Sexual Abuse

Instructor-Led Training

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Providing approximately 50,000 learning experiences to health and human services professionals annually, the Academy’s mission is to provide exceptional workforce development and learning experiences for the transformation of individuals, organizations and communities.

APSWI, or Adult Protective Services Workforce Innovations, is a training program of the Academy that provides innovative workforce development to APS professionals and their partners.

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San Diego State University

The Academy for Professional Excellence is a project of SDSU School of Social Work. Funding is administered by SDSU Research Foundation.

Purpose of Land Acknowledgement

The purpose of a land acknowledgement is to recognize the relationship of Indigenous peoples to the land. It is multi-faceted in it’s meaning. It shows respect to the people of the land, to the land itself and to their relationship to one another. They are statements that recognize the dispossession from the land, the harm brought by colonial practices, beliefs and policies. They validate and recognize the continued presence of Indigenous peoples everywhere. Lastly, when offered in earnest and with sincerity, they are the first steps in reconciliation and healing.

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Land Acknowledgement

National Deliveries

For millennia, hundreds of Tribal nations have been a part of this land. This land has nourished, healed, protected, and embraced them for many generations in a relationship of balance and harmony.

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As members of the Academy community, we acknowledge this legacy. We promote this balance and harmony. We find inspiration from this land and its original inhabitants of this Nation.

�Making a statement isn’t enough. It is important that we share ways people can take action to support Native American people and land back efforts. This can involve researching and learning more about the indigenous communities of the lands you are on at Native Land Digital; returning artifacts and land to their appropriate tribal communities; working to protect and preserve the land, and much more.

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For more information and resources, see our Land Acknowledgement page.

Housekeeping & Introductions

Technology

Agenda

Agreements

Learning Objectives

• Identify sexual abuse and its various forms.

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• Recognize common barriers to reporting and disclosure.

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• Demonstrate person-directed strategies and trauma-informed interviewing techniques.

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• Utilize intervention strategies to develop service plans that prioritize safety, autonomy, and access to resources.

Content �Warning

Terminology

• Survivors: those who have experienced sexual abuse
• May self-identify as a victim, survivor, thriver, person who experienced sexual assault, or someone who was sexually assaulted by someone else
• We may call this person our “client”

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• Victim: may be used by your region or state as the person who has experienced sexual abuse or whom the abuser abused

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• Abuser/suspected abuser/alleged perpetrator: those who perpetrate or have been alleged to perpetrate abuse

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Introduction to Sexual Abuse

Introduction to Sexual Abuse: Poll

On a scale of 1 to 5, with 1 being most uncomfortable and 5 being comfortable, select the number that represents your comfort level.

Sexual Abuse Definitions

• Sexual abuse is characterized as non-consensual sexual contact of any kind.
• Sexual abuse involves any form of sexual interaction that occurs without mutual consent.
• This type of abuse can include a range of actions such as sexual assault, rape, sodomy, forced nudity, inappropriate touching, and taking sexually explicit photos without consent.

“Contact or interaction of a sexual nature involving a vulnerable adult without their informed consent.”

CA APS Standards for Consistency in Determining Findings Matrix

Sexual Trauma Impact on the Brain

Sexual trauma triggers survival mode

• Memory may be fragmented or incomplete
• May recall only pieces, share details out of order or struggle to explain

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Brain under stress

• Amygdala activates “fight, flight, freeze, fawn”
• Prefrontal cortex suppresses reasoning and sequencing
• Hippocampus experiences disruptions in context and timeline

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Experience vivid sensory fragments but sequence is unclear

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Validate and never pressure to “get the story straight”

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Sexual Assault & the Brain in Six Minutes

• Why might older adults who experienced sexual abuse present with seemingly contradictory behaviors or inconsistent accounts?

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• Have you ever supported a client during an APS interview where their story felt disorganized or fragmented?

