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    Sexual Abuse (Assault & Long-Term Abuse): A Help Guide | One to One Counselling
    This guide provides useful information and resources for sufferers of sexual abuse and those concerned a loved one has been a victim.

    What is sexual abuse?

    Sexual abuse is any unwanted sexual activity. This involves a perpetrator using force, threat, manipulation, or otherwise taking advantage of a victim without their consent. Sexual abuse can occur as a one-off event (assault) or can be repeated over a time period. In a majority of cases, victims and perpetrators know each other. It is difficult to estimate occurrence rates of sexual abuse because it is a largely unreported crime.
    Individuals of both genders and of all ages can become a victim of sexual abuse. It is also important to understand that males, females, adults, teenagers and children can be the abusers.

    National Association for Prevention of Child Abuse and Neglect (NAPCAN) outlines the behaviours that qualify as child abuse as per below. Most can be applied to the sexual abuse of adults also.

    • Sexual touching of any part of the body, clothed or unclothed, including using an object
    • All penetrative sex, including penetration of the mouth with an object or body part
    • Encouraging an individual to engage in sexual activity, including sexual acts with someone else, or making an individual strip or masturbate
    • Intentionally engaging in sexual activity in front of an individual or not taking proper measures to prevent an individual being exposed to sexual activity by others
    • Meeting an individual following sexual 'grooming', or preparation, with the intention of abusing them
    • Taking, making, permitting to take, distributing, showing or advertising indecent images
    • Making another view images of sexual activity including photographs, videos or via webcam
    • Paying for sexual services of a child or encouraging them into prostitution or pornography


    What are the implications of child sexual abuse?

    All aspects of a child's wellbeing can be affected.

    Sexual abuse causes a child extreme mental duress. A child is more likely than an adult to feel that sexual abuse is all their fault and to not be aware that a crime and wrongdoing is taking place. Many children are sworn to secrecy by the offender who is commonly someone in a position of trust, such as a relative or family friend, and the child can fear getting the abuser into trouble or that they may be in trouble themselves.
    Physically, sexual abuse can cause injury, anogenital warts, fabricated or induced illness, and recurring abdominal pain. Bed wetting and sleep problems might be a side effect.

    Psychologically the child will exhibit agitated emotional or behavioural states and can also experience delays in development including failing to achieve behavioural, cognitive and emotional skills expected for their age range. They might exhibit attention disorders, aggression or extreme withdrawal, difficulties getting along with other children, and inappropriate sexual behaviour.

    Research shows strong links between childhood sexual abuse and the later development of mental disorders.


    What are the long-term implications of sexual abuse?

    Victims of sexual abuse can experience many negative consequences. Depending on the individual and their experience, initial feelings can involve shock, disgust, guilt, sickness, despair and helplessness.

    Common long-term consequences can surface at any time, even many years later, and can include:

    • Flashbacks of the abuse
    • Frequent nightmares
    • Sensitivity to noise, being touched, or being close to others
    • Increased anger
    • Not remembering periods of your life
    • Feelings of numbness
    • Feeling depressed or suicidal 
    • Self-harm
    • Anxiety or panic attacks
    • Letting people abuse or take advantage of you (re-victimisation)
    • Using substances as a coping mechanism
    • Distrust in others and relationship problems
    • Low concentration
    • Difficulty sustaining employment
    • Difficulty being a suitable parent
    • Behavioural difficulties
    • Low confidence and low self-esteem
    • Sexual issues
    • Social integration problems

    Research has shown that these problems can worsen or intensify when an individual is reminded of the abuse. Stress has also been found to exaggerate these problems.

    Another common consequence that victims of sexual abuse can experience is mental illness. Post-traumatic stress disorder (PTSD), anxiety disorders, personality disorders, depression, eating disorders, sleeping disorders and schizophrenia have all been found to have links with sexual abuse.

    Physical consequences may include pregnancy, sexually transmitted infection (STI) and injury.


