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Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
Sexual Abuse Prevention Consultation
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Sexual Abuse Prevention Consultation

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This presentation was prepared as part of a group consultation assignment in the psychiatric mental-health nurse practitioner program at University of Tennessee Health Sciences Center.

This presentation was prepared as part of a group consultation assignment in the psychiatric mental-health nurse practitioner program at University of Tennessee Health Sciences Center.

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  • This is extremely well done. I have been a prevention educator since the 1980's. I am the author of The Right Touch and will soon publish a second prevention book, this one based in an Alaska village. I will soon be back in front of audiences talking about prevention. Your work gave me new ideas about doing it right. Sandy Kleven, LCSW, authorhttp://www.holdingourown.net/
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  • Primary prevention: activities that take place before sexual violence has occurred to prevent initial perpetration or victimization;Secondary prevention: immediate responses after sexual violence has occurred to deal with the short‐term consequences of violence; and,Tertiary prevention: long‐term responses after sexual violence has occurred to deal with the lasting consequences of violence for the victim/survivor, as well as sexoffender treatmentinterventions.
  • Introducing the topic of molestation is awkward – introducing ideas, making touch-paranoid, cautionary and proactive rather than paralyzing and reactive? Starting the conversation is often the most difficult part. Only positive from sexual abuse is the opportunities for awareness, advocacy, and education media coverage is making
  • We can get comfortable speaking up about very small things that might not be signs that someone is thinking of sexually abusing children but that increases the risk or makes them more vulnerable.We can decide ahead of time what is okay and not okay around children and we can proactively set boundariesi.Once boundariesi are defined, it becomes more apparent when they are crossed.We need to learn to speak up immediately when we see those boundariesi ignored or violated.We can create a plan of action so that when we’re confronted with a situation that worries us, we’ll know what to do.  And we’re not talking about a stranger at the playground or someone trying to lure a child into their car. We’re talking about that nice youth worker who seems to hug the girls a lot more than the boys. Or the uncle with the roaming hands. Or the neighbor with the latest video games who encourages kids to stop by after school. Or the respected coach who takes kids on overnight trips to see professional football games. We can ask questions of the institutions and organization that work with our kids. We can learn in advance what their policies are and how they are implemented. We can ask what training our schools, youth groups and faith communities offer to staff and volunteers.We can speak up to those in leadership—whether it’s about the newest volunteer or the winningest coach. Comfort speaking upProactive boundary settingAction plan for situations of concernState mandatory reporting regulations
  • Building Effective Alliances with Child Protective Services and Law Enforcement When systems that impact children and families collaborate, families are served more effectively and children benefit. Although collaboration is recognized as important, in reality it can be difficult to achieve. Barriers include cross‐ system issues of confidentiality, minimal relationships, the complexity of each system, and insufficient time and resources. This document was prepared to assist school personnel to develop effective working alliances with child protective service agency and law enforcement personnel. An alliance is an association between two or more parties, made in order to advance a common goal, and to further the common interests of its members. School personnel are in a unique position to help prevent child abuse and neglect. For this reason, it is not surprising that schools are the reporting source of more incidents of suspected child abuse than any other institution. Developing alliances with local child protective services (CPS) and law enforcement agencies will assist school personnel to deal with the challenges of reporting suspected child abuse, and will help provide the resources and working relationships that are important to protecting and supporting children. It is best when such alliances are built in the context of planned preparation, rather than working them out in response to problems that arise concerning cases of child abuse and neglect. There are rewards for schools, child protective services, and law enforcement in building effective working alliances. These include increased rates of identification, better reports, increased communication, and greater support to affected children and families. Research has found that school personnel were more likely to report physical abuse than any other type of child abuse (emotional, sexual abuse, or neglect). However, when teachers were provided adequate training, reports in these other areas increased because teachers are in an ideal position to detect these less obvious forms of abuse. The following steps are suggested to schools in an effort to build effective working alliances with child protective services and law enforcement. Step 