One in five girls in the United States is sexually abused each year.  Some do not disclose sexual abuse until they are much older.  These children find themselves in foster care if their parent does not protect them from ongoing harm.  The most common perpetrators are boyfriends, step-parents, and relatives, with 80% of the perpetrators being within the birth family.  Studies have shown that in the aftermath of sexual abuse, 50% of sexually abused girls later become juvenile delinquents, run away, are significantly more aggressive, engage in promiscuous activities when poverty is factored in, engage in drug related activities, can self-mutilate, have uncontrolled outbursts of rage, need to always be in control of situations, and become abusive towards boyfriends, or get into abusive relationships. Sexually abused children and teens also develop eating disorders, and have guilt, shame, anxiety and depression, and poor self-esteem.

So how can we make our girls fight back and become resilient young teens?  How do we protect our young girls and teach them the right ways of coping?

Here are the top five techniques that have worked very successfully in my practice with teen girls (www.thesupportivefosterparent.com):

• Develop Body Boundaries: Sexually abused girls tend to have poor body boundaries. TEACH body space, appropriate distance, hugging from the side, not pushing themselves into others' in the front, and maintaining appropriate distance from males

• Teens and Dating: Sexually abused teens also either get victimized or become aggressive towards their dating partner.  Develop self-worth in young teens, teach them to respect their bodies, teach them about being a woman in this world and be a role model for your teen.  They learn from your actions, not just words.

• Manage Eating Disorders: Eating can be excessive with binging and purging, or refusal to eat at all.  Both forms are ways young girls attempt to control their environment.  This need to control comes from the helplessness and lack of control due to sexual abuse.  Food is a way that a young teen can exert power over adults and cause anxiety in others.  Anorexia and Bulimia are common with these teens.  To develop a healthy sense of control, provide your young teen with healthy foods, give her areas of her life over which she has control and allow her to make decisions about the foods she eats.  Making a fuss about how much she is eating is going to worsen the situation and strengthen the eating disorder instead of reducing it. Rather, make food fun, use humor at dinner and provide her with healthy childhood snacks she loved.  Creating a low tension environment with a relaxed family non-judgmental environment will gradually relax your young teen daughter and she will substitute food with activities that you have introduced her to in which she can exert control and feel empowered.

• Deal with Bouts of Rage: Intense rage reactions are fairly common in children with sexual abuse histories and they can sometimes get violent. Often they are misdiagnosed as being Bipolar and placed on medication to keep them calm.  However, their rage is a primitive reaction to the emotional trauma of sexual abuse and can be explosive.  What works for these teens is trauma therapy and most importantly predictability.  They dislike sudden changes, unpredictable actions, sudden changes in schedules, and power struggles more so than the average teen.  Allowing your teen time to regroup, holding her when she wants you to, and giving her space when she asks for it so that she can bolster her defenses will help her handle stress, get "unstuck" and cope with new situations better.  What will worsen this situation is forcing her to talk to you when she is not ready and forcing her to complete chores and engaging in a power struggle.

• How to Handle Panic Attacks: Bouts of anxiety with fear of choking up, nausea, trembling, fearing that the walls are closing in and that she is going to die are all too common for our sexually abused teen.  Create resilience by identifying the triggers that have caused the anxiety and combat these triggers by pairing them with healthy effective empowering activities. The negative effect of these triggers will disappear over time, and your teen will become resilient and strong.

Successful parenting of your sexually abused female teenager will depend on CONSISTENCY, CALMNESS and CREATIVITY; the three Cs of parenting children with boundary issues.

About Dr. Kalyani Gopal

Dr. Kalyani Gopal is a licensed clinical psychologist with special interests in child sexual abuse assessment and treatment, attachment issues, and foster care assessment, adjustment and training. She serves on the Lake County, Ind., Child Protection and Child Fatality teams, and was the recipient of the Outstanding Service to Lake County award in 2004.