Including Siblings in the Treatment of Child Sexual Abuse

Abstract

Siblings are often not included in treatment programs for children who have been sexually abused. This article describes the necessity of including siblings in the treatment of victims of child sexual abuse. Including siblings in treatment permits families to realize the maximum benefits of therapy for the victim as well as each family member. Theoretical and practical reasons to include siblings in treatment are discussed (i.e., preventing future abuse, providing support for siblings, teaching siblings to refrain from victim-blaming). Case examples using a Juanita N. Baker, PhD, is

Interventions for families victimized by child sexual abuse: Clinical issues and approaches for child advocacy center-based services

“…Not surprisingly, siblings are not immune to the many changes that commonly take place following disclosure of CSA. Siblings may face several adverse effects, including: psychological distress of having viewed or known of the abuse; greater risk of victimization; change in family dynamics; change of residence; change of school districts; loss of friends; increased feelings of isolation, shame, and stigma; and reduced family income (e.g., Baker et al, 2001;Swenson & Hanson, 1998). The level of parental and peer support for the non-abused sibling, as well as their own psychological functioning following disclosure of CSA by the victim, may warrant the need for psychologi-cal services.…”

“…The level of parental and peer support for the non-abused sibling, as well as their own psychological functioning following disclosure of CSA by the victim, may warrant the need for psychologi-cal services. Additionally, as parental support of the child victim has been shown to be of great importance to the child's functioning, so too is the support of siblings (Baker et al, 2001).…”

“…Intrafamilial CSA may include additional difficulties for family members, such as blurred boundaries and greater isolation from their communities. However, siblings of victims of extrafamilial CSA may also experience significant distress (e.g., feelings of isolation and stigma, confusion due to lack of information, distress due to involvement in the investigation, limited attention from parents and professionals who need to be attentive to the child victim; Baker et al, 2001;Grosz et al, 1999). As noted for child victims and non-offending caregivers, crisis interventions for non-abused siblings are also markedly limited.…”

“…According to Baker et al (2001), including siblings in treatment permits the family to realize the maximum benefits of therapy for the victim and also for each family member. In addition, the increased risk of victimization for siblings may warrant the need to monitor sibling interactions, as well as educate siblings about sexual abuse and prevention skills (Baker et al, 2001).…”

“…There is increasing documentation that child and adolescent victims of sexual abuse and their non-offending parents and siblings are in need of mental health services (e.g., Baker, Tanis, & Rice, 2001;Heflin, Deblinger, & Fisher, 2000;Putnam, 2003;Swenson & Hanson, 1998). In the aftermath of CSA, families often face multiple challenges (e.g., loss of income, loss of a caregiver, change of residence, and limited community support) that are often accompanied by psychological distress, such as depression, guilt, embarrassment, grief symptomatology, and secondary trauma (e.g., Deblinger, Hathaway, Lippman, & Steer, 1993;Manion et al, 1996;Regehr, 1990).…”