For Specialists

The role of the therapist in working with child victims of abuse

The literature emphasises that the therapist has an important role to play in the psychological rehabilitation of the child following the effects of abuse and neglect. The therapist has a variety of duties, including:

  • Helping the child address issues related to abuse and neglect;
  • Role modeling appropriate child/adult relationships;
  • Works to improve relationships in the family, and
  • Encourages positive and productive peer relationships and supports them.

The therapist’s initial obligation is to establish, report and develop some relationships that will help the child relate the thoughts, feelings and behaviours caused by abuse and neglect. The therapist contributes to the child’s awareness and understanding of the dynamics of abuse, encourages their growth and development beyond the role of victim or misidentification with the abuser, and encourages the child’s individuality and personal integrity. Also as part of the therapeutic process, it teaches the child to take care of themselves, to think about their own behaviour and to make choices that enhance their safety. The therapist must also help the child to regain confidence, faith and investment in establishing lasting relationships.

As an adult, the therapist models appropriate behaviour, including nurturing, affection and expression of feelings. The therapist gives the child the opportunity to explore topics related to trust, acceptance, affiliation and emotional intimacy. The child may see the therapist as a role model for safe and nurturing relationships. The therapist also shares the child’s hope and curiosity about life to help the patient/patient to trust (reinvest) in the future again.

The therapist models and maintains normal clinical boundaries. S/he understands the vital bond between parent and child and does not try to take the place of the parent. Instead, the therapist helps the parent and child to understand each other appropriately and offers alternative models for resolving parent-child relationship issues. The therapist also helps the child to be as realistic and practical as possible in dealing with his or her parents. It is a very difficult task to help a child to become realistic, but at the same time to keep hope for a change and improvement in his parents’ behaviour.

Children, like all consumers of therapy, have certain rights that must be maintained throughout therapy. These include:

  • The right to an abuse-free environment;
  • The right to ask questions about therapy and receive meaningful answers;
  • The right to hope that therapy is helpful and the right to be treated as a unique individual.

Therapist/counsellor-child relationship

To be optimal, the counsellor-child relationship must:

  • Be a link between the child’s world and the counsellor;
  • Be exclusive;
  • Be safe;
  • Be authentic;
  • Be confidential (within limits);
  • Non-intrusive;
  • Meaningful.
  • The child may see their environment differently from their parents. The counsellor’s role is to play, enjoy with the child and work in the child’s best interests.

The counsellor must establish and maintain a good rapport (a good connection) with the child, which results in establishing and strengthening the relationship between the child and the counsellor.

Basic rules in the counselling room:

  • The child is not allowed to hurt himself/herself;
  • The child is not allowed to hurt the counsellor;
  • The child is not allowed to damage objects in the room.

Attributes of the children’s counsellor

  • Congruent;
  • Connected to the child in him;
  • Accepting;
  • Emotional detachment.

As a counsellor, you can talk to the child considering their feelings as the main issue:

  • Suddenly arising feelings – you may feel that the traumatic event is happening again; it may “come over you.” When some type of recall occurs.
  • Haunting thoughts and images of the event – these thoughts and images of the circumstances can force your mind, even when you don’t want it to happen. The images and thoughts are likely to be very real and you may get the feeling that the event is happening again, with its sensations, reliving similar sounds and smells. This type of reliving is common, although it is exhausting and frightening.
  • When you no longer feel anything – you may be surprised or surprised at others that you feel almost nothing. You may seem indifferent, as if you are anaesthetised.
  • Feeling detached from other people – you may find it difficult to react or behave normally with other people. You may feel almost separated or isolated from others, even those you love or know well. This may make you feel very awkward and uncomfortable.
  • Feelings of guilt – you may feel guilty and feel that you should have died, and that it’s not right for other people to be hurt more seriously. Your feelings and thoughts may seem senseless, but despite this, they can affect you greatly.
  • Difficulty concentrating and remembering – in this case the difficulties we encounter can make us feel very upset or very worried: you may think you are “losing your mind”. Poor memory and concentration can last for quite a long time after a traumatic event.
  • Feeling nervous – you may find that you act as if you are on edge or very nervous. You may be startled by noises, even some quieter ones, or some people coming in or out when you are not expecting them.
  • Tendency to avoid remembering events – you may notice that after a while you avoid doing things or going places because these activities remind you of the event. These avoidances may be protective and helpful for a time but will work against you or be unhelpful in the future.
  • Sleep disturbances – you will find it difficult to wake up in the morning or have insomnia, especially if you have nightmares. If you wake up at night, it may be impossible to fall asleep again.
  • Feelings and behaviour ‘stirred’ by what we see and hear – we can’t always protect ourselves from spontaneous recall of a traumatic event. Television and newspaper news, photographs and conversations can be avoided at first, but all these and other things can trigger memories and bring back problems, for example lack of sleep.

Ideas to help and stimulate your child

  • Create opportunities (or topics) while doing an activity or playing together. Talking during play, making a model ship, or drawing together with your child are ways of getting closer and creating a certain comfort.
  • Ask your child how they would like to be encouraged.
  • Use books/stories/music to distract and calm the child, especially at night when thoughts that might frighten him/her arise.
  • Give of your time and attention: listen.
  • Tackle taboo subjects: ask honestly.
  • Look for changes in expression and behaviour that suggest particular problems (e.g. fear, guilt, depression).
  • Allow visits from your child’s special friends.
  • Discourage social isolation.
  • Provide an occasional opportunity for isolation, a place for the child to express emotions and be alone and quiet.

What an advisor should do:

  • Be available to the family, keep in touch with them.
  • Encourage them to talk about their feelings and concerns.
  • Restore normalcy to family feelings, accept them, explain them (if necessary).
  • Be honest and open with questions.
  • Say “I don’t know” when you don’t know the answer.
  • Ask parents/children what kind of help/support they would need.

What an advisor should not do:

  • Don’t advise family members not to worry or be sad.
  • Don’t advise them what to feel or do.
  • Don’t say you know how they feel – you can’t possibly know.
  • Don’t say “You should feel better now.”
  • Don’t say “At least you’re alive.”
  • Don’t encourage parents to hide their feelings from their child.
  • Don’t neglect cooperation with the school. When children are traumatized they are likely to “misbehave” and/or perform poorly due to poor concentration, apathy or insufficient motivation (as part of depression). Teachers may not be fully aware of the reason for this behaviour.



„Proceduri de lucru pentru recuperarea psiho-socială a copilului victimă – Ghid pentru profesioniști”, Asociația Salvați Copiii Iași, septembrie 2015;