Sexual abuse trauma and treatment of survivors

Question 1

What is sexual abuse prevelance

Answer 1

1 in 4 females

1 in 7 males

Question 2

What can sexua abuse consist of

Answer 2

inappropriate nudity
genital exposure
observation of the child
kissing, fondling, masturbation
fellatio, cullilingus 
digital/penile penitration
dry intercourse
rape

Question 3

What are most frequent diagnoses with sexual abuse

Answer 3

PTSD
BPD
eating disorders
depression
anxiety

Question 4

Individuals abused as children are more likely to do what with alcohol

Answer 4

use to self-soothe

begin drinking at earlier ages

Question 5

What is symptom severity affected by

Answer 5

Type of abuse
who abuser is and relationship to victim
age of onset and duration of abuse
other significant relationships
additional life traumas
Pre-morbid personality (some people recover from things easier than others)
Subsequent life events
support from others following abuse

Question 6

Issues in sexual abuse

Answer 6

age difference 
position of power over victim 
perception of force
secrecy
shame and guilt
threat of harm to victim or family
sexual arousal in victim

Question 7

What is the function of symptoms

Answer 7

symptoms are attempts at adaptation

Question 8

Common symptoms

Answer 8

low self-esteem
depression
hypervigilance, exaggerated startle response
self destructive behavior (eating disorder, cutting, etc)
suicidal ideation
dissociation
damage to brain, learning ability, memory
nightmares, sleep disturbances
isolation, w/drawl
addiction

Question 9

What happens with traumatic memories

Answer 9

They are encoded differently from normal events

Question 10

Where are traumatic memories imprinted

Answer 10

sensory and emotional modes in less organized and dissociated ways

Question 11

What are the 3 parts of memory

Answer 11

Encoding (memory creation)
Consolidation (storage)
Retrieval

Question 12

When may memories return

Answer 12

reminders such as flashbacks, nightmares

Question 13

What is sexual abuse

Answer 13

Traumatic

violation of the body, boundaries and trust

Question 14

What is the betrayal trauma theory

Answer 14

predicts that the degree to which a negative event represents a betrayal by a trusted needed other will influence the way in which that event is processed and remembered

Question 15

What is not the goal of treatment

Answer 15

Not have the patient remember

Question 16

What is explicit memory

Answer 16

consciously able to retrieve past experience (readily available)

Question 17

What is implicit memory

Answer 17

info that is not consciously available to the individual

Question 18

What are the long term effects of childhood sexual abuse

Answer 18

cognitive
emotional
behavioral
interpersonal
physical

Question 19

What are principles of sensitive practice

Answer 19

respect 
rapport
sharing control
sharing info
respecting boundaries
fostering a mutual learning process
consideration of ebbs and flows
demo of awareness of the prevalence of violence and CSA

Question 20

What are feelings that may interfere with treatment

Answer 20

fear and distrust
physical pain
need to feel in control
discomfort w/ men
triggers
dissociation
self harm
ambivalence about the body
conditioning to be passive

Question 21

What are possible treatment issues

Answer 21

Trust-pt. question trust w/ therapist, therapist goes long distances to prove trust
distance- distrust may lead to distance when pt. needs opposite
Boundaries- abusive family roles are distorted, leads pt to ask personal info about therapist
Limits
Flexibility
Anger
Control-major goal in tx is balancing both letting go of control and being in control
Role modeling
Responsibility
Idealization

Question 22

Red flags during treatment

Answer 22

dissociation
flashbacks
silence
safety concerns w/ regard to leaving places
Acting out (suicide attempts, cutting , drinking, etc.)

Question 23

What is grounding

Answer 23

methods for stopping the re-experiencing of trauma, or related symptoms, and getting back to the here and now

Question 24

Grounding techniques

Answer 24

Maintain visual contact w/ environmental cues
keep client in well lit area
don’t allow hiding in dark confined areas
have client keep eyes open
instruct client to focus on objects around them
discuss previous flashbacks
use clients name
remind client to look at your face
Assist client to write or draw something
plan ways to cope with stress
develop crisis response plan

Question 25

Items to use for Grounding

Answer 25

Sight
Sound
Smell
taste
touch

Question 26

What is helpful to do with clients who dissociate or have flashbacks

Answer 26

brainstorm a list of techniques (e.g take deep breaths, stretch upper body, shake out legs, etc.)

Question 27

Strategies to use with cutting

Answer 27

Mark the body (with marker)
Feel pain (snap rubber band)
feel pressure (rub skin with brush)
Need to feel (eat, touch, shower, jumping jacks, massage)
Express rage (punch punching bad, hit pillow, throw things)
Punish self (write down reasons, remind self you re punishing yourself with feelings)
Feel calm or in control (deep breathing, journal writing, bath)
Communicate indirectly (write letter and don’t mail it, paint/draw)

Question 28

Treatment interventions for self harm

Answer 28

psycho-education
communication skills
music 
art techniques
sensory based treatment
journaling 
guided imagery
cognitive behavioral 
DBT

Question 29

What are the 4 core areas of DBT

Answer 29

Emotional regulation
crisis survival
interpersonal effectiveness
mindfulness