click on this link to download or print this information, the basics of treating Child Sexual Abuse, always good to remember the basics.

10 command treat CSA

When there is sexual abuse, either from an adult or another youth, there must be some level of coercion. Most situations of sexual abuse involve coercion, which is emotional ways to force someone to do something, usually tricks and threats.  A young child may consent to sexual behaviors because they are not aware of what sex is, how the private parts are supposed to be special and kept private (they don’t know the privacy rules) or they have been taught that sex is OK for kids by a caregiver.

Sometimes this diagram helps folks understand who is really responsible for sexual abuse because healthy sexuality is 100% consensual for both parties who are old enough to consent.

click on this link to see the diagram in a pdf form which you can copy  coercion arrow

The dynamics of consent in relationships can get really complicated.  True consent only involves people who have the same level of power and control, for example, a teen may fully consent to sexual activity with their teacher, but it’s not true consent because the student doesn’t have the same amount of power in the relationship.   For information on unhealthy dynamics in relationships, visit  https://www.itspronouncedmetrosexual.com/2016/11/rest-columns-shadows-healthy-relationship-model/

 

 

When very young children are processing their sexual abuse in treatment, it may be very difficult for them to figure out their thoughts and feelings about the person who hurt them. One technique is to have them complete a worksheet that can be sent or given to the person who is responsible for the sexual abuse. This worksheet may or may not actually be sent to the person, but the child is likely to feel better if they can give that person a message in writing.

Click on the links below to view a worksheet that maybe helpful to a preschool child.

questions from preschool girl

questions from preschool boy

 

 

 

Letter of Blessing for Child Who Has Been Sexually Abused

By Sheryl Overby, MS LIMHP        Woodhaven Counseling   402-592-0328

 

 

All children seek  verbal or non-verbal feedback from the adults in their life to understand what has happened to them.  A caregiver can provide encouragement, hope and a vision of a positive future for youth who have been sexually abused.  I believe that putting these thoughts in writing makes it more sincere to the child and enables the youth the opportunity to re-read the information whenever needed.

Here are some ideas about what to include in a letter to your child:

  1. Reminders that you do not blame them for any of the abusive events, even if your child feels partially responsible.
  2. The progress your child as made so far; what are you proud of?
  3. Praise and  encouragement for effort and attendance, “it has been hard, it will be hard, but I/We can handle it”.
  4. Talk about the future in a positive way, including your hopes and dreams for your child.  For example, think of the coin, “I, you, we will be OK”
  5. Statements that model the appropriate reaction to learning about the sexual abuse, and apologize if your earlier reaction was not what you wanted it to be.
  • You believe your child was sexually abused (even if some of the details may not be 100% correct). It is OK to acknowledge that the abuse has been a “really really bad thing”.
  • You will support your child no matter what. Please give a concrete example of how you will be supportive, such as:
    • Attending and paying for trauma focused therapy (without complaining).
    • Having empathy for them; try to understand your child’s thoughts and feelings, even if your child hasn’t worked through all the trauma yet.
    • Showing love and caring by listening to them, or leaving them alone, etc.
    • Changing things in the home environment to encourage sexual respect and reduce triggers/reminders.
    • Having hope that they will achieve healing, even when therapy is difficult, even if they don’t like it or want to quit.
  • You will be resilient and handle the adult stresses in life, including your own feelings about the abuse or managing the court system or your budget, etc.
  • You will protect your child from any future harm to the best of your ability. (This does not mean your child will always be happy, since they will still have chores, homework, etc.)

Thank you so much for doing all you can to help in your child’s healing process.

 

When treating sexual abuse, it’s important to remember two things or have two memories of the event.  First, remember that it was a very bad thing and the traumatic response in your body is real and needs to be honored.  But it doesn’t stop there, the sexual abuse has also given you opportunities.  In this case, this child had the opportunity to stop his abuser from hurting other children.  The end result if knowing that you will be OK AND it was a really really bad thing.

Each family and situation is unique and The Privacy Rules can be tailored to suit your individual needs.  Please consider the development, emotional maturity and past behavior of the child.   I recommend that the child or family make their own poster by choosing which cards to use and what the title should be.  Then they can use their own creativity to decorate it and post it in the home.  If you would rather just download the list, then that is fine too.   Please read the post on this site called “The 9 Rules about Private Parts that may Prevent Sexual Abuse” for more information on how to explain the privacy rules to children.  http://sheryloverby.com/9-rules-private-parts/ 

Hover your mouse over the titles and click on them to be linked to a PDF that you can print out and use.

The basic Privacy Rules for anyone who will grow up someday, own a mobile device or know how to use google images.  privacy rules cards

The Privacy Rules for pre-teens or anyone who has at least one underarm hair, or thinks the pictures on the other cards are way too dumb for them.  The youth can make their own title and decorate the numbers and keep the list safely hidden where no peer can find it….which is fine, as long as they follow the rules.   privacy rules no clipart

Credit for knowing about privacy rules goes to the lovely folks at Oklahoma University and NCSBY.

Enjoy.

Children with a history of sexual abuse will benefit from their caregivers being aware of future stuck points.  Sometimes, the issues will resurface as children grow and develop both mentally, emotionally and physically.  If that happens, even if your child is grown and out of the house, please talk to your child and assess if they need more support or mental health services.

STAGES OF LIFE

  • Starting middle school
  • Starting dating
  • Leaving home; going to college or living on own
  • Getting married
  • Deciding to have children, trying to get pregnant
  • Birth of child
  • Child becomes same age as the parent was at the time they were abused, may be especially hard on future parent if they have a child who is the same gender.
  • Any life stage situation in which they feel threatened or unsafe which is similar to the dynamics present when they were abused, for example, if they were abused during one of their birthday parties, there may be issues anytime one of their children attends or has a birthday party.