1. Recruit members and build trusting relationships. To develop the alliance, school administrators should contact their local CPS District administrator and local law enforcement office(s) to identify the members of the alliance. At a minimum the alliance should include school representatives and the key staff involved with investigating reports within both CPS and law enforcement. Membership can also include community providers representing various disciplines who are able to provide support or assistance to families. CPS often has a designated school liaison person assigned by school district. Each entity should be represented on the alliance. A schedule of meetings should be agreed upon to discuss both issues related to the issue of child abuse prevention and issues around working collaboratively. Leadership is important to building and maintaining a successful alliance – the leader assures that all of the stakeholders are represented on the alliance, can build trust across agencies, is able to manage conflict effectively, and facilitates group discussions. Leadership can be determined collaboratively among the members of the alliance and can rotate. It is important to establish authority for the alliance within the school. NATIONAL HEADQUARTERS15757 North 78th Street Suite B ∙ Scottsdale, AZ 85260 ∙ T 480‐922‐8212 ∙ F 480‐922‐7061 ∙ www.childhelp.org/SpeakUpBeSafeBuilding Alliances with CPS and Law‐July 2011 For instance, will the principal be the representative from the school, or will she/he designate to someone? If a designee, then that person needs to know the principal supports the efforts and has given him/her the authority to serve in that role. Step 2. Clarify values and roles. All three entities play important and different roles in keeping children safe from child abuse. All professionals must be aware of the role each entity plays in child abuse prevention and the unique knowledge and skills they bring to the alliance (2003). Although roles may differ, it is likely that the entities hold a number of core values in common. Clarifying core values and the various roles can help build clarity and cohesion, and can clear up common misconceptions. Step 3. Identify objectives for the alliance. When developing an alliance with the local child protective services and law enforcement offices, the members should seek clarity on what it is they want to achieve. There are three broad areas such alliances often focus on: prevention, identification, and intervention. Below are some sample objectives for consideration. Develop and implement prevention programs for children and parents. Increase understanding of the mandated reporting laws of the state. Increase knowledge on the warning signs of abuse. Consult on the procedure for reporting abuse. Understand how to support children in the disclosure process to mitigate future harm. Ensure that 100% of suspected child abuse is reported. Increase understanding of what happens after a report of suspected abuse is made. Increase understanding of how to support students who are the alleged victims of child abuse and neglect in the school system. Develop a local resource directory of services that are critical to meeting the needs of children and helping them to focus in school, increasing attendance, decreasing behavioral problems and thereby improving school performance. Increase understanding of how to make referrals for services when necessary (food, clothing, housing). Develop collaborations with key resources provided with the community who can be called upon for advice or assistance with challenging situations. Step 4. Develop a common language. Each profession has its own terminology, jargon, and acronyms. To facilitate communication it is important that each party explain technical language, refrain from using acronyms, and work toward a common understanding of key terms. Step 5. Work through conflict. It is likely that conflict will arise in regard to the handling of child protection reports and investigations. Being able to discuss differences and reach consensus will be a major benefit of the alliance. Discussing what went well and what could be improved with regard to specific cases can help move the alliance forward. Step 6. Develop protocol. Changing practice requires a commitment to change at all levels as well as a willingness to actually examine and formalize what is working. Step 7. Evaluate. Adopt an outcome focus to the work of the alliance in order to measure the benefits of cross agency collaboration. 1 U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2010). Child Maltreatment 2008. Available from http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#can. 1 U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2003). A coordinated response to child abuse and neglect: The foundation for practice. http://content.a-b-c.com/emailattachments/ddcmhs/DDCMHS-Child-Sexual-Abuse-Fact-Sheet.pdfAdd to paper:http://www.stopitnow.org/9questions
  • Transcript

    • 1. PMH802ELEMENTARY SCHOOL CONSULTATION Sexual Abuse Prevention
    • 2. Scenario• The Principal of PS 2009 reports that last week, a third grade student was molested on her way home from school.• The teachers, parents and students are in a state of panic.• There are accusations that an older student in the school is the perpetrator and this has led to anger and divisiveness within the school community.• The Principal is requesting a consultation to discuss ways to best cope with the fallout from this situation for staff, students, and community and to address the safety and boundary issues this situation presents so hopefully it will not reoccur.
