Helping Children Heal From Sexual Abuse

Parents are often afraid to foster or adopt a child who has experienced sexual abuse, but children can and do heal from this type of abuse. We talk about what parents can do to help the child heal with Dr. Jennifer Shaw a Clinical Psychologist with the Gill Institute for Trauma Recovery who specializes in the assessment and treatment of trauma in children, especially those who present with sexual behavior problems.

Transcript

spk_0:   0:07
* Note that this is an automatic transcription.  Please forgive the errors.

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spk_0:   0:07
Welcome to Creating a Family Talk about Adoption and Foster Care. Today, we're going to be talking about helping children heal from sexual abuse. We'll be talking with Dr Jennifer Shaw. She received her master's and doctorate in clinical psychology, and she specializes in the assessment and treatment of trauma in Children, especially those who presented with sexual problems. She is a psychologist at the Gill Institute for Trauma Recovery. Welcome, Dr Shaw to Creating a Family.

spk_1:   0:35
Thank you, Don. Glad to be here.

spk_0:   0:37
Um, this is a topic that you and I have talked about in the past. It is a topic that you and I both feel you a professional passion as well as me. I was, uh I have come to realize in talking with many, many parents as well as caseworkers, that if a child has sexual abuse in their file, it has become like the Scarlet Letter. A people are afraid parents are afraid to have him in their home. Case workers say they have increasingly hard time finding families for them. And so I I'm so thankful that you are here to help us understand Maur about the complexities of sexual abuse and as it compares to other forms of abuse, trauma and neglect. So let's start with the very basic. Which would be what? What do we consider sexual abuse is? Does it have to be penetration? Does it have to be gonna be touching? Does it? What does it? What? How big of ah, of, ah, definition, Dewey, How big of a net do we cast?

spk_1:   1:41
Yeah, well, you know, a general definition is child child sexual abuse is really any contact or behavior, you know, without the consent of a person. And a child can never get give consent. So it might be sexual assault or sexual violence, but also exploitation of the child. We're looking at the child or any behavior. Um, that suggests the the abuser is, um, seeking gratification. My touching the child or viewing the child's body. Then that child has been sexually victimized.

spk_0:   2:16
What about a child who is exposed to adult sexual activity?

spk_1:   2:22
Adult sexual activity either. Direct witnessing more pornography? Yes.

spk_0:   2:27
Okay. All right. Now, adoptive foster and kinship parents often don't know prior to fostering. Are adopting that the child has experienced sexual abuse. So what type of behaviors might indicate that a child has had experienced sexual abuse of any form.

spk_1:   2:46
It's a good question, you know, in our field will often get reports from Children in foster care recently been adopted where there might be language like suspected right? But but the information remains relatively unknown, Um, and that that leaves people you know nervous and what to look for. So it's a good question. It's also a hard question because each child is different in each abuse experiences. Different. But in general, I would put it in two categories. You're looking for Externalizing behaviors, which might be a sexual acting out, or curiosity beyond what's age difficult. Um, where it might be, um, curiosity when touching another child were seeking to touch another child. And then there's internalizing behaviors, and that might be more worried about showing their body or more distrust of of adult strangers than might be typical. But it's difficult to tease out, you know, was a child who's been victimized. They'll often feel a deep sense of shame, Um, where they might act out and become just regulated on Dawn Lee, after a period of time where their safety and security might you be able to find out what's going on underneath, which may include the victimization experience.

spk_0:   3:58
So what? Children are greatest risk for being sexually abused?

spk_1:   4:05
Well, Children, where they're in an environment that might have been chaotic. So a supervision is, Ah, is his lack of supervision is often consistent with Children who either were abused by older Children in the home or other adults in the home. So there's dysfunctional family patterns, lack of supervision, Um, but also, when there's physical abuse and multiple adults in the home, multiple transitions between homes, eso generally there's instability of an adult caregiver as well as a supervision

spk_0:   4:37
issue. So, in other words, a lot of Children who do end up in, ah, institutionalized settings, foster care, whatever are at higher risk

spk_1:   4:47
with a history of domestic violence in the home. Yes.

spk_0:   4:51
So how does the impact of abuse differ depending on the relationship of the abuser to the child? And what I'm thinking of is, like, well, a stranger abuse versus your uncle or your father or your brother or something along those lines?

