Family therapy gives family members a
safe place to talk about their feelings. Having an outside person facilitate the conversation is helpful. The therapist can point out certain ways of communicating that are not effective and can informally teach
communication skills. Family therapy can help
families talk about what is important to them, resolve conflict, and increase understanding and empathy. If the therapy process feels safe, families can be open and honest, communciate their wants and needs to one another, and learn again how to trust.
Bringing the whole family into therapy provides an opportunity for them to talk about the
sexual abuse and communicate their feelings to one another. Professionals do not always prioritize
siblings, and sometimes
mothers do not want siblings involved in the therapeutic process. The inclusion of siblings is important because:
- Sometimes they knew about the abuse and have been holding the secret.
- They may feel guilty and responsible for the abuse continuing.
- They are afraid of what is happening to their family and what the future holds.
- They may be angry at the victim, the perpetrator, and the mother for not preventing or stopping the abuse.
- They may have been abused and never disclosed.
- They may know of others who have been abused.
- Therapy may have coped with the knowledge of the abuse by isolating, withdrawing from the family, or escaping into self-destructive habits. They need counseling help and assistance in their recovery process.
Support groups, therapy groups, parent groups, and individual family and multi-family therapy groups have all been utilized as interventions with mothers of sexually abused children. Individual sessions are also beneficial to a mother following disclosure as they allow her to focus on anxiety, depression, and other emotional reactions and deal with issues surrounding her secondary victimization.
Groups are effective with mothers because they provide a sense of belonging. This reduces the isolation that is normally felt. Being with other women who have survived this process gives mothers hope that they can survive. Groups provide comfort, practical help, and a new social network. Groups help mothers rebuild their self-esteem, increase problem-solving skills, process through anger, learn new coping skills, and practice assertiveness.
Agencies offering multiple family services are most effective. All members of the family need counseling, both individual and as a family unit, in order to reduce short and long-term consequences of the abuse. If the father figure is not the perpetrator, counseling services may look like the following:
- Parent and marital counseling - mother and father
- Sibling sessions - Siblings with and without the victim(s)
- Whole family sessions
- Parent and victim
- Individual sessions for all family members
- Extended family members, as appropriate
If the father is the perpetrator, then services will differ. The perpetrator is not appropriate to include in therapy until after adjudication and treatment if reunification is an option and if the family chooses this option. This is a difficult and complex decision. Many risks are present if the perpetrator is to re-enter the home at any time in the future. Safety precautions will have to be in place. Trust is not an option.
If reunification efforts occur, the victim must be willing for this to occur - without pressure from any family member. She may not be willing as long as she is at home. If her choice is not honored in this, life-long consequences can occur to the victim and to trust relationships within the family. Presuming that reunification is a goal:
- The perpetrator would have completed sex offender treatment and be rated a low risk by treatment providers.
- The perpetrator would be willing for safety and accountability to be in place.
- Issues would be discussed in family counseling in thorough detail, with practice scenarios and "if, then ______________" problem-solving and decision-making.
- House rules would be formulated, discussed, and contracted. These would include general house rules, physical touch and physical affection rules, bedroom rules, bathroom rules, internet rules, and rules about secrets.
- Safety plans would be in place.
In addition to the above family-focused services, family members should have the option to attend victim groups, parent groups, and sibling groups. Child sexual abuse affects all members of the family. The focus is typically on the offender and the victim. Many families do not have the option of receiving the services above, either because they are not available or because families cannot afford them. Victim's funds are available through the Coordinator of Victim Services in local courts. This may be an adjunct service of the Office of the District Attorney. Funds for services for other family members may also be available.