    • 3. Guidelines and Legal Aspects• The law requires professionals who work with children to report suspected neglect or abuse.• Guidelines for reporting sexual abuse and neglect are state-specific but they all show commonalities in the reporting process. Failure to report child abuse or neglect is a violation of the law (Department of Children’s Services, 2011).• Victims can sue their abusers in civil court• Many states have extended their criminal and civil statutes of limitation for child sexual abuse cases.• Any suspicion of child sexual abuse must be reported to child protective services agency or law enforcement agency immediately.• Local child protection agencies investigate intra-familial abuse and the police investigate extra-familial abuse.
    • 4. Tennessee LawIf a school official, or any other school personnel has knowledge ofsexual abuse on school premises then they must notify the parent orlegal guardian within 24 hours that a report has been made and shallprovide other information relevant to the future well- being of the childwhile under the supervision or care of the school. The notice must alsobe coordinated with the DCS.https://www.sworps.tennessee.edu/child_abuse_reporting/start.html
    • 5. Needs Assessment• Staff • Internal procedures to report, track, and follow-up on disclosure/suspicion • Who is trained/interested in teaching SA prevention • Preferred formats for education• Students • Effectiveness of SA teaching • Preferred methods of instruction and available teaching tools• Parents and Community (and staff) • Role in educating children about body safety and boundaries • Available secondary and tertiary care for SA • Level of SA knowledge in school-aged peers and mandatory reporting laws
    • 6. Cost-Effective Primary Prevention• Nine Principles of Prevention • Comprehensive Varied Teaching Methods • Sufficient Dosage Theory Driven • Positive Relationship Appropriately Timed • Socio-Culturally Relevant Outcome Evaluation • Well-Trained Staff• Free Programs • Stop It Now! • Speak Up Be Safe • Vermont Sexual Violence Prevention Taskforce • Community education resources
    • 7. Agency Resources• Service Providers • Educators • Counselors • School/District Nurse• Training • Relationship with community resources • Facilitator training: Child Help, Darkness to Light• Outsourcing • In-Agency • Collaborative • Third-Party
    • 8. OutcomesStudents• Increased perception of appropriate vs. inappropriate touching.• Increased understanding of how to report abuse.• Increased self-esteem.• Increased perception of personal boundaries.• Appropriate assessment of risk.Parents and Staff• Increased confidence among teachers and staff in reporting protocols• Increased confidence among teachers and staff in responding to students concerns.• Increased understanding of how to discuss issues of risk, abuse, boundaries and reporting according to developmental stages.• Local child protective services to be prepared for possible disclosures following presentation/consultation by notifying administration prior to program (Barron and Topping,
    • 9. Troubleshooting• Secondary trauma, re-experiencing a primary trauma, revealing staff or parental molestation are potential scenarios that may be addressed through primary, secondary, and tertiary sexual abuse prevention strategies.• Post consultation questionnaires to be evaluated to assess understanding of presented material and unmet needs and or questions.• Concerns not met by plan and plan items with poor learning outcomes to be addressed or readdressed as necessary within an agreed upon time frame.• Booster sessions may be necessary to reinforce previous learning as well as address new concerns.