Acknowledging Neurocognitive Disorders and Cognitive Impairments

• Impacts memory, perception, and communication

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• May impact disclosure and consistency

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• Requires trauma-informed interviewing

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Prevalence

Commonalities About Perpetrators

• Perpetrators can be any gender

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• Abusers span all age groups

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• Access often through relationships or roles

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• Family members may be responsible

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• Facility abuse often involves residents

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• Community-based caregivers can be abusers

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• Prosecution is rare

Reasons Sexual Abuse Often Goes Unrecognized

Limited public awareness

Isolation and communication barriers

Misinterpreted injuries

Lack of specialized training

Barriers to reporting

Under-detection in investigations

Unrecognized

Commonalities About People who have been Abused

• Female, but males are also impacted

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• Sexual abuse occurs at any age

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• Happens with other forms of abuse or neglect

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• Cognitive/physical limitations make reporting difficult

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• Fear of retaliation/ties to abuser prevent disclosure

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• Reports are met with disbelief

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• Past trauma can resurface and complicate responses

Linda’s Story

1. Watch the video

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• Small group discussions

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• Large group debrief

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Content Warning

SEE HANDOUT

Summary and Grounding Exercise

• Abuse can affect anyone
• Listen without making assumptions
• APS role:
• Identify signs of abuse
• Reduce barriers to disclosure
• Respond with trauma-informed care

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Activity: Pause, Breathe, and Release

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Poll: �APS Reports

In your experience, in what ways does APS become aware of possible sexual abuse allegations in your work?

Signs & Symptoms

Physical Symptoms

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• Genital/anal pain, irritation or bleeding
• Bruising on external genitalia or inner thighs
• Difficulty walking or sitting
• Torn, stained or bloody underclothing
• Intimate body parts are treated roughly while receiving care, such as when being cleaned or dressed
• Refer to CA Matrix for others

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Psychosocial Symptoms

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• Anxiety, agitation, PTSD
• Attempt to flee
• Fear
• Depression
• Nightmares and insomnia
• Withdrawal from social activities or relationships
• Dissociation (numbness or detachment)

Coded Disclosures

Coded Disclosures

• “My partner makes me do things I do not want to do.”
• “They came into my room at night, and I didn’t like it.”
• “I can’t go back to that room.”
• “They touched me where they shouldn’t.”

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A way for survivor to use language that is comfortable to them

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Clear Disclosures

• “The resident in the next room came in and got into bed with me and molested me.”
• “They touched my breasts without my consent.”
• “When they help me bathe, they touch my private parts inappropriately.”
• “I was sexually assaulted in that room.”

Activity: Coded Disclosure Practice

Identifying Abuse through Various Channels

In Person Observations

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• Watch for nonverbal cues and visible injuries
• Get consent before asking to see injuries
• Note changes in hygiene, clothing, or social engagement
• Look for physical evidence (e.g., torn clothing, unexplained items)
• Observe interactions closely

During Assessment

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• Ask open-ended safety questions
• Speak with the adult alone
• Gather collateral info from those in regular contact
• Use multiple approaches such as questions, observation, assessments

Trauma-Informed Principles

Preparation/Before the Interview

• Review all relevant information beforehand

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• Prioritize safety, privacy, and confidentiality

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• Maintain privacy in public or facility settings

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• Coordinate with family and seek consent for privacy at home

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• Schedule when the alleged perpetrator is absent

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Activity: Small Choices with Big Impact

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Interviewing Approach and Considerations - Working with Law Enforcement

• Check if law enforcement has been contacted and case assigned

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• Coordinate early and support a joint interview

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• If disclosure comes first to APS; acknowledge, then offer choice to report to law enforcement

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• Explain what to expect and ask what would make them most comfortable

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• If APS joins mid-process; respect prior interviews and offer advocacy support

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• Review all relevant information beforehand

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Interviewing Approach and Considerations: Start of the Interview

