2. Childhood sexual abuse (CSA) is
a worldwide, human rights and
public health problem, affecting
millions of children each year.
The effects of CSA can last a
lifetime, affecting both the
victim and their family.
2
3. CSA Statistics
Uganda - 11, 928 cases of CSA
were reported to police in
2006(ECPAT-Uganda, 2008).
3
4. CSA Statistics
In the United States, the prevalence
for boys was estimated at 10% and
12.5% for girls (Finkelhor,Turner,
Ormond, Hamby, & Kracke, 2009).
4
5. CSA Statistics
In an international study comprising of 22
countries, findings estimated that
approximately 7.9% males and 19.7%
females experienced CSA (Pereda, Guilera,
Forns, and Gomez-Benito (2009) .
5
6. CSA Statistics
The prevalence in New Zealand was
the highest with rates for women
ranging from 23.5% in urban areas and
28.2 % in rural areas (Fanslow,
Robinson, Crengle & Perese, 2007).
6
8. The trauma
from CSA has
been linked to
problems in
mental health,
physical
health, and
social well-
being.
• For example, child
victims of CSA
experience numerous
short-term and long-
term effects such as,
post traumatic stress
disorders (PTSD),
depression, conduct
disorders, anxiety,
eating disorders,
substance abuse,
interpersonal
problems, and
promiscuity.
8
9. Victims of CSA
often have
histories that are
complex due to
stressful and
probable
traumatic life
events.
It is critical to conduct a thorough
assessment of their trauma history.
Two widely used self report measures
to assess trauma exposure are:
UCLA
Posttraumatic
Stress Disorder
Reaction Index
(UCLA PTSD RI,
Steinberg,
Brymer, Decker,
& Pynoos, 2004)
Child PTSD
Symptom Scale
(Foa, Johnson,
Feeny, &
Treadwell, 2001)
Survivors of CSA
benefit from
psychotherapy.
9
10. There is a variety of treatment modalities for
treating children and adolescents victims of
CSA.
Trauma-Focused Cognitive BehavioralTherapy
(TF-CBT) is currently the most widely tested
treatment.
TF-CBT is the most effective trauma-specific
intervention in the field for treating children
and adolescents (Silverman et al., 2008).
10
11. TF-CBT is also effective for families and
caregivers of children exposed to CSA
Helps to improve caregiver stress and parenting
skills.
11
12. Reduce children’s negative emotional and
behavioral responses to the trauma.
Correct maladaptive or unhelpful beliefs and
attributions related to the traumatic experience
(e.g., a belief that the child is responsible for the
abuse).
Provide support and skills to help nonoffending
parents cope effectively with their own
emotional distress
Provide nonoffending parents with skills to
respond optimally to and support their children12
13. Treats children ages 3 to
18 years experiencing
behavioral and emotional
difficulties resulting from
trauma.
It is a conjoint child and
family psychotherapy.
It typically last 12 to 20
sessions.
Over 80 % of traumatized
children who receiveTF-
CBT experience significant
improvement after 12 to
16 weeks of treatment.
13
14. Combines elements drawn from:
Cognitive Therapy
▪ which aims to change behavior by addressing a person’s
thoughts or perceptions, particularly those thinking
patterns that create distorted or unhelpful views
BehavioralTherapy
▪ which focuses on modifying habitual responses (e.g.,
anger, fear) to identified situations or stimuli
FamilyTherapy
▪ which examines patterns of interactions among family
members to identify and alleviate problems
14
15. It is based on components provided
individually to child and parent.
P R A C T I C E
15
16. P - Psychoeducation
and Parenting Skills
Discussion on CSA
Education about CSA
• Emotional reactions
• Behavioral reactions
• Training for parents
• Child behavior
management strategies
• Effective communication
16
18. A - Affective Expression
and Regulation
Helps the child and
parent manage
their emotional
reactions to
reminders of the
abuse.
Improve their
ability to identify
and express
emotions.
Participate in self-
soothing activities.
How thoughts
affect the way
they feel and act
(behavior).
18
19. C - Cognitive Coping
and Processing
Helps the child and
parent/caregiver
understand the
connection between
thoughts, feelings,
and behaviors.
Explore and correct
inaccurate
attributions related
to everyday events.
Rate feelings
19
20. T - Trauma Narrative
and Processing
Gradual exposure
exercises:
• Verbal
• Written
• Symbolic
• Recounting of abusive events
Clinician and child
process what happened,
before, during and after
the abuse.
Narrative Writing
Trauma Reminders –
words, people, places,
sounds
20
21. I - InVivo Exposure
Gradual exposure to
trauma reminders in
the child’s
environment
• basement
• darkness
• school
The child learns to
control his or her
own emotional
reactions.
Expressing thoughts
and feelings about
the CSA.
• Why did this happen to
me?
• How will this event affect
me in the future?
21
22. C - Conjoint
Parent/Child Sessions
Family work to
enhance
communication.
Create
opportunities for
therapeutic
discussion
regarding the
abuse.
The child to share
his/her trauma
narrative.
22
23. E - Enhancing Personal
Safety and Future Growth
Education and
training on:
• personal safety skills
• interpersonal
relationships
• healthy sexuality
Encouragement in
the use of new skills
in managing future
stressors and
trauma reminders.
Your circle of safety.
Building trust.
Your fabulous
future – hopes,
dreams, goals.
23
25. Banwari, M. (2011). Poverty, child sexual abuse and hiv in the
Transkei region South Africa. African Health Sci, 11, 117-121.
ECPAT-Uganda. (2008). The Uganda national plan of action on
childhood sexual abuse and exploitation. Kampala, Uganda:
ECPAT
Silverman, W. K., Ortiz, C. D.,Viswesvaran, C., Burns, B. J., Kolko,
D. J., Putnam, F.W., & Amaya-Jackson, L. (2008). Evidenced-
based psychosocial treatments for children and adolescents
exposed to traumatic events. Journal of ClinicalChild &
Adolescent Psychology, 37, 156-183.
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