Helping Abused Kids in Care Heal
Several years after they first became foster parents, Randall Ruth and his wife took a child into their home who'd been sexually abused. The 7-year-old boy had been living with other foster parents in their Minnesota community, and Ruth knew why he'd been removed: he was angry all the time, he ran away every chance he got, he stole, and he destroyed property. Over the next few years, Ruth, the current president of the National Association of Foster Parents, learned to wait out his foster son's tantrums. Sometimes they'd last an hour or two, while the boy ran up and down the stairs, screaming and swearing. Ruth waited, too, until his foster son grew secure enough to take the first cautious steps towards closeness. "It took about two years," Ruth said. "Then he began to crawl up on my lap. But the memories would come back and he'd take off. He could only take so much closeness at a time." Eventually the Ruths adopted their foster son. He is now 25, and doing well. Over the years, the Ruths have fostered almost 20 sexually abused children. The Ruths remain in contact with many of these children, and say most are doing well.
Sensitivity and patience: keys to healing
What the Ruths have learned through experience is backed up by research indicating that sexually abused children in foster care can heal emotionally and avoid some of the potential serious long-term effects of abuse (attachment disorder, post-traumatic stress disorder, depression, etc.) if their foster parents offer good support. A study of 30 young people in foster care who had been sexually abused, published in the 2000 issue of the Journal of Child Sexual Abuse, found that when victims of sexual abuse were placed in foster homes where they felt supported—where they were believed, responded to empathetically, and where the foster parent made sure the child received appropriate medical and psychological care—the young people reported significantly fewer symptoms of depression. They also reported more comfortable social interactions. Dr. Leonard Gries of St. Christopher's-Ottilie Services for Children and Families in Sea Cliff, N.Y., conducted the study. He found that even children who had been rejected by their biological parent after disclosing the abuse showed signs of emotional recovery when placed in a supportive foster home. "What we found was most important to a child's recovery was the reaction of the foster parents who the child was currently living with." But such children do present special challenges. Children who have been sexually abused—especially when the abuser is someone they trusted and were close to—can have difficulty forming new emotional relationships. They may withdraw or become angry at attempts at emotional intimacy. In turn, foster or adoptive parents may feel rejected, and respond with frustration and even anger. A 1994 study conducted by Susan Livingston Smith and Jeanne A. Howard and published by the National Association of Social Workers found that victims of sexual abuse were more likely to experience disrupted foster placements than other children, with an average of 6.49 moves during their time in foster care, in contrast to 4.42 moves experienced by other children. Because of this, and because of the difficulties of fostering a child traumatized by sexual abuse, proper training for foster parents is critically important. "Part of being an experienced foster parent is that you learn that you can't let the way the child is treating you affect your feelings. Most of the children we've cared for do attach, but it's on their terms, and that's fine," Ruth said. But too often, people in the field say, foster parents don't receive adequate training, information or support.
Helping caregivers help children
Over the years, the Ruths sought out ways to become better educated on parenting children who have been sexually abused. They read books on the subject, and they turned to the Attachment Center in Evergreen, Colo., for advice. Learning about sexual abuse helped them understand their foster children's actions. It also helped them respond in an accepting way when their foster children wanted closeness, and when they wanted distance too. Above all else, Ruth said, "you have to realize these are just kids who have had many things happen to them, and you have to treat them and love them like kids. You have to develop a relationship. You can't focus on sex as the main issue." (Learn how one survivor of child sexual abuse negotiates the question of telling /not telling her story in Alene's story) A therapist specializing in sexual abuse can help. For instance, the Ruths had a child in their home who responded to the abuse by becoming obsessive-compulsive. "He took control of his life by making everything neat and concise, and the therapist helped us understand why he was doing that. We were actually kind of glad when he started getting messy," Mr. Randall said.
A need to know
Part of the problem is that often, foster parents don't know that the child in their home has been sexually abused. The agency that places the child may not know, or sometimes child welfare authorities withhold information to protect the confidentiality of the biological family. But many experts and foster parents agree that foster families need to know enough to understand the feelings and actions of children who are placed with them. "Foster parents have to know that they have to maintain confidentiality," said Mary Boncher, clinical coordinator of Our Place: Special Treatment Services for Children and Families at the New York Foundling Hospital. Still, Boncher added, it's important for foster parents to know details that might affect their relationship with the child. In particular, she said, foster parents should know whether the child was abused by someone close to him or her or by a stranger—though the foster parent doesn't need to know who specifically committed the abuse. A child may not like to be touched as a consequence of the abuse, and foster parents should be told that too, said Boncher. "If a foster parent doesn't know that, they may go and do very normal kinds of touching and that child may lash out," she said. If the foster parent doesn't understand the reason for the child's anger, "they're going to walk away saying, ?What's wrong with that kid?' Most foster parents want to give kids love, and love is a very very important ingredient, but it's not the only ingredient, because some kids may be afraid of love."