• Initial APS interviews clarify risk, safety, or statutory criteria

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• Respect client autonomy and explain reporting duties but honor their choice

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• Focus early questions on what happened, who was involved, and safety now

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• When a crime is suspected, shift to a liaison role

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• Collaborate on forensic interviews, evidence, and advocacy services

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• Use engagement skills and be transparent and respectful

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• Introduce yourself, explain purpose, confidentiality limits, and reporting obligations

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• Adapt communication to the adult’s needs

Interviewing Approach and Considerations: Throughout the Interview

Practicing Open Ended Questions

Activity: Practicing Open-Ended Questions in Sexual Abuse Cases

Laying the Groundwork for a Trauma-Informed Conversations

Reactions & Responding to Disclosures

• There’s no single “right” way to respond
• Normalize feelings to reduce shame & isolation
• Be mindful of culture, disability, gender, & generational norms
• Apply APS interviewing techniques that build trust and connection

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• Responding with care:
• Stay calm & avoid shock, disbelief or judgement
• Maintain a steady, supportive presence
• Use open-ended questions
• Assess immediate safety & emotional well-being
• If needed, create a safety plan together

Practice : Tammy’s Story

Content Warning

• Were there any questions you would have wanted to ask Tammy?

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• What trauma-informed strategies could you use to make Tammy feel safer or more in control during this interview?

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Self-Care While Interviewing and Documenting Sexual Assault Cases

During Interview

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• Ground self before starting
• Use a centering statement
• Maintain body awareness
• Micro pauses
• Visual anchor

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Activity:

Self-Care Moment

During Documentation

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• Step away before writing
• Debrief with a peer or supervisor
• Set a calm environment
• Use soothing physical anchors

Impacts of Sexual Abuse and Trauma

Comprehensive Service Planning Introduction (Part 1)

Comprehensive Service Planning Introduction (Part 2)

Comprehensive Service Planning Activity

Sexual Abuse Service Planning: Immediate & Follow-Up Resources

• Immediate needs focus on protection, medical care, crisis intervention, and basic necessities

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• Long-term needs address ongoing recovery, housing, financial stability, advocacy, and emotional support

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• Consider immediate resource needs:

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• Safety & protection
• Medical care
• Crisis support
• Basic needs
• Medical & therapeutic care

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• Legal & advocacy services
• Social support & daily living
• Housing & financial stability
• Ongoing safety planning

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Specialized Interventions

Resource Mapping Activity

• Handout: Sexual Abuse Resource Mapping Worksheet
• Search and consider local, state, and national resources
• Think broadly:
• Prevention and education
• Reporting and legal advocacy
• Medical and forensic services
• Emotional and mental health support
• Housing and safety planning
• Disability-specific services
• Culturally responsive or identity-affirming supports

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Self-Care

• Take time for yourself
• Hearing traumatic stories can bring up strong emotions
• Self-care supports empathy, clarity, and resilience
• Prioritize your well-being to continue showing up effectively for others

Vicarious Trauma, Neutrality, and Resilience

• Secondary trauma
• Feeling trauma symptoms after hearing others’ experiences
• Vicarious trauma
• Over time, worldview shifts and you may feel less safe, more anxious, or withdrawn
• Vicarious neutrality
• Stay balanced and nonjudgmental to ensure fairness, safety, and objectivity
• Vicarious resilience
• Draw strength from witnessing survivors’ courage and recovery and it restores hope and purpose

APS professionals often witness deep trauma, which can be emotionally taxing

Strategies for Self-Care

• Pause and breathe
• Check in with peers
• Debrief with supervisor
• Consider supportive practices
• Monitor warning signs
• Remember YOU matter and the work you do matters

Summary

Summary Continued

P-I-E

• Priceless piece of information
• What has been the most important piece of information to you today?

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• Item to implement
• What is something you intend to implement from our time together today?

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• Encouragement you received
• What is something that you already are doing and were encouraged to keep doing?

Evaluations

Thank You!

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