1. Together we can prevent child sexual abuse Safeguarding Londons Children The annual conference of the London Safeguarding Children Board Meeting the therapeutic and recovery needs of sexually abused children Tink Palmer Director Stop it Now! UK & Ireland 13 th December, 2007

2. Together we can prevent child sexual abuse Key issue SOCIETYS CONSPIRACY OF SILENCE The triangular gridlock

3. Together we can prevent child sexual abuse Gridlock Parent/carer Abuser Abused child

4. Together we can prevent child sexual abuse A childs message Its not so much what was done to me but what it did to me

5. Together we can prevent child sexual abuse Facts Children who are victims of sexual abuse are rarely able to tell because they are silenced by their abuser, who may make the child believe he/she invited the abuse, may threaten or use violence towards the child or make threats about someone close to the child to intimidate him/her.

6. Together we can prevent child sexual abuse Facts Adult survivors report that the majority of them did not disclose as children and thus most sexually abusive behaviour remains hidden. This means there are 1000s of children within our society who are being sexually abused and are unable to tell us.

7. Together we can prevent child sexual abuse Facts Over 95% of allegations of sexual abuse made by children do not achieve convictions. Sexual abuse may have long-term harmful effects on a child, but early detection with appropriate support and counselling may eliminate such effects. Child victims of sexual abuse are not an homogenous group. They each have their individual needs which must be addressed and they have their individual views regarding what should happen to their abuser.

8. Together we can prevent child sexual abuse Facts Child sexual abuse takes many forms and may not be an isolated activity Intra-familial Inter-familial Extra-familial Abuse through prostitution Abuse through trafficking Abuse via the new technology Joined up thinking!

9. Together we can prevent child sexual abuse When does therapy begin? Therapy is not an event, it is a process Pre –disclosure Disclosure Investigation Post investigation Witness experience Post witness experience

10. Together we can prevent child sexual abuse Therapy in isolation? Who else needs to be involved? Parents/carers Other family members Siblings Significant adults in the childs life Why do they need to be involved?

11. Together we can prevent child sexual abuse Disclosure – a rare occurrence Child may tell – rarely Confidante may tell Abuse may be witnessed by A.N. Other Child displays concerning behaviours the aetiology of which is investigated The image of the child is discovered

12. Together we can prevent child sexual abuse For disclosure we need: A culture that will hear children One which listens to and hears what children are trying to say This has implications regarding the myths that abound in society regarding CSA Children will try to talk about an experience which is out of context for their age and development They dont have the adult terminology They will be scared and frightened

13. Together we can prevent child sexual abuse For disclosure we need A culture that will hear children cont. The younger the child the less likely they are to be heard Why? Because they tell their story differently How do they tell their story? Why? Their receptive language and understanding is much more developed than their expressive language

14. Together we can prevent child sexual abuse For disclosure we need A legal framework that will: - offer protection to the child - actively pursue the alleged perpetrator through the criminal justice system & offer appropriate assessment and intervention programmes - reflect the differential needs of child witnesses What else might a legal framework offer? Why does there need to be change?

15. Together we can prevent child sexual abuse In the aftermath of disclosure the child needs: To feel believed To be in a safe place To be protected from contact with the perpetrator To be offered therapy To be supported through the process of being a witness

16. Together we can prevent child sexual abuse Therapy – what does this involve? 1.Helping the child make sense of what has happened to him/her by Addressing the impact issues Addressing the resultant behavioural issues Working with the child on core issues Never under-estimate the impact of disclosure

17. Together we can prevent child sexual abuse Outcome predictors Nature of the abuse Length of time the abuse has occurred Perpetrators relationship with the child Nature of the grooming process Resilience of the child

18. Together we can prevent child sexual abuse What are the impact issues? Damaged goods syndrome Guilt, fear, depression, low self esteem, poor social skills Repressed anger and hostility, inability to trust Blurred role boundaries and role confusion Pseudo-maturity and failure to complete developmental tasks – nb. Recent research on trauma in childhood Lack of mastery and control, cognitive confusion Grief

19. Together we can prevent child sexual abuse What are the resultant behavioural issues? Acting aggressively, breaking rules/breaking the law, Compulsive masturbation/sexual acting out Eating disorders, running away, attempts at suicide Withdrawn/isolated, self mutilation, unfeeling/denying emotions, sleeping problems, flashbacks Lack of memories of parts of life Lack of trust Inability to make relationships

20. Together we can prevent child sexual abuse Working with the child therapeutically Planning process Confidentiality – what will happen if…… Recognising that disclosure is also a process Consistency Pre-trial therapy?

