Child Sexual Abuse (CSA) can create profound impact, potentially causing both physical and emotional harm, that may leave lasting imprints and significantly impact mental wellbeing even in adulthood. Survivors of CSA can encounter anxiety, the feelings of shame, guilt or worthlessness, distorted self-perception, low self-esteem, depression, post-traumatic stress disorder (PTSD) and dissociation. The consequences affect their behaviour, academics, and confidence as a child and can extend into adulthood and affect relationships, quality of life and overall growth.
Considering this situation, there is a clear need to focus on alleviating the effects that CSA can have on the mental health of those who experience it. However, discussions often centre only around the need for strengthening the law and order or the justice system. And, in this pursuit, we often overlook a critical aspect – mental well-being.
How to approach the problem
It’s crucial to be aware about signs and symptoms of Child Sexual Abuse, and to be observant of any drastic shifts in a child’s behaviour, especially because they may find it hard to seek help from us directly. Children may hesitate to disclose their experiences if the caregivers have not created a safe space or initiated conversations around these issues.
Post the discovery of the occurrence of sexual abuse, survivors should be provided prompt support. Immediate assistance is crucial in mitigating impact, offering survivors a foundation for healing, and empowering them to navigate the path toward recovery with resilience and understanding. This will help in rebuilding trust which is a pivotal element in the healing journey for survivors.
Rebuilding this trust, hampered by traumatic experiences, demands robust strategies. Predictable gestures, consistent reassurance, and unwavering support form the foundation of these strategies.
Most critically, recognizing the crucial role of caregivers/support persons in the healing process is paramount. They are one of the most important stakeholders to facilitate the creation of a supportive environment. Informed and supportive caregivers can become key allies in facilitating open communication, understanding, and the overall recovery journey. Often to facilitate such level of care and support, a prolonged intervention is required.
The three-phase model of trauma treatment – Stabilization, Re-Processing, and Reintegration – proves to be a comprehensive and effective approach for survivors of Child Sexual Abuse (CSA), offering a holistic path to recovery. Stabilization, the first phase, establishes the essential groundwork for therapy by prioritizing the creation of safety and trust between therapist and survivor. Psychoeducation plays a pivotal role in this phase, aiding survivors in understanding their symptoms, reducing feelings of shame, and identifying triggers. The dynamic nature of Stabilization, marked by the development of safety plans and the building of support systems, emphasizes the importance of stability before delving into the deeper processes of trauma.
Trauma re-processing, the second phase, constitutes a transformative journey, focusing on reshaping beliefs and empowering individuals through the understanding of past experiences. Therapeutic models such as Eye Movement Desensitisation and Reprocessing (EMDR) and Trauma Focused – Cognitive Behavioural Therapy (TF-CBT) guide survivors through the intricate layers of traumatic memories, enabling them to resolve them and construct narratives, examine beliefs, and gain control over automatic reactions. This phase represents a crucial step towards reclaiming agency over one’s life.
The final phase, Reintegration, solidifies the notion that the survivor is now safe, fostering a holistic transformation of self-perception and beliefs. This stage serves as the culmination of the therapeutic journey, allowing survivors to incorporate gains made in therapy into daily life and cultivate resilience. By reflecting on responses to potential triggers and achieving closure, survivors emerge from the Reintegration phase equipped with newfound strength and clarity, ready to navigate life beyond the undue influence of trauma memories. The three phases collectively offer survivors a comprehensive roadmap towards healing, resilience, and a hopeful reclamation of their lives.
Challenges in providing mental health support to CSA survivors
The latest NCRB report (2022) reveals a troubling reality: one in every three crimes against children involves sexual abuse, based on registered cases. This is just the tip of the iceberg as there may be many cases that remain unreported. The magnitude of the problem emphasizes the urgent need for concerted efforts, particularly in providing mental health services to survivors.
Despite growing awareness of Child Sexual Abuse (CSA), significant challenges persist, hindering the support system crucial for survivors. Firstly, there is a prevailing lack of awareness regarding the profound and enduring impact of CSA, fostering the misconception that children will naturally forget these experiences. To address this, awareness campaigns and sustained dialogue are imperative, paving the way for a comprehensive understanding of the mental health implications of CSA and fostering a sense of urgency to provide healing support.
Secondly, the societal taboo surrounding speaking out about CSA and seeking mental health services remains a formidable obstacle. Cultural norms that perpetuate silence around CSA and stigmatize mental health access need to be dismantled through public campaigns and holistic interventions challenging these structural drivers. By initiating a sustained dialogue, society can gradually shift towards empathy, reducing victim blaming and creating an environment conducive to healing.
Lastly, the limited availability and accessibility of mental health services present a significant hurdle. Integrating trauma-focused education into higher education curricula for mental health professionals, expanding government initiatives like Adolescent Friendly Health Clinics, and ensuring trauma-informed support in schools are critical steps. Overcoming these challenges requires collaborative efforts from private and government institutions, encompassing awareness, destigmatization, and systematic improvements in mental health infrastructure to ensure comprehensive support for CSA survivors. Implementing these strategies will help foster trauma-informed institutions, train mental health professionals, and ensure holistic support for CSA survivors.
These multipronged approaches and robust efforts are needed to raise awareness, break down structural barriers and challenge negative social norms. Most importantly, they will help create a pool of trained mental health experts.
Conclusion
As India strives to achieve ambitious goals during the ongoing “Kartavya Kaal,” it is crucial to invest significantly in the development of tomorrow’s citizens- our children. This imperative extends to the safety and security of our children, especially survivors of Child Sexual Abuse (CSA). Mainstreaming mental health access and strengthening the three-phased trauma treatment approach stand as a potent model in this endeavour. By prioritizing the physical, emotional safety and mental well-being of our children, we can pave the way for a resilient and empowered generation, ensuring that they thrive as confident contributors to the nation’s progress.
Link: https://timesofindia.indiatimes.com/life-style/parenting/moments/trauma-from-child-sexual-abuse-unlocking-healing-through-holistic-mental-health-support/articleshow/109690262.cms
