Child Sexual Abuse Case Management

Child Sexual Abuse Case Management Rape: Child Sexual Abuse Deirdre F Smith Social Work and Criminal Justice A violent crime is a  crime  in which an offender uses or threatens force upon a victim. This entails both crimes in which the  violent  act is the objective, such as murder, as well as crimes in which violence is the means to an end, such as robbery. Violent crimes may, or may not, be committed with weapons. Depending on the jurisdiction, violent crimes may vary from homicide to harassment. (Violent Crime) Rape falls into the category as a violent crime. Rape is a type of  sexual assault  usually involving  sexual intercourse  or other forms of  sexual penetration  initiated against one or more individuals without the consent  of those individuals. The act may be carried out by physical force, coercion, abuse of authority or against a person who is incapable of valid consent, such as one who is unconscious, incapacitated, or below the legal age of consent. The term rape is sometimes used interchangeably with the term sexual assault. (Rape) It is commonly believed that rape only happens to women and children, but this is false because it can also happen to men. Rape is not about sex, but about power. One out of every six American womenhas been the victim of an attempted or completed rape in her lifetime. 17.7 million American womenhave been victims of attempted or completed rape. The Average number of rapes that occur annually in the United States is 89,000. Men make up 3% of the total rapes. Children under the age of 12 make up 15%.There is still 60% of rapes never reported and 95% of college rapes are also never reported. There are 47% of rapes that have occurred while both the victim and perpetrator had both been drinking. Victims of rape are more likely to suffer from depression, post-traumatic stress disorder, abuse alcohol and/or drugs, and contemplate suicide. (Who are the Victims?) The rape of a child is referred to as child sexual abuse. Child sexual abuse is a form of  child abuse  in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include asking or pressuring a child to engage in  sexual activities  (regardless of the outcome),  indecent exposure(of the genitals, female nipples, etc.) to a child with intent to gratify their own sexual desires  or to intimidate or  groom  the child, physical sexual contact with a child, or using a child to produce  child pornography. The  American Psychiatric Association  states that children cannot consent to sexual activity with adults, and condemns any such action by an adult: An adult who engages in sexual activity with a child is performing a criminal and immoral act which never can be considered normal or socially acceptable behavior. Rapes can occur in either the perpetrators or victims’ home, in a vehicle, outdoors, in a bar, or anywhere. Sometimes it can occur in the home that both the victim and perpetrator share, because most people are raped by someone they know including a spouse. Since rape or sexual assault is under reported only about 3% of rapist will ever spend a day in jail. (Rape Statistics, 2014) Under federal law, the punishment for rape can range from a fine to  life imprisonment. The severity of the punishment is based on the use of violence, the age of the victim, and whether drugs or intoxicants were used to override consent. If the perpetrator is a repeat offender the law prescribes automatically doubling the maximum sentence. A person who has committed such offenses gains the label as a sex offender. Once you are given that title you will forever carry that label. Even upon release of incarceration, one still must register as a sex offender with local law enforcement and follow specific guidelines which includes, informing law enforcement if you move and update any information. You will be placed in a public database where your status is automatically known. Children who have been sexually abused may feel guilty, ashamed, or confused so, they may not tell anyone. There are symptoms that you can look for they may tell you that a child is being sexually abused. The symptoms include withdrawal from friends or activities, may become aggressive, changes in school behavior and attendance, depressed, and attempt to runway or commit suicide. There can also be physical signs of sexual abuse such as, Sexual behavior or knowledge thats inappropriate for the childs age, pregnancy, sexually transmitted diseases (STDs), trouble walking or sitting, or sexually abusing other children. (Child Abuse Symptoms) Children who have been abused sexually are 25% more likely to experience teen pregnancy. The effects of child abuse are also that they begin drug and/or alcohol use, commit violent crimes, become depressed, and have low self-esteem. Some may actually become abusers themselves. They develop psychiatric disorders that carry on into their adulthood. Some will become involve in abusive relationship and some become promiscuous. As adults they may even take jobs as prostitutes. (Rape Statistics, 2014) As a social worker, working with sexually abused children you may experience conflicts between personal values and professional values. There are certain standard you must adhere to according to the NASW when dealing with adolescence. Standards for the Practice of Social Work with Adolescents: Standard 1. Social workers shall demonstrate knowledge and understanding of adolescent development. Standard 2. Social workers shall demonstrate an understanding of and ability to assess the needs of adolescents; access social institutions, organizations, and resources within a community that provide services for adolescents and their families; and advocate for the development of needed resources. Standard 3. Social workers shall demonstrate knowledge and understanding of family dynamics. Standard 4. Social workers shall demonstrate acceptance of and contribute to the development and maintenance of culturally competent service delivery. Standard 5. Social workers shall possess or have access to specialized knowledge of the legal, regulatory, and administrative requirements and resources for youths and their families. Standard 6. Social workers shall strive to empower adolescents. Standard 7. Social workers shall advocate for an understanding of the needs of adolescents and for resources and cooperation among professionals and agencies to meet those needs. Standard 8. Social workers shall participate in multidisciplinary case consultation across agencies that provide services to adolescents and their