    • 10. TEACHING PLAN: STAFF Jaclyn Engelsher
    • 11. Objectives• 1. Identify 3 sexual violence prevention resources that can be used for classroom learning• 2. Describe 3 concerning behaviors that could indicate a child has been exposed to sexual abuse• 3. List 5 appropriate responses for handling student disclosure of sexual abuse• 4. Name a community resource for each level of prevention (primary, seconder, tertiary)
    • 12. The JerrySandusky/Penn State Teaching Moment
    • 13. Common Sexual Behavior in School Age Children• Questions on physical development, babies, puberty, sexuality• Experiments with same age and gender peers through games and role play in spontaneous, mutually enjoyable fashion (pre-puberty)• Increasing interest in sexual discussion and experimentation with peers (puberty)• Private self-stimulation• Follows limits set by adults and community
    • 14. Concerning Sexual Behavior in School Age Children• Interprets social gestures as sexual• Explicit sexual knowledge; provokes sexual discussion• Mimics adult sexual behaviors• Exhibits sexual behaviors in public, on the phone, or online• Prefers to play with younger/smaller children including secret or special games involving physical contact, exhibition, or voyeurism• Uses physical or verbal sexual threats/harassment• Regressive behaviors, fearful or explosive around particular peer(s)
    • 15. Warning Signs of Possible Sexual Abuse(or divorce, death, trauma, conflict, life-change illness . . . )• Low self-esteem• Misses or skips a lot of school• Shows unusual signs of anxiety• Shows signs of guilt• Exhibits signs of depression• Becomes more angry and hostile• Runs away from home• Using drugs or alcohol• Assuming perpetrator role
    • 16. Reporting & Disclosure• Avoid denial, interrogation, implication of blame• Do not make assumptions, judgments, promises• Provide a safe environment• Reassure and support• Active listening• Document with exact quotes• Seek advice• Report suspicions
    • 17. Sexual Violence Prevention• Primary • Promote resilience: caring relationships, high expectations and academic standards, provide opportunities for participation and contribution • Implement education guidelines using 9 principles of prevention • Build alliances with CPS and law enforcement to define roles, values, objectives, and language; reporting and debriefing protocol; and outcome evaluation measures• Secondary • Schools are primary reporting of source suspected SA • Crisis counselor, ER/SANE/MD, CPS, legal • Re-victimization, vicarious trauma• Tertiary • Long-term MH services for victim/survivor: individual, group, family • Offender treatment and rehabilitation
    • 18. References• Barron, I. G. & Topping, K. J. (2009). School-based child sexual abuse prevention programs: The evidence on effectiveness. Journal of Children’s Services 3(3), 31-53.• Center for Women and Families, (2011). Community education and training. Retrieved from http://www.thecenteronline.org/learn-more/community-education-and-professional-training• ChildHelp (2011). Speak up be safe: The evolution of good touch bad touch. Retrieved from http://www.speakupbesafe.org/index.html• Department of Children’s Services (2011). Child safety. Retrieved from http://www.tn.gov/youth/childsafety.htm• Smith, M. C. (2008). Pre-professional mandated reporters understanding of young childrens eyewitness testimony: Implications for training. Children and Youth Services Review, 30(12), 1355-1365.• StopItNow! (2007). Do children sexually abuse other children? Preventing sexual abuse among children and youth. Brandon, VT: The Safer Society Press.• StopItNow! (2010). Training for prevention. Retrieved from http://www.stopitnow.org/training• U.S. Department of Health & Human Services, (2011). State statutes search. Retrieved from http://www.childwelfare.gov/systemwide/laws_policies/state/index.cfm?event=stateStatute s.showSearchForm• Vermont Sexual Violence Prevention Taskforce, (2010). Technical assistance resource guide. Burlington, VT
    • 19. TEACHING PLAN: PARENTS Tawney Burgess
    • 20. How can I keep my child safe? 1. Teach healthy boundaries – it is acceptable to have privacy to dress, bathe, use the bathroom and sleep. 2. Teach the difference between O.K. touch and inappropriate touch 3. Make sure your child knows it is o.k. to tell 4. NO! Teach your children it is alright to say no about their body and respect when they do 5. Teach the proper names for body parts 6. Make sure they know the difference between a secret and a surprise. Secrets leave our children vulnerable. 7. Teach internet safety • http://www.stopitnow.org/dont_wait_ everyday_prevention
