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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5107
Experience:  Dr. Mark is a PhD in psychology in private practice
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My adopted daughter 4 yrs old we believe was sexually abused

Customer Question

My adopted daughter 4 yrs old we believe was sexually abused by her older brother. He was abused by his biological dad. We have caught her masturbating with her kuppy.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Mark replied 1 year ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.



This is indeed a very troubling and difficult situation. It is too severe, it seems to try to manage it by yourself with self help techniques. A professional is indeed required here.

Is your income low enough that she could qualify for children's Medicaid in your state? The requirements for children if she has no insurance are usually less stringent.

Would the adoption agency have funds as this was a preexisting condition of the adoption?

Would you be able to work with someone who accepts a sliding fee scale?

When you say other things, to what do you refer?

Any extra information that will help, feel free to share.

Please go ahead and post your response. I'm going to be going into therapy sessions in my office soon, so if I can't answer before that, would later tonight be okay for me to respond?


Dr. Mark

Customer: replied 1 year ago.
Well, here's the whole thing, i am with her mother. Her four yr old calls me dad and it feels normal, but I have not officially adopted her yet. The child has a therapist which she has being seeing for about a yr or more and has not really helped at all. I have a therapist also, she doesn't deal with kids, but to whom I do confide her with whats going on. My therapist, like you shows great concern with the child's behavior. The therapist the child has seems to be the only one she can get with her insurance. I really cant afford the ones I know would really help her. We now have a newborn and we know we cant leave her alone with him. She also asks to do strange things to him. We NEVER leave them alone.
Customer: replied 1 year ago.
Actually, please respond anytime you can. We really need some help with her problems.
Customer: replied 1 year ago.
My 5 month old is teething so no sleep. I never properly answered all the questions. Never heard of a sliding fee scale, and my gf didn't know about child medicare. We are looking into both possibilities. One thing we do make sure of is we never punish or praise the behavior we distract her from it.
Expert:  Dr. Mark replied 1 year ago.

Thank you for your patience; I'm sorry, I was away for a while.

I know you want an answer as quickly as possible. But this is your life and I want to make sure that the answer I give you is the most fitting to your specific situation and who you are. So I need to ask just a little more:

Again, this is not a self help situation. You MUST be guided in how you deal with your daughter by a competent psychologist. I am not clear, though, about the child's therapist. She's the ONLY one your insurance will cover does not make sense from my experience. What is your insurance company and what location are you in?

Is there a university with a psychology department near you? I'm wondering about getting in touch with the head of the department to see if he/she has a faculty member whose specialty is children's disorders and seeing if such a severe case would be of interest to them and you could use them to get advice and help.

The same with a Children's Hospital Psychiatric Department. Your daughter is not a common case, much more severe. If you can consult with them, they might be interested in helping and they usually take EVERY insurance.

Dr. Mark

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5107
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.
Hello Dr Mark,

I am the girlfriend/ mother. My Daughters insurance carrier is Gateway through the state, and we live in Harrisburg, PA. I called the providers and asked if any were Trauma Therapists, this was the only place that said they had a trauma therapist who took her insurance.

As to a University with Psychology Department, I'm not sure what is available around here. Penn State Hershey Medical Center is the closest big Children's Hospital that we have and they no longer do adolescent psychiatry unit there, it was merged with Pennsylvania Psychiatric Institute (PPI). This is the only number I could find for PPI (XXX) XXX-XXXX. As far as I know the only way to get my child seen there is a recommendation from a professional.

Her current therapist does not seem to think that it is the right step for my daughter at this time. My daughter has been with her a year and in some areas we have seen improvement, but this one we have not and whatever is going on with her is spilling over into her interactions with her baby brother.
Expert:  Dr. Mark replied 1 year ago.
Gateway is the Medicaid program in PA. Medicaid doesn't have the best of the best as you can imagine, because it doesn't pay very much. I actually accept Medicaid in my county because I like working with people who can't afford my services regularly. But I can't afford to have too many Medicaid clients. So I understand.


That's why you need to contact the top people. See if you can get them interested. I know that here in CO the Children's Hospital people in Denver might get interested; or the CU profs working with children's disorders. Even if they're a long drive away, you're really talking about having them supervise or consult with your current therapist. So it might be once a month there.


Here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!) look at the listing and see if they list working with children and accepting Gateway. I don't know if there are any, but it's a resource. Interview the therapist and make sure he/she shares your values and you each feel confident in him or her or if they maybe know someone who might be very experienced in child abuse cases.

http://therapists.psychologytoday.com/rms/



You know, the DA's office would be a resource. It might be too scary, but if not...


I know a lawyer in my local DA's office who handles the child abuse cases. She's terrific. I bet she knows all the top psychologist here. I wonder if it would be the same in your area.


I'm just trying to think out of the box because Gateway is very much "the box" and your daughter needs more than standard treatment.


Okay, stay in touch and all the best,
Dr. Mark

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