spk_1:   5:07
Another good question in a significant one in terms of what to do next in terms of treatment. So I would say you know, stranger abuses relatively uncommon compared to the known um, perpetrators. And we're now talking about this much more in our society, which is helpful, the Children to know that it's not, you know, when you tell it's not always because a stranger has been inappropriate. Sometimes it's because it's somebody Mom and Dad trusted. Um, and that's what we what we generally referred to is A is a more complex trauma. And if you have a longer lasting effects that essentially means there's a betrayal of trust. There's somebody that the child or the family trust, but also things were happening that make the child uncomfortable, and so there's just really complicated feelings that emerge. So that's an interpersonal trauma in a personal type of sexual abuse, which is much more common and also has much deeper ramifications Psychologically.

spk_0:   6:07
And if it's the child's primary caretaker, that adds further complications.

spk_1:   6:12
Absolutely. And yes, it adds further complications in terms of recovery. What we really look for is what happened next on. Once it happened, once the abuse occurred with a trusted caregiver, was there another trusted caregiver that came along, believed the child and protected the child? That's really what will dictate how the child starts to resolve what occurred?

spk_0:   6:37
Oh, good. What were they were gonna come to that towards the Indian? That's wonderful. Um, to know that there's there's hope that we can do things that we specifically couldn't do. Let's do a brief refresher on on the typical, um, psycho sexual development in Children and how sexual abuse impacts that, because I do talk to people and they and they are upset, worried about sexual abuse with a foster child or an adopted child. But once they learn that this behavior is actually fairly typical of Children, sexual exploration, sexual curiosity, it helps, it helps relax him. And then there's some behaviors that are are not typical. So I think it's helpful for parents to know the distinction because either they don't remember our of their own youth. Are there other Children that they've raised? They were unaware of their sexual developments? Are they Are they just They were. They love their Children more particular that curious.

spk_1:   7:37
Another good question. And we, you know, through the lifespan what we will often tell parents. As as we try to differentiate typical sexual behavior to a typical is first. The starting point is all Children or sexually curious and sexual development starts as soon as they enter the world. So when we when as they're roaming even through toddlerhood, they have different interest in their own body and other bodies, Um, and then they become in preschool. We all see this right. They want to play doctor or house, and the interest increased, so those around 4 to 6 will often see a spike. There's an increased curiosity on, but also because of that there's there starts to be an opportunity for creating awareness of the child. What is friend of left for more private, Um, for the private parts to be, um, you know, cared for and cleaned only by adults you trust. And there's opportunity within that priest fool the early childhood years that some Children get in. Some Children don't. But the reality is all told, we will express curiosity, and all Children will test the boundaries of that. What we look for in terms of when it crosses over to a typical and potentially problematic, is, if apparent response in a non punitive way. Get some brief education, the child about appropriate boundaries and the child then continues to push the boundary and maybe even become secretive about it. Um, you know, most Children, once they're taught the boundary, they'll move on to other types of play. Right? Maybe have something. You There's an impulsive quality into the behavior, or there's a guest experience. The curiosity is too intense for the more standard boundary, and so they may seek to do it in secret. And that's when parents will come in and say, I think this is beyond you know, the what's developmentally typical that I might say yes. And that might not mean the child needs treatment. It might need a little bit of a parent coaching.

spk_0:   9:35
Okay, Yes, because it could be it could be abnormal, But it also could be that it's a child, that is, I mean, some Children have different levels of curiosity in different temperaments differently. Yeah, so all of that.

spk_1:   9:48
And it might have been a secondary gains from it, you know, So we don't know yet. If the child is, um, if the child gets a lot of attention from that, they may be doing it again to get the same attention. And so we don't necessarily want to do an intervention of child therapy or sexual abuse. You know, work with a child. If it's actually more dynamic or relationship this. You've been tweeting child apparent. You want to start with the

spk_0:   10:12
pair. Excellent. Can Children heal from sexual abuse? Absolutely. And all the time. So I think there is a general, uh, preconceived idea that Children who have been sexually abused will become abusers, either in their in their childhood, are in adulthood. What's the truth behind that?

spk_1:   10:38
Well, it is. It is a fear onda lot of parents. Therefore, their interventions tend to be fear driven. But there's very little empirical evidence for that. There is there Dust Team to be more of a likelihood of further victimization on dhe, the adult becoming a perpetrator for males who were abused by females. But what I think is more important is what the studies will show is. There's little empirical evidence one, and to the the probability of it, becoming a behavior that the child adopts really depends on what the world and the adults do after the abuse. So the rates are higher. For example, the child's been sexually abused, but the protective factors were absent. It was not a supportive caregiver that immediately protected and believed the world did not show the child that it, in fact, most of the time, was a safe place, even though something bad happened. So if they're continually in a chronically dysfunctional home and they haven't met supportive caregivers to making to begin to heal, then yes, they will be a higher risk. But really, the question is, how What can adults do to prevent that from happening? Not whether or not that the Children are ready to heal. It depends on how the world responds to them once we find out they've been hurt.

