Behind Closed Doors

1. Behind Closed Doors As counselors, we are often on the front line. It is common that we are the first person notified or made aware of a crisis situation.

2. Introduction • It is often the counselor’s responsibility to: • Intervene • Ensure safety • Provide counseling to those in crisis • Referrals to agencies

3. Introduction • Purpose • Present real life situations that occur in all schools • Give you insight into the many different types of crisis situations that you may face • Listen to your comments, opinions, and insights as we present

4. Introduction • We will present the child involved, the crisis situation, and course of action: • Jennifer---Physical Abuse • Dana--Sexual Abuse • Marci--Teen Pregnancy • Candace--Stereotypes, Gangs, & Eating Disorders

5. Issue #1--Sexual Abuse State of Indiana: Children with Sexual Abuse Marion County: Children with Sexual Abuse

6. Sexual Abuse • Statistics • 60 million survivors of childhood sex abuse • 31% if women in state prison were abused • 95% of teen prostitutes were abused • Long term effects: fear, anxiety, depression, anger, hostility, inappropriate sex behavior, poor self-esteem, substance abuse, difficulty in relationships

7. Sexual Abuse • Legal Distinctions • A. Child Sexual Abuse • B. Statutory Rape • C. Rape

8. Sexual Abuse • I. Childe Sexual Abuse • States Abuse Laws Vary • Major element: Perpetrator defined as a caretaker • II. Statutory Rape • Laws are much more diverse & complex • Learn the legal terms for each state • Age usually ranges from 14-16 years (IN-16) • Based on age differences too (ex: 16 yr.old can have sex with 17 yr.old but not 23 yr.old • III. Rape • Definition: Unlawful sexual activity with a person without consent usually by threat or force

9. Sexual Abuse • Indiana’s Law (handout)

10. Sexual Abuse • I. Physical Cues that indicate Sexual Abuse • Signs of difficulty in walking or sitting • Torn, stained, or bloody clothing • Indications of internal injury or bleeding • Complaints of pain or itching in genital area • Venereal disease in children under 13 • Pregnancy during or before adolescence • II. Most cases of sexual abuse leave no sign

11. Sexual Abuse • I. Behavioral Cues of Sexual Abuse • Having poor peer relationships • Appearing withdrawn, engaging in fantasy behavior • Engaging in delinquent acts • Displaying of bizarre, sophisticated, or unusual sexual knowledge or behavior • Verbal disclosure • Self mutilation • Engaging in sexual activities with another child

12. Sexual Abuse • I. Do children lie about being molested? • Not usually

13. Sexual Abuse • I. Why do many children NOT tell when they are abused? • Fear • Unaware of the nature of the abuse • Lack of trust • “At fault” feeling • Protection of perpetrators • Secrecy

14. Sexual Abuse • Behind Closed Doors • Case Study Handout

15. Sexual Abuse • Plan of Action • 1. Did proper authorities get notified? • 2. What was done to ensure the safety of the child? • 3. What outside organizations were contacted for additional help for the child? • 4. What support plant was put in place for the child? • 5. What could have been to prevent this?

16. Sexual Abuse • What authorities need to be notified? • Child protective services • School Principal or school district designee • Maybe even law enforcement • What else needs to be done to ensure safety • School should NOT investigate • If school is afraid to send kid home, call CPS • CPS or Law should contact parent • CPS or Law initiates investigation • CPS will send feedback report after 30 days

17. Sexual Abuse • What outside organizations should be contacted? • Social Workers • Legal Representatives • Outside Therapists • Know local therapists & agencies • What support plans need to be put in place? • Regular meetings with school counselor • Counselor should serve as coordinator

18. Sexual Abuse • Counselors Duty • Legal Issues • Reporting: Should report sexual abuse • Questions: Call CPS & present hypothetical situation • Ethical Issues • Clear & Imminent Danger • Statutory Rape • Rape

19. Sexual Abuse • Prevention Activities • Conduct in service training for school personnel • Develop a consultation of network counselors • Know CPS workers, therapists, etc. • Develop a system for maintaining accurate professional school counseling records • Establish an abuse prevention program at school

20. Issue # 2--Physical Abuse • Definition of Physical Abuse • Indiana State Definition • Harm Standard • Endangerment

21. Physical Abuse • Statistics • Indiana (2003) 61,492 children reported • 51 Fatalities in the last 5 years • Perpetrators-age, race, relationship

22. Physical Abuse • Risk Factors • 1. Family Problems • Lower socioeconomic status • Marital issues • Domestic violence • 2. Parenting • Single parents • Inexperienced or isolated parents • Heavy child care responsibilities • 3. Other Factors • Emotionally disturbed • Alcohol or drug problems

23. Physical Abuse • What to Look for • Unexplained damage to the body • Evidence of an accumulation of injuries over time • Patterned injuries • Damage in unlikely places • Excessive damage to eyes or mouth

24. Physical Abuse • Signs from the child • Changes in behavior • Learning problems • Over complaint, always watchful, withdrawn

25. Physical Abuse • Signs from the adult or caregiver • Discipline • History of abuse • Unconvincing explanations

26. Physical Abuse • Impact of Physical Abuse • Physical • Social • Emotional • Adult impact

27. Physical Abuse • Interventions for Parents • Anger management goals • Educating useful skills • Appropriate social services marital counseling, psychotherapy

28. Physical Abuse • Interventions for Child • Anxiety management techniques • Play therapy • Social skills training

29. Physical Abuse • Prevention • Early Detection and knowledge • Tranferrance • Focus on general population and subgroups • Media campaigns • Peer helplines • Social support • In-home service

