Das perdas a possibilidade de reparação: um estudo de caso

Abstract

The cognitive behavioral therapy (CBT) focused on trauma has shown high efficacy in reducing symptoms of posttraumatic stress disorder (PTSD) and in restructuring of dysfunctional beliefs about the abuse experience. Considering the negative consequences of sexual abuse for the psychological development of the victims, as well as the positive outcome of cognitive behavioral therapy for symptom reduction and restructuring of dysfunctional beliefs regarding the abuse experience, this article aims to answer the following question: would CBT apply to outpatient treatment of PTSD of a sheltered child victim of sexual abuse? Violence against children and adolescents are being considered a serious public health problem due to the high prevalence and the serious consequences for the child development. Among the various forms of violence, we can identify sexual abuse, physical abuse, psychological abuse, abandonment and neglect. According to Seraphim, Saffi, Achaia, et al (2011), scholars of child sexual abuse (CSA) recognize that sexual violence increases the risk of victims to develop some mental disorder, cognitive deficits and self-destructive behaviors; moreover, depression diagnosis and PTSD are the most common disorders among the victims. The use of CBT as a method of psychological intervention in cases of child sexual violence, individually and in groups, is potentially beneficial to include treatment strategies that have as main objective to identify specific symptoms (HABIGZANG, L. F; HATZENBERGER, R.; CUT , F., et al.2008). The main focus of the interventions are the symptoms of PTSD. This study reports the case of a nine years old girl treated in the Clinic of Trauma (AMTRA) of Psychiatric Services of the Hospital das Clinicas, Medical School Hospital of UFMG. This child was a victim of intrafamilial sexual abuse perpetrated by her stepfather. At the end of June 2011, S.M. was received in a shelter located in the metropolitan region of Belo Horizonte after anonymous denounces of sexual violence. Sexual abuse was confirmed by a forensic medical examination. CBT has demonstrated some limitations. Therefore we cannot state strongly that this methodology of work is in fact applicable to the outpatient treatment of PTSD in a sheltered child victim of sexual abuse.