*4.1.2 Perpetrator characteristics*

Most perpetrators were adults. In 36 (90.0%) cases, the perpetrators were less than 30 years of age. Most of the child sexual abuse cases were intra-familial. Of the 40 cases studied, eight victims were raped and or defiled by their fathers, twelve by uncles, six by cousins, four by brothers, four boyfriends, and six by unknown persons. This finding confirms other studies that most rape and defilement incidents are perpetrated by people known to victims and who are usually male family members [2].

#### *4.1.3 Characteristics of reports and reporters*

Narratives revealed two types of sexual abuse reports: direct and indirect. Direct reported cases are cases where victims and or their parents lodged complaint following an abuse and this could be following the abuse immediately or later. The indirect reported cases were cases which were not originally reported due to the sexual abuse. Rather, parents/caregivers often accompany victims to lodge complaints of neglect and or denial of pregnancy where interrogations revealed that the girls were impregnated through sexual abuse. About 60% of the cases were indirect reported cases while about 40% account for direct sexual abuse reports. This finding confirms [27] affirmation that, children rarely disclose sexual abuse immediately after the event. Out of the 40 victim participants, 27 (67.5%) pregnancies cases were recorded. Fifteen (37.5%) of the victims had been defiled more than once. Pregnancies were found mostly among 14 year olds and above who were defiled by intra-familial offenders.

#### *4.1.4 Level of training of VSU officers in counseling*

The level of education and or professional training of officers is presented in **Table 2** below.

**Table 2** above indicates that of the 20 VSU officers from Ghana, 3 hold 2nd degree, 6 had 1st degree, 6 hold diploma and 5 hold certificates. Of these, was also reading law at the time of this study. From Zambia, VSU officer holds 1st degree; five hold diploma and 15 have certificates. Additionally, 20 VSU officers from both countries received certificates from various workshops attended broadly on gender and child abuse issues for capacity building.


#### **Table 2.**

*Educational and professional qualification of VSU officers.*

*Counseling Sexually Abused Children: Lessons from Ghana and Zambia DOI: http://dx.doi.org/10.5772/intechopen.97413*

Data revealed that in both Ghana and Zambia, VSU officers were not adequately trained in counseling especially in the area of CSA. It must be mentioned, however that, some of the officers who indicated having a certificate did not necessarily undergo formal training in counseling, but were rather referring to certificate of attendance obtained from workshops.

*For me I think though I don't have any qualification in counseling the capacity workshops we attend from time to time have been helping me. You know, last year I attended a two-week workshop on sexual abuse and reproductive health issues organized by UNICEF at the Kofi Annan Peace Keeping Center. I think this made me better understand sex and its related issues of abuse.* **GPO1**

#### **4.2 Nature of counseling services offered**

Under this theme we explored the general approaches, techniques and skills in counseling that VSU officers used in providing support to victims who reported their abuse. VSU officers disclosed that they lacked professional counseling skills. It was found that counseling was rarely offered in some VSU in both countries. VSU officers confirmed that:

*We rarely provide counseling services to children because of lack of proper counseling facilities and work over load.* **ZPO3**

Similar narratives abound in the data. Narratives above imply that though officers were aware of the essence of counseling they lack the requisite training to practice. They therefore engage victims and their families in what they think best by resorting mostly to advice giving on medical and legal processes leaving out the psychological and emotional assistance that victims need.

#### *4.2.1 Approaches to counseling*

Results show that there were various services offered to victims of CSA to help reduce their trauma. These could be classified as: trauma counseling, individual counseling and group counseling.

#### *4.2.1.1 Trauma counseling*

VSU officers try their best to handle sexual abuse cases brought before them. Regarding cases reported, VSU officers first and foremost try to secure the victim's safety and then encourage disclosure of abuse. Under this approach, two stages of trauma counseling were identified. These are: establishing safety and security of victims, and encouraging disclosure (remembering and mourning).

#### *4.2.1.1.1 Establishing safety and security*

In addressing the issue of the nature of counseling services provided to victims, narratives reveal that officers usually try to provide safety nets as the first step to providing counseling.