    • 21. What do I do if my child discloses? 1. Believe them 2. Stay calm 3. Assure them they are not to blame 4. Let them know “telling” was the right thing to do – don’t promise not to tell 5. Report the abuse 6. Make sure to tell them it is o.k. to be mad or sad 7. Seek medical attention – documentation of injury, preservation of evidence and treatment if necessary 8. If the incident was recent (within 5 days) wait until after seeking medical attention to take a bath/shower, use the bathroom (if possible), change clothes, eat or drink. Preserve as much evidence as possiblehttp://www.shelterhousemidland.org/index.php/is-this-abuse/signs-of-child-a-teen-abuse/what-do-i-do-nowhttp://www.rainn.org/get-information/aftermath-of-sexual-assault
    • 22. Don’t Add 1. While it is important to let the child talk as much as they want about the incident, do not ask a lot of questions about it or quiz them. Information gathering is best accomplished by forensic interviewers, SANEs and law enforcement. This protects the integrity of the statement. 2. Do not discuss the incident with those who do not need to know. Protect your child’s privacy. 3. If there are other victims, do not discuss the incident with them either….this protects all cases involved. 4. Do not promise the child they will not have to tell their story more than once. 5. Do not share your anguish with your child, they need to see you calm. Find someone to talk to such as a therapist.http://www.shelterhousemidland.org/index.php/is-this-abuse/signs-of-child-a-teen-abuse/what-do-i-do-now
    • 23. Self Care• Although it will be natural that your thoughts will be centered on your child, it is important to remember that you can provide a better environment for your child by taking care of yourself.• Journaling, meditation and seeking counseling are all recommended by RAINN.org for family members of abuse victims.• http://www.rainn.org/get- information/sexual-assault- recovery/tips-for-friends-and-family
    • 24. Where do I go for help?Your childspediatrician or yourlocal emergencydepartment are goodstarting places. Theycan help link you tolaw enforcement,child protectiveservices, and healthcare providers thatspecialize in the careof the abused child.
    • 25. Questions to consider when choosing a school or afterschool program• What is their policy of abuse prevention?• What is the staff screening process?• Are background checks and references checked?• Are child/adult interactions monitored and do they have a policy regarding interactions between staff and children?• Do staff receive training about the prevention of child sexual assault?• How do they handle allegations of abuse? http://www.stopitnow.org/9questions
    • 26. References• Aftermath of Sexual Assault | RAINN | Rape, Abuse and Incest National Network. (n.d.). RAINN | Rape, Abuse and Incest National Network | RAINN: The nations largest anti -sexual assault organization.One of “America’s 100 Best Charities" —Worth magazine. Retrieved November 28, 2011, from http://www.rainn.org/get-information/aftermath-of- sexual-assault• Child Sexual Abuse: What do I do now?. (n.d.). Shelterhouse of Midland and Gladwin Counties: Eliminate Domestic Violence and Sexual Assault. Retrieved November 28, 2011, from http://www.shelterhousemidland.org/index.php/is-this-abuse/signs-of-child-a-teen- abuse/what-do-i-do-now• Don’t Wait: Everyday Actions to Keep Kids Safe | Stop It Now. (n.d.). Stop It Now | Together We Can Prevent the Sexual Abuse of Children. Retrieved November 28, 2011, from http://www.stopitnow.org/dont_wait_everyday_prevention• Nine Questions Parents Need to Ask When Selecting a Program for their Child | Stop It Now. (n.d.). Stop It Now | Together We Can Prevent the Sexual Abuse of Children. Retrieved November 28, 2011, from http://www.stopitnow.org/9questions• Self-Care for Friends and Family Members | RAINN | Rape, Abuse and Incest National Network. (n.d.). RAINN | Rape, Abuse and Incest National Network | RAINN: The nations largest anti-sexual assault organization.One of “America’s 100 Best Charities" —Worth magazine. Retrieved November 28, 2011, from http://www.rainn.org/get-information/sexual- assault-recovery/tips-for-friends-and-family
    • 27. CONSULTATION TEACHING PLAN: CHILDRENSharon D. Ward,PMHNP-Student
    • 28. I Am Somebody Pearls for Boys and Girls
    • 29. Goals and Objectives• The goal is to teach children how to prevent or reduce the risk of sexual abuse.• The students will be able to define child sexual abuse.• The student will be able to verbalize appropriate names of their body parts.• The students will be informed that they have the to make decisions about their bodies.• The students will be able to name safe places to go and safe people to tell if they are being sexually abused.
