BOOK
Psychological First Aid for People with Intellectual Disabilities Who Have Experienced Sexual Abuse
Aafke Scharloo | Simone Ebbers-Mennink | Martine Spijker-van Vuren | Valerie Sinason
(2016)
Additional Information
Book Details
Abstract
People with intellectual disabilities are particularly vulnerable to sexual abuse, and offering them psychological support at the earliest possible moment greatly increases their ability to cope with the event and return to daily life. This book provides a complete, structured, evidence-based programme for providing this help to survivors of sexual abuse with developmental disabilities, both adults and children.
Step-by-step session plans, as well as comprehensive background information and downloadable worksheets, provide the means by which to offer effective help to clients and recover their feelings of safety and trust. Sessions are also included for helping parents and caregivers to cope with their own reactions and emotions on the discovery of the abuse. Each session is adaptable for the needs of people with severe, moderate and mild intellectual disabilities in order to provide exceptional care to every individual who needs it.
This important book considers a whole system approach when supporting the needs of individuals with learning difficulties who experience sexual abuse. Practical exercises appropriate to mild, moderate and severe learning difficulties provide a containing and therapeutic experience for the individual at different stages in the recovery process. Essential reading for professionals, parents and caregivers.
Dr Martina Higgins, former social work manager and co-author of Disability and Child Sexual Abuse: Lessons from Survivors' Narratives for Effective Protection, Prevention and Treatment
This book is the first of its kind to provide a practical guide for those caring for individuals with intellectual and developmental disabilities in the aftermath of the discovery of abuse. Its approach is unique in that it teaches and empowers those who know the victim best, to support the victim and provide timely - nearly immediate - support, information and guidance. The great thing is that those who provide this support, among them the parents, do not require a degree or extensive training! One can work directly from the book and provide needed support. In addition, the book provides updated information on abuse including incidence and prevalence, vulnerability factors, and empowerment strategies for the direct and indirect victims. I strongly recommend this book.
Dr. Nora Baladerian, licensed psychologist and author of the Risk Reduction Workbook
Aafke Scharloo MSc. is a clinical psychologist and remedial educationalist who has pioneered international approaches to helping people with intellectual disabilities recover from sexual abuse. Aafke is a consultant on special cases throughout the Netherlands and lectures internationally on issues concerning people with an intellectual disability, sexual abuse, maltreatment and trauma.
Simone Ebbers MSc. is a healthcare psychologist, child psychologist, EMDR-practitioner and sexologist. She runs a private practice assessing and treating trauma and sexual abuse, and specialises in working with people with intellectual disabilities.
Martine Spijker MSc. is a healthcare psychologist, EMDR-practitioner and psychotraumatherapist. She co-founded a treatment centre for helping children and young adults with mild intellectual disabilities and trauma. Martine also runs a private practice specialising in treating trauma and sexual abuse in children, teenagers and young adults.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Foreword | 15 | ||
| Acknowledgements | 19 | ||
| General Introduction | 21 | ||
| Chapter 1 -The SOS Handbook: Psychological First Aid After Sexual Abuse | 25 | ||
| Introduction | 25 | ||
| 1.1 Target group of the SOS handbook | 26 | ||
| 1.2 The importance of the system | 27 | ||
| 1.3 Task of the behavioural specialist | 28 | ||
| 1.4 Aims of the SOS handbook | 29 | ||
| 1.5 Structure of the SOS handbook | 30 | ||
| 1.6 The SOS help books | 31 | ||
| 1.7 What to do in the case of serious problems after completion of the SOS programme | 32 | ||
| 1.8 Care for yourself as implementer of the SOS handbook | 33 | ||
