The trauma of child sex abuse was personified in a Centre County courtroom over two weeks where eight victims testified against former Pennsylvania State University assistant football coach Jerry Sandusky. Sandusky was found guilty June 22 of 45 counts after a two-week trial.
But victims of child sexual abuse, including the 10 Sandusky was convicted of violating, face a long healing process.
Experts say treatments for the mental symptoms of abuse are often effective in helping victims come to terms with what happened, but certain effects remain.
"We're not looking for major breakthroughs. We're looking for the person to be able to function as well as they were before," said Michael Tony, who leads the treatment team at Pittsburgh Action Against Rape.
"We've had victims tell us that this has affected every decision they've ever made, and these are victims that have thrived," said Alison Hall, the group's director.
Lasting mental symptoms are different in every victim as they move into adulthood. However, victims often experience anxiety, post-traumatic stress, sadness, and problems trusting others.
While someone is still a child, signs of sexual abuse include anger problems, acting out in school, changes in friend groups, bed-wetting, sexualized play and eating disorders.
"I think the biggest thing that is the most common is a sense of shame," said Mary Carrasco, director of A Child's Place at Mercy, which evaluates children to determine if they have been abused. "The child feels that they are someway at fault and they are afraid to tell. And I think you saw that consistently in the [Sandusky] testimony. A skilled pedophile, as this guy undoubtedly was, used this as well as bribes to keep them quiet."
One of the most effective treatments is cognitive behavioral therapy. Through guiding questions, a therapist allows victims to express what happened to them in a way that helps them conceptualize the events in a way that is easier to live with.
"It involves helping the child to conceptualize cognitively what happened to them and realize they're not at fault," said Michael Franzen, chief of neuropsychology at Allegheny General Hospital.
Treatment usually takes around six months. Tony, of Action Against Rape, says it is hard to pinpoint what percentage of victims can be called successfully treated. However, he says, "I think we have a pretty high success rate."
A 1999 study in the journal Social Service Review found that 30 percent to 40 percent of women and 13 percent of men say they were sexually abused during childhood.
However, the number of child sexual abuses that are reported to authorities is far lower. Data compiled by the U.S. Department of Health and Human Services shows that about one in every 1,000 instances are reported to child protection agencies.
Publicity, such as the revelation of the Sandusky allegations and the subsequent trial, can increase the number of reports. Calls to the Pennsylvania Childline hotline were up 40 percent in November, when the allegations became public, compared with November 2010.
Action Against Rape says its hotline has received 20 percent more calls since the trial began.
Docherty, now a research consultant and president of the board of directors of Action Against Rape, said treatment helped her heal.
She said she was able to "go in and just talk about what happened, get all those things that I had never talked about and just talk about it with someone and learn that the way that I was feeling was common."
"I wasn't just alone in feeling this shame and feeling this anger."