Physical abuse involves using physical force against a child in a way that causes or risks harm — including hitting, slapping, burning, or other physically harmful actions. Emotional abuse involves patterns of behavior that damage a child's emotional wellbeing and development — such as constant criticism, humiliation, threats, rejection, or the withholding of love and affection. Both are serious forms of abuse, and both can have profound and lasting effects on a child's mental health, development, and sense of self.

Signs of abuse in children can be physical, behavioral, or emotional. Physical signs may include unexplained injuries or bruising. Behavioral signs may include sudden changes in behavior, regression to earlier developmental stages, fear of certain people or places, sexual knowledge inappropriate to age, or extreme reactions to being touched. Emotional signs may include low self-esteem, excessive anxiety, depression, or withdrawal. If you suspect a child is being abused, contact a professional — including the Maryland Child Abuse and Neglect Hotline at 1-800-332-6347 — rather than waiting for certainty.

This is a complex situation that requires careful clinical consideration. If a child is currently in an abusive situation, ensuring their immediate safety is the priority. A therapist can help assess safety, develop safety plans, and provide emotional support while safety planning is underway. In some circumstances, therapy can also proceed alongside child protective services involvement. Your therapist will work with your family and relevant systems to prioritize the child's safety at every step.

Trauma-focused cognitive behavioral therapy (TF-CBT) is one of the most well-researched and effective treatments for children and teens who have experienced abuse or trauma. It is a structured, skill-based approach that includes psychoeducation, coping skills, processing of traumatic memories, and cognitive work to address harmful beliefs. A key feature is parent or caregiver involvement throughout. TF-CBT is appropriate for most children ages 3 to 18 who have experienced trauma, and your therapist can assess whether it is the right fit for your child.

Talking to a child about abuse requires care and age-appropriate language. In general, it is important to let the child lead, listen without expressing shock or disbelief, thank them for telling you, reassure them that it is not their fault, and avoid pressing for details or asking leading questions. Your child's therapist can provide specific guidance on how to have these conversations in ways that support the healing process rather than inadvertently creating additional stress.

The duration of therapy for a child who has experienced abuse depends on many factors, including the type, severity, and duration of the abuse, the child's age and developmental stage, the presence of a safe and supportive caregiver, and the child's current symptom level. Structured approaches like TF-CBT typically span 12 to 25 sessions, though many children benefit from additional ongoing support. Your therapist will work with your family to set realistic goals and regularly evaluate progress throughout the treatment process.