*We normally send them to shelters. Here, luckily for us there are two NGOs who work with us in providing shelter to these girls when they are brought to us.* **GPO17**

*We make all efforts to get perpetrators arrested and prosecuted* **ZPO11**

*We made prompt arrest and arraigned the offender before court. One very thing we did was to place the girl with the social welfare to secure her safety.* **GPO9**

#### Some victims corroborated this:

*When I reported my problem I was sent to the social welfare home. I spent one week there before my mother came for me. They [VSU Officers] told me that I should stay there so that the man who abused me will not harm me.* **GV6**

This approach by VSU officers in providing safety and security for victims is entrenched in the first stage of trauma counseling [15]. Depending on the perpetrator characteristics, officers provide safety where some children were taken to shelters or social welfare homes for protection and to reduce revictimization. This resonates with [28] that sexually abused children generally need safety upon disclosure.

#### *4.2.1.1.2 Encouraging disclosure*

Disclosure of abuse was seen as one fundamental phenomenon in the healing process. When victims report their abuse they are requested to disclose. Data reveal that in most cases, the reports made by non-offending parents are quite incongruent with the disclosure of victims. One officer noted:

*When the mother came and reported that the daughter was abused through the anus and we asked the girl to tell us, she said the man penetrated through her vagina.* **GPO20**

*You see, some of the girls do not like to talk to us about their predicament initially. Sometimes we allow them to sit for about two hours or more before they begin to talk. And when they do they take so long to say something meaningful.* **ZPO 18**

*When I was taken there [VSU office] and I was asked to narrate my problem, I was scared. There were a lot of people around, moving here and there and then some of them were police men coming to the room. So I was not comfortable but I told them later.* **GV15**

To overcome the stress of remembering and mourning, the victim needs to narrate his or her experiences in depth with great detail. The goal is to modify the traumatic memories so they become more meaningful in the person's life and less anxiety provoking. As the narrative develops, the memories become less disjointed, more depersonalised and more coherent. With this emotional reworking and cognitive restructuring, the memories become more manageable and the significance of the trauma changes from a story of victimisation to one of dignity and agency [16]. Once the victim is able to emotionally and cognitively process the traumatic experiences, he or she is then able to mourn the losses experienced during the abuse. Victims face the reality that they may never regain what they have lost. Herman [15] argued that with the new story, the intrusive and hyper-arousal symptoms subside.

Associated with reporting and disclosure is the issue of power imbalance. The police stations do not seem to provide a safe environment that promotes disclosure. Ironically, while the officers were interested in providing safety from perpetrators, their own personalities and immediate environments smack of insecurity and impact on effective disclosure.

*Counseling Sexually Abused Children: Lessons from Ghana and Zambia DOI: http://dx.doi.org/10.5772/intechopen.97413*

#### *4.2.1.1.3 Reconnecting*

In most cases, officers attempt to re-unite victims with their families especially with their non-offending parents or caregivers. This is as the result of lack of shelter and other logistics in handling the victims. Officers revealed:

*We have no place to keep them for long so what we do is to ask the parents to take them back and advised them strongly to take good care of them.* **ZPO5**

*You see we have the social welfare to take care of these children, but we do so in very severe cases where we suspect revictimization.* **GPO7**

This reconnection is thus exigent on the prevailing circumstances in the VSU offices. One finds it difficult to assess whether reconnection to the families has positive outcome for the victims or not as VSU officers have no means of follow-up on cases. This study thus, revealed that the reconnection stage of Herman's model was woefully completed. Victims were not reconnected in the real sense of recovery geared towards healing and empowerment. At best their reconnections could be described as disposal.

#### *4.2.1.2 Individual counseling*

This is normally done with victims in the same office with their parents and other VSU officers. Narratives reveal that for lack of space and other logistics, VSU officers carry out their counseling activities right in the same office with other colleagues. One stated

*Oh we do the counseling right here [referring to the general office of VSU].* **GPO1**

*What we call individual counseling is when we sort of interview the victim upon reporting of abuse and take their statements. I think our interviews are like counseling where we listen to them and advise them on what to do.* **ZPO13**

The term individual counseling is used interchangeably with taking victims' statements and asking probing questions for clarification. Through observation and narratives, it was revealed that the individual counseling provided was short of appropriateness. With individual counseling done in the same office with other officers and visitors coming in and out, then the counseling environment is not conducive enough to uphold the principles of confidentiality and to promote disclosure.

