This summary guide lists some common impacts of sexual abuse on children’s emotional health and wellbeing, and explains what any practitioner working with a child who has been, or may have been, sexually abused can say and do to support the child through a trauma-informed approach.
It is vital for all practitioners to think about the child’s emotional health and wellbeing, especially if statutory agencies are not currently involved in the child’s life. You all have a responsibility to ensure the child’s emotional wellbeing is prioritised – and you don’t need to be a qualified therapist to acknowledge, empathise and support a child.
How might the child’s emotional health and wellbeing be affected by abuse?
If a child is being or has been sexually abused, possible signs of the abuse’s impact on their emotional health and wellbeing include:
- depression and/or anxiety
- symptoms of post-traumatic stress disorder (PTSD), such as flashbacks or panic attacks
- sexualised behaviour towards other children
- low self-esteem and/or lack of confidence
- disordered eating/eating disorders
- sleep disturbance
- obsessive behaviours
- being aggressive, having frequent temper tantrums or displaying other disruptive behaviours
- confusion about the meaning of healthy relationships
- unhealthy coping mechanisms, such as self-harm, excessive alcohol consumption or substance misuse
- suicidal thoughts or attempts.
For a full list of possible signs and indicators of sexual abuse, see our Signs and indicators template.
If the child feels unable to tell anyone about the abuse, this can add to their distress The child is likely to feel isolated from those around them, especially if they believe that they do not fit the stereotype of a victim of sexual abuse.
How can you best help the child?
If a child’s behaviour is regarded as ‘difficult’ or ‘challenging’, this can affect practitioners’ response. Taking a trauma-informed approach can make a big difference. It helps the child when adults reassure them that their struggles are because of the harm they've suffered – and that, with the right support, these difficulties will pass.
- A trauma-informed response understands that a child is not just behaving badly or acting out. Instead, these are ways the child has learned to cope and protect themselves when they haven’t felt safe or have been under a lot of stress.
- A trauma-informed approach changes the focus from “What is wrong with this child?” to “What has happened to this child?”
- Children often blame themselves for the abuse they have suffered. If practitioners do not view and understand their actions from a trauma-informed perspective, it can make things worse.
- You do not need to be a specialist to make a difference; being an authentic, reliable, and consistent presence is vital.
Give the child opportunities to talk with you about how they are feeling,
- Facilitate gradual sharing: Recognise that telling about sexual abuse is a process built on trust, not a one-off event. Provide safe spaces and allow the child to use signals to indicate when they need a break from difficult conversations.
- Adopt a stance of belief: Ensure every interaction – from daily routines to serious discussions – is grounded in believing and respecting the child.
- Offer choice and predictability: Help the child regain a sense of control by offering real choices throughout the day and providing advance notice of any changes to their routine.
- Implement emotional first aid: Work with the child to create a ‘kit’ of grounding items – such as fidget toys, calming music or self-help statements – to help them manage moments of being overwhelmed.
- Support regulation through activity: Encourage ‘ordinary’ activities like dancing, drawing or walking, which can help the child regulate their emotions in a low-pressure environment.
You can also support the child's emotional health in a range of other ways:
- Think about your interactions with the child. It’s often the small, everyday moments – how you speak, how you listen, how you respond when a child is upset or withdrawn – that shape whether a child feels safe and understood.
- Talk to the child’s parent(s) and cares. Provided they haven't been involved in the abuse, you can empower them to create the stable, supportive environment the child needs for long-term resilience and healing.
- Arrange appropriate support to meet the child’s emotional health needs. When appropriate therapeutic support is provided at the right time, it can make a great difference to the child’s emotional health and wellbeing. Even if the sexual abuse is being investigated by the police, the Crown Prosecution Service says children can receive emotional support and therapy at this time.
If a referral for sexual abuse concerns is not progressed by social care, support the child to understand why the decision has been made. To learn more, read our guide here.
The full practice guide for this aspect of the Response Pathway contains much more detail, and provides links to a wide range of organisations and resources which can help you support the child’s emotional health and wellbeing.
Voices of experience
"For the first time in my life I felt like I could actually talk about what happened without feeling judged... there’s a trust there that I didn’t feel with anyone else."
"I had the belief that this does not happen to boys... You have such a sense of isolation where this did not happen to anyone else, it was just me."
"[My worker] made me feel I was worth something… He just made me feel calm."
"She’s just given me a bit of hope... she kind of brought the good out in me."
"They don’t tiptoe around you – but they do go gently – they tell you it straight – such and such is going to happen and it’s going to be hard but we’re going to help you get through this."
For the sources of the quotations above, please download our full guide to this aspect of the Response Pathway.
External links
- NICE guideline: Child abuse and neglect [National Institute for Health and Care Excellence]
- Prosecution guidance: Pre-trial therapy [Crown Prosecution Service]
- Guide to CAMHS [YoungMinds]