Teenage dating abuse, also called dating violence or teen domestic violence, is any type of abuse that takes place between two teens in a dating relationship. Dating abuse may be emotional, physical or sexual in nature. Dating abuse is a huge problem, not only because it's prevalent among teens but only 40% of victims reach out for help (only 21% of perpetrators ask for help).

Why Do Teens Stay in Abusive Dating Relationships?

While it may seem like the obvious choice, many people have trouble leaving a dating relationship, even if it is abusive. This is true both in adults and in teenagers. Some of the reasons teens stay in abusive dating relationships include:¹

• Love – everyone wants to be loved and if the victim feels the perpetrator loves them, they may not want to give that up. Additionally, the victim may believe that no one else will ever love them the way the abuser does. The abuser may rely on this false belief in order to continue the abuse.
• Confusion – because teens are new to dating, they may not have enough experience to spot violent or abusive behaviors. They may confuse violence and abuse with love, especially if they grew up in an abusive household.
• Belief he or she can change his or her partner – teens may cling to the hope that their partner can change if they just "do all the right things." Unfortunately, abuse tends to worsen over time – not get better.
• Promises – abusers often promise to stop the abuse and say they are sorry and sometimes victims believe them. This is referred to as the cycle of violence and abuse.
• Denial – as with anything we don't like, sometimes we like to pretend it's not there. It's natural to want to deny abuse in a relationship but that never makes it go away.
• Shame / guilt – some teens may feel the violence or abuse is their fault; however, violence is always only the fault of the abuser.
• Fear – teens may fear retaliation or harm if they leave their abuser.
• Fear of being alone – like the desire to be loved, many people have a desire to be together with someone, even if that someone is abusive, just so they don't have to be alone.
• Loss of independence – teens may fear that telling their parents about an abusive relationship may put their recently-gained independence at risk.

Dealing with Teenage Dating Abuse

As with any violent relationship, teenage dating abuse must be stopped. Teenage violence is no more acceptable than adult violence and, in fact, it's against the law. It's important to remember that it is never the fault of the victim – no one deserves to be emotionally, physically or sexually abused.

According to loveisrespect.org, an organization dedicated to eradicating relationship violence, there are many steps you can take if you find yourself in an abusive dating relationship. If you choose to stay with an abusive partner, it's important to know that violence can escalate quickly, so protect your safety:²

• If you go to an event with your partner, make sure to plan a safe ride home
• Avoid being alone with your partner
• If you are alone with your partner, make sure someone knows where you are and when you'll return

Teenage Dating Abuse – Breaking Up

A better idea, though, is to break up with the person who is abusing you. A breakup, especially when dating abuse is present, may not be easy, however, so try these planning steps:

• You might be scared of being lonely without your partner. This is normal. Talk to friends and find new activities to fill your time.
• Write down the reasons you're leaving your partner so that later, if you're tempted to re-enter the relationship, you're reminded of the current dating abuse.
• If your partner has been controlling, it may be challenging to again be making your own decisions. May sure you have a support system ready for these times.
• Put safety measures into place before the actual breakup. More information on safety plans can be found here.

Once you have planned for the breakup it's time for the actual event. Breaking up is never easy but if it is what will keep you safe, it is the right thing to do. Remember – trust yourself. If you think you have a reason to be afraid, you probably do.

Here are some tips for breaking up:

• If you don't feel safe, don't break up in person. It may seem cruel to break up over the phone or through an email, but that may be the best way to stay safe.
• If you break up in person, make sure to do it in public and have your support system nearby in case you need them. Take a cell phone with you in case you need to call for help.
• Don't bother trying to explain your reasons for breaking up more than once. It is likely nothing you can say will make your ex happy.
• Let your friends and family know you are breaking up especially if your ex is likely to visit them.
• If your ex visits you while you're alone, do not open the door.
• Ask for help from a professional such as a counselor, doctor or anti-violence organization.