BODY DEVELOPMENT AND CHANGES

  • Puberty starts
  • Puberty finishes
  • Becoming sexually active
  • Pregnancy/fathering a child/conception
  • Sexual activity that triggers flashbacks

COGNITIVE CHANGES / BRAIN DEVELOPMENT

  • Stops believing in magical things such as Santa Claus, Tooth Fairy, Easter Bunny, etc
  • Abstract thinking, can think about things that aren’t there, philosophical thinking, sarcasm
  • Learns about sexuality facts, especially if it’s related to abuse, formal sex education in schools.
  • When understands the emotional aspects of sexuality and that sex does something to your soul; why someone actually wants to have sex, most likely high school age
  • Starts thinking about future/college/career choice (possibly 8th grade, possibly 12th grade)
  • After brain is fully developed, age 23 – 25

After a child has been sexually abused, they can never regain their innocence.  This is one of the main reasons caregivers grieve for their children.  This graph is meant to help others understand the difference between ideal development of a child and the detour that children are forced to take when they are abused. Hopefully, caregivers will have a better understanding of how they can help the child compensate.  Please be aware that this graph is not based on clinical studies or research, but the combined clinical experience of Sheryl Overby and Vickie Peyton equaling 65+ years.  The example illustrated in the chart below is of a child who was sexually abused at approximately 8 years old.  We believe that a child will have a better chance of returning close to an “ideal development” of their sexual experiences if they receive treatment after their sexual abuse.

sex-dev-2016

The ages and stages of sexual development are based on information from American Academy of Pediatrics 2009.

It is really important to remember both sides of the coin as you heal from trauma or sexual abuse.

  • It was a really, really bad thing AND…
  • I/You/We will be okay AND….

coin2 coin1

The Link Between Sexual Abuse and Sexual Offending

Sheryl Overby MS LIMHP

It’s really difficult to know if you should be worried about your child after they have been sexually abused in some way. It’s important not to over react, or under react. You should be prepared to have issues with sexuality in some fashion as the child grows into a teen, starts dating and eventually has their own children. But, THERE IS NO PROOF THAT BEING SEXUALLY ABUSED WILL LEAD TO THAT PERSON BEING A SEXUAL ABUSER either as child, teen or adult. Here are some statistics that might help.

  • Some children do react to their sexual abuse by doing sexual things to other children.  The legal term for this is child on child sexual assault.  Therapists call this sexually reactive. These kids can be helped by counseling and have a reduced risk that they will sexually abuse again in the future.
  • Physical abuse of the child or domestic violence in the home is just as traumatic for the child as a history of sexual abuse. All of these factors maybe related (not the only cause) to children who have problematic sexual behavior (PSB).
  • Most kids who have been sexually abused have also had other types of abuse or difficult home life, so it is very difficult to find out exactly what is causing their problems.
  • 13 different studies that involved 1353 children, who were sexually abused, 35% of preschool aged children had sexual behavior problems, and 11% of school age kids had sexual behavior problems.
  • Some studies regarding adult sex offenders indicate that 60 to 70% of them were sexually abused as children.  However, other studies which included polygraph testing of their sexual abuse history found that approximately 20 to 30 % of adult sex offenders were sexually abused as children.
  • Most experts agree that adult sex offenders commonly have difficult childhoods, which included a combination of emotional, physical and sexual abuse.
  • 5 to 10 % of adolescents with sexual behavior problems have true sexual deviancy, so they will have problems with these issues for a very long time.

MANAGING BEHAVIOR DURING

SOCIAL INTERACTIONS

Sheryl Overby, MS LIMHP


There are 3 main types of ways to help kids with their social interactions with peers. Pre-teaching, coaching in the moment and giving feedback. All social interactions between children improve based on trial and error, and some kids need extra help from adults to understand their peers’ responses and to know how to change their behavior to make the interaction more pleasant.

PRE TEACHING: 

Identify House Rules

  • House rules, or rules for the activity should be decided between the caregivers and discussed in advance.
  • These rules maybe different than those of siblings, and should be based on the needs of the child. Children who demonstrate good judgment will have different rules than children who have shown to have difficulty making good decisions.
  • All privacy rules are expected to be followed by all children in the home and all children who interact with your child.
  • Physical boundaries about where the children are allowed to go should also be determined ahead of time and should be stated as a house rule.
  • Rules about the use of food and drinks should also be decided ahead of time.

Identify an agenda for the peer interaction

  • Have an idea if the peer will be involved in snack or dinner time, the expectations for arrival and pick up, and their planned activities.
  • Explain to your child what the expectations are for supervision (line of sight/hearing?) and how they should respond if the friend wants to do something that is against the supervision rules.
  • Sometimes, kids need help to decide what to do with unplanned time, and a back up plan or activity is helpful if the original activity does not go well or the children change their mind and don’t want to do it anymore. Examples are to play a board game, play outside (depending on their need for supervision), do a craft activity or watching a movie.
  • The parent needs to be available for coaching during all peer interactions and should be available as needed.

Identify an escape plan

  • Have an idea of how you will handle things if the peer interaction is not going well for whatever reason and how the activity will end.
  • You may need a signal your child can give you if he/she wants the friend to go home or have an excuse prepared that won’t hurt the friend’s feelings.
  • Have a plan on how the friend can go home early if needed and who will provide transportation.
  • Sometimes the phrase “cooperation/patience/ability to share is all used up” can explain the problem if the friends are arguing without placing blame on either child.

COACHING:

Prepare for Caregiver Intervention

  • Depending on your child’s supervision plan, you will need to provide visual and/or
    auditory supervision with all peers.
    If your child has a sexual behavior problem, they have already shown that they have a problem with good judgment. You will also need to know what they do well with peers and what areas need improvement so you can know how to proceed in the future.
  • Sometimes, a simple statement can help the peer interaction proceed more smoothly.
  • Examples are to: label/notice positive behavior, suggestion to change activities, Suggest to your child in private to use the STOP or Turtle steps or distract both children with a snack.
  • Be careful not to “shame” either child in front of their friend as this may backfire and create long term problems in your relationship and embarrass the child.
  • If you need to provide individual feedback to your child, do so in private. Praise may or may not be provided in private, depending on the preferences of your child.

FEEDBACK:

Use Natural and Logical Consequences

  • If the interaction goes well, provide more opportunities and go out of your way to provide transportation so your child can have positive peer time.
  • If the interaction does not go well, explain to your child the problem and the need for more supervision or the need to reduce peer time in frequency or length until the child has better skills.
  • DO NOT completely stop all peer interactions; ask your therapist for help in getting creative to make opportunities for positive peer interactions.
  • These interpersonal skills will be needed the rest of your child’s life and it is part of the endless, unrewarded job of parenting to help your child learn this skill. Some children do not automatically have this skill and it will take lots of time and practice to learn it.