21. Together we can prevent child sexual abuse Working with the child therapeutically Key aspects of the work: Perception of safety Expression and ventilation of feelings Empowerment Sex education Education about sexual offending Guilt, trust and ambivalence Assertiveness and communication skills Wishes and fears for the future

22. Together we can prevent child sexual abuse Pre-trial therapy Issues: For law enforcement – police, CPS and courts Evidence will be tainted and prosecution lost – lack of understanding regarding the therapeutic process For therapists The unique and confidential nature of the work will be jeopardised

23. Together we can prevent child sexual abuse How are these issues overcome? Working protocol Disclosure of files

24. Together we can prevent child sexual abuse Witness preparation Aims – educate, address fears & reduce anxiety Components of witness preparation – assessment, education, enhancement of ability to testify and emotional resilience, involvement of childs carers, liaison, debriefing Preparing the child for the possible outcome – the defendant may plead guilty at the last moment, may change the plea, the hearing may be postponed, the defendant may be found not guilty or the defendant may be found guilty, but sentences can vary and cannot be reliably predicted.

25. Together we can prevent child sexual abuse Secondary victimisation of carers Carers need: Support in coming to terms with their childs disclosure Education - regarding modus operandi of offenders - regarding the impact of sexual abuse on the child and the possible resultant behaviour

26. Together we can prevent child sexual abuse Secondary victimisation of carers cont... - regarding the impact of the perpetrators modus operandi on the carers themselves Personal support, due to the possibility of issues from their own past being re-stimulated Dont forget the other children in the family

27. Together we can prevent child sexual abuse The new technology as a conduit of abuse Children who view adult pornography Children abused through prostitution using the Internet and mobile phones to contact their abusers Adults or young people who engage in cyber sex with children

28. Together we can prevent child sexual abuse The new technology as a conduit of abuse Children of adults who download or distribute sexually abusive images of children Children groomed online for sexual abuse offline Children sold online for sexual abuse offline

29. Together we can prevent child sexual abuse The new technology as a conduit of abuse Young people who place images of other young people online Children who download sexually abusive images of children Children sold online for live sexual abuse online Children made the subject of child abuse images

30. Together we can prevent child sexual abuse The impact on child victims when images of their abuse are placed on the Internet Very little research to date: Burgess et al, 1984, Pornography and Sex Rings Silbert, 1989, Pornography and Child Prostitution Svedin & Back, 1996, Pornography and Intra- Extra Familial Abuse Scott, 2001, Pornography and Ritual Abuse

31. Together we can prevent child sexual abuse From discovery to recovery Discovery Identification Disclosure Investigation Assessment Therapeutic intervention Witness experience

32. Together we can prevent child sexual abuse Discovery Proof of abuse Proof of activity Proof of distress What are we doing about it? Identification? Should we leave well alone? Hidden nature of sexual abuse Lasting impacts Children are not going to tell us We must go out and seek them

33. Together we can prevent child sexual abuse Disclosure by discovery Being seen to let it happen Looking happy about it Thinking its normal Not stopping it Letting it happen to other children Group secrecy – group responsibility Humiliation: who has seen the picture? do they recognise me? No control of the process of disclosure The secret between victim and perpetrator becomes the most open secret

34. Together we can prevent child sexual abuse New issues Police and social worker have access to exactly what has happened to the child via the abusive images This differs significantly from any other form of police/social worker interviews of child victims Children limit disclosure – telling people only what they think they know The child is often so silenced that he/she cannot admit what has happened even when confronted with the evidence

35. Together we can prevent child sexual abuse New issues Is it always necessary to interview the child for evidential purposes? In what circumstances might it not be necessary? Number of interviews Use of audio/video equipment Who are the adults and children that live in the home where the abuse occurred? Have they been involved? What do they know? Understanding such issues becomes more important due to the new images that are being discovered Implications for therapy - Impotence regarding disclosure, shame, responsibility and non resolution of the abuse

36. Together we can prevent child sexual abuse Prevention – Stop it Now! It is a public information and awareness raising campaign regarding sexual abuse. It aims to prevent the sexual abuse of children by - Giving accurate information - Shifting existing beliefs - Motivating positive actions

37. Together we can prevent child sexual abuse Prevention – Stop it Now! Targets: Adult abusers and potential abusers: to encourage them to recognise their behaviour as abusive and seek help to change. Family and friends: to encourage them to recognise the signs of abusive behaviour in those close to them and to seek advice about what action to take. Parents of young people with sexually worrying behaviour: to encourage them to recognise signs of abusive behaviour in their children and seek advice about what to do.

38. Together we can prevent child sexual abuse Prevention – Stop it Now! Shift existing beliefs Adults are helpless to do anything Sex offenders are monsters Reliance on children to complain Messages Abusers are people we know/care about We are in a unique position to stop them 30-50% of abusers are children/adolescents Effective self control is possible via intervention All adults have a responsibility to work together to stop the sexual abuse of children. Motivate Positive Actions Change of attitudes and beliefs is not enough Adults need skills to set clear sexual boundaries Stop it Now! Helpline can be called Clear accessible help/resources are available Adults / adolescents can seek help and/or self report to the authorities

39. Together we can prevent child sexual abuse Prevention – Stop it Now! Imagine…………

40. Together we can prevent child sexual abuse The End Tink Palmer Director Stop it Now! UK & Ireland