spk_0:   12:03
Yes, I thank you, that is, that's that's saying so spot on to me and and from what I see as well, let me pause for a moment to remind people that this show and all the resources at creating a family, is underwritten by the support of the jockey being Family foundation. They want all adoption agencies to know that they are eligible to participate in a wonderful program called the Jockey Being Family Backpack program. Newly adopted Children will have access to a backpack, and it is a personalized backpack that is got the child's initials on it. Inside there is a blanket and a bear and, most important, a parent tote with information for parents. For post adoption support. Eso If your apparent listening, please have your agency reach out to jockey being family at their website jockey being family dot com. Click on backpack and your agency can subscribe, and your child and other Children who follow it will be able. Thio have one of these backpacks, so thank you. Yeah, all right. We were talking about helping Children heal from sexual abuse, So let's jump right in. You have said that one of the most crucial elements as to how Children will help how impactful abuse will be for a child both in the short term in the long term is what happens both immediately afterwards but also further down the road, the adults in a child's life, how they responded, how they can help a child. So how can parents help the child healed after sexual abuse? And in the case where most of the cases that we're talking about, the child has been abused in the past and likely has either been removed from the home or in the case of international adoptions, a child would have been brought from an orphanage removed from the situation room for the orphanage, and so is now in a home with parents who are ready and willing to help that child hell so they don't have the advantage of immediately being able to respond to a child. But they do have the advantage of of now being in the child's life. So what can What are the factors You've talked about protective factors. Let's talk about some of the protective factors and then move into what parents can do to help.

spk_1:   14:33
Um, first of all, the first thing a parent can do is to become an informer informed caregiver, and this is a complicated topic, and it's scary. It's scary for a lot of parents and adults, but with more information, a caregiver could become pretty confident that healing will occur and competent in providing a space for that recovery to occur in their home. So with information, it becomes a research and formed approach versus fear driven. And that's number one for the caregivers, too. Relax. And when the behaviors emerge that you know what to do, and they're armed with information, not myth. That's the most most important thing from then the protective factors when we when we use that phrase, were really referring. Thio is the child believed in C and felt, heard and understood was the response from a caregiver or the world around them. I'm so sorry this happened in whatever words that is I'm so sorry this happened and we're gonna work together to move through this and make sure this doesn't happen again and believe the child. And in most cases they will need some specialized treatment, not necessarily long term. It depends on what the other pre existing factors were. But the protective factors in terms of long term recovery really depends on at least one caregiver who serves as an anchor and an informed ally throughout. The healing is, for example, if a child's five and healing their that their needs are gonna be different in terms of recovery. Things might emerge again at age nine and again at puberty, and so they really do need to be on an ally throughout development.

spk_0:   16:18
What do you mean by a parent being an anchor

spk_1:   16:22
that the home and the primary caregiver. Whatever happens outside the outside the home where that school of the community or the past that the home is a place that is predictable and the child is respected, their body is respected and the home and the caregiver becomes an anchor for whatever else might happen. Kind of like an anchor in the middle of a store. You know, you can you stay steady. You are seeing you are understood. And no matter what happens, you can go home and you will be OK, and you will be understood, and you will be protected.

spk_0:   16:58
When you said that, uh, parents, one of the things for parents is to feel confidence that healing will occur. But how do you address a parent who is not feeling confident, who is afraid? Because I think you're spot on that. I think a lot of times our responses are fear based because we're frightened. We this'll behavior. Seems it's just seems uncomfortable when we see Children acting out sexually are talking sexually It it just feels uncomfortable.

spk_1:   17:31
Well, first you know, way encourage them to talk to other parents who have been through it but also has to be a therapist, too conservative parent coach in this regard, because there are a lot of myths, even phrases like you mentioned Scarlet Letter. But there might be permanent damage may be floating around in their minds over absolutely yeah or these lifetime spars. And there is no doubt that it's life altering, especially the chronic and more complex. As I talked about where there is a betrayal of the trusted caregiver, absolutely, that is that that can be life altering. Um, on the other hand, it's not true that there's permanent damage. And so, working with someone to say, Hey, this is how the brain repairs and and a child's brain, especially it sze very plastic. So how they experience the world from here forward is what's most important the healing. And I've worked with countless Children who the parents have a harder time recovering, then the Children. And it's the fear Children are not fearful about their future, their curious, and they're spontaneous adult ideas that there's going to be lifelong problems can create anxiety that then gets in the way of a parent child relationship. Absolutely. They may need treatment and increase supervision initially as they reset their understanding of how things work given their prior world. But the main thing is for parents to arm themselves with education. And we now know yes, Children get better, depending on what we adults do best not depending on what they do. It's what the world shows that and how the world responds to them. And that's our job bright as adults.