Once you have broken up with your abuser, keep in mind, you still may not be safe. It's still important to maintain good safety habits like:

• Don't walk alone and don't wear earbuds while walking
• Talk to a school counselor or teacher you trust so that your school can be a safe space. Adjust your class schedule if you need to.
• Keep friends or family close in places where your ex might hang out.
• Save any threatening or harassing messages your ex sends. Set your profile to private on social networking sites and ask friends to do the same
• If you ever feel you're in immediate danger, call 911
• Memorize important numbers in case you don't have access to your cell phone

Help with Teen Dating Abuse

To get help with teenage dating abuse contact loveisrespect.org. This national program provides a hotline, live chat, texting and other services: 1-866-331-9474

The National Domestic Violence Hotline provides crisis intervention, information and referrals to anyone touched by domestic violence, including professionals. Call: 1-800-799-SAFE (7233)

The Rape, Abuse and Incest National Network (RAINN) is an anti-sexual assault organization. Call: 1-800-656-HOPE (4673)

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Would you know how to spot child physical abuse? Despite the popular notion that physical child abuse is rare, almost 200,000 cases were reported in the United States and its territories in 2007. The actual number of cases is probably much higher because many people fail to report known or suspected abuse.

Social workers and other health-related professionals used to refer to signs of child physical abuse as battered child syndrome. This terminology referred to the bone fractures and related injuries occurring when the child was too young to accidentally become injured in this way.

Physical Child Abuse Definition

Experts have now expanded the physical child abuse definition. They now define it as:

non-accidental injury resulting from hitting, whipping, beating, biting, kicking, or anything that harms a child's body.

Children in physically abusive situations often have unexplained broken bones, bruise marks in the shape of an object such as a belt or hand, or burn marks from cigarettes on exposed areas or on the genitalia.

Physical Child Abuse – How and Where to Report It

You may encounter someone that exhibits the signs of physical child abuse at a family or school event, church gathering, or any number of places. Sometimes health care professionals identify physical child abuse when an adult brings a child to the emergency room with an unlikely explanation about how the injury occurred. Sometimes it's evident that the injury is old.

If you see a child with unexplained bruises, black eyes, choke marks around the neck, human bite marks, lash marks, or the like, it's your responsibility to report it to the proper authorities.

All states have laws in place requiring you to report known or suspected child physical abuse or neglect. You can call your own health care provider or your state's Child Protective Services.

Most states have a child abuse hotline that you can call to report child physical abuse. You can also call the Child Help National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453). Of course, if you suspect a child is in immediate danger, call 911 immediately.

What Happens After You Report Child Physical Abuse?

Child Protective Services (sometimes called Social Services, Human Services, Human Welfare, or Children and Family Services), the police or emergency services will never reveal your identity to the child or any adults involved in the abusive situation.

Social workers and other appropriate authorities will investigate the situation and evaluate whether or not abuse or neglect has occurred. If they determine the child is being abused or neglected, they may temporarily or permanently remove the child from the situation and he or she will undergo further diagnostic tests and exams. The investigative team will then come up with the best possible recovery plan for the child.

Parents or other adults involved in inflicting physical child abuse will need therapy and sometimes other (more punitive) interventions. Recovery prognosis for the child depends upon the extent of the abuse, the nature of the injuries, and the psychological effect these experiences have had on him or her.

Read more about Healing from Child Physical Abuse.

Please, if you suspect child abuse or neglect, report your concerns to the proper authorities. You may be wrong, but it's better to err on the side of caution, especially when an innocent child hangs in the balance.

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Signs of physical child abuse are easier to spot than other types of abuse, such as neglect or emotional abuse. In order to help an abused child, you've got to know how to recognize the signs. Just as the presence of one of the signs associated with diabetes doesn't mean the person actually has the disease, the presence of one sign of physical child abuse doesn't necessarily mean a child is suffering abuse. But – noticing just one sign of child abuse may hint that a closer look is in order.

Signs of Physical Child Abuse

While people rarely openly abuse children, certain signs of physical child abuse can indicate a need for further investigation. Below are some signs of physical abuses. Please note that these basic signs may not be readily apparent in some physically abused children.

