When our practice with children and teens in psychotherapy, or in medical and other practice areas, reveals a history of childhood sexual abuse, we often find it is challenging to know how to proceed. What are we to look for in terms of the impact of abuse? Often, the history of child sexual abuse (CSA) is eclipsed by the acute presentation. These presenting problems are usually variations on trauma symptoms such as inattention, hyper-vigilance, impulsivity, easy frustration, poor social skills, and other emotional, social and cognitive concerns (Finkelhor, 2009). Although these are trauma-related problems, too often, they are not conceptualized as the sequelae of trauma. Instead, the presenting problems among children who experience sexual trauma are often diagnosed as ‘external
izing disorders’. 

 Social workers are expected to conduct a preliminary assessment of sexualized behavior, but are often unprepared to do so (Finkelhor, et al., 2010).  Few social workers are familiar with how to assess these, this training will conclude with guidelines for the assessment of sexual behaviors in children and teens.

Learning Objectives: 

 Upon completion, readers will:

1. Understand current research and practice findings in social work assessment and intervention that support resilience in sexually abused children. 

2. Critically evaluate stigma associated with child sexual abuse (CSA) in two ways:

○○First, in terms of its historical foundations, and how stigma has influenced social policies in child welfare.

○○Second, how stigma contributes to assessment and intervention that tends to omit the importance and the impact of the betrayal of caregiver relationships when a child is sexually abused.

3. Appreciate the significance of assessment and intervention that address the relationship violations that characterize CSA.

4. Apply research and practice findings that differentiate the developmental etiologies of relational trauma associated with CSA, from the etiologies of childhood disorders with similar presentations

5. Assess and understand differences in the behavioral manifestations of relational trauma, especially in terms of children’s and adolescents’ externalizing, sexual behaviors.