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Services
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Yellowhead Family Sexual Assault Treatment
Program
THE YELLOWHEAD FAMILY SEXUAL ASSAULT TREATMENT PROGRAM
BACKGROUND HISTORY
The YELLOWHEAD FAMILY SEXUAL ASSAULT TREATMENT PROGRAM was developed in 1983. At
the onset of the program there were three therapists providing therapeutic
services. Tony Martens, with Alberta Social Services in Hinton,
Alberta; Bob Lyons, with Alberta Mental Health Services;
Ruth Sauer, a Probation Officer with the Alberta Solicitor Generals' Department.
The Yellowhead Family Sexual Assault Treatment Program (Y.F.S.A.T.P.) was
developed in the community of Hinton, Alberta. Hinton is located approximately
300 kilometres west of Edmonton, Alberta and about ninety kilometres east of
Jasper National Park. In 1983 the population of Hinton was approximately 9,000
people, and the major industries being pulp and paper and coal mining.
Representatives from the Solicitor Generals' Department, Social Services, Mental
Health, and a local judge by the name of His Honour: Judge Michael Porter, were
concerned that families, although few in number, had to travel to Edmonton to
receive therapy. They believed that families should be able to receive services
in their own community.
In October 1983, Tony Martens, employed with the Alberta
Ministry of Social Services, was given the task of developing a treatment
program. This program would provide individual and group therapy to victims,
families, and regressed sexual offenders of incest and child sexual abuse. The
program would also provide treatment to the victim's immediate and extended
family members.
During the developmental stages of the program, Tony and Bob received additional
training from the Alberta Hospital Forensic Assessment and Community Services
Program (FACS). For a six month period, under the direction of Dr. Al. Riediger,
they developed the skills needed to provide treatment assessments and to
coordinate group therapy for incest (regressed) offenders. Simultaneous to their
involvement with FACS, the process of individual and group therapy, community
development, and strategic planning were being developed in the Hinton and
the surrounding area.
Early in 1984 The Y.F.S.A.T.P. was in full operation in Hinton, Alberta. The
service area covered Hinton, Edson, Jasper, and Grand Cache.
Ruth Sauer was the therapist who operated the non offending parents' group
(mothers' group). Throughout her involvement she was assisted by other
counsellors who volunteered their time. Ruth's involvement in the program was
supported by the Solicitor Generals Department (Hinton Probation Department).
She worked several hours per month in the program as part of her regular
Probation Officer duties. Ruth also provided individual counselling to a few of
the individuals within her group. Ruth remained involved with the Y.F.S.A.T.P.
until June 1985 when she moved from the Hinton area.
Bob worked in the program as part of his responsibilities as a Clinical
Supervisor for Alberta Mental Health. Bob was involved in co-leading the
offenders' group and provided individual, couple, and family therapy to families
involved in the program. Bob remained involved in the Y.F.S.A.T.P. until June
1987 when he moved from Hinton to Montreal, Quebec.
At the initial stages of the program, Tony was involved in providing individual,
couple, family and group therapy as part of his duties as an employee of Social
Services. In 1987 Tony left the employment of Social Services and went into
private practice, taking over the program on a full time basis.
Tony continued the operation of the program in Hinton, Alberta until December of
1988, when it was relocated to Surrey, British Columbia, under the
direction of Tony Martens of Martens & Associates.
Since 1983 the Y.F.S.A.T.P. has provided individual, couple, family, and group
therapy to hundreds of people. This includes victims, non-offending
spouses/parents, offenders, the siblings of the victim, the parents of the
offender and non offending spouse/parent, and other family members or community
people associated with the families.
PHILOSOPHY OF THE PROGRAM
The Yellowhead Family Sexual Assault Treatment Program is based on a humanistic
philosophy with the following beliefs about people:
1. Human beings are basically prosocial. They want to feel good about
themselves, and tend toward growth and self actualization.
2. Each person is unique.
3. People have a personal responsibility for the choices they make and the
consequences they entail.
4. People are capable of change and self-awareness which leads to the ability to
choose and change behaviour.
5. Human beings have a need to relate to others in order to develop a sense of
self.
6. People's spirituality and culture are an important part of their existence
and they have a right to express and hold valuable their beliefs.
7. Each person is of inherent worth and should live with dignity.
8. Each person must have an opportunity to participate in the moulding of our
society.
9. People with healthy self concepts are not likely to engage in
hostile/aggressive
behaviour. Specifically, they do not deliberately undermine the self concept of
family members, especially those of children.
