ERIC Identifier: ED315706
Publication Date: 1990-00-00
Author: McFadden, Emily Jean
Source: ERIC Clearinghouse on
Counseling and Personnel Services Ann Arbor MI.
Counseling Abused Children. Highlights: An ERIC/CAPS Digest.
Counseling abused children is a challenging task for practitioners. The
incidence of reported and substantiated child abuse and neglect has risen
dramatically since the "discovery" of the Battered Child Syndrome in the
sixties, and subsequent mandatory reporting laws. The nation has moved through
stages of public awareness about the phenomenon. Currently practitioners have
become aware of the widespread sexual abuse of girls (estimated at one in four
females) and are developing increasing awareness of the sexual abuse of boys.
Rapid changes in the knowledge base demand that counselors keep abreast of the
indicators of maltreatment, the laws for reporting suspected abuse, and the ways
in which children can best be served to overcome effects of a negative family
experience.
All fifty states require that helping professionals report suspected child
abuse to the child protection agency or the police. Many counselors experience
difficulty with reporting requirements for fear of violating the trust of a
child, or creating mistrust with the child's parents. Such reporting to
Children's Protective Services has saved the lives of many children, and brought
help to families. Although children are still removed from their families and
placed in foster homes when it is necessary for their protection, the emphasis
has shifted to serving children in their own homes, and providing services to
help the family overcome the situations which lead to abuse or neglect.
Counselors should be familiar with child abuse reporting laws in their own
states. Typically counselors and school personnel are required to report
suspected abuse, and are granted immunity from liability because they are
presumed to be acting in good faith. Many states also have criminal or civil
penalties established for mandated professionals who fail to report.
TYPES OF MALTREATMENT
A common theme underlying most forms
of maltreatment--physical abuse, neglect, or sexual abuse and exploitation--is
that of emotional hurt. The child who is physically abused often suffers
emotionally from inconsistent parenting and fear. The sexually abused child
suffers from the lack of affection or supervision which leaves him/her
vulnerable to the subtle advances of the perpetrator; and the neglected child
becomes anxious or apathetic about a life in which basic needs aren't met. One
general consequence of child maltreatment is developmental fixation or "freezing." The child who comes to the attention of the counselor due to
difficulties in the classroom or poor social adjustment may very well be a
maltreated child.
NEGLECT
Neglect accounts for more deaths than the physical
abuse of children. In a national study of reported child maltreatment, only 4%
experienced major physical injury, while 60% experienced a type of physical
neglect. Neglect was associated with 56% of child deaths (American Humane
Association, 1983). All types of neglect are essentially a failure by the
parents to provide something needed for the child's healthy growth and
development. The concept of neglect includes the assumption that some harm must
befall the child as a result of the parents' failure to provide.
PHYSICAL ABUSE
Physical abuse is usually defined as the
intentional or nonaccidental inflicting of injury on a child by a caregiver. It
manifests as bruises, welts, broken bones, burns, lacerations, or even death. It
may occur through hitting, striking, beating, kicking, biting, slapping or other
forms of violence directed at a child. Many, if not most, parents who abuse
children have been reared in an environment in which some form of maltreatment
occurred. Physical abuse appears in all socioeconomic classes, but is correlated
with the stresses of poverty.
SEXUAL ABUSE AND EXPLOITATION
Child sexual abuse is the
adult (or older child) exploitation of the normal childhood development process,
through the use of sexual activity. Examples of the types of sexual activity
might include touching, kissing, fondling, manipulations of the genitals with
the fingers, and actual sexual intercourse (Stovall, 1981).
In examining patterns of sexual abuse and exploitation, it is important to
keep in mind that the knowledge base is changing rapidly. While earlier belief
was that sexual abuse perpetrators were almost always men, McCarty (1986)
studied female perpetrators and found both accomplices who aided male
perpetrators, and independent abusers, who had come from a background of bad
childhoods, unhappy marriages and earlier sexual victimization. Within the last
decade it has been acknowledged that male children are also sexually victimized
and are at great risk (Bolton, Morris, & MacEachron, 1989). It currently
appears that female children are more likely to be sexually abused in an
incestuous situation, while more male children are sexually abused outside the
home.
EMOTIONAL ABUSE OR NEGLECT
Emotional neglect generally
implies a consistent indifference to the child's needs and covers a range of
behavior, from the parent who never speaks to the child and doesn't remove the
child from a crib, to the psychotic parent unable to acknowledge the reality of
the child's world, or that the child actually exists. Emotional abuse, on the
other hand, implies an active rejection or persecution of the child by the
parent. Chronic verbal abuse erodes the child's self-esteem. The use of
confinement or excessive punishment is also a form of emotional abuse. Emotional
abuse or neglect is usually accompanied by other forms of maltreatment such as
sexual abuse or physical abuse. Clearly, children who are being maltreated are
not getting their developmental needs met.
