Child Sexual Abuse: A guide for health professionals PDF
Preview Child Sexual Abuse: A guide for health professionals
Child Sexual Abuse THERAPY IN PRACTICE SERIES Edited by Jo Campling This series of books is aimed at 'therapists' concemed with rehabilita tion in a very broad sense. The intended audience particularly includes occupational therapists, physiotherapists and speech therapists, but many titles will also be of interest to nurses, psychologists, medical staff, social workers, teachers or voluntary workers. Some volumes are interdisciplinary, others are aimed at one particular profession. All titles will be comprehensive but concise, and practical but with due reference to relevant theory and evidence. They are not research monographs but focus on professional practice, and will be of value to both students and qualified personnel. 1. Occupational Therapy for Children with Disabilities Dorothy E. Penso 2. Living Skills for Mentally Handicapperl People Christine Peck and Chia Swee Hong 3. Rehabilitation of the Older Patient Edited by Amanda J. Squires 4. Physiotherapy and the Elderly Patient Paul Wagstaff and Davis Coakley 5. Rehabilitation of the Severely Brain-lnjured Adult Edited by !an Fussey and Gordon Muir Giles 6. Communication Problems in Elderly People Rosemary Gravell 7. Occupational Therapy Practice in Psychiatry Linda Finlay 8. Working with Bilingual Language Disability Edited by Deirdre M. Duncan 9. Counselling Skills for Health Professionals Philip Burnard 10. Teaching Interpersonal Skills A handbook of experiential learning for health professionals Philip Burnard 11. Occupational Therapy for Stroke Rehabilitation Sirnon B.N. Thompson and Maryanne Morgan 12. Assessing Physically Disabled People at Horne Ko.thy Maczka 13. Acute Head lnjury Practical management in rehabilitation Ruth Garner 14. Practical Physiotherapy with Older People Lucinda Smyth et al. 15. Keyboard, Graphie and Handwriting Skills Helping people with motor disabilities Dorothy E. Penso 16. Community Occupational Therapy with Mentally Handicapped Adults Debbie Isaac 17. Autism Professional perspectives and practice Edited by Kathryn Ellis 18. Multiple Sclerosis Approaches to rnanagernent Edited by Lorraine De Souza 19. Occupational Therapy in Rheumatology An holistic approach Lynne Sandies 20. Breakdown of Speech Causes and rernediation Nancy R. Milloy 21. Coping with Stress in the Health Professions A practical guide Philip Bumard 22. Speech and Communication Problems in Psychiatry Rosemary Gravell and Jenny France 23. Limb Amputation Frorn aetiology to rehabilitation Rosalind Ham and Leonard Cotton 24. Management in Occupational Therapy Zielfa B. Maslin 25. Rehabilitation in Parkinson's Disease Edited by Francis I. Caird 26. Exercise Physiology for Health Professionals Stephen R. Bird 27. Therapy for the Burn Patient Annette Leveridge 28. Effective Communication Skills for Health Professionals Philip Bumard 29. Ageing, Healthy and in Control An alternative approach to rnaintaining the health of older people Steve Scrutton 30. The Early Identification of Language Impairment in Children Edited by James Law 31. An Introduction to Communication Disorders Diana Syder 32. Writing for Health Professionals A rnanual for writers Philip Bumard 33. Brain Injury Rehabilitation A neuro-functional approach Jo Clark-Wilson and Gordon Muir Giles 34. Perceptuo-motor Difficulties Theory and strategies to help children, adolescents and adults Dorothy E. Pensa 35. Psychology and Counselling for Health Professionals Edited by Rowan Bayne and Paula Nicholson 36. Occupational Therapy for Orthopaedic Conditions Dina Penrose 37. Teaching Students in Clinical Settings Jackie Stengelhofen 38. Groupwork in Occupational Therapy Linda Finlay 39. Eider Abuse Concepts, theories and interventions Gerald Bennett and Paul Kingston 40. Teamwork in Neurology Ruth Nieuwenhuis 41. Eating Disorders A guide for professionals Sirnon Thompson 42. Community Mental Health Practical approaches to long-term problems Steve Morgan 43. Acupuncture in Clinical Practice A guide for health professionals Nadia Ellis FORTHCOMING TITLES Research Methods for Therapists Avril Drummond Spinal Cord Injury Rehabilitation Karen Whalley Hammell Child Sexual Abuse A guide for health professionals Celia Doyle Nene