10. When people are simply punished for abusive behaviour, and not provided with
an understanding of their behaviour and the effects it has on others, it serves
only to reinforce their poor self concept and destructive attitude. Even when
punishment serves to frustrate one type of hostile behaviour, its destructive
energy is diverted to another external outlet, or turned inward.
11. That although the members of a family system exhibit behaviours that are
destructive and painful for other family members, it does not exclude that they may
love and care for them. There is an inherent need/desire to work through and
resolve problem issues in their relationships. The family unit is important to a
person's sense of being.
12. That a person's experiences can shape and affect their current situation and
that it is important to resolve these issues.
In respect to our program, we view the family as a system in which individuals
strive to maintain some type of balance. Any change in one part of this system
has implications for every other member. In First Nations communities the
immediate family, extended family, and community as a whole are included in this
system.
Although the family is viewed as a system, it is composed of individuals whose
personal treatment needs are attended to before they start family therapy.
Because parents and other family related caregivers lay the foundation of the
family system, the health of their relationship with other family members has
strong implications for the functioning of the family as a whole.
Disturbances within the family system manifest themselves in a variety of
symptoms, one of which can be child sexual abuse. Other symptoms include
physical abuse, mental abuse, wife battering, alcoholism, and other forms of
family violence. Acts of violence within the family are committed by people with
an unhealthy self-concept and poor self-esteem (to name only a few). To
successfully treat such individuals, efforts are made to help them understand
their past, resolve unresolved issues, and accept personal responsibility and
accountability. Providing only a punitive approach to the problem serves to
intensify the negative self-image, and reduce personal motivation or conviction
to their own healing, thus increasing the likelihood that the violent behaviour
will continue. This is not to say that offenders should not be charged, but that
they need to be held accountable for their actions.
The foundation of our treatment approach believes that human beings are
basically good, and given the opportunity and proper support and direction, will
strive toward that end. The human tendency toward growth and self-actualization
is a normal process that, at times, needs assistance.
Before starting therapy, all individuals go through a series of assessments to
determine the types of services they require and the methods those services
should be delivered. We do not assume that our program has the answers for all
people. The assessment helps us to determine whether they will benefit from our
program. The assessments are conducted by our staff, contract Psychologists,
Psychiatrists, Forensic Services, Medical Doctors, Elders, community
Care-givers, and other qualified professionals.
The Y.F.S.A.T.P. focuses on four main aspects of the individual: the
mind (psychological self), the body (physical self), the emotions (emotional
self), and spirit (spiritual self).
In the realm of the mind, we address what people think and why they view things
the way they do. Here too, experiences strongly shape attitudes. We help people
make a transition or distinction between their psychological and emotional self,
enabling them to differentiate between what they think and what they feel.
If physically (body) the person is suffering from headaches, stomach problems,
back pain, or other ailments, they are often referred to doctors, nutritionists,
medicine people, or others trained to treat their specific problem. We believe
we need to understand whether the persons' pain is caused by emotional problems
or by a physical agent such as a car accident, drug or alcohol abuse, or any
other factor.
In treating the emotional self, we help the individual to understand feelings,
many of which tend to be strongly related/connected to their past. We help them
to gain an understanding of why they feel what they do, why they interpret
things the way they do, and how their interpretation expresses itself through
their actions. We have found that often when treating the emotional self the
physical symptoms (such as headaches) disappear.
In the area of one's spiritual self, each person is encouraged to examine and
evaluate their spirituality; to review what they believe in terms of morals,
ethics, values and beliefs. We may work together with their religious or
community spiritual leader. The spiritual self has a great influence on the
other aspects of the person.
It is our belief that family violence occurs in families that are unhealthy, and
is a symptom of a problem, and not the problem itself. The consequences and
effects of family violence touch the entire family system. To simply stop the
behaviour does not eliminate the effects and attitudes which were present prior,
during, and after the abuse.
Providing therapy to only selected individuals in the family often does not
meet their needs and provides little for the family unit. If
therapy/counselling ignores the problems that exist within the family system
it may make their
problems and circumstances considerably worse.
It is our belief that the child who is directly affected by the sexual
abuse/incest (the victim) needs therapy. Because of their victimization, they
may have experienced conditions such as, "role reversal"; the effects of verbal,
emotional, psychological, or physical violence; and/or the coercion and
manipulation created by the offender in order to commit the sexual abuse. There
are many reasons for the victim to enter treatment in order to promote their own
healing.
