Combined Therapeutic Program for Sexually Abused Children: A Case Study

In this presentation we will discuss a unique therapeutic program that combines educational, cognitive and psychotherapeutic elements. We shall present a case study demonstrating this technique.

Background: Nadav, son of an immigrant family from Ethiopia, was 8 years old when admitted. He was referred to us due to "deviant sexual behaviors" in his family group home. As an infant, reports from welfare services described severe violence of the father, and alcohol and drug abuse by both parents. The mother was apparently engaged in prostitution, also at home, where Nadav was exposed to it.

Therapy plan: Nadav was in our therapeutic program for four years. During the first year it was apparent that Nadav was very confused about sexuality, especially confusing sex and violence. Therefore, a combined therapy plan was designed in relation to these aspects; group psycho-educational intervention (2 years), individual psycho-educational intervention (1 year), and individual play psychotherapy (4 years). Cultural issues, as well as defense mechanisms, were considered.

Conclusion: the combined therapy provided Nadav the opportunity to explore many aspects of sexuality: conscious and unconscious levels, infant child and adolescence issues, "appropriate and inappropriate" sexual behaviors in relation to cultural norms, bodily changes and his own impulses. Towards the end of therapy, some changes could be identified. For example, his stance towards women was transformed: As he came to therapy the female figure was unconsciously experienced as a weak prey, helpless when encountered with the violent male predator. As therapy ended, there were signs indicating that the female figure was being perceived also as a strong and helpful individual character.