 Do all you can to make the feedback session positive

  • Get your child’s permission first, especially for girls. Always ask your child if they are willing to talk about the peer interaction and listen to feedback.
  • If they say no, then WAIT until they are ready. This issue can always wait until a positive conversation is possible.
  • Make sure both you and your child are in the mood (not hungry or tired) to provide and accept feedback.
  • Always sandwich negative feedback between praise for something positive, even something simple as being willing to listen and end feedback session with praise or hope that things will go better in the future

 OTHER OPPORTUNITIES FOR SOCIAL INTERACTIONS:

  • Allow “growth privileges”!! Participation in team sports, clubs at school or attendance of birthday parties are all good chances for your child to have interactions with friends while being supervised in a group setting.
  • Use good judgment if you take away these opportunities as a punishment, it may backfire and cause more problems in the long run. Your child needs opportunities to practice and learn to share, respect authority and cooperate with others.
  • Remember, coaches and other adults may be able to teach your child skills that you will receive benefits from in the future.
  • Coaches are often willing to have child “run extra laps” or have other consequences while remaining on the team or do other things to help motivate your child to improve their grades or behavior. Please talk to your child’s coach or adult mentor before making them quit the activity.
  • If your child has had problematic sexual behavior (PSB) or has committed a child on child sexual assault, please read other articles on this website for more information or go to NCSBY.org.

Possible Reason Why a Protective Caregiver

Might Deny Signs of Sexual Abuse

Sheryl Overby, MS  LIMHP

There are many many reasons why someone would question whether or not a person that they know, love and trust would sexually abuse a child.  Sexual abuse is one of the most hated social problems in our society, and no one freely admits they they have committed sexual abuse.  And for the sex    offender’s friends and family, it is just so hard for them to put that person  in the category of “sex offender”; frankly it’s so embarrassing that it  literally turns your world upside down.  Here are some common reasons why  it’s so hard to believe your child was sexually abused by someone you love.

  • Feels conflicted, has affection for abuser
  • Forced to choose between child and abuser
  • Feels ashamed, there must be something wrong with their familydangerous-rope-bridge-1
  • Feels responsible for abuse since she couldn’t protect her child in the first place
  • Loses trust in self and ability to “tell” when someone might be an abuser
  • Issues with own sexuality or attractiveness
  • Fear of losing financial security if the abuser was provider for family
  • Fear of NHHS involvement
  • Fear of being blamed
  • Fear child will be blamed, so would rather keep it a secret
  • Emotional dependence on abuser
  • Afraid of being emotionally or physically hurt by offender
  • Ashamed of her choice of partner
  • Sexual abuse history in self (too many triggers)
  • Protection not role modeled in family of origin
  • Made her own attempts to protect the child (but they didn’t work)
  • Believes they can solve the problem within the family

Maximizing Sexual Respect  for Children under 10

Sheryl Overby  MS  NCC  LIMHP

 If everyone in the world has sexual respect, then there would be no sexual abuse.  One of the best ways to help kids have healthy ideas about sexuality is to teach sexual respect.  The world and its “pornified culture” will have a huge impact, sure, but do all you can to minimize that impact by implementing ideas of sexual respect.

Here are my best tips…….

  • Clothing Choices:  It is a good idea for ALL family members to be conscious of what they wear outside of the bedroom. Seeing others in their underwear or pajamas may be over-stimulating to a child.  Reframe desire for clothing choices from sexual “hotness” to appropriateness for the event or comfort
  •  Language:  Suggestive, sexualized, objectifying or obscene language is not allowed from anyone.  Reframe focus of compliments from attractiveness to character strengths.
  • Objectification:  The concept that people are treated like objects, most typically a sexual object.  Do all you can to avoid this from a very early age.  The American culture is prevalent with pornography, sexualized media and the meeting of sexual desires with people outside of relationships.  But, it is more than sexual objects, so teachers are more than just teachers, waiters are more than just servers, husbands are more than a paycheck, etc.
  • Sexually explicit materials such as magazines, videos, catalogs, or TV programs should be completely eliminated from the household.  Don’t keep TV and Video game systems in your child’s room that have adult swim or internet access that they can use in the middle of the night.
  • Computer time should be monitored to make sure the youth is not “accidently” exposed to sexualized images.  Remember, the youth has more time, energy and motivation to break through the parental controls software than the parent has to maintain it.  This includes ALL MOBILE DEVICES and gaming devices.
  • Explain what you are doing  Kids want to know why.  Depending on their age, you can give varying degrees of explanations about why you are putting filters on the internet, or not allowing TVs in their room, etc.  Most of them will appreciate your involvement.   Go to commonsensemedia.com for videos you can show your kids about how sex is used for marketing and advertising.
  • Don’t use porn Sexual respect means ADULTS have sexual activity in a RELATIONSHIP with a REAL LIVE PERSON, not an image on the computer screen, which may or may not be real.  Make sure the adults in the child’s life model this message in their own behavior
  • Sex Education: All children need basic information about how they develop sexually.  They also will benefit from an atmosphere in which it is OK to talk about sex.  Appropriate words for body parts, such as penis, vagina, breasts, and buttocks, will give the child helpful words to use to describe themselves, especially if they have to talk about sexual behavior.  All children (any age) should have an age appropriate explanation for the sexual behavior that has been done to them if they have been abused by an older teen or adult.
  • Encourage them to Say NO Children need to learn that they have the right to assertively say “no” when someone touches them ANY WHERE or in ANY WAY they do not like. Help them to practice this. A youth should NEVER be pressured into touching someone or showing affection if they are not comfortable. If your child has been sexually abused, this is especially important that they can say NO in any type of situation they do not like.  This may include situations of feeling intimidated or taken advantage of.
  • Mutual Respect Among Siblings Sometimes intimidation is a part of a problematic sexual behavior.  This needs to be turned into mutual respect.  Encourage equality among siblings by giving younger children equal power when deciding family activities.  Teach the appropriate use of drawing straws, taking turns and rotating responsibilities.

 

  • Privacy for Children: Everyone has a right to privacy. Children should be taught to knock when a door is closed and adults need to role model the same behavior. Children also deserve to have privacy with their thoughts, feelings, personal belongings, personal space and time.  I am repeated this for a reason, Children also deserve to have privacy with their thoughts, feelings, personal belongings, personal space and time.  Think about it.  Children who have been abused or who have sexually harmed another person deserve the right to privacy when determining who needs to know about their history

  • Secrets:  Help the child understand the difference between secrecy, surprises and privacy; this is a tricky thing for all of us, frankly. This relates to gossip, tattling, reporting abuse and sharing feelings.  In general, it’s always OK to ask mom and dad for help to figure this one out.  Secrets are usually discouraged, privacy is usually encouraged and surprises are usually a lot of fun, except if there is a spider in bathtub.