Visible signs of physical child abuse

• Unexplained or frequent bone fractures
• Black eyes
• Bruises in areas of the body not typically injured by accident vs normal childhood activities
• Human bite marks
• Burns on the arms, legs, or around the genitalia
• Cigarette burns
• Bruises shaped like objects, such as a hand or belt buckle
• Unexplained lacerations or cuts
• Marks around the wrists or ankles, indicating someone may have tied the child up

Behavioral signs of physical child abuse

• Depression
• Withdrawal from friends and social activities
• Poor (unbelievable) or inconsistent explanations of injuries
• Unusual shyness
• Avoidance of eye contact with adults or older kids
• Excessive fear of caretakers – this could be fear of the parent(s) or of a nanny or babysitter
• Antisocial behavior (older kids) like truancy, drug abuse, running away from home
• Child seems overly watchful, on edge, as if anticipating something bad is going to happen
• Expresses a reluctance to go home

Parental or Other Caregiver Behavior Indicating Possible Child Abuse

• Demeans the child. Sees him or her as wholly bad and burdensome
• Expresses little concern for the child and his or her performance in school, visible injuries, etc.
• Rarely touches or displays physical affection toward the child
• Thinks of the relationship as completely negative
• Verbalizes dislike for the child

Physical Child Abuse Images

It's important to look at some physical child abuse images, so you can recognize the injuries if you come across them. If you've never seen a child with a cigarette burn, you may not recognize it as such right away.

The image below shows a child with the circular burn typically caused by a cigarette.

Photo credit: reference.medscape.com

Notice the bruising on the face of this child, which resembles a handprint.

Photo credit: laboratoryconsultationservices.com

The child in this physical child abuse image shows laceration marks from being whipped.

Photo credit: childabuse.com

It's important to note that these and many physical child abuse images you may find online and elsewhere represent readily apparent injuries. Not all abused children have injuries on exposed areas. Some abusers cleverly inflict the injury on areas of the body usually covered by clothing.

If a child whimpers in pain from a hug or other gentle touch, he or she may have an injury concealed by clothing. Also, it's rare for a young child to accidentally get a black eye during normal play activities, although it does happen on occasion. Observe the parent (or other caregivers) and child relationship. Does it seem unusually strained? Unloving? Does the adult in the relationship seem to harbor resentment or disdain toward the child?

Ask the adult caregiver about the child's injuries after you've asked the child. Inconsistency or unbelievable stories as to how the injuries occurred may warrant closer investigation by proper authorities, such as your local Child Protective Services or other similar agency.

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The effects of child physical abuse may last a lifetime and can include brain damage and hearing and vision loss, resulting in disability. Even less severe injuries can lead to the abused child developing severe emotional, behavioral, or learning problems. Injuries to a child's growing brain can result in cognitive delays and severe emotional issues – problems that could adversely affect his or her quality of life forever.

Some effects of child physical abuse may manifest in high-risk behaviors, such as excessive promiscuity. Children who develop depression and anxiety due to their abusive past often turn to smoking, alcohol and illicit drug use and other unhealthy, dangerous behaviors to cope with their emotional and psychological scars. Of course, long-term, things like smoking, excessive alcohol consumption, and promiscuity can lead to cancer, liver damage, and infection from sexually transmitted diseases. This is why it's so important to recognize the signs of child physical abuse and take immediate action by reporting the abuse to the proper authorities.

Primary Effects of Child Physical Abuse

The primary, or first, effects of child physical abuse occur during and immediately after the abuse. The child will suffer pain and medical problems from physical injury and, in severe cases, even death. The physical pain from cuts, bruises, burns, whipping, kicking, punching, strangling, binding, etc., will eventually pass, but the emotional pain will last long after the visible wounds have healed.

The age at which the abuse occurs influences the way the injuries -- or any permanent damage -- affect the child. Infant victims of physical abuse have the greatest risk of suffering long-term physical problems, such as neurological damage that manifests as tremors, irritability, lethargy, and vomiting. In more serious cases, the effects of child physical abuse can include seizures, permanent blindness or deafness, paralysis, mental and developmental delays and, of course, death. The longer the abuse continues, the greater the impact on the child, regardless of age.

Emotional Effects of Child Physical Abuse

The emotional effects of child physical abuse continue well after any physical wounds have healed. Numerous research studies conducted with abused children as subjects have concluded that a considerable number of psychological problems develop as a result of child physical abuse. These children experienced significantly more problems in their home lives, at school, and in dealing with peers than children from non-abusive environments.