College, Northampton, UK Springer-Science+Business Media, B.V. Distributed in the USA and Canada by Singular Publishing Group Inc., 4284 41st Street, San Diego, Califomia 92105 First edition 1994 ISBN 978-1-56593-136-7 ISBN 978-1-4899-3364-5 (eBook) DOI 10.1007/978-1-4899-3364-5 © 1994 Cella Doyle Originally published by Chapman & Hall in 1994. Typeset in 10/12pt Palatine by Mews Photosetting, Beckenham, Kent Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, this publication may not be repro duced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries conceming reproduction outside the terms stated here should be sent to the publishers at the London address printed on this page. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. A catalogue record for this book is available from the British Library Library of Congress Catalog Card Number: 94-70273 (§ Printed on permanent acid-free text paper, manufactured in accordance with ANSI/NISO Z39.48-1992 and ANSI/NISO Z39.48-1984 (Permanence of Paper). Contents Acknowledgernents ix Introduction xi 1 Terms and definitions 1 Definitions 4 Specific terrns 12 2 Forrns and settings 20 Forrns of abuse 20 Settings for child sexual abuse 28 Incidence and prevalance 40 3 Perspectives on perpetrators 43 Perpetrater profiles 47 Perspectives on abusing behaviour 55 Fernale perpetrators 74 Child and adolescent abusers 78 4 Victirn perspectives 84 Perspective of abused children 84 Children with added disadvantages 95 Siblings of abused children 104 Non-abusing parents 107 Helping professionals as victirns 111 5 Recognizing and responding 114 Physical signs and syrnptorns 114 Uncornrnon sexual behaviour 121 General behavioural signs 127 Other people' s behaviour 130 Obstades to disclosure 131 viii Contents Readiness to disclose 135 Facilitating disclosure 136 Responding to disclosure 139 Alternative informants 147 6 Investigation and beyond 153 Interviewing child witnesses 154 Medical examinations 165 Multidisciplinary working 168 Legal steps 174 Coping in court 177 Helping victims after the investigation 186 General comments 190 7 Protection and prevention 192 Sodetal attitudes 192 Focus on perpetrators 194 Strengthening external inhibitors 199 Prevention programmes with children 205 Vulnerable children 208 8 Helping adult survivors 214 The long-term effects of sexual abuse 214 Helping survivors 225 The health professional as a survivor 232 Survivors in perspective 237 Appendix A Legal steps in England and Wales 239 Protection 239 Criminal prosecution 241 Appendix B Fernale circumcision 243 Appendix C Glossary 246 Appendix D Guide to additional reading 253 References 267 Index 281 Acknowledgements My first debt of gratitude is owed to those former colleagues and mentors who initially awakened and then sustained my interest in child protection work, especially Professor John Cooper, Dr Margaret Oates, Dr Peter Barbor and David N. Jones. This is followed by my thanks to my more recent associates, who have provided me with articles, information and challenging ideas; among these are Madeleine Collinge, Liz Brayne, Dr Mike Kiddie and Eddie Brocklesby. I would also like to thank staff at the Gracewell Institute, notably Jenny Still, Jo Fairfield and Hilary Eldridge; and I am grateful to the many students who have so generously exchanged their ideas with me and passed on references, especially Sally Chapman who provided me with the Kirkwood report. I doubt if this book would have materialized if it had not been for a chance discussion between Rosemary Galleymore and Jo Campling. Jo' s encouragement has been a very impor tant factor during the past few years, for which I am very grateful. A special acknowledgement goes to the many people, young and not-so-young, who have been the victims of child sexual abuse and have shared their experiences and permitted me to use their accounts in my teaching and writing. My family have, as ever, been a valuable source of support. My brothers, Mike Doyle and Dr Peter Doyle, have helped mein my struggles with my computer, while Peter and my sister-in-law, Belinda, provided essential assistance in reading through all the more technical sections. My mother, Joan Doyle, also provided sterling support by reading and editing the earlier drafts.
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