 

  • Privacy for Adults: Don’t forget that adults need privacy too, especially if engaged in sexual activity.  Lock the bedroom door always and make sure children cannot hear sexually related noises.  This is extremely overwhelming and arousing for a youth who may not have a healthy understanding of sexuality.
  •  Follow the 9 Rules:  See Handout on the 9 Rules that May Prevent Sexual Abuse
  • Practice Critical Thinking: Ask your child why they think the strawberry commercial pretends to be sexual or why a restaurant wants their waitresses to look a certain way.  Ask your child why they think a swimsuit top for a 2nd grader would have padding or ask about the current jokes kids tell at school.  The goal is to help your child think; send the message that they have a choice about their sexual behavior, their sexual thoughts and their sexual gender issues.  Things they will have a long time to figure out if they wait until they are grown up to share their bodies with someone.
  • BE PEPARED:  Now that your child knows they can talk to you, knows they have a choice, be prepared to have lots more discussions with them about their sexual choices and the sexual messages in society when they are teenagers. That’s a whole ‘nother paper and much more complicated, so come find me when they are about 11 or 12, I’ll have something on sheryloverby.com.

 

NO MEANS NO

 

Stop  –  means no

Turning away  –  means no

I don’t want to  –  means no

Shoving you away  –  means no

Leave me alone  –  means no

Not touching you   –  means no

I’m not ready  –  means no

Playing dead / not moving  –  means no

 

I don’t feel like it   – means no

Drunk or drugged  –  means no

Get away from me  –   means no

Screaming  –   means no

Don’t   –  means no

Crying  –  means no

 

Yes means one thing only:   FREELY GIVEN CONSENT, where BOTH person’s needs, wants and desires are the foundation for the interaction.

 

Encouraging Healthy Sexual Boundaries In the Foster Home

SHERYL OVERBY  MS  NCC  LIMHP  www.sheryloverby.com

Woodhaven Counseling Associates  402-592-0328

All humans have to learn boundaries, either by modeling or teaching in early childhood; it simply is not something hardwired into the brain.  It would be nice if all the youth who come to your home had good boundaries, but chances are, you will have some work to do.    Since part of the definition of healthy sexuality is that it happens in private, most children and teens simply do not know that there is anything other than what they have seen in their history or via our current American sexualized culture.  Families are the perfect place to offer an alternative and healthy view of sexuality.  Here are my best tips on how to help the kids in your home.

#1 Create an Atmosphere of Sexual Respect

Sexual Respect

  1. Do not allow suggestive or obscene language from anyone of any age. This includes sexual innuendos and jokes that creates the message that sex is an everyday thing.
  2. Do all you can to avoid objectification, which is seeing a person as an object, most typically a sexual object.
  3. Sexually explicit materials such photos, videos, catalogs, music, computer games or TV programs should be completely eliminated from the household, and the garage, and underneath the seat in your truck.
  4. Reinforce healthy messages like: “every person, young and old, deserves to have their body respected and sex is a great and wonderful thing for adults, when they think and think about when to share their bodies” or “sex can be a special way to connect to another person, but now is not the time for you”.
  5. It is difficult to traverse the wide gap between clothing fashion trends and sexual respect, but you gotta try. It is important for both girls and boys to know a) That even if a girl wears something sexually provocative, it does not give anyone the right to abuse her AND b) That boys (especially age 11-14) have erections at seeing even the slightest bit of cleavage and the girls can help them out by not wearing sexually provocative clothing AND c) That even if something is in style, it is not allowed if it contributes to the objectification of that person, male or female.

Sex Education

  1. All children need basic information about how they develop sexually. Make sure they have an age appropriate book that they can keep in their room and look at any time to answer their questions about sex.
  2. They also will benefit from an atmosphere in which it is OK to talk about sex, but you will have to bring up the subject often so they know it is OK to talk about it. Sometimes, you will be the one doing all the talking.
  3. Appropriate words for body parts, such as penis, vagina, breasts, and buttocks, will give the youth helpful words to use to describe themselves, especially if they have to talk about sexual activity or sexual abuse.

Saying NO

  1. Youth need to learn that they have the right to assertively say “no” when someone touches them ANY WHERE or in ANY WAY they do not like. Help them to practice this with peers, siblings and adults.
  2. A youth should NEVER be pressured into touching someone or showing affection if they are not comfortable.
  3. For teenagers, both young women and young men need to know that NO MEANS NO.
  4. Remind everyone that all sexual activity is consented by both parties every single time, even between a couple who has been together for years and years. Both parties have the freedom to say yes, and both parties have the freedom to say no.

 

#2 New Rules to Prevent Future Problems

Being Alone With One Other Person

  1. If your youth has problematic sexual behaviors or if they behave seductively or aggressively, they need direct supervision! This means they are never alone with another child and sometimes this includes older children and other adults.
  2. You may need to be able to both SEE and HEAR everything your youth does and says when they are with others. This eliminates any anxiety when confused or ambivalent about the intent of a behavior.
  3. Consult a therapist to decide the supervision needs of a child with a history of sexual abuse. Some youth need very little, others need very firm limits and structure.
  4. The goal of supervision is to have “in the moment coaching” for problem solving, social skills and to help them manage feelings.
  5. Siblings are not allowed to provide supervision; this alters the family dynamic and creates an unhealthy balance among siblings that could facilitate additional problems.
  6. Remember, children do not need “foreplay” in order to have a desire for sexual behavior, it only takes a child about 12 seconds to invade another child’s boundary or body.

Touching

  1. All children need NON SEXUAL touch. If a youth’s only form of affection in the past has been via sexuality, they will need to learn how to show and receive affection in non-sexual ways again and again, and again.
  2. Do not be afraid to touch your child or teen, however, it is advised that the touching be interruptible or observable. Please consult with the youth’s therapist to identify what types of touch will be the most helpful.
  3. Help your youth learn the appropriate use of all different types of healthy touch. They include: affection, brotherly love, comfort, friendship, encouragement, comradery, greetings, praise, nurturing and playfulness.
  4. Be cautious about wrestling and tickling, as common as these behaviors are, they are often tinged with sexual overtones and can put a younger child in a weak or humiliating position.
  5. Do not allow other children to sit on the lap of a youth with sexualized behavior.
  6. Adults in the home should also show NON SEXUAL affection towards each other in front of the children (hugging, holding hands, light kissing). They can learn that affection is a part of sexual activity, but not always, and there is a way for a couple to show affection in public that is NON SEXUAL.

