Social Work Essay代写: Hypothetical Case Study Of Childhood Sexual Abuse

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 Social Work Essay代写:处理儿童性虐待如梅利莎的情况下,需要很多的努力。有一种诱惑,以同情的孩子回应。然而,为了解决性虐待的问题,我们必须做的事情比照顾更深入。



Dealing with a case of child sexual abuses such as Melissas, demands a lot of effort. There is a temptation to respond to the child with compassion. However, to address the issue of sexual abuse, one must do something more than care deeply.

Before one can sufficiently assess or treat a sexually abused child, it is vital to have a solid knowledge of how sexual abuse and how it happens, the adverse impacts of the abuse on the child, relationship and behavioral problems of the child caused by the abuse. In this case it is important to survey development of childhood in a normal way, and see how it differs from development problems seen in the children who have undergone child abuse.

Prior to initiating a plan of treatment, it is vital to have knowledge of why sexual abuse occurred in a particular scenario.


Trauma assessment should also be done before treatment. Trauma assessment is an approach used to comprehend the effects of sexual abuse on the child and to check the extent of harm. It helps one measure the child's views of the the past and current effects of the abuse. However, Trauma assessment does not try to clear up problems, but rather to know the impact of abuse on the child, comprehend the damage, and think of the treatment needed. Assessment is a "road map" for treatment. Because of its casual format, it will help to build mutual understanding with the child as one collects important information. It is vital to consider the following issues while taking the assessment, as these will have an influence the treatment decisions:

What is the connection of the victim to the abuser? What is the level of stability in the family that the child comes from? What are the risk factors involved, Should the child still remain with the family or move?, what role is the court playing in the case?

Eventually, to come up with the applicable treatment plan, the assessment must examine all developmental issues, appraise social areas and evaluate behavior in compliance with what is there in normal development. Therapy based on this evaluation will address the child's requirements one at a time.

Treatment is the procedures of assisting the child learn to differentiate between her healthy and destructive coping ability (Flaherty et al, 2006). Selecting the mode of treatment will depend on the goals for the child developed from the assessment report, the coordination between the objective and service being thought of, and the child's preference and likelihood of taking part in and profit from the treatment that is offered. In principle, effective treatment will reduce the severity of symptoms and protect against suspended start of emotional disorders. Osmond and colleagues, explain treatment goals as involving:

Allowing safe release of the feelings, Overcoming negative and self-destructive behavior, Assisting the child to understand the part of her thinking that has been affected by abuse and also helping her correct those distortions, assisting the child to overcome self-blame and hatred , Assisting the child to build in herself sense of trust and have a future that is positive.

Ensuring the child achieve a sense of view about the abuse and to have the emotional space necessary to keep the anguish from hurting her in the future

Intervention plan

Therapy of child sexual abuse is an elaborate procedure. Emotionally, it stimulates you to remain unbiased the middle of a highly charged case. Intellectually, it requires that you have the knowledge of the impacts of abuse on both the child and the family, and also the sources of the problem. Practically, it demands that one collaborates with various professionals in the efforts to do what's best for the sexually abused child

In Melissa's case the most appropriate plan of intervention would use is trauma-focused cognitive behavioral therapy.

Trauma focused cognitive therapy is grounded on the theory where it is explained that traumatic events bring out materials that are difficult for the child to group, sort out and place it into their prevailing scheme (English et al, 2004). On instances when the child may not completely understand a traumatic event, the emotions which are usually strong that come from the traumatic event are unprocessed. When the child tries to process that information; facts are either distorted to fit in the realm of what is already known or understood or may distort the beliefs to link together the unprocessed material into their prevailing scheme. Both are bad since they lead to guilt and shame and also self blame. To counter act this, the child should be shown how to work on confusing emotions and hence correct maladaptive beliefs.

Proof is showing that trauma-focused cognitive-behavioral therapy is a successful treatment for children who are sexually abused, and also those who have got experiences of multiple traumatic events of other forms.

Most of the inquiries that have examined TF-CBT have been designed properly. This treatment model stands for a combination of trauma interventions and established cognitive behavioral therapy guidelines. The Trauma-focused cognitive-behavioral therapy was brought in by groups of researchers who jointly in the recent past worked together to administer multisite, treatment-outcome examinations for the sexually abused, traumatized children. The treatment was initiated to give answers to posttraumatic stress disorder, depressive and also anxiety symptoms. It was also to deal with fundamental twisted views on blaming oneself, security and trusting of other people. The therapy is also useful in dealing with sexual abuse and other traumatic instances into a wider context of children's lives so that their identity is not like that of a victim.

