54. årgang, Tema Børn og Seksuelle overgreb nr. 4 september 2017

Beskrivelse

Anna Louise Stevnhøj og Mimi Strange: From asexual beings to focus on abuse. Pædagogisk Psykologisk Tidsskrift, 2017, Vol 55, 4, 5-10. Before the 19th century children were widely regarded as being asexual beings that should not be contami-nated by adults. Freud changed this view, but it was only in the 1990s that there was a general consensus that sexual contact between children and adults is harmful and that sexual abuse against children is a widespread problem. The subsequent focus on abuse has meant that normal sexual expressions in children are also problematized and that adults who work with children are afraid of suspicion.

Anna Louise Stevnhøj og Mimi Strange: Infantile sexuality differs decisively from adult sexuality. Pædagogisk Psykologisk Tidsskrift, 2017, Vol 55, 4, 11-18. Children have an innate sexuality, which differs from adult sexuality by being un-conscious and not genitally focused, but children are curious about body, sex and reproduction. The child’s sexuality must be seen in the context of theories of attach-ment, as the development of sexuality in childhood occurs in interaction with the child’s environment and the close adults in the child’s life. Children exhibit sexual play and behaviour from early childhood to puberty, where sexual curiosity is gradu-ally replaced by more conscious and operative sexuality. Some types of behaviour in children are worrying and should make adults react, but one can not conclude from the behaviour of the underlying cause.

Helene Oldrup: Sexual violence against children and youth. Pædagogisk Psykol-ogisk Tidsskrift, 2017, Vol 55, 4, 19-. Sexual violence against children and adolescents continues to be a problem for child health and welfare, also in Denmark. This article presents the results from a Danish survey measuring the extent of sexual violence against children, important characteristics of victims and offenders of this violence and the risk factors. The nationwide representative survey was carried out in 2015 amongst 2000 pupils in grade 8 in 92 classes at both normal and special schools. The survey measures sexual violence in terms of exposure, touchings and attempted or full sexual intercourse. Key results are that around 12 %. of all adolescents experi-enced unwanted exposure and touching, while 6 %. experienced unwanted attempted or full sexual intercourse. Girls more often than boys experience unwanted sexual violations. Other adolescents are most commonly the offenders. Important risk fac-tors for being a victim of sexual violence includes gender (female), living with a single father, psychological violence in the family and lack of family harmony.

Anne Grethe Mogensen, Maja Leth Laursen, og Marianne Holst Nielsen: Dilemmas that a PPR-psychologist can experience when dealing with professionals’ worry, suspicion or knowledge regarding sexual offence against a child or an adolescent. Pædagogisk Psykologisk Tidsskrift, 2017, Vol 55, 4, 33-38.This ar-ticle describes five dilemmas that a PPR-psychologist can experience when dealing with professionals’ worry, suspicion or knowledge regarding a sexual offence against a child or an adolescent. One of the main points of the article is that these dilemmas are always in connection with the given municipal confines and directions.
Therefore, this article initially introduces Respekt for Grænser (Respect the Boundaries), which is the preparedness of (The Children and Adolescents adminis-tration) regarding prevention and handling of sexual offence against children and adolescents in The Municipality of Aarhus. Respekt for Grænser was established in 2008, arising from a comprehensive paedophilia case in a kindergarten in the mu-nicipality. Today, RFG is one of the part elements in the municipal preparedness (called) Fælles Beredskab (Mutual Preparedness). The five dilemmas are chosen on the basis of the work and experience of the PPR-psychologists, and it is continuously supported by (specialist) literature. The dilemmas concern the generalist role of the PPR-psychologist, the advance knowl-edge of the child, the emotional reactions of oneself and others, the expectation of counselling, and the challenge of being a player in different pedagogical contexts.
In conclusion, the article calls for establishing a municipal preparedness that constitutes an engaged third party, in cases where there is concern, suspicion or knowledge regarding sexual offenses against children and adolescents. Further-more, PPR is accentuated as a relevant place to embed the effort.