| Chapter 2 - Sexual Abuse of People with an Intellectual Disability: Explanation and Definition | 35 | ||
| Introduction | 35 | ||
| 2.1 The definition of sexual abuse | 36 | ||
| 2.2 Complex dynamics | 37 | ||
| 2.2.1 The splitting phenomenon | 37 | ||
| 2.3 Sexual abuse and the law | 38 | ||
| 2.3.1 Legal status of people with an intellectual disability | 39 | ||
| 2.3.2 Legal vs. clinical evidence | 40 | ||
| 2.4 Informed sexual consent | 41 | ||
| 2.4.1 Assessing informed sexual consent | 42 | ||
| 2.5 Prevalence of sexual abuse in people with an intellectual disability | 42 | ||
| 2.5.1 Surrounded by care but still not safe | 43 | ||
| 2.5.2 Perpetrators of sexual abuse | 44 | ||
| 2.6 An explanation of the prevalence of sexual abuse in people with an intellectual disability | 45 | ||
| 2.7 The implications of sexual abuse in people with an intellectual disability | 48 | ||
| 2.7.1 Parents | 48 | ||
| 2.7.2 Accumulated powerlessness | 49 | ||
| 2.8 The well-known perpetrator | 50 | ||
| 2.9 Consequences of sexual abuse in victims with an intellectual disability | 50 | ||
| 2.10 Victims of sexual abuse and sexually inappropriate behaviour | 52 | ||
| 2.11 Sexual education for people who have been sexually abused | 52 | ||
| Chapter 3 - The Legal Framework in Cases of Sexual Abuse of People with an Intellectual Disability | 55 | ||
| Introduction | 55 | ||
| 3.1 Reporting obligation, reporting code and sexual abuse protocol | 56 | ||
| 3.1.1 Law reporting code domestic violence and child abuse | 57 | ||
| 3.2 Laws and regulations | 57 | ||
| 3.2.1 Who has to give permission? | 58 | ||
| 3.2.2 In which cases is permission necessary? | 59 | ||
| 3.2.3 Building dossiers and the right to access | 60 | ||
| 3.2.4 Information obligation | 62 | ||
| 3.2.5 Professional confidentiality and the reporting code | 62 | ||
| 3.2.6 The right to refuse to give evidence | 63 | ||
| 3.3 Minimum fact interviews | 64 | ||
| 3.4 Statement or report to the police | 64 | ||
| 3.4.1 Support in making the statement | 67 | ||
| 3.4.2 Talking about sexual abuse and the police interview | 68 | ||
| 3.5 Medical investigation | 70 | ||
| 3.6 Dealing with the media | 70 | ||
| Chapter 4: Trauma and Coping with Trauma | 73 | ||
| 4.1 What is trauma? | 74 | ||
| 4.1.1 Trauma and DSM | 74 | ||
| 4.1.2 Types of trauma | 76 | ||
| 4.2 Trauma – what happens in the brain? | 77 | ||
| 4.2.1 The structure of the brain | 77 | ||
| 4.2.2 The brain and stress | 78 | ||
| 4.2.3 The influence of trauma on the brain structure | 79 | ||
| 4.3 Reactions to trauma | 80 | ||
| 4.3.1 Coping process | 81 | ||
| 4.3.2 Dissociation | 82 | ||
| 4.3.3 Other associated disorders | 83 | ||
| 4.4 Age-specific reactions to traumatic events | 83 | ||
| 4.4.1 Reactions in babies to traumatic events | 84 | ||
| 4.4.2 Reactions in toddlers and young children to traumatic events | 84 | ||
| 4.4.3 Reactions in school children to traumatic events | 85 | ||
| 4.4.4 Reactions in teenagers and adolescents to traumatic events | 86 | ||
| 4.5 Coping with trauma | 88 | ||
| 4.5.1 Psychological rumination | 89 | ||
| 4.6 Trauma and coping with trauma in people with an intellectual disability | 89 | ||
| 4.6.1 Coping with trauma and a disharmonic developmental profile | 91 | ||
| 4.6.2 Attachment and coping with trauma | 94 | ||
| 4.6.3 Dissociation and people with an intellectual disability | 95 | ||
| Chapter 5 - Psychological First Aid for Clients with Intellectual Disabilities After Sexual Abuse | 100 | ||
| Introduction | 100 | ||
| 5.1 Core aspects for initial support | 101 | ||
| 5.1.1 Creating safety | 102 | ||
| 5.1.2 Coping with stress reactions from the client | 104 | ||
| 5.1.3 Psychological first aid for other clients | 107 | ||
| 5.2 The SOS programme for the client with an intellectual disability | 109 | ||
| 5.2.1 Attitude aspects | 110 | ||
| 5.2.2 Preparation by the professional | 111 | ||
| 5.2.3 Alignment with the internal protocols and the police | 112 | ||
| 5.2.4 Time and place of the sessions with the client | 113 | ||
| 5.2.5 Alone or together | 115 | ||
| 5.2.6 Preparing the client | 116 | ||
| 5.2.7 Resistance from the client | 117 | ||
| 5.2.8 Structure of the session | 117 | ||
| 5.2.9 Using the help book | 119 | ||
| 5.3 Client sessions | 119 | ||
| 5.3.1 Client session 1: as soon as possible | 120 | ||