spk_0:   19:24
So getting educated. Certainly listening to this is the first step in that direction. And that's great. So congratulations to all of you who are listening. Um, but where are other? What are other? Resource is for parents to become the educated ally. Umm, I think we can work on being. I think we already provide a lot of information on how to be the anchor. But how to become the educated ally for the child, the educated parts, what I'm focusing on. So where can people get information other than creating a family?

spk_1:   20:01
Hey, well, one, you can look online. I would I would I would point really anyone the direction of the work by Dr Eliana Gil should she does talk extensively about, you know, present and future oriented healing of Children ever worked does help to debunk some of the midst that keep us fearful, Um, and maybe looking for behaviors that were missing the opportunity to tear. He'll, um, and arm yourself with education on basic child development, including psycho sexual development. Something's may emerge that or not that I'm not problematic. They're just opportunities to learn, learn new boundaries and move forward. So some of some of this the sexual development and also there are There are professionals in most communities that work in the field of sexual abuse on childhood trauma. More broadly, to just go in and ask questions, even if it's I'm considering having a child with a suspected history. You know what, what would I look for and what what might this child need when they come and start to get educated that way? Just asking the questions. And it probably will start to defunct the myths that keep parents worried, um, about bringing a child home with a suspected history

spk_0:   21:20
Does it because how can that fear? Ah, understandable fear. And I don't think either, and I are you. Either you're in or I or is trying to downplay it. But how can that fear interfere with the child, even healing

spk_1:   21:35
right well. And that's Ah, that's really critical, if you know all often saying in my own work to parents, even if they come into my office and they're incredibly anxious, you know, the Children are then experiencing their their parents as afraid of them or afraid of their behavior. And for a child who's been abused, they're looking for the world to tell them what to do next. And if caregivers are behaving in a way that's uncertain or sends a message of anxiety, the child's gonna further keep thoughts and feelings to themselves and feel bad or different. And then in that way, other symptoms can start to emerge because they made their cue is, you're kind of on your own with this because this is too much for adults. That's how they read it. You know, my mom or my dad or my foster mom doesn't really know what to do. That's that's the message when there's a really anxious parent, um, and and then they feel like they're on their on their own. And that can deepen the shame and increase other than other behavior's inappropriate behaviours because they're left feeling like they must be so different from other Children that adults cannot help them. That can be the unintended message,

spk_0:   22:55
or adults are afraid of them.

spk_1:   22:58
Yes, yes and what they need. And you can get this in treatment. But we always work with families and parents. Is everybody around the really to send a message of We got this. This happens sometimes. We're sorry it happens, But there's certain things we can do to make you feel less afraid. And we're trusting, and we're in this together. We got this. If you send that message of confidence to a child, they that have become confident they can heal, and you start to see that in their recovery. If we're not confident, they're not going to be

spk_0:   23:29
confident. There's, uh, and so if a child often times Children come to us, and as you say, we either don't know, there may say, suspected very often we don't even see suspect, and some of that's because I think that caseworkers and social workers are sometimes afraid to put that if they're not 100% sure, because they know it's going to make it really hard for that right to find a home so, uh, so we don't know. But as the child starts settling into our homes and our home and is feeling more comfortable and begins to trust us, a child may disclose either outright are dropped hints that they have experienced abuse sexual abuse in the past. How should a parent respond if their child opens up to them?

spk_1:   24:21
It's a really good question. Again, it's, I would say it's typically individualized response, but in general, just a statement that there thank you for letting me know. That's a really, really hard thing to hold by yourself. And I'm so glad you told me, and we're gonna talk about this together. I say a general response because you really don't want to over question a child too much in some situations because they may need to do a forensic interview, for example. Somebody may need to talk to the child to get information, but the important thing is is that there's an immediate, um, response to the child of I'm so glad you told me we're gonna figure this out together.

spk_0:   25:05
What is it? The and and then find out and make decisions and who

spk_1:   25:09
shot whether you have to do a forensic interview or right into therapy.