Helene Almind Jansen: Child Sexual Abuse Online – Typology and psycholog-ical treatment. Pædagogisk Psykologisk Tidsskrift, 2017, Vol 55, 4, 39-51. Within the last 15-20 years access to the internet has increased at an extremely rapid pace and so has the phenomenon of Child Sexual Abuse Online. This has created new challenges toward the psychological treatment of children and adolescents exposed to sexual abuse online or sexual abuse due to an online contact. There is scarce lit-erature on the psychological treatment and how it might differ from the therapeutic work with sexual abused children in general. This article focuses on the therapeutic challenges and points out similarities and differences within online abuse and of-fline sexually abuse. The concept and typology of Child Sexual Abuse Online will be described and exemplified to give a broader understanding of a phenomenon that rapidly keeps changing and emerging in new forms. abused children – both from parents and professionals, such as social services, family doctors and the police. The Centre offers medical examination and treatment, coun-selling and psychological treatment.
The psychological treatment incorporates the whole family and consists of a short-term abuse – focused psychosocial treatment. An intervention shortly after disclosure to both the child and the non-offending parent can help the parents to support the child and provide a secure base and help the child to find narratives about the sexual abuse, which makes it possible to think and talk about the abuse, can minimize the trauma symptoms, prevent negative impact on the parent/child – relationship and create hope for the future.
The goals of the psychological treatment are to help the child to talk about the abuse – “to put the experience and cruel reality into words”, to identify the thoughts and feelings connected with the abuse as being normal human reactions, to address feelings of guilt and responsibility and to rebuild attachment to the non-offending parent and focus on competence and courage.

Anette Baadsgaard: Treatment for non-offending parents in the  Centre of Sexually Abused Children at Rigshospitalet, Copenhagen. Pædagogisk Psykol-ogisk Tidsskrift, 2017, Vol 55, 4, 62-71. The Centre for Sexually Abused Children at Rigshospitalet, established in 2001, is a multidisciplinary centre consisting of a paediatrician, a nurse, social workers, psychologists and a secretary. The Centre re-ceives all kinds of referrals concerning sexually abused children – both from parents and professionals, such as social services, family doctors and the police. The Centre offers medical examination and treatment, counselling and psychological treatment.
The psychological treatment incorporates the whole family and consists of a short-term abuse – focused psychosocial treatment. An intervention shortly after disclosure to both the child and the non-offending parent can help the parents to support the child and provide a secure base and help the child to find narratives about the sexual abuse, which makes it possible to think and talk about the abuse, can minimize the trauma symptoms, prevent negative impact on the parent/child – relationship and create hope for the future.
The goals of the treatment to the non-offending parents are to help the parents to restore their belief in the ability to be parent, so that they can go back to being a stable attachment figure and emotionally available to the child.
These goals are achieved by helping the parents to talk about their own situation and feelings. The therapist will help the parents to be aware of the cause of their reactions and thereby help them to change them to more appropriate reactions that will help their child.

Vanessa Schmidt-Rasmussen og Elisabeth Frahm: Children and adolescents with sexual behaviour problems (SBP). Pædagogisk Psykologisk Tidsskrift, 2017, Vol 55, 4, 72-81. This article focuses on children and adolescents with sexual behaviour problems (SBP). The article begins with an overview of the characteristics of the children and ado-lescents with SBP. It is argued that childhood SBP can range widely in their degree of severity and potential harm to other children. Children appear to exhibit con-cerning sexual behavior for a variety of reasons and come to it via many pathways. The datasample from JanusCentret indicates that both boys and girls can exhibit SBP, but the majority of the clients at JanusCentret are boys and their average age of the first abuse is almost 12.
The article reviews some of the risk factors associated with the development of SBP in children and adolescents. Children with SBP appear to come from more troubled families and have experienced more adversity than their peers. A substantial number of these children and adolescents are placed in residential homes or foster care. At-tachment difficulties as well as a history of abuse – emotionally, physically and sexu-ally – seem to predispose children and adolescents to exhibit SBP. It is argued that SBP is often accompanied by other difficulties. Social difficulties are common among children with SBP and the experience of social isolation is con-sidered a significant risk factor. Another considerable risk factor in the develop-ment of SBP is neuro-psychiatric difficulties. A substantial number of clients at JanusCentret have been diagnosed with one or several psychiatric disorders before referral, typically attention disorder, autism or intellectual disabilities.
The article then describes different forms of intervention for children with SBP. It is argued that the primary treatment should be relationship based, tailoring indi-vidual treatment to the child’s developmental level. Different forms of intervention used at JanusCentret are presented.
Network based treatment targets children and adolescents with specific (neuropsychi-atric) difficulties. It is planned with the client’s special needs and difficulties in mind, and with involvement of the network, so that skills and knowledge taught in treatment, can be maintained and trained in everyday life. Apart from treatment directed at the client, a purpose in this specific form of treatment, is to upgrade the network (parents, school, residence), so that they will be able to handle the client’s difficulties later. Another form of intervention commonly used at JanusCentret is parallel therapeutic sessions where the child is offered individual therapy while the child’s network (parents and professionals) are offered counselling or supervision simultaneously. It is important to keep in mind that a substantial number of children and adolescents with SBP have been victims of abuse. Therefore, it is important to target not only the client’s sexual of-fenses but also the client’s own traumatic experiences in the treatment.
Lastly, the article emphasizes the importance of early intervention and preventive work and stresses that potential for development among children and adolescents with SBP.

