Treating Child Sexual Abuse in Family, Group and Clinical Settings

Culturally Intelligent Practice for Caribbean and International Contexts

Adele D. Jones, Ena Trotman Jemmott, Hazel Da Breo, Priya Maharaj

• Publisher: Palgrave Macmillan
• Year: 2016
• Print ISBN: 9781137377685
• eBook ISBN: 9781137377692
• Topic: Social Sciences
• Subtopic: Criminology
• Index: Social Sciences

  

© The Author(s) 2016

Adele D. Jones, Ena Trotman Jemmott, Hazel Da Breo and Priya MaharajTreating Child Sexual Abuse in Family, Group and Clinical Settings 10.1057/978-1-137-37769-2_1

Begin Abstract

1. The Gifted Practitioner

Emotionally Intelligent Practice; Self-care

Adele D. Jones¹ , Ena Trotman Jemmott², Hazel Da Breao³ and Priya E. Maharaj⁴

(1)

The University of Huddersfield, Huddersfield, UK

(2)

Florencena Consulting, Bridgetown, Barbados

(3)

Sweet Water Foundation, Grenada, Grenada

(4)

The Alpine Project, La Romaine, Trinidad and Tobago

End Abstract

Introduction

This book is about practice and interventions for abused children, their families and abusers too. Our work on violence against children and child sexual abuse (CSA), in particular, continues to be informed by the theoretical lens of intersectionality,¹ ecological systems theory and the public health approach, Our aim is produce knowledge and interventions to prevent sexual abuse and other forms of gender-based violence across entire societies rather than at the individual level. The first two books in this series were also informed by these lenses. It is important, though, that while we seek to tackle abuse at the societal level, we pay mind to the needs of individuals who are harmed by abuse and that we recognise that the statistics the public health approach seeks to reduce are composed of individual acts of harm stacked one on top of the other. So, we have written a book that provides an ecological approach to dealing with the effects of abuse on individuals and families. Using case studies, we demonstrate the interconnecting factors that contribute to children’s maltreatment and explore some clinical and therapeutic approaches to assisting them and their families. Our approach shows the non-linearity of causes and effects of abuse, reminding us that the uniqueness of each child’s situation requires a specific and individual response. However, we should also be cognisant of the common factors that contribute to abuse, and where possible we should provide group prevention and treatment interventions. Children’s resiliency following abuse and the extent of any adjustment difficulties they may face (such as certain mental health outcomes like depression, conduct disorder and attempted suicide) are influenced by a range of factors. An important objective of this book, therefore, is to increase critical thinking about the imperative need for a range of child, family and group interventions within the Caribbean for responding to the harm of sexual abuse. Sometimes the interventions we describe are taken directly from practice—these are examples of actual treatment approaches we have used. Other times we provide examples of interventions that would be appropriate for the cases presented; in these instances, these are hypothetical treatment approaches. We have used approaches from the fields of social work, clinical psychology, psychotherapy, art therapy and organisational psychology; for example, we borrow the concept of Emotional Intelligence (EI), derived from organisational psychology, to argue for reflective practice.

The academic framework for this book is informed by the theories of intersectionality, ecological systems and EI. This suits our focus: the introduction of therapeutic approaches to child abuse in the Caribbean for family, group and clinical settings. We recognise, though, that the practitioner’s life story to some extent may mirror that of some of her or his clients/service users. For is it not true that the systems and intersecting factors that contribute to the environments in which abuse flourishes are the very environments out of which we too are born—the activists, the researchers and the practitioners working to ameliorate its effects. The EI model is intended to help bridge the client–therapist dichotomy and to generate the reflective skills that make for the gifted practitioner.

This book is about abused children and practitioners/clinicians/therapists (for succinctness, we often use ‘practitioners’ to cover the range of professional roles) who assist them and their families to overcome the effects of harm. The methods and models of practice we describe have been carefully selected to ensure their relevance to Caribbean contexts. We begin not by focusing on the clients and service users of abuse and trauma work but by thinking about you, the practitioner.

Writing about institutional failings within the Caribbean in regard to the protection of children’s rights to grow up free from abuse, Jones and colleagues (2014) commented:

there are many committed persons … who are working tirelessly to protect children and to prevent abuse and … there are examples of excellent practice in many agencies. These people work with limited resources, little recognition and often, inadequate remuneration; yet it is to them we owe thanks for the many children and families who are supported in dealing with abuse. Child sexual abuse is invisible, but so too are the survivors and the actions of those who may have helped them out of victimhood … working in the child protection field is exhausting and leads to fatigue, emotional burnout and frustration (162).

Jones and her colleagues were making the point that preventing and treating child abuse is not easy work. There can be few fields of practice in which one is required to bear witness to some of the worst of adult behaviours and yet at the same time be humbled by amazing displays of a child’s resilience. And there can be few fields of practice that exact so much from the professional. This therapeutic work demands a range of skills, knowledge and attitudes on the practitioner’s part, over and beyond the obvious clinical expertise, and therefore it is important that we also pay some attention to the psychological needs of the professional. The gifted practitioner is not necessarily the practitioner with the highest levels of expertise, training and skills; he or she is not the person who can command the highest fees or who can point to the best results. The gifted practitioner is a reflective practitioner—this is the person who is aware of the emotional impact upon themselves of the work they do and uses the process of self-reflection for personal and continuing professional development, for their own empowerment and for building the intuitive knowledge that cannot be obtained in the classroom. Reflective practice increases the value of therapeutic work, it can produce unexpected outcomes and solutions to problems that may seem to be beyond imagining, it helps to generate creative and emancipatory possibilities and it can help to keep in check biases and judgements that have no place in equality/human rights-based work. It is beyond the scope of this book to go into any great detail about the professional requirements of therapeutic work with survivors of CSA; so we have chosen to introduce the EI model to help inform the adaptive and emotional functioning of practitioners as they interface with the myriad of traumatic conditions facing children.