Making a safe home
The greatest concern for most foster parents concerns children who may act out sexually, or be sexually aggressive. The CV Institute, the research branch of The Children's Village foster care agency, found in one study that 12 percent of children in foster homes displayed inappropriate sexual behaviors. Sometimes the behavior doesn't pose a threat—such as when a child masturbates in public or uses language that's sexually precocious—but it can make foster parents terribly uncomfortable. If they don't understand why it's happening, they may become angry or punitive. Sometimes foster parents fear that a child may try to sexually abuse other children in the home. Though majority of children who have been sexually abused don't become sexual aggressors, it can happen. The CV Institute found in one study of juvenile sexual offenders that 46 percent of them reported having been sexually abused themselves. Kenneth Lau, the program director of Children First at Fordham University and the coordinator for sex offenders services at Westchester Community Services in New York, said that foster parents need help assessing the risk. They need to consider the ages of other children in the home and how much supervision they can provide. The Ruth's children were grown by the time they began taking children who had been sexually abused, and they made sure they didn't foster any other young children when they had a child in their home with a history of sexual aggression. In Westchester County, N.Y., Westchester Community Services will send a safety coordinator to the home of foster parents who accept a child with such a history. The coordinators look at issues like sleeping arrangements—it's usually important that children don't share a room. The foster parents may also need special house rules—for instance, no wrestling or other horseplay that may be too stimulating. The coordinator may recommend installing motion detectors so foster parents will know if a child is wandering into another child's bedroom in the night. In the Ruth's home, children don't share rooms and are not allowed in the same room unless there's an adult at home. Ruth said he didn't believe children felt stigmatized by those rules. "Once children have been abused," Ruth said, "they usually want to be in a place where somebody's watching out for their safety."
Sometimes what foster parents need most is help with their own highly charged emotions. "Sexuality and sexual behaviors are loaded issues for all of us," said the Foundling Hospital's Mary Boncher. This fall, St. Christopher's-Ottilie will begin a 15-session training program for foster parents of children who have been sexually abused by members of their own family. The program begins with foster parents being asked to talk about their own concerns about sexuality and, when relevant, their own experiences with sexual abuse. "Particularly if the caregiver was a victim of sexual abuse herself, she may have her own defenses, and hearing the child speak about sexual abuse might evoke all sorts of negative association," said Dr. Gries. The next stage aims to help the foster parent think of the child first as a child, not a victim of sexual abuse. "If the caregiver has anxiety about hearing horrific stories of sexual abuse, this gradual process helps to desensitize them," Dr. Gries explained. During this phase, foster parents explore ways to help children with garden-variety problems like trouble in school or with peers. Once the foster parents see themselves as a support for the child in these mundane situations, the trainer and parents talk about how to support the child in the aftermath of sexual abuse. Lastly, foster parents watch videos where they see other foster parents react positively and negatively to a child actor disclosing sexual abuse, and then they themselves act out various scenarios. This is more extensive training than most foster parents receive, but, said Dr. Gries, "we think there's a need… because even the best caregivers may not be ready" to deal with some of the issues that come with sexual abuse. It's especially important, he adds, because "this is one area where we can do a lot after the fact to promote recovery."
Alene, 18, understands not wanting to be seen as just a victim of sexual abuse. She came into the foster care system at 15 after having been sexually abused. At the time, she said, she blocked out her thoughts and feelings about the sexual abuse "because there was so much else going on." She doesn't know whether her foster family knew about the abuse, but she doesn't think she would have wanted to talk to them about it even if they'd made her feel welcome to. "I felt like I was taken advantage of and I felt dirty and I didn't want everybody to see me that way because they knew what happened." Only when Alene became pregnant unintentionally, a few months later, did she begin to ask herself how she might have been affected by the abuse. "I think it started making me think about my life, why things were the way they were. It was a big self-assessment thing," Alene said. Though in the years since then Alene has told people about the abuse, coming to terms with the experience is something she's done largely by herself. "Part of it is me shielding myself," Alene said. Part of it, she said, is the way people sometimes react. "People know what happened to me because they'll say, ?Why are you in care?' Then when I say, ?Oh, I was sexually abused,' they rush and move on." Alene now lives in a group home, but she considers the pastor of her church and his family her foster family. They know about the abuse, but she doesn't discuss it with them. "Even though I know this family would never reject me, it's still not comfortable for me," she said. Still, she's glad they know, and she thinks that it's always better for foster parents to know that a child has been sexually abused so they can understand certain reactions a child might have. For instance, Alene said, "There was this youth pastor who used to be in my church, and he looked like the guy who had sexually abused me. People just said, ?Oh, she doesn't like him. But it wasn't that. It was just that the resemblance was too much for me.'" Alene said it's also good to know that you could talk about the abuse, even if you don't want to. First, she said, the foster parent and child need to build a relationship and some trust. But if they do, the foster parent might want to say, "?I know you don't want to talk about it right now, but I know you have these issues and if you want to talk to me you can.'" "People try to step over the issue, or step around it," Alene said. "Like with my real father, he's just never said anything about it. People know that it happened, but instead of helping you they just sit there like whatever." And that, she said, can make you feel terribly alone. Which is why it's even more important, she added, to know that "at least a door is open."
- The National Association of Foster Parents, e-mail: firstname.lastname@example.org, phone: 1-800-557-5238
- The Attachment Center at Evergreen, e-mail: email@example.com, phone: 303-674-1910
Rachel Blustain is a writer living in Brooklyn, N.Y., and a contributing editor to Foster Care Youth United.