Some psychological and emotional effects of child physical abuse include:

• Eating disorders
• Inability to concentrate (including ADHD)
• Excessive hostility towards others, even friends and family members
• Depression
• Apathy and lethargy
• Sleep issues – insomnia, excessive sleepiness, sleep apnea

Physically abused children are predisposed to develop numerous psychological disturbances. They're more likely to have low self-esteem, deal with excessive fear and anxiety, and act out aggressively toward their siblings and peers.

Social Effects of Child Physical Abuse

The adverse social effects of child physical abuse represent still another facet of the child's life influenced by the abuse. Many abused children find it difficult to form lasting and appropriate friendships. They lack the ability to trust others in the most basic of ways. Children who have suffered long-term abuse lack basic social skills and cannot communicate naturally as other children can.

These children may also exhibit a tendency to over-comply with authority figures and to use aggression for solving interpersonal issues. The social effects of child physical abuse continue to negatively influence the adult life of the abused child. They're more likely to divorce and develop drug and alcohol addictions.

Adults, who were physically abused as children, suffer from physical, emotional and social effects of the abuse throughout their lives. Experts report that victims of physical child abuse are at greater risk of developing a mental illness, becoming homeless, engaging in criminal activity, and unemployment. These create a financial burden on the community and on society in general because authorities must allocate funds from taxes and other resources for social welfare programs and the foster care system.

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Healing from child physical abuse involves much more than merely treating the physical wounds and injuries resulting from physical abuse. Recovery and healing require that the child receive treatment for the multitude of emotional and behavioral issues that arise in the physically abused child. Therapists and other mental health professionals will help the child learn to cope with pain and fear caused by the abusive adults in their lives – adults who should be trusted authority figures.

Children who do not receive this critical help will experience difficulty healing from child physical abuse. Failing to provide post-abuse help can lead to severe psychological issues, such as posttraumatic stress disorder (PTSD).

Useful Interventions for Healing from Child Physical Abuse

Every person's recovery process is unique, but mental health professionals use several interventions regularly to help children in healing from child physical abuse. These children often need to learn skills for coping with anxiety and managing their anger in appropriate ways. Therapists may recommend play therapy to provide children with a safe way to express and work through painful emotions that contribute to their psychological difficulties.

Other common interventions include:

• Role-play therapy
• Teaching relaxation techniques
• Teaching anger management skills
• Providing supervised group interactions with others
• Social skills training
• Psycho-education on family violence

Stages of Healing from Child Physical Abuse

Recovery from traumatic events involves various stages and healing from child physical abuse is no different. The stages of healing from physical child abuse may include:

• Denial – children develop unhealthy coping skills to mask the negative feelings and emotional issues brought on by the abuse
• Reaching out – at this point, the danger of remaining quiet about the abuse becomes more frightening than the danger involved in speaking out and asking for help
• Anger – after they begin to get help, the child becomes more aware of the negative impact the abuse has had on his or her life and often must deal with uncomfortable feelings of intense anger
• Depression – child abuse survivors begin to recall the unfair and intense criticisms, negative messages, and painful childhood physical abuse that lead to sadness and depression
• Clarity – the survivor begins to see his or her emotions and feelings associated with the abuse more clearly and honestly and to share them in safe ways that do not harm themselves or others
• Regrouping – positive changes in the person's attitudes and feelings toward the past abuse. He or she has developed a new sense of trust in others, trust in themselves, and begins to form new, healthy relationships.
• Moving on – this final stage is the most important for healing from child physical abuse and involves a shift in focus from the devastation and negative effects of their experiences toward empowerment (read about: Effects of Child Physical Abuse)

It's important to recognize that healing from child physical abuse involves a commitment from people in every facet of the child's life. Teachers, therapists, caretakers, and extended family members can all provide vital help and skills to the victim.

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If you or anyone you know has hurt a child, you may need to seek therapy and counseling to develop skills that allow you to cope with children's behavior and to discipline effectively. Who would hurt a child? Physical abuse occurs in families of all socioeconomic backgrounds, although children living in single parent, lower-income households are at a higher risk of experiencing physical and sexual abuse. Regardless of these factors, any child, regardless of gender or age, could become a victim of physical abuse.

Hurt a Child? Not Me!

