Supporting Victims of Child Sexual Abuse in Singapore by qnl49935

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									Supporting Victims of Child
Sexual Abuse in Singapore



      Symposium on Support for Victims of Crime in the Asian
      Region
      25-26 May 2005
      Orchard Hotel Singapore

      Karen Sik
      Senior Psychologist BA (SFU) MClinPsy (UQ)
      Psychological Services Unit
      Ministry of Community Development Youth and Sports
      karen_sik@mcys.gov.sg




Children and Young Persons Act

• Provides legal protection for children below the
  age of 14 years as well as for young persons
  between ages 14 to 16.
• Amendments have been made (Oct 2001) to
  include parents or guardians mandated by the
  Court to attend treatment intervention
  programmes.




                                                               1
MCYS

• Key agency in providing care and protection of
  children from abuse and neglect.
• MCYS works in partnership with government and
  non-government agencies in the prevention and
  care of child victims of abuse.
• The Child Protection Team of MCYS ascertains if
  a child is a victim of abuse and the safety and
  welfare needs are discussed by a multi-
  disciplinary team of professionals (CAPT).




Stats 2005

• Total child abuse cases investigated: 158
• Out of 158, 87 were found with evidence of abuse
• Out of 87, 30 cases were found to be cases of
  sexual abuse




                                                     2
Early Intervention

• MCYS and other agencies establish a clear system of
  reporting and referral.
• Training for child care workers, police, teachers and social
  workers from other agencies to help them recognize signs
  of sexual abuse.
• Investigative interviewing techniques training
• Joint interviews




Support Services

• Voluntary or Court-mandated
• Includes case management, Counselling
  Intervention Unit and Psychological Services Unit,
  psychiatry, fostering services, Enable a Family
  Volunteer scheme, Family Group Conferencing,
  etc.




                                                                 3
Psychological Services Unit

• PSU within MCYS offers a range of specialized
  individual and group programmes for victims, non
  offending carers as well as perpetrators of abuse.
• Includes Positive parenting programme (Triple P),
  sexual abuse intervention groups (R4Kids, RES,
  CRES), Positive Adolescent Sexuality Treatment
  program.




Impact of sexual abuse

• Initial effects include fear, anxiety, depression,
  anger and hostility, aggression and sexually
  inappropriate behaviour
• Long term effects include depression, self-
  destructive behaviour, anxiety, feelings of isolation
  and stigma, poor self-esteem, difficulty in trusting
  others, substance abuse and sexual
  maladjustment. (Browne & Finkelhor, 1986)




                                                          4
Therapeutic Group Programmes for
Sexual Abuse Victims

• Recovery for Kids (R4kids)
• Recovery and Empowerment for Survivors of
  Sexual Abuse (RES)
• Carers Recovery and Support (CRES)




Therapeutic Group Programmes for
Sexual Abuse Victims

• Adapted from a number of well-validated
  programmes developed in the US
• Various techniques include didactic teaching,
  expressive therapy, interactive group discussions,
  therapeutic games/ activities, role plays, take
  home exercises.




                                                       5
Therapeutic Group Programmes for
Sexual Abuse Victims

• Screen for motivation to join group
• Exclusion criteria includes low intellectual
  functioning
• Amount of sharing is determined by
  participants
• Start with psychoeducation




Therapeutic Group Programmes for
Sexual Abuse Victims

•   RES        - 12 two-hour weekly sessions
•   R4Kids - 11 one and a half-hour weekly sessions
•   CRES - 8 two-hour weekly sessions
•   3 month follow-up
•   8-10 participants
•   2 facilitators




                                                      6
RES

• A systematic group programme for adolescents
  (ages 12-16) with a history of sexual abuse.
• To provide them with the necessary understanding
  of the possible effects of sexual abuse and
  essential skills to cope with the related emotions,
  thoughts, and behaviour.




RES

1.   Introduction
2.   Self-care and self-soothing
3.   Safety
4.   Understanding sexual abuse and trauma
5.   Sexual abuse and the family
6.   Sharing what happened to me
7.   Managing strong negative feelings




                                                        7
RES

8. Dealing with guilt, shame and loss
9. Managing destructive behaviours
10. Relationships
11. Boundaries, intimacy and trust
12. Decisions




Observations

• Many participants revealed that it was the first
  time they had a chance to discuss the sexual
  abuse.
• Check-in time was valuable
• Theme of self-harm
• Those who had support from mothers fared better
  than those who did not receive support.




                                                     8
Observations

• Difficulty in sharing about details of what
  happened. Expressed better in other forms e.g.
  writing, drawings
• Requests for mothers to receive help to
  understand them better




R4kids

• A systematic group programme for children (below
  12) with a history of sexual abuse.
• To provide them with the necessary understanding
  of the possible effects of sexual abuse and
  essential skills to cope with the related emotions,
  thoughts, and behaviour.




                                                        9
R4kids

1.    I am special
2.    What are feelings
3.    Sharing feelings
4.    Learning about our bodies
5.    Learning about touches
6.    Let’s talk about taking care of myself (X2)
7.    Talking about what happened to me
8.    Let’s talk about not-ok touches
9.    Let’s talk about dealing with feelings
10.   Saying goodbye




Observations

• More child management issues during sessions
• Unaccustomed to the idea of talking about
  themselves and their feelings
• Conflicted emotions with regard to the perpetrator
• Ambivalent about their decision to disclose




                                                       10
CRES

• A systematic group programme for non-offending
  parents and caregivers of children and
  adolescents who have experienced sexual abuse.
• Best suited for those in the RES and R4kids
  programme.




CRES

• To provide them with:
  (a) the necessary understanding of their child’s
  experience
  (b) essential skills to enable them to help their
  child as well as themselves
  (c) cope with the related emotions, thoughts and
  behaviours, and
  (d) knowledge and practical skills to prevent future
  sexual abuse.




                                                         11
CRES

1.   Understanding child sexual abuse
2.   Understanding the impact of sexual abuse
3.   Talking about sexual abuse to your child
4.   Coping with feelings
5.   Sharing what happened and family issues
6.   Prevention, sex education and assertiveness
7.   Coping with stress and grief
8.   Review




Observations

• Many questions during the first session
• Experienced conflicted feelings about the
  perpetrator and feelings of self-blame.
• Many perceived themselves to be supportive of their
  children but some children did not share that
  perception.
• Many had questions about how to show more
  support to children




                                                        12
Observations

• Most were uncomfortable about providing sex
  education to their children.
• Feelings of guilt for not having protected their child.
• Fears of relatives and neighbours knowing.
• Forming a support group amongst participants




Conclusion

•   Overall similarities in presentation
•   Importance of support at early stage of disclosure
•   Support for non-offending carers
•   Treatment outcome studies




                                                            13
Thank you




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