IDENTIFYING MALTREATMENT
Children who have been maltreated
are usually unwilling or unable to reveal their situation to a counselor because
of parental threats, or a feeling of loyalty to the family. While sensitive
interviewing may help to unearth details of maltreatment, counselors need to be
aware of non-verbal ways in which the message of abuse may be communicated.
The presence of one indicator alone does not necessarily mean that
maltreatment has occurred. The counselor looks rather for configurations of
indicators. If there are a number of indicators, the counselor has reason to
suspect maltreatment, even if the child has not confided in the counselor. When
abuse is suspected, the counselor is obligated, under law, to report this
concern to Children's Protective Services.
THE TEAM APPROACH
Counseling, in and of itself, cannot
ensure the safety of a maltreated child. There will be many professionals
involved in working with maltreated children. Typically, a Children's Protective
Services worker may coordinate the intervention. Medical personnel will be
involved. This may include a coordinating pediatrician who will follow the
child's growth and development, several specialists and other health
practitioners such as a physical therapist or public health nurse who has worked
with the family. If the child must be removed from the home, the team may
include a foster parent. Educators and school personnel are also an important
part of the team. They can help to monitor a child's day-to-day safety and
progress, and can build programs to help the child's self-esteem and enhance
cognitive development. In dealing with situations where there is risk to a
child, the counselor will find that a team approach accomplishes more for the
child than the single intervention of offering counseling.
COUNSELING THE CHILD
One of the primary purposes of
counseling the maltreated child is to provide a safe place and safe relationship
within which the child may experiment with new adaptations to a safer world, and
in which the child's arrested development may become "unstuck." Counselors
cannot literally replace the requisite parental bonding which helps children to
grow and develop, but have an opportunity to help the child develop a trusting
relationship with an adult.
The key to understanding the maltreated child is to look at the developmental
stage rather than the chronological age. The counselor will be able to identify
adaptations which the child made to the maltreatment and teach the child more
appropriate ways of interacting. Children often reveal in play the traumatic
events of their earlier years. They may also show to the counselor maladaptive
behavior which puts them at risk of further maltreatment.
In the counseling relationship, working with maltreated children requires
many techniques other than talking and listening. Using structured or
unstructured play situations and artwork, music or clay provide a safe way for
children to release tension and express themselves. Younger children do well
with dolls and dollhouses to act out family issues for the counselor. Many
maltreated children have not had normal play opportunities and benefit greatly
from free play in the counselor's office. Using puppets, reading stories, or
acting out role plays are ways in which abused children can try out new
approaches to relationships.
Abused children also do well when counselors work with them in groups.
Younger children do well with developmental play groups, while older children
and youth can benefit from activity groups as well as treatment-oriented groups.
Group counseling can be especially useful with children and youth who have been
sexually abused by reducing their feelings of shame and differentness and
helping them to learn how to protect themselves (McFadden, 1989).
THE COUNSELOR'S SELF-AWARENESS
Counseling abused children
is challenging in that it can arouse many complex feelings within the counselor.
Anger with the child's parents, uneasiness over the child's acting out, or
feelings of frustration and sadness are not uncommon for counselors to face.
Anxiety about protecting the children from further maltreatment may be a
predominant theme for the counselor. It is important for counselors working with
the sensitive issues of maltreatment to seek consultation, supervision, or even
treatment for themselves when they become overwhelmed with feelings. Recognizing
one's professional limitations can also be helpful. It is important to remember
that counseling alone cannot protect children, and that any effective long-term
intervention will require a concerted team approach and a community which cares
enough to offer adequate resources for families. Children will be healed and
protected as families are helped.
REFERENCES
American Humane Association. (1983). Annual
report, 1981: Highlights of official child neglect and abuse reporting. Denver: Author.
Bolton, F., Morris, L., & MacEachron, A. (1989). Males at risk: The other side of child sexual abuse. Newbury Park, CA: Sage Publications.
McCarty, L. (1986). Mother child incest: Characteristics of the offender. Child Welfare, LXV(5), 447-458.
McFadden, E. J. (1989). Counseling abused children. Ann Arbor, MI: ERIC Counseling and Personnel Services Clearinghouse, The University of Michigan.
Stovall, B. (1981). Child sexual abuse. Ypsilanti, MI: Eastern Michigan University.