spk_0:   25:15
So what do families look like who are able to help Children heal from sexual abuse? You've mentioned a couple of things. Parents who are willing to be educated. That's certainly parents who are willing to create stability. Uh, in the child's life in general. Um, a CZ Well, a cz Ah. Parents who are, uh, this is probably not the professional but aren't are not going to freak out and are willing to try to remain calm. Um, so what are some other descriptors that you could say for families, uh, who are able to help Children heal from this

spk_1:   25:58
of those air those air perfect? I would, I would add, willing and able to anticipate behaviors that may emerge sexual abuse, especially when a child becomes what what many of us call abuse reacted, which means they're acting out sexually for a period of time after after the abuse. And they need some so help with some sexual behavior problems that if you're anticipating what might come, you can then prepare for a response. So if receiving a child and you're not in the symptoms emerge, you may in your words freak out, but they're usually are some pretty short interventions. And when you're ready for them, you're essentially putting the child back on a developmental path. They're testing limits and they're doing with. Maybe they used to do what the world used to teach them, and we're just redirecting them with appropriate boundaries. Talking about privacy versus secrecy willingness toe Have those difficult conversations and what a behaviour emerge? Change our mindset to. There's a real opportunity to, um, to change this child's perspective versus this is there for the beginning of the end, that kind of fear based thinking that it's a symptom that happens. But it's not a sign of permanent

spk_0:   27:17
damage that the child, it's a symptom and the child can heal. And your job is to at that point figure out the best way to help that job.

spk_1:   27:28
And because it's sexual abuse, it's much more complicated and brings up a lot of fears and us as adults. But sometimes it can be helpful to step back. If we get a child who has been in an aggressive or violent home, and when they're in our home, they're aggressive. They're they're punching their slapping. You know we don't necessarily hesitate and ask ourselves, What should we do next? We step in, we set a boundary. We set rules for the home. We show, you know, positive discipline and love. We lean in a little bit more easily than when it's a symptom of sexual abuse. We use and don't carry so much around sexual abuse that we lean out when in fact the child needs exactly what we would do with a non sexual behavior. That's what they need from us.

spk_0:   28:21
Mmm boy, that said, That's perfectly said We do lean away because it goes back to the fear and the discomfort we have. When we think of sexuality and Children,

spk_1:   28:32
that's right. And it sends them a message that they must be so different than every other child because parents are nervous around them. And then they left isolated and often feeling very ashamed.

spk_0:   28:45
Okay, so let's talk some practical tools who? One of the things that we hear very often is when it's a couple where the father said, I, I I don't know the I don't want to have a child, a girl or boy guess who has been sexually abused as I I'm afraid that I will be accused. I'm afraid that I will never be able to be left alone with the child. Uh, I don't I don't want that, and I don't want to have to worry about that. So what are some practical things we can offer for parents who are worried about that specifically having a father not be false, accused accusations or not being able to be left alone with the child?

spk_1:   29:27
And it's It's an understandable fear, of course, but if we if you are working, if the family is working with a professional and there's a team around the family, if and when that allegation takes place, it could be seen as a symptom of the child that family come together. So really, creating a community around me around the adoption with fostering can mitigate the risk of that having any long lasting impacts on the family. Could it happen? Yes, but it's also you know, we have Children who will then make allegations of different people. It's school and allegations can start. Thio kind of emerge during that phase of treatment, but the but as long as again we live in and you have a community, Um, you know that that usually will will pass. That doesn't happen as much as people fear, though I don't have you. No, it's not. It's not as if my caseload is full of parents who have had an allegation after it's it's relatively rare, but if it happens, there's usually already an understanding of what the child's doing and what they're what they're expressing they need,

spk_0:   30:41
All right. Another thing we hear from families is the fear of bringing in a child who's been sexually abused because they have other Children in the household and they generally will share to two fears. One. Ah, the fear that the Children are already in the household will become victims if the child will have sexually on them, or that the Children in the home will be, even if not acted out, sexually will be exposed to more sexual behaviors, sexual information, things that someone said, you know, do I bring this child in and then rob my other Children of their childhood? So let's talk from a practical standpoint about that fear and what parents can do

