Childhood Trauma

1. Childhood Trauma Dan Powers, LCSW Children’s Advocacy Center of Collin County

2. Well, they have been pretty sunny days……

3. with clouds and rain

4. Effects of child abuse • fear • anxiety • depression • anger • hostility • inappropriate sexual behavior • poor self esteem • tendency toward substance abuse and • difficulty with close relationships Browne & Finkelhor, 1986

5. Clinical findings of adult victims of sexual abuse include problems in interpersonal relationships associated with an underlying mistrust. • Generally, adult victims of incest have a severely strained relationship with their parents that is marked by feelings of mistrust, fear, ambivalence, hatred, and betrayal. Tsai and Wagner, 1978.

6. Young girls who are forced to have sex are three times more likely to develop psychiatric disorders or abuse alcohol and drugs in adulthood, than girls who are not sexually abused. • Sexual abuse was also more strongly linked with substance abuse than with psychiatric disorders. • It was also suggested that sexual abuse may lead some girls to become sexually active at an earlier age. Kenneth S. Kendler, M.D., et al,

7. In the adult retrospective study • Victimization was reported by 27 percent of the women and 16 percent of the men. • The median age for the occurrence of reported abuse was 9.9 for boys and 9.6 for girls. • Victimization occurred before age eight for 22 percent of boys and for 23 percent of girls. • Source: Finkelhor et al., 1990.

8. In the adult retrospective study • Most of the abuse of both boys and girls was by offenders 10 or more years older than their victims. • Girls were more likely than boys to disclose the abuse. • Forty-two percent of the women and thirty-three percent of the men reported never having disclosed the experience to anyone. • Source: Finkelhor et al., 1990.

9. Kids who experience trauma Have their scope of the world change

10. Child Sexual Abuse • no universal definition • a central characteristic of any abuse is the dominant position of the perpetrator that allows him or her to force or coerce a child into sexual activity • may include any sexual contact or contact with sexual intent with a child. • is not solely restricted to physical contact; such abuse could include non-contact abuse, such as exposure, voyeurism, and child pornography

11. Myths and MisconceptionsAbout Child Sexual Abuse • The total stranger represents the greatest potential sexual abuse threat to a child • Sexual abuse occurs most frequently in low-socioeconomic, uneducated, non-white populations • Child sexual abuse is rare • Incest occurs only once per victim • Sexual Abuse is only committed by step-parents

12. The Issue • Every 10 seconds a child is abused • National Committee to Prevent Child abuse • Each day in the United States, more than 3 children die as a result of child abuse in the home • Childhelp USA • The Rate of Child Abuse is ten times the rate of cancer • A National Call to Action • Without intervention abused children are 67% more likely to be arrested as a teen • Child Welfare League of America

13. The Facts • The rate of child abuse is estimated to be 3 times greater than is reported. – probably more • 1 in 4 girls is sexually abused before the age of 18. • 1 in 6 boys is sexually abused before the age of 18. • 1 in 5 children are solicited sexually while on the internet. • Nearly 70% of all reported sexual assaults occur to children ages 17 and under. • An estimated 39 million survivors of childhood sexual abuse live in the US

14. The Facts • Abused kids are 25% more likely to experience teen pregnancy • Abused teens are 3 times less likely to practice safe sex.

15. The Facts • Kids who have been abused are 2.5 % more likely to abuse alcohol • 3.8% more likely to develop drug addictions • 2/3 of people in drug tretamen treport being abused as a child

16. The Facts • 14% of men in prison reported being abused as a child • 36% of women in prison report being abused as a child • Kids who have been abused are 30% mose likely to commit a violent crime

17. Sex Offenders Hurt Kids till they are Stopped! • Nearly 70% of child sex offenders have between 1 and 9 victims; at least 20% have 10 to 40 victims. • An child molester may have as many as 400 victims in his lifetime • The average male, adolescent sex offender could effect 380 victims during his lifetime, if not treated. Abel, G., Mittleman, M. and Baker, J. (1985)

18. 258 Million Cost of child abuse and neglect in United States per day Source: Prevent Child Abuse Texas

19. We Are Not in Kansas Anymore

20. We Are Not in Kansas Anymore The trauma appears as a whirlwind on the horizon of a child or adolescent’s life and turns their world abruptly upside down. The traumatic tornado engulfs reality, distorts reason, devours trust, fractures intimacy, twists emotions into knots, consumes self esteem and leaves the child in a disruptive aftermath that is choked in lies, half truths, manipulation and secrets

21. Are kids safe at home? • 30-40% of victims are abused by a family member. • Another 50% are abused by someone outside of the family whom they know. • Approximately 40% are abused by other kids. • Between 6 and 10% are abused by strangers

22. They are younger than you think • The median age for reported abuse is 9 years old. • More than 20% of children are sexually abused before the age of 8. • Force is used in nearly 50% of the time in children under 12

23. Most children don't tell, even if they have been asked • Over 30% of victims never disclose the experience to ANYONE. • Young victims may not recognize their victimization as sexual abuse. • Almost 80% initially deny abuse or are tentative in disclosing. • More than 20% eventually recant even though the abuse occurred. • False reports constitute only 1% to 4% of all reported cases.

