What Is Child Sexual Abuse?

What Is Child Sexual Abuse?
Child sexual abuse is defined as sexual contacts or interactions forced on a child by an
adult or teenager (or by any person perceived as having greater power or authority). Sexual
contact can be anything from touching breasts or genitals to oral, anal, or vaginal penetration.
The abuse may involve the adult touching the child or the child being coerced into touching the
adult. Sexual abuse may be committed by a younger person when that person is either much
older than the victim or is in a position of power or control over another child. Most often, sexual
abuse involves some direct physical contact, for instance, sexualized touching and/or kissing;
fondling, rubbing and/or penetration of the vagina or anus with the fingers; oral sex; “dry
humping,” or penetration of the vagina or anus. Sometimes a sex offender might expose himself
or herself (exhibiting the genitals or breasts) to a child; might have the child watch pornographic
or sexualized films; or might film a child removing his or her own clothes.
Children are often lured into these sexually abusive activities by playful coaxing (e.g.
"This will be our special secret, Jane...") or bribed with offers of money, candy, and favors.
Sometimes they are bullied or threatened. Physical force or violence may be used. Whether the
child is actually "hurt" or not, whether the child resists or not, whether the child likes it or not,
any such sexual stimulation, by an adult or a coercive or older child, is considered child sexual
abuse and is potentially very psychologically dangerous to the child.

Who is the victim of child sexual abuse?
Child sexual abuse cuts across all social classes, races, and religions. Both boys and girls
are victimized. Unfortunately, child sexual abuse is not rare. Our best estimates suggest that,
by the age of 18, 1 of every 7 girls and 1 of 30 boys experience some physical form of sexual
abuse. It is possible the percent of males is even higher, as male victims may be less likely to
disclose abuse because of embarrassment or shame or the fear they will be viewed as victims
or homosexuals.

Who sexually abuses children?
Although a small percentage of sex offenders are women, the majority are male. Sex
offenders are generally NOT "dirty old men" or strangers lurking in alleys. They are usually not
mentally ill or retarded. In fact, sex offenders are usually well known and trusted by the children
they victimize, and frequently are members of the family, including fathers and stepfathers,
brothers, aunts and uncles, grandparents, and cousins. There is no clear-cut description or
profile of a sex offender. Thus, there is no way to recognize a potential abuser; and it is often
hard to believe that a trusted individual would be capable of abusing children.
Many offenders had been physically or sexually abused themselves as children (about one
in four sex offenders were sexually abused; many more were physically abused as children).
Some may be unable to function sexually with adult partners and have many different
encounters with children. Others do maintain sexual relationships with adults, but may turn to
children for gratification, particularly during times of stress. A small percent of offenders sexually
abuse children while under the influence of drugs or alcohol.

What are the consequences of sexual abuse for the child victim?
Sexually abused children may experience a wide range of emotional and behavioral
reactions to the abuse. The nature and severity of these difficulties may depend upon the age of
the child, the identity of the perpetrator, the circumstances of the abuse, and the family's
reaction to the child's disclosure. Children may exhibit symptoms similar to anxiety and distress,
such as wetting the bed, nightmares, difficulty in school, and running away, which are similar to
problems exhibited by children who have experienced any kind of a trauma. Children may also
exhibit symptoms that are more specific to inappropriate sexual exposure, such as repetitive
sexual talk and play, and fears of specific situations or people that remind them of the abuse.

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Some children may not exhibit any difficulties because of their traumatic experience. In
addition, sometimes, problems will not become apparent for years, when the child has grown
up.
Once the abuse is disclosed, and stopped, some children return to relatively normal
behavior and emotions. The support and protection of the people close to them is important in
helping children get back to normal. However, some children have symptoms that persist long
after the abuse itself has ended. In fact, a significant number of sexually abused children suffer
a serious and often chronic disorder known as posttraumatic stress (PTSD). That is why it is
important for the sexually abused child to undergo a psychological evaluation and, if necessary,
receive treatment. It is important that parents recognize that children may experience different
problems related to their sexually abusive experiences as they go through different
developmental stages. Therefore, although a child may have successfully completed therapy
soon after the abuse was disclosed, or may not have had difficulties previously, he/she may
need to go to counseling later.

Where should you go for help?
If you suspect that a child has been sexually abused, you can contact a therapist, who
can assist at any step in the following process. You can also contact the child protection agency
in your community. You may remain anonymous but the caseworker will ask you important
questions about the child, the possible abuser, and the circumstances. In all states, sexual
abuse of minors is a crime, and you can file a report with your local police. In some states, the
child protection agency will need to work in conjunction with the police. In other instances, the
agency will investigate the sexual abuse allegation, provide guidance, and help to the child and
family. These strategies will often help to protect the child from further sexual abuse.
In addition, you should consider working with a therapist to protect the child’s emotional
and psychological well being.

What kind of treatment is available for victims and nonoffending parents?
Many therapy formats have been applied to sexual abuse cases including individual,
family, and group therapy. Cognitive behavioral therapy, in both individual and group settings,
effectively decreases the problems experienced by sexually abused children.
Both the sexually abused child as well as his/her nonoffending parent(s) can benefit from
cognitive behavioral interventions. The cognitive behavioral therapist may help nonoffending
parents cope with their own thoughts and feelings about their children's abuse, while also
teaching parenting skills that will help them respond more effectively to their children's
disclosures and abuse-related difficulties. Cognitive behavioral interventions for the child should
be individually tailored to target the particular child's difficulties. However, educational, coping
skills, and gradual exposure exercises are generally incorporated into the treatment plan.
Gradual exposure refers to exercises that encourage children to confront memories, thoughts,
and innocuous reminders (e.g. bathrooms, sleeping alone, undressing, showering, etc.) of the
abuse in a gradual fashion over time. This may be done by guided imagery, doll play, drawing,
reading, writing, poetry, singing, etc. By reducing the anxiety associated with abuse-related
discussion, gradual exposure exercises help sexually abused children to express their thoughts
and feelings more openly, thereby enhancing their ability to understand and emotionally process
the abusive experience(s).

Survivors of sexual assault do not need to suffer in silence. Behavior therapists can
offer effective treatments tailored to a survivor's individual problems.

What Is Cognitive Behavior Therapy?

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Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly
on research findings. These approaches aid people in achieving specific changes or goals.

Changes or Goals might involve:

• a way of acting - like smoking less or being more outgoing;

• a way of feeling - like helping a person be less scared, less depressed, or less anxious;

• a way of thinking - like learning to problem-solve or get rid of self-defeating thoughts;

• a way of dealing with physical or medical problems - like lessening back pain or helping
a person stick to a doctor's suggestions; or

• a way of adjusting - like training developmentally disabled people to care for themselves
or hold a job.

Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current
situation and its solution, rather than the past. They concentrate on a person's views and
beliefs about their life, not on personality traits. Behavior Therapists and Cognitive Behavior
Therapists treat individuals, parents, children, couples, and families. Replacing ways of living
that do not work well, with ways of living that work, and giving people more control over their
lives are common goals of behavior and cognitive behavior therapy.
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary
organization committed to the advancement of a scientific approach to the understanding and
amelioration of problems of the human condition. These aims are achieved through the
investigation and application of behavioral, cognitive, and other evidence-based principles to
assessment, prevention, and treatment.
For more information, please contact ABCT at
305 7th Avenue, 16th Fl., New York, NY 10001
Phone (212) 647-1890

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