Unfortunately, in many programs it is common that the siblings of the victim, in
the family where violence has occurred, receive little attention from
counsellors. Although the siblings in the family may not have been directly
sexually assaulted, or physically abused, this by no means should suggest that
they are not affected by the unhealthiness that exists in that home. In our
program they are an important part of the (family) healing process.
As indicated earlier, incest and child sexual abuse (family violence) occurs in
families that are unhealthy. Both parents need to resolve issues in respect to
their own relationship, the relationship between themselves and their children,
and between themselves and their own parents and siblings. Research from the
Y.F.S.A.T.P. has found that approximately 90% of the parents, whether they be the
mother or father, were themselves sexually assaulted as children. These issues
need to be addressed in therapy in order for the family to function in a healthy
manner.
Incest and child sexual abuse has no boundaries, it effects all social,
economic, religious, racial and cultural backgrounds. The impact of sexual abuse
affect not only the victim, but the entire immediate and extended family
structure, the community, and society as a whole.
STATING THE PROBLEM
Child sexual abuse can be defined as any sexual exploitation of a child by an
adult or someone perceived by the child to be more powerful or dominant than
them. Such exploitation may include fondling, intercourse, exposure to sexually
related acts or material, or verbal suggestions. Incest, intrafamilial sexual
abuse, is sexual abuse that occurs within the family. Child sexual abuse is a
crime. Children do not have the developmental ability or understanding to
consent to the sexual activity. They are damaged emotionally, psychologically,
spiritually, and physically when they are sexually exploited/abused.
The consequences of child sexual abuse are felt personally, within the family,
community, and society. The victims often feel a sense of low self esteem, guilt,
and have difficulty expressing their feelings. Suppressing the feelings created
by the sexual abuse can also have serious psychological and physical
ramifications. Sleeping and eating habits are often altered. Their ability to
concentrate and effectively manage personal issues are frequently impaired. The
family and community can be the victims' greatest strength, by providing
support, guidance and love. Or, they can be their greatest weakness by
maintaining or encouraging secrecy, isolation, mistrust, rigidity of roles and
rules, role reversal, jealousy, scapegoating, and stress (plus more).
Individuals, families, and society need to break the cycle of violence by addressing the attitudes, opinions, and behaviours that have an
unhealthy and damaging effect. In alarming numbers, the family which is supposed
to be the cradle of nurturance, is actually a cradle of violence. Child
abuse/violence is a symptom of a greater problem and is part of a cyclical
pattern. The long term effects of sexual abuse on the victim come primarily from
having to keep the secret of not being able to confide in loved ones and gain
their support, and from having a person who they have loved and cared for break
a sacred trust (these are only a few, and are meant as examples).
We can break the cycle of abuse/violence through healing, education, training,
and support. By building a safe caring environment in our society and within the
family, children will be able to express their thoughts and feelings. They will
feel and believe they are a valuable and an intricate part of their family and
community. It is important to realize that incest is not perpetrated by sexual
deviants, but by people abusing others in the family system in order to fulfill
non-sexual needs. The gratification the perpetrator receives is more one of
power, control, dominance, and the illusion of being with someone that loves and
cares for them, and not primarily one of sexual gratification. (This is not to
say that the offender does not feel sexually aroused by it, because they usual
do. However, it plays little part in why they abuse the child/person in the
first place.)
THE PEOPLE TREATED
Of the many distinct categories of sexual offenders the Y.F.S.A.T.P. focuses
primarily on one type of offender: the "regressed" sexual offender. Unlike the
"fixated" offender, or "pedophile", who has a fundamental or exclusive sexual
predisposition for children, the regressed sexual offender's primary sexual
enticement is for adults. Their sexual interest with children is an attempt to
replace their adult relationships which have become unfulfilling or
conflict-ridden. As a result of "sexualizing" needs which are non-sexual in
nature, the offender tends to select a child as a proxy for an adult. They
relate to this child as if they were a peer or age mate. The offenders treated
through the Y.F.S.A.T.P. are almost exclusively "regressed" sexual offenders,
not pedophile or hebophiles.
The victims treated through our program, whether male or female, children,
adolescents or adults, have all experienced some form of family violence and/or
unwanted sexual acts enacted by a member of their family or by someone in a
position of trust or power over them. The scope of sexual contact is anywhere
from the showing of pornographic material to intercourse, occurring once or
repeatedly. The victims range in age from newborns to seniors (The oldest person
we have had in therapy was 96 years old). Siblings (brothers/sisters) of sexual
assault victims are also treated, as they too are traumatized.
