In this his paper the authors describe therapeutic interventions with survivors of child rape and sexual abuse at Alexandra Clinic in Gauteng. Cases presenting at this community clinic are described, in the context of the startling increase in crimes against children and particularly sexual offences. The literature pertaining to the effects of trauma on children, important mediating factors in the child's experience and existing interventions with child trauma survivors are then reviewed. Attention is focused on studies taking into account the impact of the trauma on the child's familial environment. A description of the general intervention approach employed is followed by a deeper exploration of two core issues which characterised this approach — the identification of both mother and child as clients and the use of the mother-child relationship as a central focus for therapeutic intervention. It is suggested that these strategies enable greater access to the experience of the younger child in particular, address the effects of secondary traumatisation upon care-takers and ensure that the gains of therapy are extended to the child's larger social network.
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