1. Conflicted Loyalties: Working with Families where Sibling Incest has Occurred
Presented by:
Kevin Wade, LCSW-C

2. Presentation Objectives
Defining sexual abuse/sibling incest
Characteristics of families
Roles of family members
Treatment
Case Studies

3. CHILD SEXUAL ABUSE
Child sexual abuse is when an adult, adolescent, or older child partakes in any sexual activity with a child, either through the use of force and coercion or charm or persuasion
20% of girls and 10% of boys have been a victim of sexual abuse prior to 18
Discuss the what is child sexual abuse article- areas highlighted

4. Sibling Incest
Research has shown that 60% of outpatient psychiatric patients report having engaged in sibling incest
Typically age difference of about 5 years
Misrepresentation of facts, aggression, and threats
Produces fear and anxiety in the victim
Discuss developmental differences and knowledge about sex

5. Characteristics of Families
Non-protective home environment
Poor boundaries with little regard for physical and emotional space or individual needs for privacy
Physical or emotional absence of one or both parents
Frequent unresolved issues
Poor communication avenues for children
Trauma

6. Family Characteristics
Poor conflict resolution
Isolation from the community
Role confusion
Trauma

7. ROLES Everyone in the family plays a role- system issue
We must recognize the choice
Determining what those roles are will promote healthy system recovery
Recognizing the roles pre and post disclosure

8. ROLES Mother and her trauma
Offender used the roles of the family to offend
3 things exist for an offense to occur

9. Juvenile Offender Categories
Naïve experimenters
Under-socialized child exploiters
Sexual aggressive
Sexual compulsives
Disturbed impulsive
Group influenced
Pseudo socialized

10. Juvenile Offender Categories
Important to identify for treatment and system health
Three paths:
Dead end
Delinquency path
Sex interest path involving further sex offending

11. TREATMENT for JUVENILES WHO HAVE COMMITTED SEXUAL OFFENSES
Containment Treatment:
Integrated, inclusive and thorough participation of the multi-disciplinary treatment team, community, and family members
Effective with equal balance of authority and nurture
Emphasis on accountability and establishing community safety

12. TREATMENT for JUVENILES WHO HAVE COMMITTED SEXUAL OFFENSES
Cognitive Behavioral Component:
Thoughts
Feelings
Behaviors

13. TREATMENT for JUVENILES WHO HAVE COMMITTED SEXUAL OFFENSES
Relapse Prevention Model:
Identification of the chain of events or sequence which comes prior to an offense
Cycle of abuse

14. Cycle of Abuse Triggers/event PMS Isolation/withdraw Fantasy/planning
Power and control- getting the “juice”
Offense
Transitory guilt
Denial and justification

15. Common Issues and Problems Faced by Incest Survivors
Anxiety
Depression
Low self-esteem
Shame and guilt
Inability to trust
Fear of feelings
Nightmares
Insomnia

16. Common Issues and Problems Faced by Incest Survivors
Amnesia
Violence
Discomfort with touch
Compulsive sexual activity
Overachievement/underachievement
Eating disorders

17. Case Studies
Joe and Carol
Jasmine and Cody