Don't think you could ever hurt a child? Hopefully not, but a landmark research study, Third National Incidence Study of Child Abuse and Neglect (Sedlak & Broadhurst, 1996), shows that children of single female parents, especially those where there is no connection with the father, carry a significantly higher risk of becoming abusers.

This certainly does not mean that all single parents have the potential to engage in the physical abuse of children. Simply that physical abuse of children occurs in single-parent households at twice the rate of those in two-parent households.

The social isolation, lack of caregiver resources, and low levels of emotional support increase stress levels and the burdens of parenting in single-parent households. Single parents may lack adequate models from their pasts and often do not have the skills to make sound disciplinary choices. These factors all contribute to and can lead to the physical abuse of children.

Lower Income Families at Higher Risk for Physical Abuse of Children

Physical abuse of children occurs a lot more often in households earning less than $15,000 annually. In fact, the NIS-3 study, referenced above, shows that children in households below the poverty line are sixteen times more likely to suffer harm and injury due to physical child abuse. The stressors associated with low-income households can lead parents to use inappropriate discipline methods that experts consider physically abusive.

Other Risk Factors Making People More Likely to Hurt a Child

Other risk factors that make a parent more likely to hurt a child, neglect their child, or employ inappropriate discipline methods include:

Parental Risk Factors

• Negative attitudes and lack of knowledge – negative attitudes toward child behavior (whether good behavior or bad) and lack of knowledge about child development can contribute to physical abuse of children. These parents or caregivers have unrealistic expectations of their child's development.
• Marital conflict and domestic violence – children who witness domestic violence are more likely to experience physical abuse themselves. Even if they do not experience the abuse, they may suffer significant psychological issues due to witnessing the violence.
• Stress – High levels of stress – from financial concerns, health issues, social isolation, and interpersonal problems – can cause parents to have inappropriately strong responses to their child's behavior.
• Dysfunctional parent-child interaction – parents who lack appropriate parental modeling from their own pasts, rarely recognize and reward positive behaviors of their children. Likewise, they mete out inappropriately harsh disciplinary strategies rather than positive parenting strategies (e.g. reasoning, time-outs, encouraging successes).

Child Risk Factors

Children with the following risk factors are at a higher risk of becoming victims of physical abuse:

• Children with medical issues or developmental delays
• Unwanted children (accidental pregnancy)
• Difficult children (children with behavior problems, such as ADHD)
• Children with babysitters under considerable life stress
• Children with significant mental health issues, such as schizophrenia, major depression, or substance addictions

Recognizing these risk factors and getting help for at-risk families could alleviate some of the danger that the children involved will suffer physical abuse. Education about proper parenting and effective discipline as well as directing the family toward social services that can mitigate some of their financial burdens may help break the cycle of child abuse.

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While decades ago child sexual abuse was rarely recognized, we now realize as a society that sexual abuse is a huge problem affecting our population. It is estimated that up to one-in-three females and one-in-six men were sexually abused in childhood. Professionals' estimates vary widely, however, as it's believed that childhood sexual abuse is dramatically underreported with most not admitting to child sexual abuse until adulthood.

Definition of Sexual Abuse

In its simplest form, child sexual abuse is any sexual encounter that occurs between a child and an older person (as children cannot legally consent to sexual acts). This abuse may involve contact, like touching or penetration. It also includes non-contact cases, like "flashing" or child pornography.

However, in practice, there are actually two working definitions of child sexual abuse. One definition of childhood sexual abuse is used by legal professionals while the other is used by clinical professionals, like therapists.

In the realm of legal definitions, both civil (child protection) and criminal definitions exist for child sexual abuse. Federally, the definition of child sexual abuse is contained within the Child Abuse Prevention and Treatment Act. Sexual abuse is defined to include:¹

• "(A) the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or
• (B) the rape, molestation, prostitution, or other forms of sexual exploitation of children, or incest with children;..."

The age under which one is considered a child varies by state and sometimes an age differential between the perpetrator and the victim is required.

Clinical Definition of Child Sexual Abuse

Clinicians, like psychiatrists and psychologists, though judge childhood sexual abuse more on the effect it has on the child and less on a cut-and-dried definition. The traumatic impact is generally what clinicians look for in cases of sexual abuse. (Read about: Effects of Child Sexual Abuse on Children)

A clinician often considers the following factors when differentiating abusive from non-abusive acts:

• Power differential – wherein the abuser has power over the abused. This power may be physical or psychological in nature.
• Knowledge differential – wherein the abuser has a more sophisticated understanding of the situation than the abused. This may be due to an age difference or cognitive/emotional differences.
• Gratification differential – wherein the abuser seeks gratification for themselves and not the abused.