Pernille Spitz og Pernille Bird: The Danish Children Houses. Pædagogisk Psykologisk Tidsskrift, 2017, Vol 55, 4, 82-88. In 2013 5 regionally based Children Houses were established in Denmark in order to strengthen a national strategy to improve prevention, disclose and treatment of child sexual abuse. The purpose of the Children Houses is to coordinate and improve inter agency case work between social services, police and hospital agencies in order to facilitate procedures that are as coherent and non-stressful for the children as possible.
The Children Houses employ psychologists and social workers that perform as-sessment and crisis intervention in cases with suspected child sexual abuse.
Furthermore all questioning of children as a part of police investigations of child sexual abuse take place at the Danish Children Houses in interview rooms specially designed for children and are recorded electronically to avoid the children having to give testimony in court.

Vivian Keit Mortensen og Lotte Kragh: Video interviewing of children conduct-ed by the Danish police. Pædagogisk Psykologisk Tidsskrift, 2017, Vol 55, 4, 89-93. This article presents how video interviewing of children and adolescent witnesses (aged 4-15 years) is conducted by specially trained investigators in the Danish po-lice. Yearly, around 120 police investigators in Denmark, Greenland, and the Faroe Islands conduct approximately 1200 videotaped interviews in cases of physical and sexual offences towards children and adolescent witnesses (whereof 1/3 of the offens-es concern sexual abuse). The videotaped interviews have evidential significance in criminal cases. As they replace the judicial interviewing of children and adolescent witnesses in Danish courts, preparing and completing the videotaped interviews al-ways follow a strict procedure which is outlined in the article. Special attention is paid to the significance of the mental preparation of the video interviewer, the home visit the day before the videotaped interview, and understanding the child’s perspec-tive of the narrated incident, no matter how harsh or painful the narrated content may be.

Stine Tofte: Mediations: a relationship-enhancing and trauma reducing in-tervention method in cases of sexual abuse. Pædagogisk Psykologisk Tidss-krift, 2017, Vol 55, 4, 94-99.Relational-enhancing mediations are often offered at the JanusCentre as a part of a holistic intervention in cases of sibling incest or in other cases of intra familiar sexual abuse.
Mediations are a therapeutic organized meeting between a victim and the offend-ing part. The goal is to process the sexual abuse and restore the broken relationships. This is particularly necessary in those cases where you expect that all parties should live together, have a relationship or meet each other in the future.
It is crucial that the intervention in cases of sibling incest takes into account that these cases are complex and calls for more family-based methods. Therefore, parents are included in the mediation process and are required to take their part of the re-sponsibility along with the offending child. When sexual abuse takes place within families, children should not bear all the responsibility themselves. After more than 13 years of experience with mediations and ongoing evaluations with the families involved, we know that the value for the families to complete a me-diation is priceless. We experience that mediations are trauma reducing: the victim gets answers to their questions to what happened and the offender takes the respon-sibility and apologizes. Thereby, we see that mediations process the sexual abuse within the family and restores the broken relationships but we also see that it breaks down dysfunctional behaviour and problem solving within family as it teaches them to communicate in different ways.
It is characteristic for a mediation to be a carefully structured meeting with a very thorough preparation process where the victim and the offending party get profes-sional assistance from trained and well-educated psychologists.

Kristen Trans: Adult Survivors of Child Sexual Abuse. Pædagogisk Psykologisk Tidsskrift, 2017, Vol 55, 4, 100-108. This article focuses on the effects faced by adult survivors of incest (namely women). Furthermore, the author of the article describes different kinds of therapeutic treatment for different kinds of consequences.
Usually the women suffer from different disorders: they can experience mental disorders, personality disorders, sexual problems and challenges connected with finding their social network as well as being attached on the labour market.
The psychotherapeutic treatment depends on the type of disorders. Some disor-ders should be treated in a psychodynamic way, and others by means of solution-fo-cus therapy techniques.
The description of the incest consequences treatment is based on the research, treatment and development of methods of treatment practiced in one of the leading mental hospitals in Denmark