    • 30. What Is Child Sexual Abuse?• Child sexual abuse is any type of sexual activity with a child where permission is not or cannot be given.
    • 31. KNOW YOUR BODY• Know the appropriate names of your body parts. Body parts does not have nicknames. Ask parent to teach you the appropriate names.• Your body belongs only to you and it is not ok for anyone to ask to touch or look at your body especially your breast, buttock, and genitals.• It is not ok for you to look or touch another person’s body parts especially the breast, buttock, or genitals even if he/she tells you it is ok to touch them.• No one should touch your body in exchange for money, candy, toys, or other gifts.
    • 32. Know Your Voice• You have a right to tell a person that you trust if someone touches or looks at your private body parts. Sometimes it is necessary for your parent(s) or doctor to touch your private area.• Tell someone as soon as possible if someone touches your private area. DO NOT wait because the longer you wait, the longer it will take for someone to help you.• There are no secrets when someone hurts you.• You have the right to say "NO" if someone wants to touch you in any way that makes you feel uncomfortable, afraid or confused.• Safety rules about touching apply all the time, not just with strangers.
    • 33. Know Your Safe Places• Your Parent• Your Doctor• Your Church• Police Department/Police Officer in your neighborhood• School’s Guidance Counselor/Principal/Favorite Teacher
    • 34. “What If” Game• What If... something was bothering you and you did not know what to do about it? Who might be able to help you?• What If... someone touched you in a way you did not like and offered you a candy bar, a brand new doll or something else you really wanted to keep a secret?• What If... a stranger offered you a ride in a shiny new car?• What If... you did not want to be hugged by a particular adult?• What If... someone is tickling you and it starts to hurt?• What If... Mommy, daddy or a doctor touched the private parts of your body?• What If... the baby sitter wanted to touch you under your night clothes?• What If... your uncle (aunt) wanted you to sit on his (her) lap and you did not want to?
    • 35. Answers to “What If” Game• People you trust, such as a parent, another relative, neighbor, teacher, school nurse, police officer, clergy.• Say "NO!" and tell someone.• Never accept rides from a stranger.• Say "NO!" to that adult. You may like the person, but you may not want to be hugged at that time.• Tell them to stop. If they will not stop, call for help. If I am not home at the time, tell me about it later.• There are times when others may need to touch your private parts. For example, mommy or daddy may touch your private parts if you complain of pain in your private area; or a doctor may need to touch you during an examination. But, if the touching hurts or bothers you, tell them. Alternate... Grown-ups do not usually need to touch children in private areas unless it is for health reasons.• No one has the right to put their hand under your clothes; force you to touch them; touch your body; or touch your private body parts.• You can say "NO!" to your uncle/aunt if, for some reason, you do not want to do it.
    • 36. ReferencesOffice of Children & Family Services (n.d.). Say no! Protecting children againstsexual abuse pub. 1154. Retrieved November 24, 2011, from http://www.ocfs.state.ny.us/main/publications/pub1154text.asp.Tennessee Department of Human Services. Keeping kids safe. Retrieved November 24, 2011 from www.tn.gov/humanserv/adfam/kkswv.pdf.The National Child Traumatic Stress Network. Child sexual abuse fact sheet.Retrieved November 24, 2011 from http://www.nctsn.org/products/child-sexual-abuse-fact-sheet-parents-teachers-and-other-caregivers%20.

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