spk_1:   31:26
well, it's a very real real fear, especially wouldn't when there's Children younger than that, Maybe the child that's brought into the home, However I would I would say that that most Children who have been sexually abused or not a risk to other Children. So just because there's a history of sexual abuse does not mean that they are, uh, at risk of sexually abusing another child. However, sometimes there are sexual acting out behaviors, which does mean there'll be a period of time of the parent needing to have within eyesight within earshot supervision, um, and stepping in and setting new rules and parameters. And sometimes that doesn't mean having conversations with the other Children about what to do. And so my advice would be to be parents who are willing to do to bring the child into the home that is sexually acting out is to go ahead and talk to the other Children and be very specific about should something happen that makes you uncomfortable or there's a boundary, you know, as as this new child is learning new boundaries, this is what you do, you know, Sometimes we'll say, Make sure you tell in adult to a child, will most Children need something, were specific how do I tell? When do I tell, um, and just set some basic basic rules about communicating one feeling uncomfortable and everybody kind of head of a plan and and talk about it openly. It doesn't have to be a lot of detail information. It's just everybody's anticipating. If this happens, this is what we're going to do. But until you feel noble, more confident about the child that within eyesight supervision during that phase would be the first approach.

spk_0:   33:04
So when you say, be specific before the Childers are shortly after the placement, talking with the Children are already in your home about helping them understand. Boundaries are private. Parts are private parts. Nobody should ask to see or touch your private part. You mean that's that type of conversation and that if somebody and if somebody wants it, tries to touch your private Archer wants to see your private parts, you come tell Mommy or you come tell Daddy, you tell them you tell them no, and then you come to us and you will not be in trouble. Do you mean that type of conversations

spk_1:   33:37
idea what is obviously gonna be different, depending on the age of the child, but sometimes it helps kids to be very specific in terms off. Um, e e i se the difference between privacy and secrecy to just just say kids, you know, private parts secrets are never for keeping. It's too much for any child to hold, and then maybe even anticipate gives specific examples. You know what if, um, somebody does do something that makes you uncomfortable, but they say, please keep it a secret. What might you do next? Well, let's tell cause private price secrets are never secrets to key. Um, or they say that they're gonna be your best friend if you don't tell and really help them. Kind of think through these things through through specific examples.

spk_0:   34:21
Okay, So you're a cz much

spk_1:   34:24
then, Children, I'm sorry. And Children have a hard time using it. I have some families that when they were uncomfortable, they might have a place in the home where the child will put a note. Right. Come talk to me. I have something to tell you or they'll choose a symbol of I need some time to talk with you. Because if you can imagine a child coming up and saying Hey, this happened. Sometimes they're not quite sure how to do that. And so they can talk together about, um, I have I have one child who will put a red sock in his father's toward, Say, he kind of wanna talk talks about something that came up, but he doesn't know how is essentially. So the father will, you know, take some time and ask some questions. Sometimes Children need us. So some some way for the Children to give a clue. Hey, can you find some time? I don't know how to bring this up and just having those conversations and planning for if that happens and you want to tell me something, but you don't know how. What can we do?

spk_0:   35:22
Okay. Perfect. And, um, some of the recommendations we hear oftentimes from agencies is to put in locks on doors to put in cameras. Ah, and particularly gets at night. Time is the concern. So to have cameras around and have Children know what do you know that the camera's exist? What are your thoughts on either locks are our cameras

spk_1:   35:50
locks? I would I would be really cost us about, especially a child with it with a trauma history because you have this concurrent goal of having the home be a place that when the doors were closed at night, this is your family, and this is a safe and secure environment. Safety is always an issue with the Children whose child was sexually acting out. Um, but there are. There are non invasive ways to do that. There are times on the door just until the parent is sure of the sleeping patterns. Feel the child goes to bed today. Do you really sleep through the night? There's a face of uncertainty about what the child's patterns are making sure Children have their own space in bed roots. Eso Sometimes times will just wait a parent up whenever a child leaves the room to go to the bathroom and and and cameras can be helpful to again, it depends on how high risk the child is Lakhs. I would be careful about Does it get? A lot of these Children are coming from, um, really, really difficult past environment, and it sends, and it sends a message, um, that you can't be trusted. And what if they're leaving their room to go to the bathroom, for example, we'll get a cup of water. So, um, anyway, case by case. But there are. There are some times available that I've seen work really well. It's just a gentle waking of the parent, and the parent will come in and guide them back to bed or get them what they need. Um, and people can have a sense of safety

spk_0:   37:18
because we do want to provide safety not only for the new child coming into the family, but also for the Children existing already in the

spk_1:   37:28
That's right, that's that's that is the that is most important. Some Children have things like locks, though What can end up happening is a power struggle where kids will then try to find out how to get around the locks so that it can start a different Siri's of behavior so that if something that restrictive is needed, it's needed. But in the beginning, saying how, um, how the child can do with um with other measures is probably the best approach, and again, most sexually abused young Children are not acting out sexually. But if it becomes a concern, then you can look at measures like a chime and different rules for bedtime.

