thus avoid the topic out of their own anxiety. Such instances might make the child avoid talking about it as they are worried that they will upset or anger the parents. If the parent is unable to help the child, it’s important to seek help.

• Do not be angry with the child for not reporting the abuse sooner. Children do not report abuse for a variety reasons including fear of being blamed or fear/anxiety that the perpetrator might be sent away from them, in cases of intra-familial abuse. Some children may have been “groomed” thus making it difficult for the child to clearly distinguish boundary violations. Other children may have even been coerced by the abuser and the fear of being harmed or harm befalling a family member may have made the child keep it a secret. Parents should not disbelieve the child just because the abuse occurred a while ago or be angry/upset with the child for not revealing such sensitive and distressing information sooner.

• Do not alter normal expectations and limits. Often times, in the aftermath of such an experience, out of their own sense of guilt, parents may be very permissive with the child. For example, the child may be allowed to watch excessive television or allowed to shop/eat excessively. This does not help the child or the parent and other behavior problems may develop.

Also read: 

1. When a child confides in you

2. Child sexual abuse: What can parents do?

References: Inputs have been taken from from Treating Sexually Abused Children and Their Nonoffending Parents: A Cognitive Behavioural Approach by Esther Deblinger and Anne Hope Heflin from the Interpersonal Violence: The Practice Series (Jon R Conte, Series Editor), Sage Publications, California, USA, 1996. (ISBN 0-8039-5929-X pbk).

Dr Preeti Jacob is an assistant professor of child and adolescent psychiatry at NIMHANS