Privacy

  1. Everyone has a right to privacy. All the youth in your home should be taught to knock when a door is closed and adults need to role model the same behavior. Modesty is the best policy.
  2. Young people also deserve to have privacy with their thoughts, feelings, personal belongings, personal space and time.
  3. Children and teens who have been abused or who have sexually harmed another person deserve the right to privacy when determining who needs to know about their history.
  4. Don’t forget that adults need privacy too, especially if engaged in sexual activity. Lock the bedroom door always and make sure children cannot hear sexually related noises.  This is extremely overwhelming and arousing for a youth who may not have a healthy understanding of sexuality.
  5. In general, it is recommended that youth who are already confused about sexuality have separate bedrooms and bathroom time. Every child needs a place and time when they can be alone and have personal time.
  6. If a youth is scared at night, work out a plan to help them feel safe without sleeping in bed with another person.
  7. Post and enforce the list of PRIVACY RULES for children and older youth; see handout attached.

#3 Interrupt Patterns of Unhealthy Sexual Behavior

Manage Arousal

  1. Help children and teens differentiate between feelings and behaviors. It is normal to have all kinds of feelings, including sexual feelings.  However, everyone does not always act on all the feelings he or she has.
  2. Remember girls gets just as aroused as boys, it’s just not visible. Both boys and girls need to understand what is happening in their bodies and to know how they should react.
  3. Some children and teens need very specific instructions on how to distract themselves when aroused and how to decide when it’s OK or not OK to touch themselves or masturbate.
  4. Youth who have been sexually abused may have trauma related flashbacks associated with arousal. It is very important to change this pattern if they are to have a healthy sex life with a partner as an adult.  Please seek the assistance of a therapist if you think this is happening.
  5. If a child (before puberty) is touching their own private parts, it is for very different reasons than a teen or adult due to the lack of hormones and sex drive. I prefer the term “self touch” rather than “masturbation”.
  6. Young children really benefit from having relaxing activities or physical activities that will change the body’s arousal pattern. Give them a list of things that they can do without permission.
  7. Both children and teens need to know the dos and don’ts regarding touching themselves, proper hygiene and how to properly care for the private parts of their bodies.
  8. Helping your child with arousal will go along way to prevent child on child sexual assault or problematic sexual beheavior (psb).

 

Understand that sexuality fills an emotional void; then fill that void in non-sexual ways

  1. Need for love and belonging. Help each youth create connections with adults in non-sexual ways, so they feel attachment and caring from others. Remember that sexuality imitates the feeling of closeness and love in the brain.  Many kids in foster care are horribly lonely; but convince themselves that they don’t need friends.
  2. Need to feel competent.  Help the kids in your home find something they are good at and encourage them. Help them fit in with at least one friend or join a club or team with a shared activity.
  3. Need for comfort when upset or stressed. Many children’s first choice of comfort is self-touch, please help them learn other ways to comfort themselves without feeling shame or embarrassment.
  4. Need for power. A person who has been abused will naturally want to compensate my controlling something else.  Give your youth something to be “in charge of” and ask for their advice regarding this subject. Teach the appropriate use of drawing straws, taking turns and rotating responsibilities so the foster youth have equal power with other siblings.
  5. Need for play and fun. Playing and having fun is one of the best ways to release stress or simply enjoy yourself.  The second best way to release stress and enjoy yourself (at least for adults) is by having sex.
  6. Need for sensory pleasure. Let’s face it, sex feels good, your body feels good and your brain is filled with endorphins.  But there are other ways to also get pleasure through the senses.
  7. Need for affection. Sometimes the need for affection is directly confused with feeling aroused and what the youth actually needs is nurturing or cuddling.  This is a little tricky in a foster home setting, as cuddling may be confused for sexual intentions and advice from a therapist or service provider is recommended.
  8. Need to avoid feeling intense pain. Being pre-occupied with sexuality fills the empty spaces in your brain so you don’t have to think about the pain in your life. Help the youth find other ways to fill this space with hobbies or other interests; better yet, help them learn to tolerate the pain in small doses and express emotions in healthy ways.
  9. Need to feel safe. In order for a child to develop emotionally, they must feel physically and emotionally safe. That means there is no threat of further abuse, shame or guilt.  Sexuality can become a coping skill by manipulating others; which also protects the youth from feeling vulnerable or weak.

Stop/Limit use of Pornography

  1. Computer and internet time should be monitored to the best of your ability. Remember, the youth has more time, energy and motivation to break through the parental controls software than the parent has to maintain it.
  2. The absolute best defense is your relationship with the youth in your home, not punishments. Talk, teach, coach, and help your youth manage what they are exposed to on the internet and how to interact with others in safe and healthy ways.
  3. Girls are just as likely to get involved in pornography as boys. In my experience, boys tend to search for porn online and girls tend to find it by accident.  But once they get exposed, they can’t resist wanting to see more.
  4. Please be willing to talk to them about what happens online and in social media, or find someone who will.
  5. 93% of teens use the internet every day and 24% use it “almost constantly”. It’s almost a full time job to manage the social media the youth in your home will have access to.  Even if it’s only via friends’ phones and the internet at school. So, welcome to your new hobby.
  6. Be informed about Cyber-bullying and sexting, which are both much more common than sexual predators online. This directly ties into emotional needs as described above.
  7. It’s a whole new world. Studies in 2013 found that 59% of children are using social networking by age 10 and 75% of children age 0 to 8 use mobile devices that can access the internet.   Children and teens have no idea that the sexual images that they will see online do not happen in real life, in healthy relationships.  This has the ripple effect of damaging future relationships.
  8. Pornography is the exact opposite of sexual respect. Healthy sexuality means ADULTS have sexual activity in a RELATIONSHIP with a REAL LIVE PERSON, not an image on the computer screen, which may or may not be real.  Make sure the adults in the youth’s life model this message in their own behavior.

THERE IS NO PROOF THAT IF A CHILD IS SEXUALLY ABUSED, 

THEY WILL GROW UP TO BECOME A SEXUAL OFFENDER

Either as child, teen or adult.

  • Some children do react to their sexual abuse by doing sexual things to other children. This is called sexually reactive. These kids can be helped by counseling and have a reduced risk that they will sexually abuse again in the future. A good evaluation is key.

