Assessment of the Trauma
This chapter reviews the factors that should be taken into consideration when a therapist first meets with a sexually traumatized child and his or her parents. It discusses the initial symptoms exhibited by sexually traumatized children: fear and anxiety, sleep disturbances, somatic complaints, regressive behavior, poor selfesteem, inability to trust, depression with its underlying anger and hostility, poor school performance, inappropriate sexual behavior, guilt, shame, and self-destructive behavior. A significant element in determining the emotional resources available to the child is the length of time that it took the child to report an incident of assault to an adult. When a court has handed down an order that a child be “evaluated” to determine possible abuse of some kind, a different set of contingencies is faced by the clinician. This most often arises in the context of a custody or guardianship dispute, when a judge needs to know what is in the best interests of the chud.