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Introduction
As a relatively hidden pattern of abuse, family violence can take a variety of shapes and forms, including physical, mental, and sexual assault. As the victims and perpetrators are generally known to each other, an interpersonal attack’s psychological impact is more significant. Children are particularly vulnerable, as they often lack the physical and material resources to protect themselves. Furthermore, children rely on family members for protection, which becomes more complicated when the parents are the abusers. The perpetrators of sexual abuse of minors often are primary caregivers, ranging from biological to stepparents. The long-term effects of a child’s sexual abuse include various psychological disorders, cognitive and interpersonal difficulties (Lawson, 2013). As a result, minors who have been sexually abused require effective treatment to offset potential future mental complications. A practical method of treating abused children is trauma-focused cognitive behavioral therapy (CBT), which combines elements of therapy, education, and skill training to help the minor. Overall, exploring the effects of sexual abuse on children requires understating the spectrum of consequences sexual abuse has on the victims and identifying possible treatment.
Effects of Child Sexual Abuse
The effects of abuse on children can vary significantly, as some would suffer long-term consequences, whereas others can be left with no plausible adverse outcomes. The overall psychological response depends mainly on two primary factors, including the child’s internal capabilities and external factors (Lawson, 2013). The former includes children’s temperament and level of psychological development. In contrast, the latter involves contextual circumstances, such as stress levels and family support abilities. Overall, the combination of the two factors leads to the establishment of the direct effects of trauma and the child’s adaptation tendencies. However, the impact of the external factors in the context of a moderate to severe trauma is particularly reliant on parents’ response. Therefore, a young child under ten exposed to continuous psychological trauma associated with inappropriate or violent behavior of family members will be more prone to exhibit severe long-term symptoms (Lawson, 2013). The instances of improper conduct can incorporate exposure to interparental violence or all forms of child sexual abuse (CSA) by a parent or a caregiver.
Furthermore, the literature suggests that sexual abuse instances throughout childhood are one of the most traumatic events that a child can experience. It can prompt consequent behavioral difficulties, influence adjustment problems, and raise the prospect of mental health issues across the lifetime. Severe effects incorporate discouragement about the future, psychosomatic disorders, anxiety, suicide attempts, depression, and poor academic performance (Kim & Kang, 2017). Other severe outcomes of CSA have been associated with higher levels of shame, embarrassment, self-blame, suppression, denial, sexual deviances, relationship issues, and trauma (Sinanan, 2015). As a result, sexual trauma can interfere with early childhood’s standard developmental process, which is subsequently manifested by emotional or behavioral characteristics that exhibit psychological and physical suffering. Victims of CSA endeavor countless attempts to mentally escape from trauma through avoidance, memory repression efforts, self-distraction, and addictions (Sinanan, 2015). In addition, children utilize cognitive coping mechanisms, including reappraisal, minimization, reframing, and controlling the abuse outcomes. Overall, the severe psychological effects of CSA frequently transpire irrespective of the child’s degree of trauma throughout the abusive period.
Moreover, studies suggest that children tend to encounter a greater extent of psychological suffering if the perpetrator is a family member. Thus, a close relative, including parents, has more significant effects on a child’s development of trauma than a neighbor or a family friend (Sinanan, 2015). Children under ten years old are more likely to undergo more adverse consequences following the CSA. The child has a high potential of experiencing negative psychological effects despite not being fully aware of what is sexually occurring. Additionally, children that experienced sexual abuse during the early stages of cognitive development have fewer mental resources to cope with the suffering appropriately. Apart from the psychological consequences, some of the significant social and interpersonal effects include tendencies to violate others’ rights, poor relationships with peers, trust issues, social alienation, and difficulty establishing contacts (Lawson, 2013). Alongside thought problems, physical issues, such as internal somatic complaints, bruises, genital discomfort, walking and sitting difficulties, sleep disruption, eating disorders, stomachache, and headache can transpire (Lawson, 2013). Overall, CSA can be particularly harmful to children under the age of ten, leading to adverse mental, behavioral, social, and physical effects.