 

  • The best interventions for kids who are sexually reactive are good supervision, sex education and understanding their body’s reaction to sex (arousal). Their parents will probably need help to understanding their child’s behaviors. Teens need extra care since they have a more developed conscience and thus more guilt.

 

  • Most kids who have been sexually abused have also had other types of abuse or difficult home life, so it is very difficult to find out exactly what causes problems later.

     

  • Physical abuse of the child, domestic violence in the home and exposure to pornography are all factors related to children abusing others. Research shows that domestic violence is the greatest factor for kids under 11.

 

  • There are over 40 million people in the US who have been sexually abused, and there are not 40 million sex offenders, so there must be other factors related to why adults sexually abuse children.

     

  • The popular belief that all sex offenders have been sexually abused as a child is not based on accurate research. When polygraphs were used to verify offenders’ histories, they found that many adult sex offenders played the “victim card” and reported they were abused when they were not.

 

 

BUT ALSO, DON’T PRETEND

  • If your child has been abused, don’t pretend that they have not been exposed to sexual things before they were ready. Sex is not meant for kids and when abuse happens, it is very confusing. Make sure your child learns the context in which healthy sexuality is supposed to take place.

     

  • If your child has had a problem with acting inappropriately sexually or not having healthy boundaries, don’t pretend that these events have not happened. Ask a professional for help in identifying how to keep your child and others safe from future problems.

     

  • Read “New Rules After Sexual Abuse” to make sure you are doing everything you can to help your child heal from their abuse and maintain appropriate behaviors in the future.

 

A child who has been sexually abused will benefit from clear guidelines that set the rules for their behavior. These kinds of rules provide the structure, comfort and security all children need to grow into healthy adults.

Sexual Respect

  • Suggestive or obscene language is not allowed from anyone. It is sometimes a trigger for old feelings and does not create sexual respect.
  • Do all you can to avoid objectification, which is seeing a person as an object, most typically a sexual object. The American culture is prevalent with pornography, sexualized media and the meeting of sexual desires with people outside of relationships.
  • One possible message is: “every person, young and old, deserves to be respected and sex is a great and wonderful thing for adults, when they think and think about when to share their bodies”.

 

Sex Education

 

  • All children, including the child who has been abused, need basic information about how they develop sexually. They also must know the terms for what was done to them so they aren’t surprised during sex ed at school or with their friends.
  • They will benefit from an atmosphere in which it is OK to talk about sex.
  • Appropriate words for body parts, such as penis, vagina, breasts, and buttocks, will give the child helpful words to use to describe themselves, especially if they have to describe their abuse.

 

Saying NO

  • Children need to learn that they have the right to assertively say “no” when someone touches them ANY WHERE or in ANY WAY they do not like. Help them to practice this.
  • A child should NEVER be pressured into touching someone or showing affection if they are not comfortable.

 

Privacy

  • Everyone has a right to privacy. Children should be taught to knock when a door is closed and adults need to role model the same behavior when entering their child’s room.
  • Reinforce that “It is NOT OK to look at other people’s private parts or show your parts to someone else unless there is a medical reason”.
  • Children also deserve to have privacy with their thoughts, feelings, personal belongings, personal space and time. Remember, this privacy is different than secrets.
  • Children who have been abused deserve the right to privacy when determining who needs to know about their history. If parents need to talk about the event for support, make sure it is with the child’s approval.

 

No Secrets

  • Make it clear that any “secret games”, particularly with adults, are not allowed. Tell children if an adult suggests such a game, they  should tell you  immediately.
  • Help the child understand the difference between secrecy and privacy. This relates to gossip, tattling, reporting abuse and sharing feelings.

 

 

Arousal

  • Help children differentiate between feelings in your body and feelings that are emotions. It is normal to have all kinds of feelings, including sexual feelings. However, everyone does not always act on all the feelings he or she has.
  • Make sure the child knows how to react to feeling aroused emotionally or if their body is aroused and help them to excuse themselves from difficult situations.
  • Some children need very specific instructions on how to distract themselves when aroused.
  • Children who have been abused need to know that if their skin/body parts were aroused during the abuse that they are still NOT responsible for the abuse and it does NOT mean that they liked it. It is possible that their offender has already convinced them otherwise.

 

Touching

  • No one should touch another person without permission. Everyone should ask for hugs.
  • Do not allow them to sit on the laps of adults, as this is a common behavior that offenders encourage and they may be more likely to be abused by others in the future.
  • A person’s private parts should not be touched except during a medical examination or in the case of young children, if they need help with bathing or toileting.
  • Help your child understand that “It is OK to touch yourself if you are in private and it does not interfere with other fun things like playing with friends”.
  • Children need lots of NON SEXUAL touch. The need to feel affection, friendship, caring and love in non sexual ways. Please consult with the child’s therapist to identify what types of touch will be the most helpful.

dr-phil

 

Wrestling and Tickling

  • Tickling and wrestling is not allowed.
  • As common and normal as these childhood behaviors are, they are often tinged with sexual overtones. They can put the weaker child in an overpowered and uncomfortable or humiliating position. Touching of private parts can be “accidental” or not accidental and justified as tickling.

 

Bedrooms and Bathrooms

  • These two locations are often prime stimuli for children and will sometimes trigger traumatic memories. In general, children who have had sexual acts forced on them are probably confused about sexuality it is recommended that they have separate bedrooms and bathroom time.
  • It is not advisable to bring a child who has been sexually abused into an adult’s bed. Cuddling may be over stimulating and misinterpreted. A safer place to cuddle may be the living room couch.
  • If a child is scared at night, work out a plan to help them feel safe without sleeping with another person.

 

Clothing

  • It is a good idea for family members to be conscious of what they wear outside of the bedroom. Seeing others in their underwear or pajamas may be over-stimulating to a child.
  • The goal is to create the feeling of sexual respect with clothing choices.
  • You can send the message that a woman’s worth is based on more than just looking “hot” or “cute”.

 

Being Alone With One Other Person

  • Sometimes children who have been abused behave seductively or aggressively, they need direct supervision. This means they are never alone with another child and sometimes this includes older children and other adults.
  • This eliminates the possibility of false allegations or confusion about the intent of a behavior.
  • Provide coaching and feedback to your child as they learn to interact with others.
  • Babysitting is a choice that needs careful consideration. Ask your therapist for advice.

