Controversies and challenges of ritual abuse

Children who have survived ritual abuse have endured physical, psychological, and sexual trauma; brain-washing; and mind-altering drugs. Their trust in adults has been eroded. Their coping strategies include anxiety, denial, self-hypnosis, dissociation, and self-mutilation. Although reports of ritual abuse initially seem hard to believe, nurses have a responsibility to detect clues to abuse, diagnose the child's responses, and recognize controversial issues regarding ritual abuse. To evaluate ritual abuse, nurses should avoid interview strategies that influence the child's recall (e.g., coaching, suggestions) and recognize that some reports are discounted as false memories because they emerge from fantasy, distortions, innocent deceptions, false beliefs, lies, or adult coaching. Nurses play an important role in case finding and treatment. They can evaluate clues to ritual abuse to reduce sources of error in assessment, build a child's trust, monitor their own attitudes toward ritual abuse, and intervene to increase self-esteem, empathy, boundary establishment, and coping. Nurses have an important opportunity to detect and begin healing the wounds caused by a child's abuse.