The aim of this study is to contribute to the understanding the interaction between the emotionally destructive intensity of the trauma and forces that foster growth in therapists who treat sexually abused children. Data were collected through in-depth semistructured interviews with 14 experienced social workers. Content analysis reveals two emotional poles. At one pole, the dominant experiences are anxiety, turmoil, and intrusion that disrupted the order in the interviewee's secure world. At the opposing pole, the dominant experiences are positive, such as hope and faith. These formed the basis of empowering meaning construction that engendered a sense of control, enabling the therapists to trust the value of intervention with sexually abused children. The discussion uses a dialectical perspective to examine how interaction between these two poles enhances our understanding of the emotional and existential threats inherent in working with children who have experienced sexual abuse and on the potential for positive change.
A variety of theoretical approaches, from the individual to ecological levels, was applied to the following clinical case in order to understand why a five-year-old boy demonstrated sexual behavior. Inappropriate sexual behavior in children is presented as symptomatic of problems in intrapersonal and interpersonal boundaries, relationship capabilities, and superego consolidation. The case material emphasizes that only when the child is helped to stop his sexual acting out can he access the sources of his emotional distress. The theoretical underpinnings that are relevant to this case will be shown as instrumental in the therapy of this child and his family. By integrating theory with practice, we hope to highlight this sensitive and prevalent issue as well as aid in the early identification and treatment of sexually problematic behavior.
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