Circumstances of Childhood Sexual Abuse

In most cases, the abused child knows their abuser and the abuser is someone who has access to the child - such as a family member, teacher or babysitter. Only one-in-ten cases of sexual abuse involve a stranger. Childhood sexual abusers are normally men, whether or not the victim is a female.²

Children may be abused in a variety of situations including:

• A two-person (dyadic) relationship involving one abuser and one victim
• Group sex – may involve one or more abusers and one or more victims
• Sex rings
• Child pornography
• Prostitution
• Abuse as part of a ritual

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Child sexual abuse is a terrifying idea to contemplate for any parent, but not knowing the child sexual abuse signs can be a big mistake. Missing symptoms of child sexual abuse can mean allowing a child who needs help to go without it and possibly even allowing an abusive relationship to continue.

It is a myth that children report sexual abuse directly after it occurs. More often, people ignore, repress and deny child sexual abuse, often until adulthood. It is only through subtle signs of child sexual abuse that many cases of sexual abuse are even uncovered.

Symptoms of Child Sexual Abuse

Symptoms of child sexual abuse vary depending on the age of the child, the type of abuse and on the child himself (or herself). Different people will react differently to abuse. It's also important to realize that even if seen, the signs and symptoms of sexual abuse may be related to another circumstance altogether and so one should never jump to the conclusion that sexual abuse is occurring.

Symptoms of child sexual abuse are similar to those of other emotional problems such as depression, severe anxiety or nervousness. Symptoms of child sexual abuse include:¹

• Eating disorders such as anorexia or bulimia
• Vague complaints of stomach pain or headaches
• Sleep problems
• Bowel disorders, such as soiling oneself (encopresis)
• Genital or rectal symptoms, such as pain during a bowel movement or urination, or vaginal itch or discharge

Child Sexual Abuse Signs

In addition to the physical symptoms of sexual abuse, there are additional child sexual abuse signs. The specific signs are often related to the age of the child with younger children being less able to process and express sexual abuse.

Particularly in children age 12 and younger, the following are signs of child sexual abuse:²

• Lack of self-esteem/self-destructiveness – the child may make statements that they are worthless, harm themselves or even exhibit suicidal ideation
• Advanced sexual knowledge – the child may possess knowledge beyond his level of development, specifically detailed sexual information.
• Being depressed, withdrawn or excessively fearful
• Drop in school performance
• Sexualized behavior – such as dressing seductively or acting sexually through dolls, around peers or adults. The child may also masturbate excessively.
• Distress around a particular person – the child may not want to spend time with a particular adult
• Seeking excessive time with an adult – he may also be given extra attention, gifts, privileges, etc.
• Aggressiveness
• High-risk behaviors or drug use

A child may also show signs of sexual abuse in play or through art. Older children may drop hints of sexual abuse before actual disclosure to "test the waters" and see how adults will react to the news. In this case, it's important not to lead the child's disclosure and to be as open, caring and non-judgmental as possible.

More information on Sexual Abuse Help: Where to Find It

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If the unthinkable has happened, people need to know how to report child sexual abuse. There are many ways to report child sexual abuse including child abuse hotlines. Reporting child sexual abuse, though, often starts with the act of disclosure on the part of the child and this disclosure must be handled carefully in order to facilitate the effective reporting of child sexual abuse. Victims of child sexual abuse often feel a lot of shame and guilt attached to the experience and are less likely to come forward than victims of other types of violence. Because of this, false reports of child sexual abuse are rare.

Disclosure of Child Sexual Abuse

Children often drop hints before formally disclosing sexual abuse. Adults might hear statements like:

• I don't like ____ anymore.
• ____ plays games with me I don't like.
• You'll be mad at me . . .
• I'm bad . . .

It's only by listening very carefully that a suggestion of child sexual abuse is noticed. Children are more likely to report abuse to adults that they think are non-judgmental, won't be mad or already know about the abuse. Learn more about Warning Signs of Child Sexual Abuse.