spk_0:   38:09
So summarizing some of what you have said as faras what to do with protective factors, things that we can do his parents one would be before the child comes. Our soon as we've become aware that there may be a problem, talk with the Children existing in the home. Ah, and not only explicitly talk about private versus secret. Private parts are private parts that for you only in that but but also to give them anticipate that they may have a hard time talking about this and giving them some nonverbal ways to indicate to you that that there may be problems. So that's certainly one of them. The other one, um, having the child within your sight until you learn the child's behaviors and you learn the child's triggers and you learn whether the child has any interest in acting out sexually or any other way. Another thing you've said, it's lean in. I really like that, as opposed to have this image. You know, when Children are physically adding or whatever we do, we lean in, we come in and we and we physically are involved in their space to help them learn how to self regulate. But if it's a sexual activity, you're so right. We just we lean away. I mean both figuratively and literally, and so to focus on redirection that that's the real key here is that we're thinking in terms of redirecting, just like we would redirect a child who is is hitting our screaming or saying a bad word or any of the other things that Children might do who have come from chaotic environments, Um, and then physical things like times and and for nighttime, trying to impractical things such as future Children have alone space in their rooms and things like that.

spk_1:   39:56
That's right, Yeah, and bathroom rules. You know, you wanna get very, very specific. Maybe the family makes a poster of certain privacy rules in the home. When a new child comes in where everybody has the bathroom, time alone with the rules, for when you wear a shirt and really setting, you know, frankly, pretty specific boundary rolls around the body if the child has been exploited so that this is a place where they are protected safe and the boundaries were really, really clear,

spk_0:   40:25
and we could beam a little more specific on this. So when you're saying the boundaries, okay, the bathroom. When you go in the bathroom in your oven door, nobody can come in. They could knock on the door, but they can't come in because that's your private space on dhe. So do you mean for the adults? Toe have rules As far as, uh, when Mom gets up, she puts on a robe in the morning. Or are you mean for the Children to say that, uh, you know, you don't run around without your clothes and always make sure that time the thing

spk_1:   40:55
that's yes, yes, I was thinking more for the Children when there's multiple Children in the home, but also, if it's a child where there is known sexual abuse again, creating a home that really is sending a message to the child that that there is privacy and will be respected bodies are respected. So while there's families operate in different ways and we would never tell a family what their own boundary rules are, different things with clothing. On the other hand, if it's a child who's been abused, you might need to tweak it for a little while. again is an opportunity to reset the child's perspective of of body privacy and private parts. And so when you might not necessarily wear a robe all the time in that beginning phase, you're really is really about sending a message to child that this is the way we do things here. Close the bathroom door. When parents are in the bathroom, you need to knock, too, so it might be different than what the family used to do before. But in this phase, it's really were. We are this child's world now. The message we're sending is is an opportunity for the child. We consider how adults live, how they should live, and it's really through modeling that that happens. So

spk_0:   42:10
when you're setting up these rules, do you involve the Children in the making of the rules?

spk_1:   42:14
Yes, yes, I'll sometimes do it in session O. R. And families can take the poster home or work on it themselves. But even if it's in the child's own language and having them talk about it, whether it's not when you leave the bathroom, should you have a robot and a shirt, or how can we do this and everybody kind of create a poster on these. There are privacy rules in the house.

spk_0:   42:37
Okay, so you make rules, everybody contributes to their rules. And, uh, and then and it's written down and it's posted. And we remind people when when people forget which Thanks. All right, Nellis, talk about, uh, you said a couple of things about therapy. Um, And while you say people confined the therapist, I think that, um, I think that sometimes harder said than done necessity is what should, especially with with issues, I think for general trauma, it's it feels easier. But I think when this specific trauma I think therapists lean out as well. I don't think it's just parents. So, uh, what? How what should parents look for when trying to find the therapist to work with their family? Ah,

spk_1:   43:31
couple of things first, a therapist who has training experience in working with young and school aged Children. So the basics and child development, so a background in child development and child therapy onda specialization in childhood charmer. There's there's also a certification. It's from registered play therapy when which could be helpful because that it's on our p t. She can look for someone with an R P take. However, that by itself is insufficient that somebody who s training and experience in trauma and sexual abuse and I would also say toe ask the questions of Does that person collaborate? And are they pretty family focused, for example, of you have a therapist who has a child for 45 minutes, 50 minutes? But there's not parent coaching or collaboration with school and home. It's gonna be the The effectiveness is really limited, even with the best therapist.