At the outset, we put in a disclaimer of sorts because we are not suggesting that EI is something that should be addressed in the rather superficial manner that we are guilty of here. It should not. Its virtues, however, need to be known. It speaks to a range of sensitive and cognitive abilities and capacities of the individual. Its value might be pitted against the global standard of measuring human intelligence—the intelligence quotient (IQ) yardstick—in our view, a reductionist approach that undervalues the breadth and depth of emotional skills (McClelland, 1973).

IQ and EI

The EI research shows that it is twice as important as IQ in predicting outstanding performance. A practitioner’s work is not usually described in such performance terms, because of the sheer number of unpredictable variables that cannot be foreseen or measured in as tangible a way as non-therapeutic work. This uncertainty in itself demands the kind of approach which can best deal with ambiguities. The gifted practitioner requires more than a particular IQ score.

Emotional skills, which is what EI refers to, reflect a lifetime of learning (Lopes and Salovey 2004) that people bring to their understanding of the problems that confront them. Brackett and Salovey (2004) suggest, however, that it may be possible to stimulate the development of emotional learning even among those (such as children) who have not had the benefit of a lifetime of varying experiences:

if traditional schooling increases cognitive abilities … it might be possible that educational programs focusing on social and emotional abilities stimulate EI. In fact, it appears that infusing emotional literacy programs into existing school curricula can help increase emotional knowledge and work against the initiation and progression of harmful behaviors such as excessive alcohol consumption, illegal drug use and deviant behavior (Brackett and Salovey 2006, 39).

The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) (Mayer et al. 2003), which measures psychological and behavioural outcomes of EI-based work, would be one way of putting Brackett and Salovey’s observations to the test. However, for the purposes of this book, we are content to accept the general tenet of Brackett and Salovey’s ideas, that EI is potentially available to everyone and greater awareness of emotional capacity can ward off the development of self-harming behaviours (Brackett and Salovey 2006). The starting point for the gifted practitioner—the emotionally intelligent practitioner—is to know oneself.

Applicability of EI in Therapeutic Settings

‘There are three things extremely hard: steel, a diamond, and to know one’s self.’ Benjamin Franklin (1750 Poor Richard’s Almanac, cited in Association for Psychological Science 2005, 1)

Knowledge of the self is the bedrock on which all other sources of knowledge pertinent to working with survivors of abuse and trauma are layered. The overestimation or underestimation of the capacities and sensitivities of the self is a self-deception which clouds judgement and causes us to stand tall and pre-eminent when humility might be needed or to shrink away with a lack of confidence when we need to stand tall. This can apply to all of us, the social worker or psychologist who underestimates or overestimates his or her skills in helping a traumatised child and mother; the doctor who may overestimate or underestimate his or her ability to treat a particular condition or the psychotherapist in his or her self-reflection of how well an intervention with clients is going. The relationship between self-assessment of a person’s knowledge and skill and the person’s actual performance, when measured objectively, reveals some surprising findings:

In general, people’s self-views hold only a tenuous to modest relationship with their actual behavior and performance. The correlation between self-ratings of skill and actual performance in many domains is moderate to meager—indeed, at times, other people’s predictions of a person’s outcomes prove more accurate than that person’s self-predictions. In addition, people overrate themselves. On average, people say that they are “above average” in skill (a conclusion that defies statistical possibility), overestimate the likelihood that they will engage in desirable behaviors and achieve favorable outcomes, furnish overly optimistic estimates of when they will complete future projects, and reach judgments with too much confidence. Several psychological processes conspire to produce flawed self-assessments (Dunning et al. 2004, 69).

Achieving congruence between how a person views their performance and how they actually perform is the goal of EI—but what assists them in achieving this state, and what would a fully congruent picture of them painting a picture of themselves look like? Dunning and colleagues (2004) use this metaphor to describe the complexity of self-evaluation and why what we see when we are in reflective mode may not be what others know:

We feel that the psychological literature has painted only a few brushstrokes toward a portrait of the person as self-evaluator—and there is much more painting to be done to complete that portrait. But, perhaps more important, there is also much work to be done about another portrait well worth painting. That second portrait is one that depicts what an individual looks like when he or she has achieved an accurate impression of his or her talents, capacities, and character. How one retouches the first portrait to create the second is an issue that requires much more theoretical and empirical work (Dunning et al. 2004, 99).

At this juncture, we should recognise that there is a large body of psychological research on the ‘presentation of self’ that we cannot do justice to in this book, but recommending an EI model is an acknowledgement of this fact. As Dunning and colleagues (2004, 69) state ‘Several psychological processes conspire to produce flawed self-assessments’, the questions arise, therefore, how can we better evaluate our abilities, needs and areas for development and how can we better manage the emotional impact of the work we do? The clinical focus of this book compels us to recognise these psychological and cognitive processes and the part they play in our everyday activities and the shaping of our behaviours. Writing about EI, Mollon (2002) identifies several emotions that can impact our well-being, shame being one of them; ‘Shame is a response to failure and to ensuing feelings of inadequacy-especia...

Table of contents

• Cover
• Frontmatter
• 1. The Gifted Practitioner
• 2. Working with Adolescent Girls who have been Sexually Abused
• 3. Working with Children with Learning Disabilities
• 4. Working with Young People with Harmful Sexual Behaviour
• 5. Interventions with Children in Residential Care
• 6. Art as a Therapeutic Modality
• Backmatter