Child abuse is a harrowing topic of discussion. While childhood is meant to be an oasis of happiness in the lifespan, the actions of others can sometimes shatter this precious time.
Dealing with the aftermath of child abuse is difficult for both the individual and their families and requires early and ongoing intervention.
In this article we will discuss the effects of child abuse and the various treatments that are recommended in order to piece things back together.
WHAT DO WE MEAN BY "CHILD ABUSE?"
Child abuse is often divided into four main categories:
Neglect is when the child suffers harm due to being denied something by a caregiver. This may be food, clothing, warmth, supervision etc. Neglect normally occurs over a period of time and will be apparent in a variety of ways. Sometimes neglect will be materially obvious from poor clothing or hygiene. Other times it may manifest itself in other ways; for example, if a child injures themselves due to lack of supervision.
Emotional abuse is normally seen in the relationship between child and parent/caregiver as opposed to a set pattern of events. Emotional abuse does not refer to anything physical but refers to a range of behaviours exhibited by the caregiver that prevent the child from obtaining his or her emotional need for affection, safety and security amongst others.
Examples include excessive criticism, under or over protection, emotional unavailability and unrealistic expectations. Emotional abuse may manifest itself many ways including low self-esteem and unhappiness as well as unhealthy attachment styles.
Physical abuse involves any behaviour by the parent or caregiver that either directly or inadvertently results in physical harm. This form of abuse may refer to a once off incident or a repeated series of events. Physical abuse may involve severe physical punishment, pushing/shaking, induced illness and forced observation of violence.
Sexual abuse is when an adult uses a minor for their own sexual gratification. Examples of sexual abuse include, amongst others; sexual intercourse with a child, exposing sexual organs to a child, involving a child in masturbation and sexual exploitation. As children cannot give sexual consent any act between an individual over 18 and an individual under 17 is considered sexual abuse.
For a full description of sexual abuse types and ways to identify whether sexual abuse may be taking place, please follow this link. If you have concerns for a child then make sure to check out the information provided here.
What is the Impact of Abuse on Children?
Child abuse can have a major impact on any young person. Research indicates that the most serious mental health problems often arise from repeated trauma. This is because repeated trauma such as child abuse can often last years or even decades of a young person’s life, leaving them little time to experience the stability required for secure development.
In addition to this, some psychologists have made the case that the most severe psychological effects arise from relationships in which the child is dependent. The most obvious example if this is parent- child relationships. When this relationship is abused by a caregiver it deeply disrupts the ability of the child to form attachments, develop self-esteem and resilience.
It is hard to pinpoint the results of child abuse as it depends on the individual’s subjective experience, length of abuse and severity of abuse. Research has linked child abuse to a variety of emotional and behavioural issues however. These include:
Child abuse may also have long- term effects for the individual. Neglect as well as emotional, physical and sexual abuse in childhood have all been linked to range of poor long-term mental health outcomes. Depression, anxiety and addiction have all been linked to adverse experiences in childhood. In addition to this child abuse has also been linked to poorer physical outcomes. It is important to note however, that not all children who experience abuse will go on to develop such issues.
Interventions for Children who have Experienced Abuse
Treatment methods that have the most scientific backing are based on CBT (Cognitive Behavioural Therapy) and focus on the abuse itself. CBT addresses the child’s thinking patterns, emotional responses and behavioural reactions to the abuse.
In particular the treatment will attempt to correct any misattribution of blame the child may demonstrate i.e. blaming themselves as opposed to the adults for the abuse. It is important not to force the child to directly discuss the abuse too quickly, but rather ease into a discussion of it. In this way, the child’s embarrassment and anxiety is reduced as much as possible.
The therapist may also teach the child skills to cope with the negative emotions arising from the abuse. These may include stress or anger management techniques. The child is taught to identify any triggers they may have for negative behaviours and ways to minimise the effect they have on them. The aim of such training is to improve social and interpersonal functioning as well as reducing daily distress.
The aftermath of abuse may be highly stressful and the child may be dealing with court proceedings or the social care system. In such cases the therapist may work with the child to teach relaxation techniques. This aims to reduce anxiety levels and to reduce any fear surrounding reminders of the abuse. For example some children may be afraid of being in smaller rooms or startle easily around adults.
The most important thing for any child is that they receive the support they need as quickly as possible. Suitable intervention in the aftermath of abuse has been shown to reduce the impact in the long- term. Childhood abuse is something no child should have to suffer and they deserve as much help and compassion as we can provide.
Afifi, T. O., MacMillan, H. L., Boyle, M., Cheung, K., Taillieu, T., Turner, S., & Sareen, J. (2016). Child abuse and physical health in adulthood. Health reports, 27(3), 10.
Nemeroff, C. B. (2016). Paradise lost: the neurobiological and clinical consequences of child abuse and neglect. Neuron, 89(5), 892-909.
Wamser-Nanney, R., Scheeringa, M. S., & Weems, C. F. (2016). Early treatment response in children and adolescents receiving CBT for trauma.Journal of pediatric psychology, 41(1), 128-137.