Core elements of TF-CBT are;

Psycho education about child sexual abuse, here the victim is learns the effects of the trauma as a whole physically, sexually, and emotionally and the common childhood counteraction to abuse .for example in the case of Melissa whereby her sense of self may be altered. Feelings, the invasive and also the intrusive disposition of the sexual activity affect the child's self-esteem negatively .The impact is both in the physical, whereby children have a distorted sense of their bodies, and psychologically, child sees herself as variably different from her peers

The task here is let Melissa understand that it is normal to feel that way after abuse but also to make her feel whole and good about herself again.

The second component of TF-CBT is the trauma narration and gradual exposure technique whereby the child explains the traumatic event in my case Melissa. This improves gradually until Melissa is able to comfortably talk about the event in details. This desensitizes the event and rubs off the stigma that is so commonly linked with child abuse. The end goal is for the Melissa to be in a position to discuss the distressing experience with no negative feelings. In that effect she is desensitized to the event. This will be accomplished by letting Melissa work her own way into the full disclosure slowly and methodically. At the end of therapy the aim is to enable Melissa to talk comfortably about her abuse.

The next component is cognitive reframing whereby Melissa should talk out the inaccurate feelings of the distressing event and she should be taught why those feelings are inaccurate for example self blame whereby Melissa may be blaming herself for having spoken out and therefore feeling guilty, and distorted sense of self and low self-esteem because of the sexual abuse, and fears and anxiety. Melissa needs to be helped to understand intellectually and accept emotionally that she was not responsible. Her mother's boy friend Tony sexually abused her; she did not sexually abuse him. It was his job - not hers - to prevent the abuse.

This is done by teaching the connection between thoughts, feelings and the way a child behaves. Melissa will be taught how feelings and the behavior connect and how she can control or completely change those thoughts and feelings to her advantage.

The fourth component is the stress management technique whereby Melissa will be taught different stress management technique, such as the capacity to control her thoughts. The child will learn that she is capable of controlling her automatic physical reaction. This will help reduce her anguish.

The other component is that of safety training whereby Melissa will be taught how to avoid victimization. She will learn how to know red flags that indicate a high-risk situation. The child will also be taught who to turn to if she finds herself in a tricky situation. The child will be taught to differentiate between decent and indecent touch and what to do in case of an inappropriate touch.

Parental participation is the last component whereby Melissa's mother Asher will participate in parallel or conjunction with her child's therapy.

A few parent-child joint sessions are conducted in order to accommodate communication in the family on issues like sexual abuse.

Therapy of interfamilial abuse that ends in successful reunification of members of the family is based on the mother's relationship with the child. This may prove to be a difficult relationship especially at the time of disclosure just like when Asher. The offender in this case Tony may have got in manipulations that have separated the mother and Melissa from one another. Melissa developed behaviors that were problematic because of the abuse, which damaged her relationship with the mother. The mother-victim relationship will be enhanced by assisting the Asher to develop empathy for the Melissa; by facilitating their communication; Initial work will be done in personal therapy with the mother, and then later with both the mother and child.

Enhancing the mother and child relationship is generally an important issue in helping the mother to protect her daughter in future. Intervention to make the Asher as the mother more protective can be implemented in different ways. When the mother has a good relationship with her daughter, she will be inclined to prevent the child from any harm. Treatment to enhance the mother-child relationship and will create the probability that the child will talk out to the mother. Moreover child and the mother relationship is to encourage communication freely specifically about the child's safety. Mothers must also deal with various issues connected to the present functioning and past experiences in treatment. A common issue regarding present functioning is low self-esteem. Other issues to be addressed are experiences of violence, dependency, and emotional problems, in order to assist the mother in taking care of her daughter.

In past trauma area the common issue is having been sexually abused themselves. Such an experience has effects in the way a mother's deals with her own child's sexual abuse (De Bellis & Thomas, 2003). The mother may be so affected by her of her own abuse and not be in a position to deal with her child's. In such instances like the case of Asher, her own abuse has to be sorted out first. Her being a victim hinders her ability to discern risky situations, and also her choices of partners; hence she plays a role in her choosing a partner who goes sexual her child.

With increased rates of divorce, more children are getting at greater risk .Mothers, in their trials to find a partner, may unknowingly be placing their children at risk of sexual abuse from the men they date just like the case of Melissa and Asher. When the mother remarries or moves in with her partner, according to a research done by Russell, the stepdaughters are more than eight times higher in risk of being abused sexually by their stepfathers who stay with them than are daughters who are taken care of by their real fathers. According to Finkelhor (1986), "Some researchers have already started to speculate, that it could be a case that more stepfathers are increasingly becoming 'smart pedophiles 'In that they marry single women with families as a method of getting near to the children” (pg34).


In conclusion the issue of child sexual abuse is very critical in our society today and needs to be addressed keenly.