The non-offending parents treated are either the mothers or the fathers of the
child who has been sexually assaulted. Treatment is also provided (where
required) to the parents of the offender or non-offending parents (victim's
grandparents) and the siblings of offenders or non-offending parents (victim's
aunt and uncle). In some cases, treatment goes as far back as two or three
generations.
TREATING THE FAMILY WHERE SEXUAL ABUSE HAS OCCURRED
Treatment services are provided to both individuals and families through our
program. Prior to the provision of these services, each person is interviewed in
order to determine if our agency can provide the service which best meet their
treatment needs. Not every person or family applying is accepted into our
program. The reasons for denial into the program are wide and varied, however,
the two most common are, the program is filled to capacity, or the families'
needs require a process not available through our agency.
When the initial interview is completed we ask the person to think about what
we've reviewed and then conclude if they still wish to enter a process of
therapy. We seldom accept a person into therapy immediately after the first
interview, without first giving them adequate time and personal privacy to make
a well informed and thought out decision. We usually ask or suggest that the
person speak to other counsellors/programs and review their options. When
interviewing the person/family we review with them the therapeutic process, and
inform them about things they can expect to experience and/or encounter in the
treatment process. We seek to provide an accurate picture of what therapy is
like and not one that gives false hope and expectations.
When people enter the process of therapy, they are often in a crisis state and
the family system is frequently fragmented. The fundamental concerns we have at
the start of therapy is to ensure the safety and well being of the victim and
other children in the family. If people don't feel safe, they will likely not
engage themselves in the healing process and may feel a lack of trust and
disloyalty by the very system there to help them.
Our program believes that individuals and families have their own personal and
collective needs, and therefore, it is important that an individualized
treatment plan be developed for each person, and that that plan be dovetailed
together with the overall plan for the family. We do not take people and have
them fit into our model, but instead develop a process to fit their treatment
needs. Our therapeutic model employs a systemic, holistic, eclectic approach to
healing.
Although our program provides services most often to families, we also have many
individuals/people working through their own issues with no immediate or
extended family members involved. It should be noted that the decision to
incorporate family members into the treatment process is the decision of the
individual and not that of the program.
Children and other family members are never placed in a position to accept
anyone, including the offender, back into their life. If, however, they desire
to explore their relationship with certain people, including the offender, and
want to resolve the past issues/abuse, the program has the mechanisms to
clinically evaluate and assist them. All efforts are made to ensure that people
are safe, and that the decisions made are well thought out with all options
thoroughly explored.
When we are providing services to families where an offender is involved in the
therapeutic process, the offender is usually (almost always) living outside the
family home and is not residing where there are children. If a court process
does not stipulate this as a condition, then it is discussed with the family and
the offender voluntarily leaves the home. This assists in ensuring the safety of
the children and aides in empowering them. It is also necessary to both identify
and correct the problems dealing with the role of family members and because
incest tends to have its basis in issues pertaining to power and control over
other people, it is extremely difficult to deal with these issues with the
offender residing in the home. The offenders' absence also allows time for the
victim, their siblings, and mother to begin working on their relationships.
Incest tends to be a self-perpetuating problem
unless the cycle is broken by a therapeutic intervention. Most offenders and
non-offending spouses suffer from low self-concept and many come from a
background where incest and child sexual abuse has occurred within their own
families; most have, themselves, been sexually assaulted. Acting in the way they
have been taught, they tend to enter into unhealthy adult relationships which
reflect and perpetuate the abuse they have suffered in their past. Role
reversal, for example, is a recurring pattern. In a family where sexual abuse
has occurred, the child victim often ends up "parenting" the parents.
Many non-offending spouses enter marriage hoping their spouse will provide them
with the nurturance and security that was lacking in their family of origin.
Yet, without realizing it, they often seek a partner who has some of the same
attributes and qualities as their non-nurturing and absent caretakers or
parents. Thus, when they fail to receive the emotional support they need from
their spouses, they turn to their children for support, just as their own
parents may have done with them.
For similar reasons the sexual offender may also seek "parenting" from their
child victim. For the child, the premature and inappropriate sexual experience
with an adult, and the fact that they are unable to disclose the secret, serve
to exacerbate the role confusion, and it promotes a "pseudo-maturity". Without
therapeutic help for the individuals involved, the conditions are set for a
multi-generational cycle of role reversal and abuse. The goals of therapy are to
break the cycle and assist all the family members to relate to each other in a
healthy manner.
