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Child abuse counseling is a specialized field of counseling that focuses on treating children who may have been injured or traumatized by a trusted loved one. The children that Amy Southerland, Liz Goldy and Karen Chapman, clinical social workers for Family & Children’s Place, see may be victims of abuse themselves, or they may have witnessed someone they care about being abused – a parent or sibling.

Following is the third in a series of published conversations with Southerland, Goldy and Chapman about their work, the process, the challenges, the impact and the rewards. First in the series. Second in the series.

QUESTION: WHAT TOOLS DO YOU USE TO HELP CHILDREN AND THEIR FAMILIES HURT BY ABUSE?

Liz Goldy – I use a lot of books, especially one written by a nine-year-old victim of abuse. I read the book to the child to show him or her that he or she isn’t alone, that there are others going through the same thing they are. I think it helps kids move along with their own trauma narrative. It helps them understand the emotions they are feeling and see how thinking bad things about themselves affects them.

Amy Southerland – I use stuffed animals and other tools and toys, like Nibbles the Foster Bunny. He’s a toy we have in the office and I like to use his adventures to help reinforce with children and address their behaviors. For example, if they’ve gotten in trouble for running in school or here in the office, I share that Nibbles had some problems this week with his walking speed, or if there were other acting out behaviors, how Nibbles had some other challenges he needs to work on. The children make the connections themselves and because it’s about Nibbles, not them, they are more comfortable with the learning.

I also use the Exceptional Kids Guide to Touch to teach body safety. This is important to the children and to the parents, especially when a child has been abused. It helps them sort out normal behaviors vs. reaction to the trauma. It helps them see beyond a child’s reaction or behavior to begin to understand what might be causing it.

Liz Goldy – It’s important to use the correct names of body parts, too. For example, I had a child tell me, “My dad ate my cookies.” It took some time to understand what she meant – that her father had assaulted her, so clear communications is really critical. Children need clarity and to know the names of their body parts, and what is safe and what is off limits.

Karen Chapman – Recently, I had a parent come in who at first could only use the first letter of the name of the body part. They were so uncomfortable, and you could see it, but now they understand how important it is to be clear and to use the correct names, so they do.

Amy Southerland – None of this is easy on parents, who are going through their own emotional upheaval. They are impacted, too, especially in how they see themselves as parents, whether they feel like they did all they could to protect their child.

There are a lot of grief issues tied up in all of this. People think about what their life might be like had this not happened. And depending on the case, children may be getting care from someone other than their parents – grandparents, uncles, aunts, second shift caregivers who have things to think about themselves – increased costs, will they be able to retire now – there is lots of uncertainty for everyone. It’s a quagmire of issues and we try to help them sort them all out.

Karen Chapman – We use genograms – a graphic representation of a family tree – to help tell and show a family’s story, to help them see that learned behavior can be unlearned.

Amy Southerland – We use these to show patterns of behaviors – anger issues, drug issues, crime issues – it really opens their eyes to understanding that these behaviors can and do have a direct impact upon them.

Karen Chapman – It helps parents see the connections they may not have realized or pay attention to. It’s like the ACES test (Adverse Childhood Experiences Score) – the more adverse events a person had in their childhood, the higher the risk of negative behavior, bad health, issues with crime or substance abuse, etc. It’s very revealing.

Liz Goldy – We use a games a lot. The psychoeducation helps children create their trauma narrative. For example, I work with a child who gets tokens when she shares her trauma narrative. She uses those tokens to buy coloring sheets she can take home to color. This reinforces to her that it’s good to talk, that therapy is good.

In another case, I had a client who didn’t want to talk, so I would write things on a piece of paper, make a paper airplane out of it and sail it over to him. It felt like a game, but it was serious work and it helped him open up.