05 May, 2023

Counselor's Corner

Counselor's Corner - Counselors Corner

Child Sexual Abuse: Raising Kids with Healthy Body Boundaries by Amy Sarah Marshall - UVAHealth 

Having an open relationship with your kids can help prevent child sexual abuse. 

Child sexual abuse. Whether we like to think about it or not, it happens, and way more often than you think. Globally, a range of 7-36 percent of women and 3-29 percent of men experience sexual abuse in childhood. It also happens at the hands of people you might least expect. Most child sexual abuse is perpetrated by adults or older children who know the child or family. This could be a relative, babysitter, coach, teacher or family friend. 

For Sexual Assault Awareness Month, we spoke with Laura Shaffer, MD, pediatric psychologist with the UVA Children’s Hospital, to get some practical tips on what parents can do. You can’t protect the kids you love from every threat. But you can teach skills that empower them to protect themselves, establish boundaries and act with assertiveness. You can also help them understand that they can come to you with anything. 

Healthy Body Boundaries 

The main lesson to give kids? “Your body is your body,” Shaffer says. She encourages parents to speak with children from an early age about physical boundaries and the privacy of body parts. “This is your body, and it’s not ok for anyone to ask you to do certain things or to do things to you that make you uncomfortable.” 

Talking to very young kids about their bodies can prove challenging. “You want to strike a balance between teaching that certain body parts are private but not so private that you can’t talk about them,” Shaffer says. She suggests teaching children the names of the genitals just as you do other body parts. This helps keep channels of communication about the body open between parents and kids. 

Another challenge, of course, arises from the fact that we try to teach kids, in general, to comply with adults and follow their rules. And there’s plenty of times we do things to children they don’t want, like giving them flu shots, for instance. So it’s important to stress the distinction. 

“This is the one area where we don’t want them to be compliant,” Shaffer says. “So you need to explain how we want them to follow directions and be respectful, but when it comes to their bodies and unwanted touch or violations of privacy, the rules are different. It’s OK to say no and tell somebody.” And you want to help them know the difference between good secrets (like birthday surprises) and bad secrets (anything that makes them feel unsafe or uncomfortable). 

Shaffer encourages parents to continue promoting this message about boundaries throughout your child’s life, though how you do that — the language you use — will change as they age. 

Why Don’t Children Tell? 

About 60 percent of children who are sexually abused do not disclose it. Children often feel powerless, afraid of consequences and of not being believed if they disclose sexual abuse, which prevents them from telling parents about sexual abuse. 

Assertiveness: No Means No 

A critical aspect of sexual abuse prevention is raising assertive, confident kids who stand up for themselves. 

Shaffer encourages parents to look for everyday opportunities. Siblings, for instance, provide an abundance of chances to help learn the skills of communicating boundaries. Parents can help kids establish privacy and personal space when they change clothes or use the bathroom. 

“When you see them doing it not quite right, step in and give them guidance,” Shaffer suggests. Modeling these skills within the family relationships, taking advantage of opportunities for kids to practice them, gives children a sense of accomplishment and empowerment. 

Assertiveness Training 

Find real-life situations that push your child outside of the comfort zone. “Make your daughter order for the whole family at a restaurant, and support her,” Shaffer suggests. “Have your son count change at the store, and speak up if something adds up wrong. Get your kids to speak up and step up. You might have to push them a little bit, but really praise them when they do it. Coach them through it if they’re really shy and need help knowing what to say and how to do it.” Also, encourage them to ask for help or address conflict themselves, when appropriate, instead of relying on you to do it for them. 

Create An Open Relationship 

Want to protect your child? Establish and maintain an open, trusting relationship so that your child feels comfortable coming to you with anything, including uncomfortable topics like the threat of or occurrence of abuse. The American Academy of Pediatrics recommends teaching children “early and often that there are no secrets between children and their parents, and that they should feel comfortable talking with their parents about anything – good or bad, fun or sad, easy or difficult.” 

This may seem easier said than done. Shaffer breaks an open relationship down into two pieces. 

Leave the Door Open 

Shaffer suggests “Talking to your kids, asking but not pushing hard. Kids who withdraw more will clam up tighter if you really push. Ask, and let kids know you’re there.” 

In other words, saying to a child, “You look sad today; do you want to talk about it?” invites conversation, instead of repeating, “What happened? What happened? What happened?” which can feel demanding and shut off conversation. 

Open the door for conversation, but don’t force it; and leave the door open, so the child can choose to talk when ready. 

Respond With Openness 

When a child does tell you something, that’s your chance to establish trust. Reserve judgment and let your child talk. 

This can feel counterintuitive. “As a parent, you’re trying to teach right from wrong,” Shaffer says. “But if your child steps out on a limb to tell you something if you have a strong emotional reaction to it, that can shut the conversation down.” 

And that’s a problem when it comes to a child disclosing abuse. “A big, angry reaction would be pretty normal and healthy,” Shaffer acknowledges. “But that might frighten the child, and they might become less forthcoming.” 