THE INITIAL PHASE OF TREATMENT
For our program, the first intervention in child sexual abuse usually occurs at
the point of disclosure by the victim. The person hearing the disclosure may be
a teacher, nurse, friend, parent, social worker, or police officer. Sensitivity
is needed on the part of the person hearing the disclosure because the child is
torn between conflicting needs. On the one hand they want to disclose in order
to end the abuse, and on the other, they may want to shield the offender and
avert causing "problems" for the family. The child is also perplexed as to
whether what is happening is right or wrong. Frequently the offender tells them
that they are special and that no one loves them as much as they do, and they
are often fearful about the aftermath of revealing the abuse.
The child will often disclose only selective information, often to test the
reaction of others. How their disclosure is handled is of great significance to
them. They need support and help through the process of disclosing. If they are
not believed, or otherwise traumatized as a result of their disclosure, they may
recant their statements and seek to deal with the abuse on their own. Without
immediate therapeutic intervention the chance of the abuse ceasing on its own is
limited.
THE THERAPEUTIC PROCESS:
INDIVIDUAL THERAPY FOR VICTIMS
Understanding the distinct issues regarding the traumatic impact on the sexually
abused child is essential for treatment to be effective. Most of these issues
revolve around their fears and negative self-image. They may fear being
physically injured by the offender or other members of the family. They may fear
the continuation of the abuse, and if intercourse has occurred (vaginal or
anal), they may fear that this has caused some physical damage to them.
In addition, the victim is often afraid of being punished or of being rejected
by loved ones. These fears are intensified if, when the abuse is disclosed,
family members direct their anger, frustration, and blame at them. The victim
already feels guilty about the sexual abuse and they may feel responsible
because they did not know how to stop it. The victim's feelings of shame, guilt,
and of being "damaged" cause them to be very concerned as to how society views
them. If their friends are suddenly prohibited to associate with them, their
negative self-image will be reinforced. Social, family, and community isolation
imposed upon them by others may influence them to segregate themselves further
compounding the problem. This is often the case when a child victim has had to
restrict their outside relationships and rely on an unhealthy family to meet
their social/personal needs.
At the same time, the victim also fears that the family will break up. The
offender may have threatened that this will occur if they disclose the abuse and
often tells them that they will be to blame. This leads to intense fears and
elevates a sense of responsibility for holding the family together which they
may try to do by sacrificing themself. Consequently, most child abuse victims
show some signs of being depressed prior to, during, or after the disclosure.
This depression may be masked over as most victims have learned to hide their
feelings. In addition to powerful feelings of guilt and fear, the victim often
feels hurt and betrayed. These experiences make it very difficult for the victim
to ever trust people again.
All the feelings of shame, guilt, fear, hurt, betrayal, and rejection combine to
undermine the victims' self-confidence and self-esteem. As a result of these
influences, victims of sexual abuse may outwardly appear to be very passive and
compliant, but inwardly many are seething with anger and hostility. Their anger
(in part) arises from feelings of powerlessness and being unable to control the
direction of their lives. These feelings may be directed towards the offender,
parents, family members, neighbors, friends, school personnel, classmates, or
other people within the community. It can also be used to deny other feelings
such as pain, hurt, and sadness.
The goals of individual therapy are to assist the child in learning to express
their feelings and thoughts, to realize that they are important, and to build a
healthier self-image and self-esteem. They are helped to realize why they were
chosen by the offender (to be sexually assaulted), to understand why the abuse
persisted, and why they are not responsible for it. They are helped to replace
angry self-abusive behaviours such as running away, alcohol or drug abuse, and
violence, with more positive avenues of expression. They are helped to become
empowered, assertive, and develop a healthy awareness of themselves, their family,
and community.
At a certain point in therapy it is not uncommon to discover that some victims
have committed sexual assault in their past. It is important that this
information is revealed and fully addressed.
The victim has many issues to understand, resolve, and explore between them and
their non-offending parent(s) and siblings. At certain stages in the therapy
process, the victim usually elects to address these issues with them. Again,
this is their choice and they are not forced or pressured to do so, however, we
have found that most victims have a desire to work on these relationships. The
victim begins to address these issues, usually after they have gained some
healthier sense of self and feel safe that they will be heard, respected, and
validated. In many cases the extended family members, including the
grandparents, uncles, aunts, and cousins, are part of the healing process for the
victim.