    Recommended treatments

    Sexual abuse is very traumatic and difficult to process by yourself. It doesn't matter if the abuse you suffered was recent or a long time ago, it is important to seek help if you are suffering from the consequences. This can be in the form of a support group or therapy.

    A therapist creates a safe space for you to process your unanswered questions and unresolved issues, as well as helps you find coping strategies for symptoms you are suffering such as anxiety and flashbacks. Therapy can also help you counteract the affects your abuse might be having on your life, such as helping you improve your relationships, self care, and employability.

    As for intervention when it comes to child sexual abuse, it can be a delicate and tricky area. If you are worried about how it works and how a diagnosis is made, you can read the  Australian Government guidelines to suspecting child maltreatment, who works to maintain a set of specific, concise statements that healthcare professionals can refer to to maintain quality standards for patient care.


    Help and resources for sufferers

    Help for reporting sexual abuse

    No one has the right to sexually abuse you, not even your partner. It is a crime and the law takes sexual abuse cases very seriously. It can be difficult to build up the confidence and strength to report sexual abuse. For information, support and guidance in doing so see this site: 
    http://www.lifecentre.uk.com/police_info/lead_police_information.html

    Self-help books
    • The Courage to Heal The Courage To Heal: A Guide For Women Survivors Of Child Sexual Abuse. Ellen Bass and Laura Davis, 1988.
    • The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse. Wendy Maltz, 2001.
    • Surviving Childhood Sexual Abuse: Practical Self-help for Adults Who were Sexually Abused as Children. Carolyn Ainscough, 2000.
    • Overcoming Childhood Trauma: A Self Help Guide to Using Cognitive Behavioural Techniques. Dr. Helen Kennerley, 2000.
    • The Survivor’s Guide to Recovery from Rape and Sexual Abuse. Robert Kelly, Fay Maxted, Elizabeth Campbell, 2005.
      
    Helpful websites

      
    Helpful phone numbers


      
    Therapeutic services

    • Medicare - see your GP and asking for a referral to a psychological specialist
    • Local charities or organisations - check with your council for support groups, therapy and advice in your local or nearby area
    • Private counselling and psychotherapy clinics - search through online directories for one in your area. One to One Counselling is one such clinic.


    References

    American Psychiatric Association (2004). Diagnostic and statistical manual of mental disorders (DSMIV). Washington, DC: American Psychiatric Association.

    Browne and Finkelhor (1986). Impact of Child Sexual Abuse: A Review of the Research. Psychological Bulletin. Vol 99(1), 66-77.

    Goldman, J.D.G. & Padaychi, U. (2000). Some methodological problems in estimating incidence and prevalence in child sexual abuse research. Journal of Sex Research. Vol 37, 305–314.

    Hassija, C. M.; Gray, M. J. (2007). Behavioral Interventions for Trauma and Posttraumatic Stress Disorder. International Journal of Behavioral Consultation and Therapy. (Behavior Analyst Online) 3 (2) 166–175.

    Kapur, S., (2009). Schizophrenia causes. Journal of Psychiatric Research.  Lancet. 374, 635- 45.

    Lazarus, R.S., & Folkman, S., (1984). Stress, Appraisal and Coping. New York: Springer.

    Life Centre: http://www.lifecentre.uk.com/index.html

    NHS: http://www.nhsdirect.nhs.uk/en/FemaleSexualHealthSelfCare/SexualAssault

    Silverman, A.B., Reinherz, H.Z. & Giaconia, R.M., (1996). The long term sequelae of child and adolescent abuse: a longitudinal community study. Child Abuse and Neglect. 20, 709–723.

    Tyler, K.A., (2002) Social and emotional outcomes of childhood sexual abuse: a review of recent research. Aggression and Violent Behaviour 7, 567–589.

    World Health Organisation (1992). ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation.

    Braveheart

    The Blue Knot Foundation

    Child Wise

    1800 Respect

    Australian Government - Australian Institute of Family Studies

    http://www.harleytherapy.co.uk/sexual-abuse-help-guide.htm