INTERVENTIONS IN WORKING WITH LATINO CHILD SEXUAL ABUSE SURVIVORS

1. INTERVENTIONS IN WORKING WITH LATINO CHILD SEXUAL ABUSE SURVIVORS Diana Garza Louis, LPC-S, LMFT-S, LSOTP-S, RPT Rio Grande Counseling Center dglouis@aol.com

2. CSA and Latinos • Latinos are less likely to seek mental health interventions. • Non-Latinos tend to report that nothing happened when they disclosed abuse. • Latinos report that child sexual abuse is more serious than non-latinos, possibly indicating that attitudes toward sexual abuse leads to more action taken by Latinos. • Latinos report more abuse by extended family members. Clinical studies indicate that relatives are more likely to sexually abuse Latinos than White or Black children. • The most likely family perpetrator was a brother. • Other studies indicate that step fathers are the most likely to molest within the family. • Carrasco & Garza Louis • “Amor afiliativo”, “entenada“ (Rolando Diaz Loving)

3. Cultural Issues: • Virginity • a woman who loses her virginity to rape, incest, or molestation is seen as a “promiscuous” woman.  • If there was no penetration, then she’s alright, (nothing serious happened) • Guilt • Respect for cultural norms, but educate regarding responsibility • Fear of the legal system • Family loyalty and privacy • Warmth • Psycho-education as a starting point

4. TF-CBT Is a structured, directive & active model of treatment Safety Education Activity Disclosure Externalization Trust and letting go

5. SAFETY • Physical • Emotional • Hyper-vigilance • Self care/calm • Need for medication • Risk of suicide

6. EDUCATION NCTSNNationalChild Traumatic Stress Network http://www.nctsn.org/resources/audiences American Academy of Child and Adolescent Psychiatry http://www.aacap.org/cs/root/facts_for_families US. Department of Health and Human Services www.childwelfare.gov/pubs/trauma

7. Activity • Free play • Puppets • Stories • Worksheets/exercises • Abuse prevention

8. RELAXATION • Breathing • Progressive relaxation • Reading: poetry, rhyme, guided imagery • Yoga, drumming, tapping • Music: Listening, singing, natural sounds, rhythym Gaskill & CTA, 2008

9. SELF REGULATION • Signs of stress • My body and stress • Stress management game • Problem scenarios Crisci, Lay, Lowenstein, 1998

10. SENSORY STIMULATION • Sand tray, clay, play dough • Ceramics, sculpture • Songs, stories, music • Painting and coloring • Rituals, routines • Connecting • Closure Gaskill & CTA, 2008

11. Processing Information My Story Paper dolls Brave bears Mi Historia Muñecos de papel • Crisci, Lay, Lowenstein, 1998

12. DISCLOSURE • Identify triggers and reminders • Drawing the abuse • Puppets • Narrative • Role play • Telling others • My story • Brave Little Bears Crisci, Lay, Lowenstein, 1998

13. Stories And The Narrative Of The Traumatic Experience • Teach us through archetypes • Help us learn how the world works • Help us understand good and bad through narrative • Helps with Gestalt sequencing • Builds a representation of reality Gaskill & CTA, 2008

14. EXTERNALIZING Integration of traumatic experiences • Express discomfort in various situations • Define Limits • Eliminate secrets • Confront the perpetrator (when and if appropriate)

15. TRUST AND LETTING GO Relational Re-connection • Mom and I • Who Can Help Me? • What Will They Say? • Kids Without Guilt Crisci, Lay, Lowenstein, 1998

16. RECOVERY • Memory • Level of affect and tolerance • Symptom management • Grounded • Safe • Appropriate reality testing • Improved self esteem • Attachment • Mutual non-exploitive relationships • Meaning & interpretation

17. References Arroyo, Judith A.; Simpson, Tracy L.; Aragon, Alfredo S. (1997) Childhood sexual abuse among Hispanic and non-Hispanic White college women Hispanic Journal of Behavioral Sciences, February. Bratton, S., Ray, D. & Rhine, T. (2005) The efficacy of play therapy with children: A meta-analytic review of treatment outcomes, Professional Psychology: Research and Practice, 36 (4) 376-390. California Evidence-Based Clearinghouse www.cachildwelfareclearinghouse.org Crisi, Lay, Lowenstein (1998) Paper dolls and paper airplanes Kids Rights JIST Publishing Indianapolis, IN.

18. Gaskill, R. (2008) Neuroscience and play therapy Association for Play Therapy Mining Report, July, 2008. http://www.a4pt.org/download.cfm?ID=25623 Gil, E. (2006) Helping abused and traumatized children: Integrating directive and nondirective approaches, NY: Gilford Press. Kaduson, H. & Schaefer, C. (1997) 101 Favorite Play Therapy Techniques Jason Aaronson. Marvasti, J. A (1993) Please hurt me again: Posttraumatic play therapy with an abused child. In T. Kottman and C. Schaefer, Play therapy in action: A casebook for practitioners, pp 485-525 Northvale, New Jersey, l Jason Aronson. National Child Traumatic Stress Network (2007) http://www.nctsn.org Preliminary Adaptations for Working with Traumatized Latino/Hispanic Children and their Families.

19. Rappahannock Council Against Sexual Assault Blog (2010) Friday Facts: Hispanics/Latinos Sexual Violence Awareness on September 24. Schaefer, C. E. (1994) Play therapy for psychic trauma in children, in K. J. O’Connor & C. E. Schaefer, Handbook of Play TherapyVol. two, Advances and Innovations, 297-318 New York, John Wiley. Shelby, J. and Felix, E. Posttraumatic Play Therapy (2005) The need for an integrated model of directive and nondirective approaches in Reddy, L., Files-Hall, T, and Schaefer, C. Empirically based play therapy interventions for children pp.79-103. Washington, DC: American Psychological Association.