#### *4.2.1.3 Group counseling*

Data indicate that group counseling referred to in this context is when victims and their non-offending parents or caregivers are provided some advice on seeking medical treatment, legal procedures and general advice on how to prevent being re-victimised.

*Normally we talk with the victims and their non-offending parents at the same place. We do not put victims together for counseling. You know, we deal with the victims on case-by-case level, individually* **GPO19***.*

Group dynamics such as purpose of group formation, theme, and other characteristics were not considered. Group counseling was offered in a form of family therapy usually with non-offending parent or family members.

#### *4.2.1.4 Advice giving*

Regarding the approach to counseling, it was found that the counseling that was provided (if at all) that could best be described as group counseling was used in all service (VSU) centers. The counseling provided here is more advice giving especially regarding victims' right to legal assistance, medical treatment, and how victims could ovoid revictimization, and parental protection and provision. Advice on legal procedures and investigations: victims and their parents were also provided needed information on legal opportunities available to them. An officer explained:

*It is our duty to explain all the procedures and investigation process to the family and what is expected of them especially during the investigations.* **ZPO11**

#### *4.2.2 Counseling skills and strategies*

In addition to the approaches used, officers also employed some basic counseling skills such as encouragement, reassurance, and rapport. However, cognitive behavioural counseling techniques skills like assertiveness training, empathising, role-play, art therapy and belief of victims' stories were found missing. These were considered very important in reducing the grief and confusion that children abused normally go through thus, paving way for healing.

#### *4.2.3 Operational challenges in delivering counseling to victims*

On barriers associated with counseling service provision, the following subthemes emerged: lack of skilled personnel, lack of logistics, late reporting of cases, family interference, lack of safe and conducive environment coupled with presence of power relations, inadequate time and sessions among others.

#### *4.2.3.1 Lack of training and structure*

*No, we have no guidelines to follow to do counseling. What we do is to take their statements when they come. This is the same way we take all statements at the station. I think we need more to handle these children* **GPO5**

*We don't have any format for doing counseling. I guess we all rely on what we think is counseling by asking the victims questions and telling them what they should do* **GPO7**

*We need further training to do counseling* **GPO8**

Data reveal that VSU officers perceived themselves as inadequate in providing counseling services to victims. They, however, bemoan their lack of professional training and capacity. It was noted that in both countries, VSU officers have no psychological tests to administer to victims, they do not have any structured system or documents to use such as intake form upon report of an abuse.

#### *4.2.3.2 Logistics and administrative challenges*

Direct observation and in-depth interview report indicated that the VSU officers lacked capacity in terms of resources for their work. Apart from the units in the

*Counseling Sexually Abused Children: Lessons from Ghana and Zambia DOI: http://dx.doi.org/10.5772/intechopen.97413*

regional capitals of the study sites in both countries with one and two computers each in Ghana and Zambia respectively, the VSU desks in the study regions had no computers and therefore no database of cases before them. The police dockets were managed manually by using notebooks and files. Officers did not have filing cabinets. These challenges were acknowledged by the officers at the units. One officer indicated:

*We do not have the capacity to follow up on cases because of lack of basic resources like computers to keep data on offenders. For instance, for lack of computers there is no database for perpetrators making it difficult to track repeated offenders* **ZPO8**

There were also no vehicles assigned to the VSUs in the study sites in Ghana. However, the Lusaka headquarters unit had one vehicle for investigation of cases. This was however bemoaned as woefully inadequate.

*You see we are handicapped. When cases are reported, we have no means of taking swift action to cause arrest of perpetrators. We sometimes rely on reporters, other division vehicles or our own vehicles. These cause delay and sometimes give room for perpetrators to abscond. Additionally, this logistic challenge makes it difficult for us to follow-up on victims after their reports to see how they were doing.* **ZPO15**

These reports were corroborated by VSUs from Ghana:

*We have no means of effecting arrest of perpetrators swiftly. Mostly due to unavailability of vehicle some perpetrators abscond before we got there. It's a big challenge.* **GPO20**

*4.2.3.3 Late reporting of cases*

Many victims did not report the offence until later when they fell ill or got pregnant and the men refuse responsibility.

