As child clinicians we will become involved in many cases of abuse and neglect. A report of child abuse is made every 10 seconds. 3.6 million reports of child abuse, covering 6.6 million children, are made annually. Four to five children die daily from abuse and neglect. At least 80% of abused and neglected children will meet criteria for one or more psychological disorders at age 21. Up to two-thirds of people in treatment for substance abuse report a history of neglect or abuse. Incarceration rates for men and women who have been abused are substantially higher than the general population.
Child therapists are in a unique position as we often become intimately involved with victims of neglect and abuse as providers, reporters of the abuse, and sometimes as expert witnesses. To be successful with this population, child therapists must have ongoing training and support. Anyone working with abused and neglected children should seek out some form of supervision. More experienced clinicians may choose a peer supervision group which can not only offer clinical guidance, but emotional support as well. Most of us are much more comfortable in our roles as clinicians than expert witnesses. However, being an expert witness doesn’t have to be intimidating and can be a very important opportunity to serve a client. Here is a great list of do’s and dont’s if called on to be an expert witness: 25 Tips for Expert Witnesses.
Self-care is essential for clinicians working with victims of abuse. Vicarious traumatization is a significant risk and can lead to burnout. “Therapist burnout” can be manifested as reduced compassion, a loss of caring and empathy, emotional exhaustion, and not feeling competent. The Society of Psychotherapy offers some excellent insights into recognizing burnout and strategies for self-care.
We recommend that anyone doing therapy with children become a member of The Association for Play Therapy (A4PT), and take advantage of the training opportunities at the national and state conferences. A4PT publications include Play Therapy Magazine and The International Journal of Play Therapy. Online resources are also available to members. Advanced training is available from TF-CBT, which offers a certification in Trauma Focused Cognitive Behavioral Therapy. TF-CBT is listed as an evidence-based therapy on SAMHSA.GOV.
Of course, there is a treasure trove of resources available on the internet. A good place to start is the 2018 Prevention Resource Guide from the US Dept of Health and Human Services. Other helpful online resources include Prevent Child Abuse, ASPCC, and the Joyful Heart Foundation. ChildTherapyToys.com also offers a wide variety of resources to clinicians working with children and teens.