The victims are never placed in situations that are threatening or de-powering.
Their thoughts and feelings are valuable, important, and they are encouraged to
address and express them. They are never forced or pressured into forgiving
(that is their choice), into having an offender return into the family system,
into speaking to the offender, into not charging the offender, or into doing
something they don't feel safe doing.
The victims are usually involved in individual therapy on a weekly basis. These
sessions range in duration from 1 to 4 hours. They are also involved in group
therapy, with sessions once a week lasting approximately 5 to 7 hours (depending
on their age). The victims are involved in dyadic sessions with their parents
and siblings (and possibly the offender, if they so choose). The victims are
also involved in family therapy and remain in the therapeutic process for
approximately 16 - 24 months.
INDIVIDUAL THERAPY FOR NON-OFFENDING PARENT(S)
Whether the non-offending parent is the mother or father, they tend to react in
a similar manner when they discover that their child has been sexually
assaulted. They frequently have numerous issues to address as a result of their
own past unresolved issues. Among these issues are a possible impaired
self-image, denial, and an inability to trust. In most sexually abusive families
the non-offending parent suffers from feelings of low self-worth, inadequacy,
lack of trust, denial, and difficulty dealing with feelings. Many are themselves
victims of past incest or sexual abuse. Some of them may have suspected that the
family was not functioning in a healthy manner.
At a certain point in therapy it is not uncommon to discover that some
non-offending parents have committed sexual assault in their past. It is
important that this information is revealed and fully addressed.
Their own past history of betrayal and abandonment, often by their parents,
community, and spouses, often make it very difficult for the non-offending parent(s) to trust. Their relationships with other people tend to be
characterized by suspiciousness, hostility, ambivalence, and withdrawal. The
non-offending parent(s) are helped to understand their own history of abuse, to
identify unreasonable/unrealistic expectations, to develop/set personal limits,
to develop assertiveness, to develop a positive self-image, to understand the
violence in their home, and to understand that the only person responsible for
the incest or sexual abuse is the offender. Other issues that are addressed are
those of the involvement of the social services and legal system and their
impact on the family. Many non-offending parent(s) believe that the criminal
justice system is punitive against them and their children.
The non-offending parents (NOP) are usually involved in individual therapy on a
weekly basis. These sessions range in duration from 1 to 4 hours. They are also
involved in group therapy, with sessions being once a week and lasting
approximately 4 to 7 hours. The NOP's are involved in dyadic sessions with their
children, their spouse, and possibly their own parents and siblings. The NOP's
are also involved in family therapy and remain in the therapeutic process for
approximately 16 - 24 months.
INDIVIDUAL THERAPY FOR THE OFFENDER
Like the victim and non-offending parent, the offender often comes from a
background of emotional and psychological deprivation. Many have been abused as
children. Because of their background, offenders tend to be very insecure and
have an impaired self-image and self-esteem. They tend to see themselves as a
failure and believe that they are unloved, uncared for, and unworthy.
In some cases, the offender may exhibit a "Jekyll and Hyde" syndrome:
they seem somewhat passive in their daily life, until met with
confrontation, when they explode in aggression or violence. In other cases
they appear to be seething with rage most of the time (there are other personality scenarios as well).
The offenders often enter the therapeutic process in order to avoid jail, and/or
other personal consequences. It is naive to assume that just because they are
caught for the abuse that they are now all of a sudden willing to take personal
responsibility for their action. However, it is incorrect to assume that they
don't want to heal their own pain and the problems they have created. Our own
process of therapy has found that most regressed sexual offenders regret their
actions and want to change.
The process of change for regressed offenders is slow, but progressive.
Initially, many comply for the sake of compliance. However, when confronted by
the therapist or offenders in the offenders group, "going along for the ride"
becomes very difficult for them.
The offender often denies that sexual abuse/incest has occurred. They may have
utilized a multitude of rationales to permit them to sexually touch a child.
Through treatment they begin to comprehend that they alone are responsible for
the sexual abuse. They are helped to face and share their own past history of
abuse and address issues of power and control. Other therapeutic goals are to
improve self-image and self-esteem, increase the awareness and healthy
communication of feelings, and develop impulse control and empathic ability.
They address their manipulative behaviour and develop an understanding of
why they sexually abused the child. They learn to differentiate between
their thoughts and feelings, and develop listening skills (these are a few of the areas that
are addressed, and is by no means a complete list).
