Treating Victims of Sexual Abuse or Sexual Exploitation


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Treating Victims of Sexual Abuse or Sexual Exploitation

  1. 1. Treating Victims of Sexual Abuse or Exploitation By Religious or Health Care Professionals <ul><li>Gary R. Schoener </li></ul><ul><li>Licensed Psychologist & Executive Director </li></ul><ul><li>Walk-In Counseling Center </li></ul><ul><li>Minneapolis, Minnesota </li></ul>
  2. 2. What Do These Victims Have in Common? <ul><li>We are dealing with men and women, abused as children or exploited as adults; </li></ul><ul><li>Obviously dealing with a young person vs. someone who is 50+ who was abused years ago leads to great variation; </li></ul><ul><li>But, all have had their trust betrayed and thus have difficulty trusting any helper; </li></ul><ul><li>All are confronted with confused feelings and often inclarity about what they need to do </li></ul>
  3. 3. Complicating Issues <ul><li>Advocacy vs. Therapy </li></ul><ul><li>Are there legal issues? In the US & Canada these are complications </li></ul><ul><li>Reporting issues </li></ul><ul><li>By definition these are atypical cases and situations </li></ul><ul><li>If there is any legal action this gets complicated </li></ul>
  4. 4. Wheel of Options Schoener (1989) Psychotherapists’ sexual involvement with Clients: Intervention & Prevention
  5. 5. Establishing Trust and Safety <ul><li>Have a clear therapy contract </li></ul><ul><li>Your ability to listen to complaints and anger about therapists or clergy </li></ul><ul><li>Maintain clear boundaries </li></ul><ul><li>Do not push for trust in you </li></ul><ul><li>Allow patient to withhold information </li></ul>
  6. 6. Some General Rules <ul><li>Explore how patient feels about seeing you – does gender matter? </li></ul><ul><li>Focus on crisis first – health and safety are first concern </li></ul><ul><li>Be clear on what patient wants from you – his/her goals </li></ul><ul><li>Clarify current status of relationship with offender – any communication </li></ul>
  7. 7. <ul><li>Don’t assume what “sex” is </li></ul><ul><li>Don’t assume gender of offender </li></ul><ul><li>Don’t make assumptions about the impact of the sex </li></ul><ul><li>Identify patient’s remaining issues </li></ul><ul><li>Don’t focus on the abuse or exploitation as opposed to other issues </li></ul>
  8. 8. <ul><li>Provide or refer for advocacy </li></ul><ul><li>Writing journals or letters helps some patients </li></ul><ul><li>Use of reading or the internet for education of patient </li></ul><ul><li>Internet support groups </li></ul><ul><li>Face to face support groups </li></ul><ul><li>Processing sessions </li></ul>
  9. 9. Outcome predictors <ul><li>Outcome is highly variable and depends a good deal on personal adjustment, social & family supports </li></ul><ul><li>Outcome seems to be better if patient can assign blame to offender </li></ul><ul><li>Outcome not as good if patient is rageful on a long term basis </li></ul>
  10. 10. What helps the most? <ul><li>Talk with other victims is often cited as the most important help – the more similar the experience the better </li></ul><ul><li>Taking action , even if justice is not done, often seems very helpful </li></ul><ul><li>Reading materials can be very helpful </li></ul>
  11. 11. Secondary/Associate victims <ul><li>Anger towards spouse & offender </li></ul><ul><li>Distrust professionals </li></ul><ul><li>Impatient with recovery & remedy </li></ul><ul><li>Helpless & feel excluded </li></ul><ul><li>Experience feelings of loss, grief, ambivalence, confusion </li></ul>
  12. 12. The Family Meeting <ul><li>Meet the “ghost” </li></ul><ul><li>Meet the helpers </li></ul><ul><li>Clarify needs & roles </li></ul><ul><li>Information about the process </li></ul><ul><li>Help in dealing with expanded caregiving role (with children) </li></ul>
  13. 13. Group Approaches <ul><li>Our model – short term groups </li></ul><ul><li>Ongoing groups </li></ul><ul><li>Consumer-led groups </li></ul><ul><li>Internet support groups – Hope Talk at </li></ul><ul><li>Workshops – evening or day long </li></ul>
  14. 14. Errors in Treatment <ul><li>Failure to warn about limits of confidentiality – reporting </li></ul><ul><li>Setting limits on “legal involvement” </li></ul><ul><li>Pressuring to file complaint </li></ul><ul><li>Bending rules for client </li></ul><ul><li>Undue focus on client’s anger </li></ul>
  15. 15. Caution regarding confidentiality <ul><li>These patients are inquisitive – be aware of your internet presence ( google yourself) </li></ul><ul><li>Cautious in obtaining consultation – listserves not that secure </li></ul><ul><li>It is not easy to disguise cases </li></ul><ul><li>Beware of mistaken assumptions </li></ul>
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