Child Sexual Abuse : Emotional Reactions, Part 3

by Child Welfare Information Gateway

(Page 4 of 5)

Being a Parent

The experience of parenthood can impact on one's reaction to a case of sexual abuse, and working with sexual abuse can influence parenting.

Parenthood can make the professional more appreciative of the risks as well as more appalled at the transgressions of the parenting role. Parents are confronted with many situations in which the child's behavior (e.g., wanting to sleep in the bed between the parents) and parenting responsibilities (the need to assist the child in bathing, toileting, and understanding differences between male and female anatomy) can present risks for sexual activity. Sometimes, professionals who are parents are less willing to label client behaviors as sexually inappropriate because of their overidentification with the client as another parent. For example, a professional who is a father may minimize genital contact between an alleged offending father and his daughter, accepting the explanation that the daughter was being helped to learn about "wiping herself."

Conversely, certain biological drives and normative proscriptions inhibit sexual activity with children for parents. Because of these personal experiences, parents may be more censorious than nonparents when these boundaries are crossed.

In terms of work influencing parenting, a common impact of professional involvement with sexual abuse is for the parent to become quite concerned about the risk of his/her own child being sexually abused. Parents may become suspicious of family members, babysitters, friends of the family, neighbors, day care providers, and school personnel. Parents may also be hyperalert to behavioral and physical indicators, such as urinary tract infections, masturbation, enuresis, and sleep disturbances. Generally, vigilance about a child's contacts with others and concern about symptoms are positive parental responses. However, they should result in a considered investigation of suspicions, rather than an immediate conclusion that something terrible has happened.

Sexuality

Being familiar and comfortable with all aspects of sexuality is essential in working in the field of child sexual abuse. For the professional, this means being able to talk freely about all types of sexual issues.

Professional involvement with cases of sexual abuse very frequently has an impact on personal sexuality. There are at least three ways in which this occurs. First, when the professional engages in sexual activity, recollection of the sexual acts in a recent case may intrude into the sexual experience. Generally this has an inhibitory effect, that is, images of sexual activity or the particular sexual acts of the case diminish desire. However, a more troubling reaction is one in which the recollections stimulate arousal. They may become the stimulus for masturbatory activity or fantasies during sexual activity with a partner. When this happens, the professional should seek counseling.

Second, professional involvement in cases of sexual abuse may raise concerns about the professional's own sexual role performance. For example, men may wonder if they are subtly coercing or manipulating their partners. Women may become concerned that their compliance with sexual activity is not entirely voluntary, or they may worry that they are using sexual favors as a way of controlling their partners.

Third, professionals may have sexual reactions to their clients. Such reactions may be of attraction or disgust. In either case, professionals must be sensitive to these feelings and not let them influence professional responses.

Coping With Personal Issues

Dealing With Personal Feelings in Professional Practice

The best way to prevent personal reactions from undermining the quality of professional work is to be aware of their existence. In fact, the reason for describing possible sources of personal reactions and typical emotions is to encourage reflection by the reader. For many professionals, self-talk, in which the professional reminds him/herself of personal biases and reactions, should be undertaken regularly.

Second, as much as possible, the professional's intervention should be guided by practice principles, policies, guidelines, and research. For example, most communities have protocols for CPS and law enforcement collaboration. Similarly, there are practice guidelines for when to remove a sexually abused child from the home. Additionally, research on offender recidivism can assist a judge in sentencing. Nevertheless, despite the existence of these aids, because knowledge about sexual abuse is incomplete, there will be many situations in which the professional has to use his/her judgment. Sometimes, protocols and other guides actually interfere with gathering evidence or "proving" a case, engendering feelings of frustration and anger toward the system. In such instances, it is important for professionals to be able to process their feelings.

Avoiding Burnout

There is no denying that work in the field of sexual abuse is extremely stressful and may lead to burnout. There are four characteristics of cases that make the work potentially debilitating. First, the acts themselves are terrible and terribly harmful. Sexual abuse violates fundamental social norms, and the lives of some victims dramatically attest to its devastating effects. Second, cases are fraught with uncertainty. In many instances, it is not possible to determine whether the abuse occurred. Likewise, it is very difficult to determine the risk of future sexual abuse. Third, often as professionals, we do harm while attempting to do good. Victims are sometimes retraumatized by repeated interviews, intrusive medical exams, court testimony, and separation from their families. Fourth, often we are unsuccessful. Victims are not made safe, and offenders may not be prosecuted or held accountable for their actions.

Negative experiences working in the field of sexual abuse can result in frustration, rage, a sense of helplessness, and then giving up. A process of burnout eventually leads to insensitivity toward clients and disengagement in the helping relationship. Burnout is harmful for clients and professionals alike.

The best preventive measure and remedy for burnout is collaborative work. This can mean working with a partner, for example, as police officers often do. Having adequate supervision as a mental health professional is another way of working collaboratively. Sharing the treatment of an incestuous family with a colleague can prevent the sense of isolation and overwhelming responsibility that leads to burnout. Consulting with a more experienced person either within one's own agency or outside can be helpful in all professions. Interdisciplinary collaboration is also quite helpful - teams of CPS caseworkers and police or lawyers and mental health experts can enhance the quality of work as well as alleviate stress. Finally, working as part of a multidisciplinary team, which includes the range of professionals involved in child sexual abuse cases, is the most desirable way of handling these cases. Teamwork minimizes some of the problems that lead to burnout (e.g., the dilemma of uncertainty regarding whether the child was sexually abused, iatrogenic effects of intervention, and unsuccessful intervention). In addition, teamwork allows an opportunity for sharing the pain and distress that many cases cause professionals.

About the Author

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Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.