30. Physical Abuse • Case Study • Kellie • First grader • Three incidences • CPS involvement

31. Issue #3--Teen Pregnancy • Teen Pregnancy remains a major problem • The U.S. still has highest rates among industrialized countries • Fact: 10, 974 teens gave birth in Indiana in 2003 • Fact: All high school counselors will have to assist pregnant teens every school year

32. Teen Pregnancy • Statistics • 4 in 10 girls become pregnant by age 20 • > 900,000 teen pregnancies annually • 40% of pregnant teens are 17 or younger • 8 in 10 teen pregnancies are not planned • 79% of pregnant teens are not married • Some teens are having sex earlier • Hispanics now have the highest teen birth rate

33. Teen Pregnancy • Why should we care? • 4 in 10 teen mothers graduate • Half of teen mothers drop out of school before becoming pregnant • 52% of all mothers on welfare had a child as a teen • Teen pregnancy costs taxpayers $7 million/yr • Teen mothers have babies with higher rates of defects

34. Teen Pregnancy • Helpful Information • Few school officials take a stand against teen pregnancy • Arguments over abstinence vs. birth control use up resources • Programs have a high rate of effectiveness • Peer pressure effects teen behavior • Prevention is geared towards girls, not boys

35. Teen Pregnancy • Signs that someone is At-Risk at school • Low grade average • Poor self-esteem • Provocative clothing • Long term relationship

36. Teen Pregnancy • What should we do? • Increase your commitment to prevent teen pregnancy (become an activist) • Maintain good relationships with kids • Provide programs to students • Create a newsletter to parents to increase their awareness • Group therapy sessions on the pressure to have sex as teens

37. Teen Pregnancy • Helpful Website • www.cfoc.org • Lesson Plans • How to start a Prevention Program • Forum

38. Teen Pregnancy • Take a role in stopping the cycle! • Daughters of teen parents are 22% more likely to have a baby as a teen • 13% of sons of teen parents end up in prison • Children of teen mothers do worse in school • Too many teens still believe “it won’t happen to me”

39. Teen Pregnancy • Teachers and counselors are often the first people told by the student • How will you handle the situation? • What can you do to help? • What issues will we face? (abortion, miscarriages, raising the baby) • 1/3 of teen pregnancies will end in abortion, 1/3 will miscarry, 1/3 will keep baby

40. Teen Pregnancy • Video clip: “Teen Pregnancy in America” • Brochures • www.teenpregnancy.org

41. Teen Pregnancy • CASE STUDY • Sharika is a 15 year old sophomore that suspected she was pregnant. After discussing her problem with a teacher she had a test done at a local clinic. It was positive. She explained that she just started having sex with her live-in 18 year old boyfriend. They used condoms a few times. The principal contacted the mother about the pregnancy. Currently, she is 8 months along and plans on raising the baby.

42. Teen Pregnancy • Plan of Action • 1. Did proper authorities get notified? • 2. What was done to ensure the safety of the child? • 3. What outside organizations were contacted for additional help for the child? • 4. What support plant was put in place for the child? • 5. What could have been to prevent this?

43. Issue #4--Eating Disorders, Stereotypes, & Gangs • Eating is controlled by many factors: • Appetite • Food availability • Family, peer, and cultural practices • Attempts at voluntary control • www.abouteatingdisorders.org

44. Eating Disorders, Stereotypes, & Gangs • Dieting to a dangerously low body weight is highly profiled by: • current fashion trends • sales campaigns for foods • Some professions

45. Eating Disorders, Stereotypes, & Gangs • Facts • Diet industry claims an annual profit of $10 billion a year • Eating disorders involve serious disturbances in eating behavior such as: • Extreme reduction of food intake • Severe overeating • Feelings of concern about body weight & type

46. Eating Disorders, Stereotypes, & Gangs • Eating disorders are real, treatable, medical illnesses in which certain patterns of eating take on a life of their own • Three types: • Anorexia Nervosa--(our focus for the presentation) • Bulimia Nervosa • Binge-eating--not a proven psychiatric disorder

47. Eating Disorders, Stereotypes, & Gangs • Common Behaviors of Anorexia Nervosa • Restricting amount & type of food • Excessive and/or compulsive exercise • Abuse of diuretics/laxatives • Smoking • Hiding food • Vegetarianism/special diet • Elaborate food preparation • Avoidance of eating in public, mirrors • Weighing: self, food • Self mutilation • Substance abuse

48. Eating Disorders, Stereotypes, & Gangs • Anorexia Nervosa: Common Verbalizations • Denial of behavior • Denial behavior is a problem • Need to lose weight • Very knowledgeable about nutrition, diet • Talk about food, menus, recipes • Requests for reassurance re: thinness, size of body parts, etc. • Body as a collection of parts vs.. whole • Self-denigration

49. Eating Disorders, Stereotypes, & Gangs • Anorexia Nervosa: Common Beliefs • Thin=good, lucky, beautiful, intelligent, in control, etc. • Fat=bad, unlucky, ugly, stupid, out of control • Certain foods are “bad” or “dangerous” • Being fat is the worst possible outcome • Others bodies are “fine” but others are untrustworthy when giving feedback • Self as inadequate, unworthy or damaged

50. Eating Disorders, Stereotypes, & Gangs • Anorexia Nervosa: Common Experiences • Depression • Anxiety, panic, and/or obsessions • Able to present good façade • History of substance abuse self/family • Shame • Early history of trauma, abuse • Live in fear of being found out • See their behaviors as helpful