| 5.3.2 Client session 2: after one week | 124 | ||
| 5.3.3 Client session 3: the joint session – after three weeks | 128 | ||
| 5.3.4 Client session 4: follow-up – after two months | 131 | ||
| Chapter 6 - Help Book for People with a Mild or Moderate Intellectual Disability | 135 | ||
| Introduction | 135 | ||
| 6.1 Core aspects for the psychological support of people with a mild intellectual disability | 136 | ||
| 6.1.1 People with a mild intellectual disability | 136 | ||
| 6.1.2 Sexual abuse and people with a mild intellectual disability | 138 | ||
| 6.2 Core aspects in the psychological support of people with a moderate intellectual disability | 139 | ||
| 6.2.1 People with a moderate intellectual disability | 139 | ||
| 6.2.2 Sexual abuse and people with a moderate intellectual disability | 141 | ||
| 6.3 The help book for people with a mild and moderate intellectual disability | 142 | ||
| Exercise: What has happened? | 143 | ||
| Information sheet: Where does that strange feeling come from? | 144 | ||
| Information sheet: Post-traumatic stress symptoms | 146 | ||
| Worksheet: What is bothering you? | 148 | ||
| Worksheet: How do I tell others about it? | 150 | ||
| Worksheet: How have people reacted? | 151 | ||
| Worksheet: Who can I call? | 152 | ||
| Worksheet: Safety agreements | 153 | ||
| Worksheet: What was fine and good? | 154 | ||
| Worksheet: How am I doing? | 155 | ||
| Worksheet: My worries are as big as… | 156 | ||
| Worksheet: Your own tool box | 157 | ||
| Worksheet: What can you say to yourself? | 158 | ||
| Worksheet: Important post | 159 | ||
| Worksheet: My mask | 160 | ||
| Exercise: Fear, and then? | 161 | ||
| Worksheet: Sleep-well plan | 162 | ||
| Exercise: Good night! | 163 | ||
| Worksheet: The animal I look like the most when I’m angry is a… | 164 | ||
| Exercise: Being angry in a good way | 165 | ||
| Exercise: Writing a letter | 166 | ||
| Exercise: Steam is coming out of my ears! | 167 | ||
| Exercise: Blowing bubbles | 168 | ||
| Exercise: Colour | 169 | ||
| Exercise: Spaghetti arms | 170 | ||
| Exercise: Relax! | 171 | ||
| Exercise: Belly breathing | 172 | ||
| Exercise: Sunshine after rain | 173 | ||
| Exercise: Four-leaf clover | 174 | ||
| Exercise: Looking into the future | 175 | ||
| Exercise: Wishing well | 176 | ||
| Exercise: Together we are strong – the plaster | 177 | ||
| Exercise: Together we are strong – the message | 178 | ||
| Exercise: Together we are strong – the song | 179 | ||
| Chapter 7 - Help Book for People with a Severe Intellectual Disability | 180 | ||
| 7.1 People with a severe intellectual disability | 181 | ||
| 7.1.1 Cognitive aspect | 182 | ||
| 7.1.2 Social aspect | 182 | ||
| 7.1.3 Emotional aspect | 182 | ||
| 7.2 Sexual abuse and people with a severe intellectual disability | 183 | ||
| 7.2.1 Physical contact | 183 | ||
| 7.3 Core aspects in psychological support of people with a severe intellectual disability | 184 | ||
| 7.3.1 Observation | 184 | ||
| 7.3.2 Calming sensory experiences | 185 | ||
| 7.4 The help book for the client with a severe intellectual disability | 185 | ||
| Information sheet: Short screening list for sexual abuse of people with a severe intellectual disability | 188 | ||
| Form: Observations and experiences regarding the screening list per session | 190 | ||
| Form: Agreements and experiences of conducting the exercises in the daily situation | 191 | ||
| Exercise: Restoring safety and making contact | 192 | ||
| Exercise: Colour | 193 | ||
| Exercise: How are you doing? | 194 | ||
| Exercise: The elephant | 195 | ||
| Exercise: Swinging | 196 | ||
| Worksheet: Sleep-safe plan | 197 | ||
| Exercise: Look for the triggers | 198 | ||
| Exercise: Rubbish bin/tin can throwing game | 199 | ||
| Exercise: Tearing paper | 200 | ||
| Exercise: Bubble blowing | 201 | ||
| Exercise: Hand and foot massage | 202 | ||
| Exercise: Together we are strong – music | 203 | ||
| Chapter 8 - Support of Parents of Victims of Sexual Abuse with an Intellectual Disability | 204 | ||
| Introduction | 204 | ||
| 8.1 Core aspects for the support of parents | 205 | ||
| 8.1.1 Family system and family culture | 206 | ||
| 8.1.2 Types of sexual abuse | 207 | ||
| 8.1.3 Creating safety | 208 | ||
| 8.1.4 Reactions from parents | 209 | ||