families. Standard 9. Social workers shall maintain confidentiality in their relationship with youths and of the information obtained within that relationship. Standard 10. Social workers shall assume an active role in contributing to the improvement and quality of the work environment, agency policies and practices with clients, and their own professional development. (NASW Standards for the Practice of Social Work with Adolescents, 1993) Treatment of child sexual abuse is a complex process. Orchestration of treatment in the childs best interest is a genuine challenge. Moreover, it is often difficult to know how to proceed because there are so few outcome studies of treatment effectiveness. When working with children it may be difficult because of lack of support from the family. Establishing trust with the child may be difficult. One of the reasons sexual abuse treatment is such a challenge is that it occurs in a larger context of intervention. Therefore, coordination is of utmost importance and ideally is provided by a multidisciplinary team. Treatment issues are then handled by the team as part of overall intervention. The following issues are the most important of those the team should consider at this stage of intervention: separation of the child and/or the offender from the family, the role of the juvenile court, the role of the criminal court, the treatment plan for the family, visitation, and family reunifica tion. (Child Welfare Information Gateway) Case management decisions are often provisional; that is, they are based on what information about the family members and their functioning is available when decisions are made. Treatment is often a diagnostic process. The positive or negative responses of family members to treatment determine future case decisions. Outcomes of court proceedings can impinge upon and alter case management decisions and treatment. (Child Welfare Information Gateway) Before you can give a child a treatment plan you have to consider should the child remain a part of the family, do the courts have a role in the case, and is there a question of visitation? This is actually where the conflict of person and professional values arises. You may feel that if the child was sexually abused at home, they should never be allowed to return. Professionally, reunification with the family is the goal if at all possible. The task of the therapist is to make victims feel whole and good about themselves again. Work, mentioned above, that addresses the issue of self-blame is helpful. However, so are interventions that help children view themselves as more than merely victims of sexual abuse. Normalizing and ego-enhancing activities, such as doing well in school, participating in sports, getting involved in scouts, or helping a younger victim, can be very important in victim recovery. (Child Welfare Information Gateway) Treatment options include group therapy, individual treatment, and family therapy. Group therapy is generally regarded as the treatment of choice for sexual abuse. However, usually groups are offered concurrent with other treatment modalities, and some clients may need individual treatment before they are ready for group therapy. Individual treatmentis appropriate for victim, offender, and mother of victim (as well as for siblings of victims and survivors). As a rule, an initial function and a major one for individual treatment is alliance building. All parties have to learn to trust the therapist and come to believe that change is possible and desirable. The members of this triad may have different levels of commitment to therapy, with the victim usually the most invested and the offender the least. Family therapyis the culmination of the treatment process and is usually not undertaken until there has been a determination that reunification is in the victims best interest. (Child We lfare Information Gateway) The reason I chose to this topic is not because a family member or a friend sexually abused me, but at the age of 17 I was raped by seven guys who I did not know. I did not say anything after it occurred because I felt like it was my fault. I was somewhere I shouldn’t have been and my parents didn’t know. In a way I thought of it as punishment for being disobedient. Afterwards, I had become angry, aggressive, and rebellious. I would run away from home because I caused all types of problems there. At that time I was in college, but of course I quit going. I began cutting myself and I showed other emotions other than anger. Finally, after trips to the Detention Center my mother finally took me to St. Dominic Mental Health. My therapist tried to talk to me, but of course I refused to talk. He told my mother I had sociopathic symptoms, because I showed no emotions and would not open up. After those attempts I was still acting out. She finally took me to a place called Our House Shelter. It was a runaway shelter. There I had group therapy and individual therapy. That’s where I found my help. It was a social worker named Ms. Tara who reached me. I have a great mother because she knew something was wrong with me and tried everything she could to help me. She could’ve given up on me but she didn’t. She still doesn’t know what happened to me and chose not to tell her. She was just happy to have her daughter back to normal. I have seen a couple of the guys throughout the time, but I have heard most of them are in jail or dead. Do I regret never telling? Yes, because I could have stopped someone from experiencing what I did. Because of that situation and the fact that I’m here has made me stronger. References Child Abuse Symptoms. (n.d.). Retrieved November 2014, from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/child-abuse/basics/symptoms/CON-20033789 Child Welfare Information Gateway . (n.d.). Retrieved November 2014, from U.S. Department of Human Health Services: https://www.childwelfare.gov/pubs/usermanuals/sexabuse/sexabusef.cfm NASW Standards for the Practice of Social Work with Adolescents. (1993). Retrieved November 25014, from National Association of Social Work: http://socialworkers.org/practice/standards/sw_adolescents.asp Rape. (n.d.). Retrieved November 2014, from Wikipedia: http://en.wikipedia.org/wiki/Rape Rape Statistics. (2014, July 8). Retrieved November 2014, from http://www.statisticbrain.com/rape-statistics/ Violent Crime. (n.d.). Retrieved November 2014, from Wikipedia: http://en.wikipedia.org/wiki/Violent_crime Who are the Victims? (n.d.). Retrieved November 2014, from RAINN: https://www.rainn.org/get-information/statistics/sexual-assault-victims