Trauma-Focused Cognitive Behavioral Therapy Application
Finding effective treatment for the victims of sexual abuse, particularly ones in their formative childhood years, is essential to negate the aforementioned adverse effects. Cognitive-behavioral therapy (CBT) is one possible approach, as it focuses on confronting and altering the attitudes and beliefs associated, in this case, with post-abuse trauma. The trauma-focused cognitive behavioral approach is a subset of CBT that works with abuse victims in particular and is one of the most effective methods for treating children (Hines et al., 2020). One of the ways trauma-focused CBT benefits children is by educating them on emotion based-vocabulary. This allows younger victims to express their feelings more accurately, as children can often lack the ability to describe their experiences and emotions (Paul, 2013). Trauma-focused CBT has also been found as effective at treating PTSD and anxiety among children who have suffered abuse. Additionally, this treatment has improved the victims’ social aptitude post-treatment, possibly negating some of the long-term disorders (Hines et al., 2020). Overall, the evidence suggests trauma-focused CBT is an effective and valid treatment method for young children who have suffered abuse within the family.
Cognitive behavioral therapy uses various structured elements throughout eight to twenty five sessions with the victim and often a non-offending caregiver. The first of these elements are psychoeducation of the victim regarding their abuse and its effects, followed by relaxation skills to help the child deal with the results of trauma (Cohen & Mannarino, 2018). Trauma-focused CBT works on developing the victim’s practical and cognitive skills to help them understand their emotional state. The next element of this treatment uses trauma narration and processing, where the child uses the knowledge gained in the first part to describe their experiences and discuss their effects (Cohen & Mannarino 2018). This is frequently accomplished in conjunction with a non-offending caregiver, allowing them to help the child consolidate what they have learned by avoiding unintentional trauma triggers. Reinforcing the child’s relationship with the non-offending caregiver is key to solidifying treatment, as loss of trust is standard for victims of sexual abuse (Lawson, 2013). Overall, trauma-focused CBT concentrates on developing the victim’s cognition and behavior and works on building resiliency.
In practice, multiple empirical studies have shown trauma-focused CBT as an effective method for dealing with abused children’s behavioral issues. Studies varying in location and age of juvenile subjects have indicated that TF-CBT was more effective at dealing with PTSD than other treatment methods (Cohen & Mannarino, 2018). Furthermore, studies on the effectiveness of TF-CBT regarding various and possibly mixed trauma have indicated that it is a potent method for treating children (Cohen & Mannarino, 2018). In general, CBT has been shown to assist with various behavioral issues such as anger management, demonstrating its efficiency as a treatment of children’s behavioral problems (Lawson, 2013). Thus, children who have been sexually abused by family members are likely to have positive outcomes from therapy that uses cognitive-behavioral methods. However, as a relatively newer method of trauma treatment, it is still unclear if TF-CBT successfully negates many of the long-term effects of sexual abuse.
Conclusion
To sum up, child sexual abuse is an essential issue for psychologists worldwide due to the subsequent traumatic consequences toward the victims. Children often can overcome difficult events if the external factors of their existence are normalized; however, in the case of CSA, the external forces are astonishingly unbalanced. Therefore, sexual abuse from family members can cause detrimental mental harm to children under the age of ten. Some of the most noticeable effects of child sexual abuse victims are psychosomatic disorders, stress, suicide thoughts, anxiety, depression, feeling of alienation, and poor academic achievements. Additionally, issues with behavior, socialization, and the consequent sexual activities are prominent for sexual abuse victims. Lastly, one of the most efficient ways of assisting such individuals is the application of trauma-focused cognitive behavioral therapy. Literature suggests that trauma-focused CBT has numerous benefits, including its effectiveness in treating PTSD and anxiety.
References
Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused cognitive behavior therapy for traumatized children and families. Child and Adolescent Psychiatric Clinics of North America, 24(3), 557–570. Web.
Hines, D. A., Malley-Morrison, K. M., & Dutton, L. B. (2013). Family violence in the United States: Defining, understanding, and combating abuse (2nd ed.). SAGE.
Kim, S. J., & Kang, K. A. (2017). Effects of the child sexual abuse prevention education (C-SAPE) program on South Korean fifth-grade students’ competence in terms of knowledge and self-protective behaviors. The Journal of School Nursing, 33(2), 123–132.
Lawson, D. M. (2013). Family violence: Explanations and evidence-based clinical practice (1st ed.). American Counseling Association.
Paul, H. A. (2013). Trauma-focused CBT for children and adolescents: Treatment application. (J. A. Cohen, A. P. Mannarino, & E. Deblinger, Ed.). Child & Family Behavior Therapy, 35(3), 264-271.
Sinanan, A. N. (2015). Trauma and treatment of child sexual abuse. Journal of Trauma & Treatment, S4(24), 1-5. Web.
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