Introduction
Sexual abuse and assault is a fundamental public health and social issue in the United States and across the globe. The longstanding adverse consequences more often than not linked with sexual abuse mandate that effective treatment and prevention programs be developed (Morrison et al., 2004). Imperatively, sexual abuse acts are in violation of the trust, safety and development that ought to be a natural part of the life of a child or adolescent. Its regularity and extensively harmful effect make it one of the most severe psychosocial issues with potentially pervasive longstanding costs and problems to persons, families and communities as a whole (Lesmana, Suryani, and Tiliopoulos, 2015). Childhood and adolescence sexual abuse can have long-term and overwhelming effects on individual and relational growth and development. Sexually abused children have a tendency to portray greater rates of poor school performance, belligerent behavior, posttraumatic stress disorder, or depressive symptoms, in addition to social and interpersonal insufficiencies. The trauma that comes after this kind of abuse can further have an impact on mental development and functioning, exasperating mental or physical problems in adulthood (Lesmana, Suryani, and Tiliopoulos, 2015). Therefore, this places great significance to the treatments and services rendered to victims of sexual abuse. In addition, the different cultural contexts and societies in which sexual abuse practices take place also play a significant role and are potent factors of perpetuating sexual abuse. The main purpose of this paper is to investigate the services or treatment rendered to victims of sexual trauma and the manner in which culture and society influence how such services or treatments are managed.

Sexual Abuse Services and Treatments

The effects of sexual abuse on individuals in terms of their mental health have gained traction in the past decade. Research studies have substantiated that sexual assault facilitate significant levels of psychological and behavioral problems amongst young individuals and has strong links of interpersonal and mental problems. It is imperative to have cognizance into effective practices and interventions for utilization when it comes to treatment of sexual abuse survivor. With mounting sexual assault and traumatization instances, the necessity for knowledge, comprehension and execution of effective treatment and service practices becomes palpable (Underwood, Stewart, and Castellanos, 2007).

Lawson (2017) conducted an evidence-based case study concerning the treatment of adults with complex trauma. Research indicates that victims of such trauma have a greater and higher risk of interpersonal revictimization across their life span. Revictimization more often than not is linked with mounting ruthlessness of traumatic events in addition to symptom intricacy beyond the effect of several kinds of trauma exposures. What is more, the intergenerational diffusion of abuse every so often is a crucial component in complex trauma. For instance, a mother’s history of child sexual abuse is the sole strongest forecaster of child sexual abuse in the forthcoming generation. In fact statistics indicate that the daughters of such mothers have higher risk of child sexual abuse that is 3.6 times higher. When combined with the usage of drugs, this level of risk goes up to 24 times. Lawson (2017) makes the argument that with the multifaceted nature of complex trauma from sexual abuse, interruptions in normal child development and the distinctive profile of every individual, treatment of such sexual assault also needs to be multifaceted and adapted to every individual.

In accordance to Briere and Scott (2013) treatment and services for sexual abuse and sexual assault lay emphasis not only on the reduction of symptoms but also on the development of individual capacities in regards to aspects such as identity, relatedness as well as affect regulation. Imperatively, restricted self-capacities intensify and aggravate the severity of symptoms and their chronicity. Majority of the treatment models for sexual assault and sexual abuse are relationship-based, trauma focused, cognitive behavior therapy that include at least three key stages, which are safety, stabilization as well as formation of alliances. The models may comprise of couple counseling and family counseling. Notably, strength-oriented interventions, for instance the identification of solution behavior, are pivotal in every phase (Briere and Scott, 2013; Lawson, 2017).

Deblinger, McLeer and Henry (1990) conducted a study investigating the efficacy of a cognitive behavioral treatment program intended for sexually abused children suffering from post-traumatic stress disorder. In the investigation, 19 different girls who experienced contact sexual abuse and satisfied DSM-III-R criteria for PTSD were incorporated into the research study. These participants included girls of ages ranging from 3 years old to 16 years old. Structured interviews were undertaken to evaluate the presence or lack thereof of post-traumatic stress disorder symptoms, before, during as well as after the sexual abuse. What is more, the parents of the girls involved in the study filled the Child Behavior Checklist and the research subjects with the age of at least 6 years were administered the Child Depression Inventory and the Spielberger State-Trait Anxiety Inventory at the preliminary assessment and once more just about two to three weeks afterwards prior to the initiation of treatment. The results of the study indicated significant improvements for the participants on all measures (Deblinger et al., 1990).

Sinanan (2015) conducts a research study examining trauma and treatment of child sexual abuse. Psychotherapy helps as the initial model of a healthy association...
Shafe and Hutchison (2015) outline that the treatment of sexual abuse continues to be significantly challenging, owing to the perception of sexual abuse in different cultures. For instance, in a review of sexual practices and transgressions in the Indian culture, it was reported that in the course of trials, suspected sexual offenders more often than not stated that they were not cognizant that they committed an offense. In a number of cultures, there is strong belief and conviction sexual abuse and sexual assault is warranted on the basis of how girls dress and not being adherent to the customary values. This significantly impacts the treatment and services rendered to victims of sexual abuse owing to the reason that the level of openness is impacted by sensitivity that is linked to sexual abuse and the general impact on the household unit (Shafe and Hutchison, 2015). For instance, in China, which is a less open cultural context, the victims of sexual abuse may not volunteer information regarding their abuse as a result of cultural reasons. Furthermore, invasion of sexual privacy may be accepted and embraced where there is insufficient education and information is every so often attained with challenges from unenthusiastic information who are in fear of the cultural implication of the information that they disclose. This makes the treatment and services rendered to such victims much harder to diagnose. Furthermore, child abuse in Jordan is solely recognized and acknowledged for treatment only when there is severe damage. This implies that treatment for sexual abuse is overlooked for numerous other victims (Shafe and Hutchison, 2015).

Children as well as adolescents continue to be subjected to sexual abuse for cultural reasons that comprise of patriarchal philosophy, which is worsened and aggravated by age-associated hierarchies in a number of societies such as Africa and Asia. This significantly hampers the treatment and services provided to the victims of sexual abuse owing to the reason that there is diminished reporting of such sexual assault incidences. In addition, treatment is not deemed necessary and is even discouraged because some of the instances are in fact justified in such cultural contexts. For instance, the child abuse patterns may be as a result of forced marriages. Alignment toward a certain group, family structure, and conformism to norms and the problem of shame continue to be key significant factors and play a major role in reporting and dealing with sexual abuse practices. Cultural and community practices continue to be strong forces in exacerbating sexual abuse and hampering the treatment and services rendered to victims of sexual abuse (Shafe and Hutchison, 2015).

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