 

Let’s be honest, the rules about private parts are usually not talked about and not talking about them makes a child vulnerable.

You know there are unspoken rules about all sorts of things: what to do in church, when and where to pass gas, how to pick your nose, and when to ask a lady if she is pregnant.  If you didn’t know, the rule is to NEVER ask.  It’s hard figuring out all these rules as a kid, especially the rules about private parts.  This makes children vulnerable to participate in sexual behavior because they simply don’t know what the rules are.  Even when older children do know the rules, they might not have the sophistication to know how to handle stress, control sexual urges, or respond to unintentional exposure of explicit material (which by the way, will happen to 70% of them).

Kids get mixed messages about sexuality.

To complicate things further, kids simply don’t know the difference between acting sexy and acting sexual.  Think about the messages given by you, friends and family, or society at large.  Young girls are applauded for twerking during a dance recital but are promptly told they are being “nasty” by prancing down the hallway.  So, what if their piano teacher wants them to act sexy? Or their cousin tells them to play strip poker? How will they know what to do? Well, hold on to your hat, you will have to talk about sexuality and teach them the rules.

Yes, I know it will be hard, but you can do it.

You will have to teach your child about Privacy Rules; the rules about the private places on their body.

You will have to tell them about sexual behavior and the rules that go with it. You can call it touching rules or privacy rules or just the rules.  Telling a child what is OK and what is NOT OK concerning their private parts goes a long way in preventing sexual abuse.

You can be casual.  Talk about the rules concerning your child’s body in general.  Say, “brush your teeth, use a Kleenex when you pick your nose, and oh, here are some rules about your private parts.”  Or, bring up the rules during bath time, when you encourage your child to wash their own private parts.  Mention the rules when you see someone breaking them (or following them) on TV.

Or, do it formally. Sit everyone in the family down, including teenagers, and have a family meeting.  Go through the rules and explain that you, as the parent, are there to help them follow the rules.  Make a poster of the rules and put it up somewhere.  Don’t forget to add that all grownups are supposed to respect the rules that kids have about their private parts.  If you don’t want to make your own poster, you can download these examples Privacy Rules Cards    Please pick whichever way works best for you, just do it.

Rule # 1   It is NOT OK to touch other people’s private parts.  

If needed, explain to very young kids that private parts are the places on their body that are covered by a swimsuit.  Pretty simple and straightforward, right?  Except nothing about sexual abuse is straightforward.  That is why you will need to have more than one, maybe even dozens, of conversations about privacy rules.  To be more specific with this rule, you may add:  If an older person makes you touch their private parts, it is not your fault and you will not get into trouble.  The older person is almost always to blame for breaking this rule since they are older and know more about what is OK and not OK.

A case in point is the 7 year old child abuse victim who is forced to “do things” (sexual things) to a much older youth. For years, the victim was asked if anyone had “touched him inappropriately,” and of course he responded with the technically correct answer of “no.”  Even worse, was that he felt responsible for his abuse, and his own traumatic memories, since he was the only one “doing the things.”

         broke yours off2

Rule # 2  It is NOT OK for anyone to touch your private parts.

This rule has an exception:  Sometimes, very rarely, it’s OK for someone to touch your private parts.  If you are not sure, please ask me or someone you trust ( also rule #8).  One way to tell if a type of touch on private parts is OK, is to think about secrets.  The times it is OK to touch private parts is when it is NOT a secret, like when someone is changing a baby’s diaper or the doctor checks them for medical reasons.  If someone touches your private parts and you feel like it should be secret, then that is NOT OK, and this is called secret touching (thank you Jan Hindman and the Very Touching Book).

Side note: I also like to use the term secret touching instead of bad touching so kids don’t associate sex with something “bad.”  Their future spouse or partner will appreciate it.

Rule # 3 It is NOT OK to look at other people’s private parts (in real life or in pictures).

This rule gives you (and me) a chance to talk about pornography.  I believe it is especially important to enforce this rule as generations of kids become more advanced with technology and even toddlers know how to access the internet.  Unfortunately, the internet is filled with billions of inappropriate images and pornography, mostly homemade.  However, it is natural and healthy for children to be curious about the difference between the private parts of boys and girls.  There are lots of good sex education books available with cartoon drawings of private parts that are appropriate, healthy and positive for children. Please visit the book store and find one that matches your family’s values and place it in your child’s room.  Then remind them: it’s OK to look at pictures of private parts in this book that I gave you since it will help you know how bodies are made.

My advice about pornography for adults :   Please don’t have pornography in the house or on any electronic device your child even touches.   Or in the car, or the attic, or the box in the basement leftover from college that actually belongs to your old roommate. I haven’t met a kid yet that didn’t find the “hidden” porn collection. Let’s be real, kids have more motivation, time, and energy to go looking for porn and other “adult” items than adults have the motivation, time, and energy to keep the same items locked up and hidden.  Please just think about it, even if you think it’s OK for adults to look at porn, it is really damaging to kids.

Rule # 4  It is NOT OK to show your private parts to other people.

This rule is the counterpart of “looking” at private parts in rule #3.  Younger kids need this concept split into 2 rules to cover all the bases.  I like this rule since it will help prevent your child from being used for child pornography.  It happens more often than you think.  Again, follow the advice in Rule #3 as to help kids with their natural curiosity to know what the private parts of the opposite sex look like.

Rule #5 It is NOT OK to take pictures of private parts.

As of 2017, the average age of a child getting a smart phone or internet capable mobile device is 10.3.  That means children as young as 4th grade have the ability to send and receive sexualized images of themselves or their peers.  Current research indicated that about 15 percent of kids age 12 to 17 had either sent or received a sexualized image from a peer.  So, besides hoping that your child will be in the other 85%, lets plant the seed early that this behavior is NOT OK.  Private parts are special and sharing them, even in a photo or an app on a smart phone is a big decision that needs to be made when you are much much older.  To read the research on sexting, look here:  https://cyberbullying.org/new-teen-sexting-data

Rule # 6  It is OK to touch yourself if you are alone and behind a locked door and do not take too much time.

OR

Rule #6A   It is OK to touch your private parts to keep them clean.

This rule doesn’t really have all that much to do with preventing sexual abuse, but since all human being touch their privates, even if it’s only to wash them, the rule about touching yourself needs to be explained.