| 8.1.5 Reactions of the child | 211 | ||
| 8.1.6 Dealing with the child’s stress reactions | 213 | ||
| 8.1.7 Other members of the family | 216 | ||
| 8.1.8 The surrounding environment | 216 | ||
| 8.1.9 The coping process of the parents | 217 | ||
| 8.2 The SOS programme for parents | 218 | ||
| 8.2.1 Attitude aspects | 218 | ||
| 8.2.2 Preparation by the professional | 218 | ||
| 8.2.3 Time and place of the sessions with the parents | 218 | ||
| 8.2.4 Structure of the sessions | 219 | ||
| 8.2.5 Using the help book for parents | 220 | ||
| 8.3 Sessions for parents | 221 | ||
| 8.3.1 Parent session 1: as soon as possible | 221 | ||
| 8.3.2 Parent session 2: after a week | 224 | ||
| 8.3.3 Parent session 3: Joint session – after three weeks | 227 | ||
| 8.3.4 Parent session 4: follow-up – after two months | 230 | ||
| Chapter 9 - Support of Healthcare Professionals Working with Victims of Sexual Abuse | 233 | ||
| Introduction | 233 | ||
| 9.1 Core aspects in the support of healthcare professionals involved | 234 | ||
| 9.1.1 A safe and reliable environment for the client | 234 | ||
| 9.1.2 Talking with the client about the sexual abuse | 235 | ||
| 9.1.3 Getting back to normal life | 237 | ||
| 9.1.4 Dealing with trauma reactions of the client | 238 | ||
| 9.1.5 Dealing with stress reactions from parents | 239 | ||
| 9.1.6 Splitting | 240 | ||
| 9.1.7 Transference and countertransference | 242 | ||
| 9.1.8 The personal coping process of healthcare professionals | 243 | ||
| 9.2 The SOS programme for healthcare professionals | 244 | ||
| 9.2.1 Attitude aspects | 244 | ||
| 9.2.2 Preparation by the professional | 245 | ||
| 9.2.3 Time and place of the sessions \nwith the healthcare professional | 245 | ||
| 9.2.4 Separately or together? | 246 | ||
| 9.2.5 The structure of the sessions | 246 | ||
| 9.2.6 Using the help book for healthcare professionals | 247 | ||
| 9.3 The sessions for healthcare professionals | 247 | ||
| 9.3.1 Healthcare professionals session 1: as soon as possible | 247 | ||
| 9.3.2 Healthcare professional session 2: after one week | 252 | ||
| 9.3.3 Joint session: after three weeks | 255 | ||
| 9.3.4 Healthcare professional session 3: follow-up – after two months | 259 | ||
| Chapter 10 - Exercises for the Support of Parents, Caregivers and Professional Caregivers | 263 | ||
| Introduction | 263 | ||
| Information sheet: Sexual abuse | 265 | ||
| Information sheet: Facts and fables about sexual abuse | 267 | ||
| Information sheet: How should I react to sexual abuse? | 270 | ||
| Information sheet: Dos and don’ts for talking about sexual abuse with a victim | 272 | ||
| Information sheet: Reactions to trauma | 273 | ||
| Information sheet: Overview reactions and needs of the child/client | 274 | ||
| Information sheet: Dos and don’ts in the support of victims of sexual abuse | 275 | ||
| Information sheet: Reporting and making a statement of sexual abuse | 276 | ||
| Information sheet: Studio hearing | 278 | ||
| Information sheet: Dealing with the media | 280 | ||
| Information sheet: Tips for and from parents | 281 | ||
| Worksheet: Talking about sexual abuse | 282 | ||
| Worksheet: Secondary traumatic stress checklist | 283 | ||
| Worksheet: Stress symptoms | 284 | ||
| Worksheet: Looking after yourself test | 285 | ||
| Worksheet: Child/client post-traumatic stress symptoms checklist | 288 | ||
| Worksheet: Recognising trauma triggers | 289 | ||
| Worksheet: Session preparation | 290 | ||
| Worksheet: Session evaluation | 291 | ||
| Form to fill in: Name and numbers of helpful people | 292 | ||
| Worksheet: SOS evaluation form | 293 | ||
| Worksheet: Safety agreements | 294 | ||
| Worksheet: Safety and reliability | 295 | ||
| Worksheet: Who needs to know about the abuse and in which way? | 297 | ||
| Worksheet: Thoughts and feelings | 298 | ||
| Worksheet: My fault or not? | 299 | ||
| Worksheet: Scary thoughts | 300 | ||
| Information sheet: How can my child sleep peacefully? | 301 | ||
| Worksheet: I hope I don’t meet him anywhere… | 303 | ||
| Worksheet: Relaxation and letting go of emotions | 304 | ||
| Exercise: Some relaxation techniques | 305 | ||
| Worksheet: Support from people around you | 307 | ||
| Worksheet: And now me! | 308 | ||
| About the authors | 309 | ||
| Notes | 311 | ||
| Blank Page |