24. Consequences • Family response (especially mom) to the abuse is one of the most important aspects of healing • Sexually abused children who keep it a secret or who "tell" and are not believed are at greater risk than the general population for psychological, emotional, social, and physical problems often lasting into adulthood. • Children who have been victims of sexual abuse are more likely to experience physical health problems and report more somatic complaints

25. Consequences Victims of child sexual abuse report: • more symptoms of PTSD, more sadness, and more school problems than non-victims. • are more likely to experience major depressive disorder as adults. • more likely to develop eating disorders as adolescents.

26. Consequences • Adolescents and adults who are abused in childhood are significantly more likely to drink alcohol and/or use illicit drugs than their peers. • Adolescents and adults who were victims of childhood maltreatment have been consistently found to be more likely to engage in high-risk sexual behaviors.

27. The Link Between Abuse As a Child & Future Criminal Behavior • 14.4% of all men in prison in the United States were abused as children • 36.7% of all women in prison report being abused as children • Children who experience child abuse & neglect are 59% more likely to be arrested as a juvenile, • 28% more likely to be arrested as an adult, and • 30% more likely to commit violent crime. US Department of Justice Reports

28. Sexual Consequences • Children who have been victims of sexual abuse exhibit long-term and more frequent behavioral problems, particularly inappropriate sexual behaviors. • Women who report childhood rape are 3 times more likely to become pregnant before age 18. • An estimated 60% of teen first pregnancies are preceded by experiences of molestation.

29. Physical Consequences • From bruises to death • Shaken Baby Syndrome • May not be immediately noticeable • May include brain, eye, spinal cord damage • Impaired Brain Development • Regions of the brain fail to develop • Cognitive, language and academic problems

30. Physical Consequences • Poor Physical Health • Relationship between abuse/neglect and poor health • Allergies, high blood pressure, arthritis, asthma have all been linked to childhood household dysfuction

31. Psychological Consequences • Immediate • Isolation • Fear • Inability to Trust • Could lead to life long consequences

32. Psychological Consequences • Infancy • Depression and withdrawal have been observed in children as young as 3 • Brain development issues

33. Psychological Consequences • Poor mental / emotional health • 80% of young adults who have been abused met the criteria for at least 1 psychiatric disorder. • Depression • Anxiety • Suicide attempts Silverman, Reinherz and Giaconia, 1996

34. Psychological Consequences • MORE • Panic disorder • Dissociative disorder • ADD/ ADHD • PTSD • Attachment disorders Teicher, 2000; De Bellis and Thomas 2003

35. Psychological Consequences • Cognitive Difficulties • Children placed out of the home scored lower in areas of cognitive capacity, language development ad academic achievement US Dept. Health and Human Services, 2003

36. Psychological Consequences • Cognitive Difficulties • Relationship between poor academic performance and classroom functioning and child maltreatment Zolotor, Kotch, Dufort, Winsor and Catellier 1999

37. Psychological Consequences • Social Difficulties • Children who experience rejection or neglect are more likely to develop antisocial traits • Parental neglect is also associated with borderline P/O and violent behavior Schore, 2003

38. Behavioral Consequences • Kids who have experienced abuse are found have behavioral problems twice the rate of kids who have not.

39. Behavioral Consequences • Adolescence • Kids who have been abused/neglected are 25% more likely to have problems such as delinquency, teen pregnancy, low academic performance, drug use and mental health problems. Kelly, Thornberry and Smith 1997

40. Behavioral Consequences • Adolescence • They are more likely to engage in sexual risk taking Johnson, Rew and Sternglanz, 2006

41. Behavioral Consequences • Juvenile Delinquency and Adult Criminal Behavior • Abused/neglected kids are 11 time more likely to be arrested as a juvenile and 2.7 times more likely to be arrested for violent and criminal behavior as a adult (National Institute of Justice)

42. Behavioral Consequences • Alcohol and Drugs • National Institute on Drug Abuse report: • 2/3 of people in drug treatment report being abused a s a child

43. Behavioral Consequences • Abusive Behavior • 1/3 of abused and neglected children will eventually abuse their own children Prevent Child Abuse America, 2003

44. THERAPY WITH CHILDREN INVOLVES • Providing a safe place for the child and establishing a relationship • Going at a pace that is set by the child and working within the child’s system • Confidentiality • Processing the thoughts, feelings, and behaviors that result from the trauma

45. Treatment Issues Require • Extensive training and experience in child abuse and family violence • Treatment professionals who specialize in this field • Coordination of treatment services for victims and their families

46. Treatment Issues Require • Coordination of efforts and sharing of information between CPS Investigators, Law Enforcement, Medical, Prosecutors, Therapists and other professionals • Understanding of the legal process and its impact on the victim and family

47. HOPE

48. Dan Powers, LCSW Sr. VP, Clinical and Administrative Services Children’s Advocacy Center of Collin County Dpowers@caccollincounty.org 972-633-6615