Technologies of social work with children who survived violence
It is generally accepted that victims of rape (adults and children) are usually in a state of post-traumatic stress.
On the one hand, post-traumatic stress is seen as a disorder characterized by the following symptoms:
- a sense of lack of control over one's life;
- changes in the emotional sphere: gloomy mood, chronic suicidal thoughts, thoughts or actions aimed at self-harm, feelings of anger or repressed anger, uncontrolled sexuality in adults, sexualized behavior in children
- changes in consciousness: amnesia or hyperamnesis of a traumatic event, dissociative manifestations, depersonalization and derealization phenomena, experiencing anew in the form of intrusive experiences and memories;
- a change in self-perception: a feeling of helplessness or initiative paralysis, a sense of shame, guilt, self-blame, a feeling of "stigma" ( me print ) and a complete difference from the others;
- changing the perceptions of the rapist, capturing the thoughts of the rapist: the idea of revenge, the unrealistic attribution of the total power of the rapist, the idealization of the rapist, there may be acceptance of the views of the rapist and attempts to rationalize the situation;
- changes in relationships with other people, communication disruption: isolation and avoidance of communication, distrust of people, there may be a need for a constant search for a lifeguard, which alternates with the emergence of a need for isolation, repeated failures in attempts to protect themselves;
- changes in the system of beliefs and values: loss of faith in oneself, in the future, feelings of hopelessness.
There is also a point of view according to which a person can be in a state of post-traumatic stress not only on condition that he himself became a victim of violence (as stated in the first version), but also if he witnessed violence or a traumatic event or learned about that one of the relatives and relatives experienced a serious trauma. As a consequence, a person manifests a personal reaction to the event: fear, helplessness or a sense of horror. Children can show disorganization of behavior, violation of psychomotor.
In the second variant, three signs of post-traumatic stress are called: experiencing the situation anew; the desire to avoid everything related to trauma; constant psychophysiological excitation.
Their manifestations in children who have experienced different forms of violence are quite common, so consider these signs in more detail.
Experiencing the situation again. There are obsessive memories of a traumatic event. In young children, this often manifests itself in the game: they play the same game or constantly repeat the same elements of a tragic game. Happened or similar is repeated in a dream. Children can have frightening dreams, associated not only with trauma, but also with terrible fairy-tale characters. The traumatic event is experienced anew. There are illusions, hallucinations. It may seem that the offender is nearby (especially often it arises in the dark). There is intense psychological distress; internal symbolic event processing. There may be physiological reactivity (redness on the skin, palpitation, etc.).
Example. A five-year-old boy, who fled with his mother from Chechnya, saw a train bombing from the plane. In the orphanage for a whole year, he painted this scene and played in the "train and war". A nine-year-old girl who became a victim of incest, often played in the "bedroom".
The desire to avoid anything related to trauma. The child tries to avoid thoughts, feelings related to trauma, and conversations on this topic. He does not want to be active, engage in any activity; Avoid those places that can remind of an event. He is not able to tell about the important moments of the traumatic event, some moments have disappeared from memory; the interest to life, to significant activity has significantly decreased. The child has a feeling of detachment from other people. There is a reduction of the sensory sphere: the inability to experience a feeling of love for people. There is a feeling that you have no future.
Constant psychophysiological arousal. There are difficulties with falling asleep or sleeping (violation of the spa, early awakening, etc.). Appears excited state or outbursts of anger. Difficulties arise in concentration of attention, increased distractibility, hyper-liberation, for example, heightened vigilance, etc., as well as an increased reaction to possible stress, for example, increased fearfulness.
If all three signs are manifested more than a month, we can talk about the special depth and severity of the severity of post-traumatic stress. If these disorders cause clinically significant distress or worsening in social or other important areas of activity, it often becomes necessary to hospitalize the child.
Highlight acute and chronic post-traumatic stress.
Acute post-traumatic stress is fixed for a duration of symptomatology up to three months, chronic - in three months or more.
In children exhibiting signs of post-traumatic stress, we can distinguish three types of behavioral reactions:
- expressive - the child has strong emotions, he can cry and laugh, tremble, swing, scream, sob; the main thing - can not control emotions;
- controlling - the child tries to restrain emotions and behaves quietly
- shock - the child is as though deafened, depressed, it is difficult to understand what happened to him.
Reactions can change each other.
Specialists in the field of working with children who have been subjected to sexual or physical violence believe that there is no generally accepted formula for crisis intervention. Interventions in the form of crisis intervention and short-term psychological counseling are effective in the case of a single incident. With prolonged violence, it takes a long time, not only with the child, but with the whole family.
There are the following general recommendations to educators, parents and psychologists.
1. Listen carefully to the child.
2. To compare with the child for understanding of the meaning of words for adults and vice versa.
3. Discuss on examples of what is good and bad touch.
4. Discuss the right of the child: who can allow him to touch him, and who does not; whom the child has the right to touch himself.
