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Section 2
Treating Male Child Sexual Abuse by Rebuilding Responsibility and Accountability

Question 2 | Test | Table of Contents

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In the last section, we discussed the various forms of isolation that male survivors of sexual abuse experience: isolation by others and isolation of themselves.

As you know, between the ages of 8 and 12, boys are building the personality traits they will call upon later on in life. Sexual abuse warps and interrupts this process.

In this section, we will address the idea of empowerment as the foundation for healing and how to build it: through building a sense of responsibility and accountability; through developing his understanding of his power and its limitations; and through equipping the client with knowledge and empowering skills.

♦ #1 The Importance of Empowerment
As you know, when a client is sexually abused, he experiences a feeling of powerlessness. I believe that rebuilding a young boy's feeling of empowerment is fundamental to his recovery process. If a boy does not resolve his feelings of powerlessness, two results can occur:
(1) he will continue to see himself as a helpless victim with very few behavioral options or
(2) he will try to regain power by controlling others through aggressive or abusive behaviors.

Craig, age 13, was already exhibiting the qualities of this last option known as identifying with the aggressor. Craig was referred to me after he was caught violently bullying children in his class during recess. His teacher relayed to me that Craig would push his classmates into wooden playground equipment, some of them suffering serious head injuries.

While in therapy, Craig revealed to me that his step-father, Jerry, had been sexually abusing him for the past three months. This abuse consisted of Jerry pushing Craig into walls. As you can see, Craig was reenacting his abuse. By adapting the tactics of his abuser, Craig was trying to overcome his feelings of powerlessness.

♦ #2 Rebuilding Responsibility and Accountability

I. The First Step
As you know, the first step in rebuilding a client's sense of healthy or positive power is by rebuilding responsibility and accountability. Craig needed to recognize when choices are available, choose an alternative, and follow through on that alternative. To do this, I made sure that I involved Craig in all of the following: setting up the assessment appointment; developing the rules that we both would follow during treatment; planning his treatment; determining the extent and type of his participation in each session; and deciding when to leave therapy. I also encouraged Craig to make important decisions in his everyday life.

♦ #3 Helping Clients Understand Power and Limitations

II. The Second Step
The second step in rebuilding a client's sense of healthy or positive power is by developing an understanding of power and its limitations. Craig needed to recognize that the limitations on his power stemmed from the fact that he was a child, and children are not responsible for the decisions of others. However, I reiterated to Craig that he could exercise power by choosing whether to develop his own ideas or to accept the ideas of others.

Each session, discussed with Craig the various ways he controlled his environment since I last saw him. Craig stated, "This week, Kevin [his friend at school] told me that he wasn't my friend anymore and I didn't hit him. I told him that I still wanted to be his friend and talked to him with words. And now we're friends still." By expressing and controlling his surroundings not through violent actions but through a mature verbal expression of emotions, Craig was already exhibiting his ability to regain power through healthy and positive means.

III. Third Step
In addition to rebuilding responsibility and understanding limitations of power, in addition to responsibility and accountability; and understanding of power and its limitations; the third step for Craig in recovering a sense power was by equipping himself with knowledge and skills. The use of knowledge and skills helped Craig recognize more options in situations and easing his feelings of helplessness. Craig realized that being powerful did not mean controlling others. To aid him in realizing this, I found the following "Self Evaluation" exercise beneficial.

♦ Technique: Self-Evaluation
As you know, boys of Craig's age are unaware of the effects his abuse is having on his development. To help him, I used the Therapy Strategy of "Self Evaluation" to analyze these effects and to initiate discussion. I asked Craig to make check marks next to the statements that best describe how he feels.

The statements that Craig checked off included:
- I feel different from other people because of the abuse.
- I'm filled with anger.
- I'm afraid a lot of the time.
- My moods change all the time.
- I can't control much of anything now.
- I can't seem to get along with other kids anymore.

The rest of the Self Evaluation Questions are found in the back of your manual that accompanies this Home Study Course.
A summary of his responses is as follows:

"I think the way my step-father treated me made me feel like I had to hurt other kids. I really want to change. I really want to have better friends and not feel like I have to control them with hurtful actions. I know now that the abuse happened because Jerry made a bad decision and it didn't happen because I was bad or deserved it."

Now that Craig could finally pinpoint the reasons he has been trying to violently control his classmates, he is taking the initial steps towards addressing these impulses. Craig was starting to gain some insight into his feeling of helplessness stemming from his step-father's behavior and not his own inherent weakness.

In this section, we discussed the idea of empowerment as the foundation for healing and how to build it: through building a sense of responsibility and accountability; through developing his understanding of his power and its limitations; and through equipping the client with knowledge and empowering skills.

In the next section, we will examine some criteria which indicates individual therapy rather than group therapy: undisclosed personal information about the sexual abuse; assault by a stranger; and if group therapy would be an unnecessarily stressful situation.
Reviewed 2023

Peer-Reviewed Journal Article References:
Drioli-Phillips, P. G., Oxlad, M., LeCouteur, A., Feo, R., & Scholz, B. (2021). Men’s talk about anxiety online: Constructing an authentically anxious identity allows help-seeking. Psychology of Men & Masculinities, 22(1), 77–87.

Ellis, A. E., Simiola, V., Mackintosh, M.-A., Schlaudt, V. A., & Cook, J. M. (2020). Perceived helpfulness and engagement in mental health treatment: A study of male survivors of sexual abuse. Psychology of Men & Masculinities, 21(4), 632–642.

Karlsson, M. E., Zielinski, M. J., & Bridges, A. J. (2020). Replicating outcomes of Survivors Healing from Abuse: Recovery through Exposure (SHARE): A brief exposure-based group treatment for incarcerated survivors of sexual violence. Psychological Trauma: Theory, Research, Practice, and Policy, 12(3), 300–305.

Keller, S. M., Zoellner, L. A., & Feeny, N. C. (2010). Understanding factors associated with early therapeutic alliance in PTSD treatment: Adherence, childhood sexual abuse history, and social support. Journal of Consulting and Clinical Psychology, 78(6), 974–979.

Lyons, J. J. (1987). "Treating sexually abused children: Issues of blame and responsibility": Comment. American Journal of Orthopsychiatry, 57(3), 461–462.

QUESTION 2
What are three ways that can rebuild a client's sense of empowerment? To select and enter your answer go to Test.

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