spk_0:   44:29
So I picked up on that. You said that a couple of times that when you would you work with the family. And that makes such good sense. Because even if you're seeking therapy more than once a week, that's still a relatively limited time. And the parents were the ones who need to be drained on hell. And so so one of things to look for is a therapist that will work with the parent, and their goal is to help that parent become the educated ally.

spk_1:   44:59
That's right, and there's different ways that providers will structure that sometimes they bring in another parent therapist or have 1/7 session with the parents. But that's just a question, I would say to ask in the beginning is, Do you collaborate? Can we also meet, um, and and what? Their experiences with sexual abuse? Because just like we want parents to be confident and competent. If a therapist is not quite sure that, then that's gonna be a really difficult time for the child is a child will probably pick up on it. And so the relationship of the child with therapist, um on be willing to try. You know, one or two, it can take time to find somebody that's a good fit for the for the family. Um, but you really want to prioritize it? A therapist who is going to do but leaning in, you know, naming it, being willing to talk about it and being willing to collaborate. And if that's that's not a signal that you're getting when talking to a therapist, that it's probably best to look so look elsewhere,

spk_0:   46:01
and so that depending on the age of the child, play therapy could be the format that issues. But it's not exclusive is not the only format.

spk_1:   46:08
It's not in our in our p. T. A Register play therapist is helpful, but again, the solid therapist. Also, they have. They have extensive training in sexual abuse, but also child development in child therapy approaches. Play therapy is one

spk_0:   46:21
of them. Okay, and is there a, uh, certification specific training anything that you could look for to know that the therapist would have specific training to handle this issue? Are Is that wishful thinking on my part?

spk_1:   46:38
No, it's not wishful thinking, and there are different. There are different training programs out there. It tends to be a certification, though, So when you're looking at a therapist website, for example, you can look for a certification in trauma or that that is their specialty within their practice. Um, but I again that's it's it's it comes down to the parent intake on the phone. What is your experience? How young Children do you work with? How do you work with young Children? You know, if they typically see adolescence, then you wouldn't want to bring your four year old because that's not something that they would be comfortable with,

spk_0:   47:11
or vice versa, half of being exactly okay. So the the fundamental message that I'm I hear from you and I find it so refreshing is that Children can and do heal from sexual abuse. And we, as parents, uh, can feel confident that we can learn how to be. And now I had to be an aid in this healing.

spk_1:   47:37
That's right. That's right. Children can and do heal. But it depends on what we do as adults,

spk_0:   47:45
which is empowering because that gives us power to help, as opposed to feeling helpless. Which I think that's part of the fear base and the leaning away bases is because you powerless.

spk_1:   47:58
Well, it's it's oftentimes very innocent, right? People don't want to do the wrong thing, huh? And so they're leading out because they're just not sure. Um, But if if we lead in together and compassionately and with firm boundaries in educated way Children, Children do get better and it's, um, it's as difficult as this work is. It's why I love it. Because if you surround the child with allies and just one anchor, it's amazing how quick recovery can happen. But it's not gonna happen if we don't have a confident, um uh, caregiver at

spk_0:   48:33
home. Yes, sir. A confident caregiver. So that's where we want our we won't be able to feel that the confidence that they can empower, change and hope healing in this job, you know,

spk_1:   48:47
expect difficulties and anticipate a response

spk_0:   48:51
is that my grandmother's ah, uh, hope for the expect the worst hope for the best and settle for anything in between. Let me pause for a moment and remind people that this show is brought to you by the support of our partner agencies, which are agencies that believe in our mission, preparing parents before adoption, in fostering and then supporting them throughout the journey and throughout a lifetime of their family. One such partner is Spence Chaff, and they are a license and accredited nonprofit organization in the New York City metro area that has been offering adoption. Service is more than 100 years. They are known for their robust post adoption service is, and they provide him to birth parents, adoptive parents and adoptees and and they continue to support all three members of the Triad throughout throughout throughout their lives. It's a great organization. Well, thank you so much, Dr Jennifer Shaw, for being with us today to talk about a topic that is an uncomfortable topic for others, but But I so appreciate your passion and your, um, your optimism on and I think it's well placed, and I truly appreciate the work that you do as well as the work that's being done at the Gill Institute. Let me remind everybody that the show's express that shows us the views expressed in this show are those of the guests do not necessarily reflect the position of creating a family, our partners or underwriters. Also keep in mind that the information given in this interview is general advice. To understand how it applies to your specific situation, you need to work with your adoption or foster care professional. Thank you for joining us today, and I will see everyone next week.