The offenders are usually involved in individual therapy on a weekly basis.
These sessions range in duration from 1 to 4 hours. They are also involved in
group therapy, with sessions once a week lasting approximately 4 to 7 hours. The
offenders are involved in dyadic sessions with their children, their spouse,
possibly their own parents and siblings, and possibly with the victim (if the
victim so chooses). The offenders are also involved in family therapy and remain
in the therapeutic process for approximately 16 - 24 months.
INDIVIDUAL THERAPY FOR SIBLINGS
Although siblings of sexual abuse/incest victims may not have been sexually
abused, they may experience a great deal of pain. The unhealthiness of the family
structure, the offenders' abuse of power and control, and the process of
manipulation and coercion, leaves the siblings with many issues to deal with,
such as, developing trust and self-esteem, gaining a sense of self-identity,
dealing with denial, learning self-control, and learning to express their
thoughts and feelings.
At a certain point in therapy it is not uncommon to discover that some siblings
have committed sexual assault in their past. It is important that this
information is revealed and fully addressed.
The siblings are usually involved in individual therapy on a weekly basis. These
sessions range in duration from 1 to 4 hours. They are, at times, involved in
group therapy, especially if they are also victims of sexual abuse. The siblings
are involved in dyadic sessions with their siblings and parents, and possibly
with the victim's offender (if the need is there, and only if they so choose).
The siblings are also involved in family therapy. They remain in the therapeutic
process for approximately 16 - 24 months.
GROUP THERAPY
At about the same time that the individual therapy begins, each person may also
become involved in group therapy with other people who share similar
circumstances: victims join a victims' group, offenders meet with offenders'
etc. Groups meet once a week and operate anywhere from 4 to 7 hours.
For the child victim, meeting in group therapy with others who have been
sexually victimized helps them to realize that they are not alone, that others
have experienced many similar feelings and thoughts, and that the trauma of
abuse can be effectively dealt with. The support of other victims' further helps
them to deal with the issues they face in individual therapy. The group process
for victims is based on a therapeutic process, and not a support group
philosophy.
Offenders meet and discuss personal issues with others who have committed sexual
offenses. They too, with the support of the group and direction of the
therapist, confront the same issues they face in individual therapy. The group
provides them with a safe place to practice expressing feelings and to develop
empathy for others. It is also where they explore ideas, set goals, and learn to
listen and communicate in a healthy positive manner. The group process for
offenders is based on a therapeutic process, and not a support group philosophy.
Similarly, non-offending spouses and siblings receive support and assistance
from the group and direction from the therapist to face the issues they must
deal with. They work on issues of self-image, self-esteem, communication,
sexuality, and assertiveness. The group process for the non-offending spouse(s)
and siblings is based on a therapeutic process, and not a support group
philosophy.
RECONSTRUCTING THE FAMILY
It is important to note that it is not the responsibility of the program to
determine whether or not the family stays together. We make no attempt to direct
the family towards reuniting. We only assist them to address the many issues
that they themselves need to understand if they choose to make this decision on
their own.
For the first three or four months of treatment, the offender is segregated (by
the court, or voluntarily) from the rest of the family. During this time, the
child victim meets in individual therapy and with the non-offending parent and
sibling(s) in dyadic sessions. This provides a means for them to work on and
resolve issues that have been created, such as, feelings of jealousy, resentment,
anger, abandonment, betrayal, and more.
After three or four months of individual and group therapy, the offender begins
their reintegration into the family through dyadic sessions with the sibling(s)
of their victim. In these sessions, the offender addresses the abusive and
manipulative ways that they have exercised power and control over them. It
is not always the siblings they meet with first.
At about the same time, or slightly later, depending on the readiness of both
people, the offender meets with the child victim for the first time in the
therapist's office. In this session the offender explains to the victim why they
sexually assaulted them and what they believed they gained from it (it should be
noted that the offender at this time still does not have a complete
understanding of the impact of their offence, but enough to assure the victim
that it was not the victim's fault). The offender accepts full and unabridged
responsibility for the sexual abuse and for the manipulative coercive manner in
which they set up the child to be abused. In the same session, the child often
explains their thoughts and feelings (as they understand them to be at that
time) to the offender so that the offender can understand (and begin to feel)
the damage they have created. This encounter begins to bring home to the
offender the reality of what they have done. If this session is beneficial to
both the child victim and the offender, then they may continue to meet on an
ongoing basis, once every couple of weeks or so, until their involvement in
treatment needs to become more regular. Around the sixth to ninth month, they
meet dyadically with the therapist on a weekly to bi-weekly basis.
