Conflicted Loyalties: Working with Families where Sibling Incest has Occurred Presented by: Kevin Wade, LCSW-C

Presentation Objectives Defining sexual abuse/sibling incest Characteristics of families Roles of family members Treatment Case Studies

CHILD SEXUAL ABUSE Child sexual abuse is when an adult, adolescent, or older child partakes in any sexual activity with a child, either through the use of force and coercion or charm or persuasion 20% of girls and 10% of boys have been a victim of sexual abuse prior to 18 Discuss the what is child sexual abuse article- areas highlighted

Sibling Incest Research has shown that 60% of outpatient psychiatric patients report having engaged in sibling incest Typically age difference of about 5 years Misrepresentation of facts, aggression, and threats Produces fear and anxiety in the victim Discuss developmental differences and knowledge about sex

Characteristics of Families Non-protective home environment Poor boundaries with little regard for physical and emotional space or individual needs for privacy Physical or emotional absence of one or both parents Frequent unresolved issues Poor communication avenues for children Trauma

Family Characteristics Poor conflict resolution Isolation from the community Role confusion Trauma

ROLES Everyone in the family plays a role- system issue We must recognize the choice Determining what those roles are will promote healthy system recovery Recognizing the roles pre and post disclosure

ROLES Mother and her trauma Offender used the roles of the family to offend 3 things exist for an offense to occur

Juvenile Offender Categories Naïve experimenters Under-socialized child exploiters Sexual aggressive Sexual compulsives Disturbed impulsive Group influenced Pseudo socialized

Juvenile Offender Categories Important to identify for treatment and system health Three paths: Dead end Delinquency path Sex interest path involving further sex offending

TREATMENT for JUVENILES WHO HAVE COMMITTED SEXUAL OFFENSES Containment Treatment: Integrated, inclusive and thorough participation of the multi-disciplinary treatment team, community, and family members Effective with equal balance of authority and nurture Emphasis on accountability and establishing community safety

TREATMENT for JUVENILES WHO HAVE COMMITTED SEXUAL OFFENSES Cognitive Behavioral Component: Thoughts Feelings Behaviors

TREATMENT for JUVENILES WHO HAVE COMMITTED SEXUAL OFFENSES Relapse Prevention Model: Identification of the chain of events or sequence which comes prior to an offense Cycle of abuse

Cycle of Abuse Triggers/event PMS Isolation/withdraw Fantasy/planning Power and control- getting the “juice” Offense Transitory guilt Denial and justification

Common Issues and Problems Faced by Incest Survivors Anxiety Depression Low self-esteem Shame and guilt Inability to trust Fear of feelings Nightmares Insomnia

Common Issues and Problems Faced by Incest Survivors Amnesia Violence Discomfort with touch Compulsive sexual activity Overachievement/underachievement Eating disorders

Case Studies Joe and Carol Jasmine and Cody