OK, get ready, this rule is a tricky one; stay with me.  Many, many people have strong opinions about touching their own private parts, and you may already know how you will handle this topic.   But maybe I have some new information for you to consider?  I believe that kids need guidance.  You may not believe me, but before puberty, before the influx of hormones, children who touch themselves are most likely doing it for comfort, not sexual satisfaction.  Some children are very sexualized because of their environment or history and it would appear that they are trying to achieve a climax of sorts with their genital stimulation.  I have specifically chosen not to use the term masturbation, as I believe that word describes adult sexual behavior.  When children talk to me about their genital stimulation, their desire is to relieve stress, feel better, end anxiety, or cope with a difficult situation.  You will have to trust me that they are not thinking, “oh, I’m aroused and I want an orgasm.”    If you have a kid that seems to really be compelled (not the same as a sex drive) but very powerful indeed, to touch their own private parts, then please use balance in helping them understand themselves.  I know it’s tempting, but telling a child that genital stimulation is nasty, gross, or perverted can damage your child emotionally.

Rule # 7 It is NOT OK to make others uncomfortable with your behavior or language when it is sexual or wrong for the situation.

These rules are all about BOUNDARIES.  Very simply,every kid will be less likely to be sexually abused if they are not confused about acting sexy or acting sexual.  These boundaries are 100 percent learned, either directly or indirectly from a child’s environment and the people in that environment.  This rule is helpful when teaching your child what’s OK and what’s NOT OK if they or anyone else:  tells a dirty joke, says Uranus (the planet), makes sexual hand gestures, calls their sister butt-face, or imitates Miley Cyrus’ twerking. Let’s go back to the statistic that 70% of children will be accidentally exposed to explicit sexual material on the internet. It may seem like you are powerless, but you do have a choice.  The choice is if you will teach them about what they see and hear OR stay silent about what they see and hear.

 

Rule #8 It is NOT OK to talk about private parts for fun with other kids.  If you have a question about privacy or sex, please ask a grown-up.

Almost all kids are exposed to some sort of sexualized information or images via their phones, social media or plain ole TV.  They want to know what all the fuss is about, especially if these images are immediately removed without explanation.  The most likely source to discuss these questions is with their friends, and the most likely source of misinformation is their friends.   The age in which this occurs is age 8 or 9.  Yup, that’s about 3rd grade.  Your kids are talking about sexual things in 3rd grade, trying to make sense of it all.  And if they tell you they have seen pictures of “naked people doing things” aka pornography aka sexualized images, then you are in for a great big discussion.  Remember, if the rule is to ask a grown up, that also means the grown up MUST give correct and helpful answers.

Rule #9  It is OK to tell (insert name here) if you have broken a privacy rule.  They will try to help you.

So this is rule can help in two different situations in which a child knows that they have broken a privacy rule.  First, it could help when a child is coerced to break a privacy rule by an older youth or adult as a means of sexual abuse, and the child doesn’t understand that their cooperation is not the same as consent.  Second, it could help in situations in which a child has a problem following the rules and they are afraid to ask for help.  It may be that the child broke a privacy rule before they knew what the rules were or they have broken a rule and are afraid they will get into trouble if they ask for help.  There are many times when children need consequences for their behavior, but this is not one of them.  Consequences alone will not solve this problem if a child feels compelled to participate in sexual behaviors with other children.  If you learn that your child has this problem, or you are unsure if your child’s behavior is concerning,  please seek professional advice, read other articles on this website or go to NCSBY.org for more information.

Rule #10  If someone else breaks a rule, tell an adult you trust and keep telling until someone helps you.

The purpose of this rule is to encourage kids to talk about sexually inappropriate acts, not to make them feel bad for keeping secrets. Only 20% of sexually abused children report sexual abuse voluntarily and there is whole list of reasons why.    Children can be coerced, tricked, bribed, and threatened into doing things and keeping secrets EVEN THOUGH they sort of know it is breaking this rule.  Children are not fully developed human beings and are NEVER at fault for complying with abusive acts or not telling someone sooner.

 

Rule # 11  If you are not sure about something, ask someone to help you decide.

So even if we include the exception to every rule, you cannot really cover everything that could possibly happen.  Therefore, the 11th rule is the net to catch everything else that falls through the cracks.  One word of caution, you might be faced with some difficult questions, like your 10 year old asking about the word orgasm or worse, what “69” means.  You better be ready, ‘cuz it could happen.  And if you go back on your word and avoid the question, don’t worry, the internet won’t let them down, it has plenty of answers.

Main Points About The Rules

  1. Don’t wait, it won’t be easier or better later; you can start teaching the rules as soon as they can take off their own diaper.  If you want to download one of my versions of a privacy rules poster, look at this post Privacy Rules Cards
  2. Be simple; there are 11 rules and you want your child to follow them. You should pick the ones that are most important to you and your situation; if you child is very small, just pick two or three of the rules to start with.
  3. Talk about it, mention it, give examples, notice things on TV, make a poster, bring up the rules whenever you can.  You will need to go over these concepts again and again to be the most effective.
  4. There is a very good chance your child will accept these rules without question and be grateful that now they know what to do (and not do) about their private parts.
  5. You will have to follow the rules too if you are going to be completely effective in preventing sexual abuse.  Is your porn collection more important than that??  Just saying.
  6. Human sexuality is complicated and there are more issues to think about and talk about. But start with the basics. You can get into the other stuff as the child gets older and sees you, hopefully, as the best resource for his/her questions about sexuality.  Check out Dr. Laura Bermans’ book “Talking To Your Kids About Sex” for more great ideas.

 Sexual abuse is real, and now preventing sexual abuse can be real too.

When a kids knows what is OK and NOT OK, then they will know something isn’t quite right IF an older youth or an adult tries to convince them It’s OK, or no big deal to look at porn and wrestle in their underwear, or pose for a picture.  I know I know, it’s not a visual you want to have.  So have this visual, your child will say “NO!  My mom said looking at naked people is against the rules and it’s NOT OK, so I want to go home now.”  Wouldn’t that be a great thing?

For more information on sexual abuse prevention, problematic sexual behavior (PSB) or child on child sexual assault visit these websites:

www.darkness2light.org (sexual abuse prevention)
www.nctsn.org (National Child Traumatic Stress Network)
www.stopitnow.org (sexual abuse prevention hotline)
www.ncsby.org (National Center for Sexual Behavior of Youth)

Reference:

Silovsky, J.F. (2009). Taking Action: Support for Families of Children with Sexual Behavior Problems. Vermont: Safer Society Press.