On the last track, 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
As you know, there are various modes in treating sexually
abused boys. Generally, sometimes it is difficult to decipher whether a boy will
benefit the most from group therapy or if he needs more individualistic treatment.
On this track, 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
Qualification # 1: Undisclosed Information
first aspect that I find most probably indicates a client is not suited for group
therapy is that the boy has not disclosed information about the abuse himself.
William, age 11, had been brought in by his mother, Janeane. Janeane suspected
William's soccer coach had been molesting him and other young boys at his house.
William showed all characteristics of a sexual abuse survivor: fighting with other
children, a sudden drop in school performance, and a reclusive personality. However,
William has not yet told me himself that he has been abused. To put him in group
therapy and adding additional peer pressure to his situation might discourage
him from revealing the embarrassing details of the abuse.
Qualification #2: Assault by a Stranger
In addition to not disclosed information
about the abuse himself, the second characteristic that indicates a client should
be referred to individual therapy is in the case of assault by a stranger. In
cases where the client does not know the abuser, different symptoms and consequences
arise. Do you agree? For instance, when a client knows the perpetrator, they experience
mistrust, ambivalence, and betrayal. In the case of a stranger's assault, these
symptoms do not occur. Matthew, age 13, was one such case.
Matthew had been abducted on his way home from school and abused in the back of the stranger's car before
being released several miles from his home. Matthew had a strong perception of
being "damaged" because of the injuries he incurred as a result of the
abuse, as is common in many incidences of stranger assault.
Also, Matthew expressed
concerns about contracting a sexually transmitted disease. Due to the extraordinary
circumstances surrounding Matthew's abuse, I believe that he would have had a
difficult time with boys of his age who were abused by a known assailant rather
than a stranger.
Technique: Feelings Wheel
Matthew's feelings of being damaged, I found the "Feelings Wheel" exercise
beneficial. In this exercise:
-- Step # 1 - I gave Matthew a sheet of paper and asked him to
draw one circle to cover most of the sheet.
-- Step # 2 - Then, I asked him to draw another,
smaller circle on the inside of the first circle and an even smaller one inside
-- Step # 3 - When he was finished, I asked him to label one circle "Parents",
the next one "Perpetrator", and the next one "Me".
-- Step # 4 - I then
asked Matthew to write in each circle all the feelings he had towards that particular
person or people at that time. In the circle labeled, "Parents", Matthew
wrote, "love, warm, safe". In the circle labeled "Perpetrator"
he wrote, "mad, hate, afraid"; and in the circle labeled "Me",
Matthew wrote, "sad, worried, hate, pity".
In connecting these feelings
with a physical person, Matthew was able to better understand his convoluted emotions.
Qualification #3: Group Therapy Proves too Stressful
In addition to undisclosed
personal information and assault by a stranger, a third characteristic to keep
in mind when deciding which type of therapy would be beneficial is if group therapy
would be overly stressful for a particular reason.
For instance, if a boy was sexually molested by more than one individual, group therapy might trigger multiple
problem behaviors. Also, if a client has a thought disorder or developmental disorder,
a group atmosphere is usually too stressful or frustrating. Kyle, age 11 who was
abused by his uncle at the age of 9, exhibited ADHD characteristics and I believed
that being in a group environment would only distract him.
In order to help William open up to me about the alleged abuse,
I found the "Details" Therapy Strategy beneficial. I provided William
with a copy of the "Details" questionnaire, which can be found in the
back of your manual that accompanies this Home Study Course. The word "Details"
refers to the fact that the client is requested to recall details of the abuse.
I asked him to fill out the questionnaire. Here are William's responses to the
"Coach Walters and his wife treated
me bad, but first they were nice. I was 10 when they started and they stopped
when I was 11. They did it to me many times. They brought me to their house and
did it in their basement. They told me to do things like kiss other boys and take
my clothes off. They recorded everything. Nobody else knew. Eric [one of the other
molested boys] told his parents. They called everyone else's parents. I'm mad
at my coach. I don't think he had to do that to me or my team mates."
this exercise, William became much more open about what happened to him and could
finally begin the early stages of his therapy.
On this track, we discussed 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 unnecessary stressful situation.
the next track, we will address examining the various aspects to keep in mind
when including the family in off hours therapy: education of the parents; developing
and understanding a client's need for security; and reestablishing good self-esteem.
What are three criteria for choosing individual therapy over group therapy?
To select and enter your answer go to