Examining treatment options for child sexual abuse and new developments in the field – focusing on play therapy as a new form of treatment.
The paper defines child sexual abuse (CSA), its history, and treatment options. It also discusses several therapeutic models, specifically focusing on individual play therapy with children who have been traumatized by sexual abuse. Several theoretical frameworks in relation to play therapy are mentioned including Rogerian, cognitive-behavioral, developmental, and psychodynamic approaches. The diagnosis and assessment are discussed using projective techniques such as drawings and stories, and treatment goals are suggested through the use of a play therapy model. Last, the paper concludes with a case study, a tripartite crisis assessment, techniques and items to utilize in therapy and prognosis.
“Child sexual abuse (CSA) is one form of child maltreatment that may indeed be the most devastating, and may occur in the context of other forms of child maltreatment such as physical abuse, emotional abuse, and neglect. In fact, CSA may also be considered a form of emotional abuse in that, “sexual abuse is among the most potentially damaging sources of emotional distress in young children” (Gallo-Lopez, 2000, p.269). CSA has been defined differently within legal, medical, and social contexts. For the purposes of this paper, CSA in general is defined as: “contact or interaction between a child and an adult when the child is being used for the sexual stimulation of the perpetrator or another person. Sexual abuse may also be committed by a person under the age of 18 when that person is significantly older than the victim or when the perpetrator is in a position of power or control over another child” (Wurtele & Miller-Perrin, 1992, p. 5). The sexual abuse and exploitation of children is not a new phenomenon. Within ancient times, “using children as sex objects was not only accepted but often encouraged by adults” and “participating in sexual activities with adults was not seen as wrong or harmful but as appropriate and even healthy for children” (Wurtele & Miller-Perrin, 1992, p.1). Glaser & Frosh (1993) suggest that “accusations of sexual abuse originating from children were interpreted either as maliciousness, or more commonly, as the product of the child’s fantasy life (ix, Introduction). During the Victorian Era, Freud started finding sexual abuse frequently among his psychologically troubled patients. However, doubting that incest could be that common, he concluded that the reported sexual activity had probably not really happened but was a fantasy connected with the developmentally important attraction that naturally occurs between daughter and father or son and mother. Freud’s Oedipus Complex and the Electra Complex, originally termed seduction theory, was a widely accepted explanation of neurosis and hysteria during the 19th century (Thorman, 1983; Finkelhor, 1984).