This guide is for anyone working with a child who has been, or may have been, sexually abused.
It is vital for anyone working with children thinks about the child’s emotional health and wellbeing, especially if statutory agencies are not involved in the child’s life. All professionals involved with the child have a responsibility to ensure the child’s emotional well-being is prioritised.
There are so many things professionals who work directly with children who have been sexually abused can say and do to support them; you don’t need to be a qualified therapist to acknowledge, empathise and support a child.
How may 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 signs and indicators 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.
When children’s behaviours are seen as ‘difficult’ or challenging it can change if and how they are helped. A trauma-informed approach by professionals can make a big difference. It helps when adults reassure children that their struggles are because of the harm they've suffered. With the right support, these difficulties will pass.
What children have said
"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."
- Sometimes professionals can misinterpret the impact of sexual abuse and other harms as the child being deliberately problematic or challenging, rather than indicators of trauma.
- A trauma-informed response understands that a child’s behaviours are not just bad behavior 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 been subject to. If professionals do not understand the abuse from a trauma-informed perspective, it can make things worse.
- Professionals do not need to be specialists to make a difference; being an authentic, reliable, and consistent presence is vital.
How can you best help the child?
Give the child opportunities to talk with you about how they are feeling:
- Facilitate gradual sharing: Recognise that telling about 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 a child regulate their emotions in a low-pressure environment.
Professionals can 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 we speak, how we listen, how we 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, practitioners 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.