Treating Victims of Child Sexual Abuse

Abstract

is a 9-year old girl, currently in third grade. She lives with her mother ("Ms. B") and her 14-year-old brother. At a recent visit to the pediatrician for a wellchild appointment, Anna refused to remove her clothes and became extremely agitated when the physician started to examine her. She started crying and disclosed that her stepfather had been "hurting" her. On further inquiry, she said that he had been forcing her to engage in "sex stuff." Ms. B was visibly shaken and distressed by the disclosure, stating that she had no idea this had happened. She did acknowledge that she and her husband had been experiencing marital problems, which resulted in his moving out of the home temporarily about 6 months ago, but she was still seeing him, and he was still at the house frequently. Ms. B did not understand how this could have happened since she rarely left her children alone with her husband. Furthermore, she said that she and Anna have a very close relationship and that Anna would have shared this if it had occurred. Since Anna was extremely upset after her disclosure and Ms. B was having difficulty believing the allegations, the pediatrician recommended a referral to the local Child Advocacy Center (CAC) for a medical examination and forensic interview. CACs provide a safe, child-focused environment and include a multidisciplinary team of professionals, comprising medical, mental health, law enforcement, prosecution, child protective services, victim advocacy, and school personnel, who work together to coordinate services for children. In addition to providing medical evaluations and forensic interviews after abuse disclosures, CACs offer therapy and medical examinations, courtroom preparation, victim advocacy, and ongoing case management.