What to Do If a Child Discloses Sexual Abuse

If there is a report of child sexual abuse to be made, it's important that the information is handled delicately. If a child discloses sexual abuse:¹

• Remain calm and don't pass judgment
• Reassure the child that you believe her (or him) and are there to keep her safe
• Tell the child you are proud of her
• Show appropriate affection
• Listen carefully and never lead a child to say something specific or "fill in the blanks"
• Take the child seriously and clarify what she is saying by saying something like, "I'm not sure I understand – can you please tell me again what you're saying?"
• Understand that child may not know all the proper words for what they are describing

Disclosure of child sexual abuse often takes place in bits and pieces, possibly even with the child denying the abuse at times. It's important to understand that what they are saying may not initially make sense to an adult and they may have trouble with sequences of events.

How to Report Child Sexual Abuse

Any time it is suspected, it is critical to report child sexual abuse to the authorities. If sexual abuse has just taken place, the child should be taken to the nearest emergency room for a physical examination. The only evidence of a crime may be gone within hours or days, so it's important to get the exam as soon as possible. A physical exam will also ensure there is no physical damage to the child from the abuse.

If the abuse is in the past, it should immediately be reported to law enforcement or a child welfare agency. Many agencies can help the adult and child through the process of reporting child sexual abuse.

Child abuse hotlines include:

• 1-888-PREVENT (1-888-773-8368) - Stop It Now
• 1-800-656-HOPE Rape, Abuse & Incest National Network (RAINN)
• The National Children's Alliance can help you through reporting and treatment

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People recover from child sexual abuse every day but most require treatment for child sexual abuse. Unfortunately, most won't receive sexual abuse therapy until they are adults, as only about 30% of child sexual abuse is reported by children. Nevertheless, there is treatment for child sexual abuse available for both children and adult survivors of sexual abuse.

Stages of Sexual Abuse Recovery

It is recognized by mental health professionals that there are stages to sexual abuse recovery. While people may jump from stage to stage and not necessarily process things neatly in discrete stages, there are basically three steps to sexual abuse therapy and recovery. These steps are experienced somewhat differently by children and adults.¹

1. Goals and Basic Safety
   1. Get a “roadmap” of treatment and set goals
   2. Establish safety within one’s body and life
   3. Tapping into one’s inner strength and other supports for healing
   4. Learning how to manage sexual abuse symptoms

Stage one is not about processing memories of the sexual abuse but rather preparing the person and strengthening her (or him) to the point where she will be able to process those memories.

2. Remembrance and Mourning
   1. Reviewing and discussing memories to lessen their impact
   2. Working through the grief about the abuse and the negative effects it has had on one’s life

Sexual abuse therapy, at this stage, is often eye movement desensitization and reprocessing (EMDR) or prolonged exposure (PE). (More about these therapies below.)

3. Reconnecting
   1. Reconnecting with people, activities and other meaningful aspects of life

Types of Sexual Abuse Therapy

There are several types of sexual abuse therapy and many therapists incorporate components from multiple types. For children and adolescents, three general types of therapy are common:

• Family therapy – needed in many cases but young children particularly require the intense participation of the caregivers.
• Group therapy – more common for adolescents who are more independent
• Individual therapy

The type of treatment of sexual abuse chosen and the specifics of what will happen in that therapy depends on many factors including the age of the victim and the type and severity of the sexual abuse. Art therapy is commonly used with young children who have trouble expressing what happened directly.

For adults, those three types of sexual abuse therapy are also options but there may be specific therapies applied on top of those general types. The therapies for sexual abuse most well-studied include:

• Dialectic behavioral therapy (DBT) – designed to help people that are having problems regulating emotions and with self-destructive tendencies – common in people who have been sexually abused.
• Eye movement desensitization and reprocessing (EMDR) – involves the rapid reprocessing of traumatic memories to reduce their influence, without the in-depth discussion seen in other types of therapy.
• Prolonged exposure (PE) – involves the detailed narration of sexual abuse events in a safe setting in order to fully incorporate new ways of thinking about the memories and realizing the old events can no longer hurt the victim.

No matter the chosen therapy, sexual abuse recovery is possible at any age.

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