5. Explain to the child that the bad touch can come from close people.
6. Teach a child to say "no" when trying to "bad" touch.
7. Discuss with the child the need to tell adults about any incidents that embarrass him and cause embarrassment. Convince that no one will accuse him of anything.
In general, researchers believe that the most difficult and lengthy work with children who survive violence occurs when, in addition to the fact of committed violence, the child has long-standing psychological and behavioral problems.
The main goal of the work of a psychologist with victims of violence is to reduce and eliminate traumatic experiences.
In the process of counseling these children, an extremely important aspect is the establishment of a psychologist's contact with the client-child, and the emphasis should be placed on the constant demonstration of caring for the child. Most likely the child will constantly check by adequate and inadequate ways, as far as the psychologist really cares about him.
The basic techniques of counseling should be aimed at overcoming the child's feelings of inferiority, inferiority, guilt, and the formation of adequate self-esteem. Feeling of guilt leads to the fact that the child is deprived of a certain freedom of action, the behavior becomes self-destructive: the child, as it were, gets stuck in the past, in the traumatic situation of violence. Therefore, it is important to bring the child to the understanding that you can not forget what happened, but you can live with it in a new quality.
The following tasks are faced to a psychosocial specialist:
- to help reduce a child's feelings of shame, guilt, impotence;
- help in strengthening the sense of self-worth;
- to form new behavioral patterns;
- to promote differentiation of interaction with surrounding people
- to promote the development of the child's perception of his own organism, self-determination.
The place chosen for the conversation should be primarily comfortable for the child. Counseling is best conducted in a gaming or relaxation room, rather than in the office or classroom. This helps to relieve tension from the child, the appearance of a sense of greater security and control over the situation. It is not advisable to create an atmosphere of a "state house", but it should be noted that excitable children are easily distracted by bright objects, telephone, ticking clock, noise outside and even a fish floating in the aquarium. Excess of toys in the room for conversation is not allowed. Also, it should be noted that the psychologist himself should not look bright: wear eye-catching jewelry or a patterned tie, so as not to distract attention.
Furniture in the room should be comfortable not only for an adult, but for a child. Do not sit at the table during counseling, as this will create an additional barrier between the adult and the child. Children see in people sitting at tables, some authoritative figures - directors, teachers. It is necessary to remember that children prefer low enough stools that legs could get to the floor.
It is believed that the counseling process is more successful if children can control the distance between themselves and the adult, since adults are too aggressive in initiating a conversation with children. Therefore, with the optimal variant of accommodation, the specialist sits opposite the child, and on the side of them there is a desk, a table or a coffee table so that the child can always use this barrier (hide behind him, moving a chair), if he is so comfortable. Sometimes professionals prefer to work with the child directly on the floor, sitting on the carpet to make the atmosphere more relaxed.
The specialist should serve as an example of compulsion for the child, do not be late and, if possible, do not postpone the meeting, as this can be interpreted as a lack of interest and cause anxiety, irritation.
When choosing the time of the conversation, it is necessary to take into account the regime of the day, which is especially important for young children. During the conversation, the presence of parents or persons carrying out the upbringing of the child is inappropriate, since the child will try to say what these adults want to hear from him. However, often children under 6 years old experience fear, remaining alone with unfamiliar adults. In these cases, it is possible to allow the presence of people close to the child during the conversation who will be somewhere nearby so that he can address them at any time.
To create optimal conditions for conversation, especially when working with young children, it is necessary to use dolls that often help the child tell what happened to him.
Children who survive sexual abuse need increased attention, understanding and support from the psychologist. Having a strong sense of guilt prevents the children from discussing their problem with the psychologist: they believe that they somehow provoked the attack or would have had to do something to prevent it. Shame for themselves does not allow them to reveal themselves - children are more afraid of subsequent questions and reactions than the actual incident itself. Therefore, when interviewing children, avoid closed or directing questions that could affect responses.
Group psychology counseling should be used with great caution for children who have experienced sexual abuse, as their wounds may be too fresh to express their feelings on the group.
Children need to learn to determine what behavior of adults (meaning behavioral forms of violence) is inappropriate and how to respond in appropriate situations.
Children need to be taught to immediately seek help in the event of possible or already occurring violence, despite the fact that adult rapists convince them to keep everything secret. Children need to help understand what information should be confidential, and what should be communicated to others; with whom they should share their problems and what to do if the adult does not believe them.
In children who survived violence, the problem of trust in others and adults, in particular, is one of the most urgent. Group discussions and exercises can help children decide for themselves who in the world they can trust, and with whom one should be careful.
In general, specialists adhere to the eclectic approach in working with such children. The most effective are visualization, hypnosis, work with emotions, keeping a diary, writing letters, cognitive restructuring, empty chair technique, psychodrama, art therapy, music therapy, dance therapy.
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