The offender then begins couple therapy with their spouse at or around four to
six months into therapy. During this process they discuss issues such as why
they got married, the quality of their marriage, and what the future holds for
them as a couple. They develop communication/listening skills and address issues
of power and control (and more). At about the eighth month of therapy, the
offender begins to make a transition in treatment from thinking and believing
that they are responsible for the sexual abuse, to actually feeling their own
pain and developing an understanding for the pain of their victim(s). When this
occurs, a night-and-day transformation takes place in the way the offender deals
with anger, frustration, hostility, happiness, sadness, responsibility, and
accountability.
At approximately the eleventh month, if all members of the family agree, the
offender goes home for the first time for a one to four hour visit with a clear
set agenda. A scrupulous review of the visit (by the therapist) is conducted and
if the situation appears beneficial for all, home visits continue and increase
over time. Once the home visits begin, the offender makes a slow transition back
into the family system, usually over a period of 2 to 5 months.
Family therapy has likely been in operation for a month or two by this time
(when the offender begins to go home). By the twelfth to fifteenth month in
treatment, the offender may be home on a full time basis while continuing with
their individual, group, couple, and family therapy.
After treatment has been completed, often between 16 to 24 months, the offender
and their families are involved in a follow-up process for approximately five
years in order to assess how well they are coping, to see if the offender
re-offends, and to assess the strength of the family system.
To this date, and to our knowledge, we have found only one offender who
has recommitted the sexual assault. Statistically, offenders who receive a jail
term without treatment often recommit within two weeks to a few months after
their release. As well, there have been less than six families who have
separated/divorced after therapy was completed, even though this is not
necessarily the goal of therapy.
IDENTIFICATION OF SOME OF ISSUES ADDRESSED IN THERAPY
In the therapeutic process many issues are addressed. The focus is not centered
only on the sexual abuse, but on all areas of the person's life. An example of
some of these issues are described below.
* poor self-esteem
* poor self-image
* denial
* anger
* guilt
* shame
* past physical abuse
* past psychological abuse
* past emotional abuse
* past neglect
* abandonment
* residential school experience
* alcoholism
* drug abuse
* gambling
* sexuality
* communication methods (skills)
* parenting skills
* role reversal
* sleep patterns
* eating habits
* illnesses (medical history)
* child birth
* eating disorders
* offending behaviours
* victimization patterns
* enabling
* manipulation
* suicide
* pseudomaturity
* family alienation
* feelings
* thought
* loneliness
* depression
* phobias
* regressive behaviour
* personal hygiene
* personal safety
* withdrawal
* sexual promiscuity
* peer relationships
* lying
* stealing
* school problems
* attention span
* truancy
* hostile behaviour
* morals
* ethics
* values
* beliefs
* culture
* isolation
* fantasy
* attitudes
* expectations of self and others
* use of pornography
* exhibitionism
* blaming
* defense mechanisms
* minimizing
* repression/selective memory
* procrastination
* reaction formation
* contact with police, social services etc.
* child welfare system
* authority figures
* heritage/tradition
* community
* family systems
* loyalty
* gossip
* socialization
* spirituality
* mind/body/emotions/spirit
* dually affected families
* A.C.O.A.'s (C.O.A.'s)
* grieving/loss/death
* trust
* self-care
* love
* finances (planning)
* relationships
* intimacy
* bestiality
* dissociation
CONCLUSION
The treatment process is lengthy and demanding. Because individuals are unique,
it is impossible to gage how each person will do in treatment as a whole. For
some families, from the point of disclosure through to the completion of
treatment, the process is relatively smooth and free of legal or therapeutic
problems. For others it can be very difficult and far more complicated. The
child may be met with anger, frustration, or rejection following disclosure. The
offender may sincerely want treatment to deal with his problems, but receive a
jail term instead. Or the offender may deny that the abuse occurred, and thus
make the child and family go through a difficult court trial. The non-offending parent(s) may support the offender, thus making it necessary to remove the
child(ren) from the family home.
These problems are very unfortunate and difficult to handle. It would be a
mistake to assume that immediately following disclosure a dramatic improvement
is made in the quality of life of any family where violence has occurred.
However, we have had hundreds of individuals and families go through the
therapeutic process and most have turned their lives around. These people are
now living healthy, productive, lives.
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