*A pregnant girl was brought here and a complaint was lodged against a man who refused responsibility. They [the girl and the mother] did not report of sexual abuse. It was during interrogation that the girl revealed that she was impregnated by her uncle and when we looked at her age, she was 15 years and we filled a case of defilement.* **GPO18**

Late reporting or indirect reporting of Child Sexual Abuse cases makes it difficult for victims to receive any form of counseling (if any) from VSU officers. This finding resonates with other research that, sexually abused children rarely disclose sexual abuse immediately after the event [27].

#### *4.2.3.4 Family interference*

The constant appeals by family members to withdraw the cases from the courts do not only thwart the efforts of the courts to prosecute offenders, it also cuts short whatever counseling interventions that VSU officers could offer the victims since the withdrawals mark the end of victims' visit to the station for further assistance. One officer bemoaned:

*Hmm, it is difficult to provide the little help we can to these [abused] girls. You see there was this case where the girl came to report her abuse personally just after the incident. Everything was there to see. We made prompt arrest and arraigned the* 

*offender before court. One very thing we did was to place the girl with the social welfare to secure her safety. But do you know the trick the family played to get the case out of court? The family insisted that they want to have and keep the girl with themselves so we allowed them to take her away and to bring her back for hearing. That was all!!! They never showed up. The case was called several times and since the complainant was not present, the case was thrown out of court and the accused released. In this case what else can we do?* **GPO9**

*Families interfere too much in our efforts to deal with offenders. This also cuts short whatever little assistance we could offer them.* **ZPO11**

These narratives point to the administrative challenges faced by VSU officers. In all, victims were provided first aid counseling. Police dockets revealed that most cases were discontinued. In most cases parents or caregivers request for withdrawal of cases to be settled at home. About 90% of reported cases were not followed up by parents and since the police have no means of following up, the cases die naturally and the courts closed dockets on them. Feedbacks on settlement were not provided by parents. The settlement of defilement cases outside court violates the very spirit and letter of the law on defilement [29] because rape under laws of both countries is a first degree felony [27].

#### *4.2.4 Benefits of counseling victims and the way forward*

Regarding benefits of counseling for victims, the following were some of the subthemes: need for professional training; assurance that will lead to disclosure, anxiety and fear reductioning, promoting healing, and empowering victims; nonbelief of victim's story and lack of privacy and confidentiality were seen as immediate issues that could be addressed to pave way for effective counseling of victims. The following narratives are revealing:

*Well, if we are asked to go for further studies, I think I would consider doing counseling because it will help me in my work when I return. That is if I'm posted back to this unit (referring to DOVVSU).* **GPO14**

*The service needs to support officers to do professional counseling and when they are done, such officers should be posted here to work. And you know, there are some officers who have their 1st degree in counseling. I know some of my colleagues here who did counseling in your university (UEW) but they have not been posted to DOVVSU desks maybe they do not want to work here or the service refuses to post them here. But I think it is more about the bosses up there.* **GPO3**

*I don't know what to say. You know, my daughter was only talked to by the police woman and after that day nothing happened again. They did not ask us to come again. So that was it. All I observe is that from time to time, she seems lost to herself and sometimes too she wants to be alone.* **GP4**

*I thank God that I was able to talk to the police about my abuse and they helped me. They talked to me and assured me that the man would be arrested and they arrested him.* **GV10**

*I wish I was given the chance to talk to the woman alone.* **GV5**

*I don't think the woman believed me and you see, I could not tell her everything knowing that she didn't believe my story.* **ZV8**

#### *Counseling Sexually Abused Children: Lessons from Ghana and Zambia DOI: http://dx.doi.org/10.5772/intechopen.97413*

Though some victims feel less threatened by their disclosure to the police the same sense of lack of security prevents detailed disclosure and hinders recovery. This finding corroborates conclusion drawn by [30] that distrust of, and poor experience with, state authorities and public services contributed to individuals abused not seeking help.
