Child Sexual Abuse: A guide for health professionals

305 Pages·1994·6.91 MB·English

by  Celia Doyle (auth.)

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.