So Shaffer advises parents to step away and deal with their emotions alone or with support from other adults before coming back to listen. 

If You Suspect Child Sexual Abuse 

What do you do if you suspect your child or any child you care about is experiencing sexual abuse? 

  • Call child protective services. You can call about any type of abuse, and the call can be anonymous. Find your local office or call the statewide hotline. 
  • If you are worried about ongoing abuse, call the police. 
  • Get support from the Sexual Assault Resource Agency (SARA), a local advocacy organization, which also has a hotline and other services. 
  • Get more prevention tools. 
  • No matter what: If the child is in immediate danger, take action to keep them safe. 

Practice Safe Interactions 

Again, the critical aspect is everyday practice. 

“If your kid comes to you to say they broke a window, you can say that’s not OK and you have to pay for it. But if they told you voluntarily, you also need to recognize that behavior and praise or thank them for telling you, so they keep coming back to you.” 

Shaffer understands some parents may feel this approach lets kids off the hook for bad behavior. But, Shaffer says, “Being open, staying as calm as you can, being receptive and staying level-headed doesn’t mean you’re letting them get away with things.” It means you’re there for them, no matter what. 

Shaffer also advises parents to “Keep your word; don’t make promises you might not be able to follow through with.” Having that trust firmly established in the relationship “sets the stage for when there’s a harder situation.” 

“Having a positive relationship goes a long way,” she says. “Not being a friend but being someone the child trusts to keep them safe.” 

Take An Active Role 

As with all aspects of your child’s life, Shaffer advises parents to take an active role. Know about your child’s activities and the other people with whom they spend time. “Be wary of adults who offer special gifts for no particular occasion,” she says, “or who frequently seek out opportunities to be alone with children.” 

Know the Signs of Possible Child Sexual Abuse 

“Anytime there are changes in a child’s behavior, you want to pay attention,” Shaffer says. Take notice of: 

  • Mood changes 
  • More solitary, withdrawn behavior
  • Increased irritability
  • Increased nightmares or bedwetting
  • A child becoming more guarded and embarrassed about his or her body
  • Unexplained discomfort, redness or bleeding in the genitals
  • Sudden avoidance of certain people or situations
  • Sexual language or behavior that seems unusual for the child’s age 

Of course, shifts in mood and behavior may reflect other stressors, too. Check in with your child, open up the lines of communication and be vigilant. 


Teen Depression 

Teen depression is a serious mental health problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teenager thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although depression can occur at any time in life, symptoms may be different between teens and adults. 

Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But for some teens, the lows are more than just temporary feelings — they're a symptom of depression. 

Teen depression isn't a weakness or something that can be overcome with willpower — it can have serious consequences and requires long-term treatment. For most teens, depression symptoms ease with treatment such as medication and psychological counseling. 


Teen depression signs and symptoms include a change from the teenager's previous attitude and behavior that can cause significant distress and problems at school or home, in social activities, or in other areas of life. 

Depression symptoms can vary in severity, but changes in your teen's emotions and behavior may include the examples below. 

Emotional changes 

  • Be alert for emotional changes, such as: 
  • Feelings of sadness, which can include crying spells for no apparent reason
  • Frustration or feelings of anger, even over small matters
  • Feeling hopeless or empty
  • Irritable or annoyed mood
  • Loss of interest or pleasure in usual activities
  • Loss of interest in, or conflict with, family and friends
  • Low self-esteem
  • Feelings of worthlessness or guilt
  • Fixation on past failures or exaggerated self-blame or self-criticism
  • Extreme sensitivity to rejection or failure, and the need for excessive reassurance
  • Trouble thinking, concentrating, making decisions and remembering things
  • Ongoing sense that life and the future are grim and bleak
  • Frequent thoughts of death, dying or suicide 

Behavioral changes 

Watch for changes in behavior, such as: 

  • Tiredness and loss of energy
  • Insomnia or sleeping too much
  • Changes in appetite — decreased appetite and weight loss, or increased cravings for food and weight gain
  • Use of alcohol or drugs
  • Agitation or restlessness — for example, pacing, handwringing or an inability to sit still
  • Slowed thinking, speaking or body movements
  • Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse
  • Social isolation
  • Poor school performance or frequent absences from school
  • Less attention to personal hygiene or appearance
  • Angry outbursts, disruptive or risky behavior, or other acting-out behaviors
  • Self-harm — for example, cutting or burning
  • Making a suicide plan or a suicide attempt 


There's no sure way to prevent depression. However, these strategies may help. Encourage your teenager to:

  • Take steps to control stress, increase resilience and boost self-esteem to help handle issues when they arise
  • Practice self-care, for example by creating a healthy sleep routine and using electronics responsibly and in moderation
  • Reach out for friendship and social support, especially in times of crisis
  • Get treatment at the earliest sign of a problem to help prevent depression from worsening
  • Maintain ongoing treatment, if recommended, even after symptoms let up, to help prevent a relapse of depression symptoms. 

Reference - https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985