Once children are rescued from the torment of child pornography, they enter a collaborative legal, social services and health care system dedicated to keeping them from any further harm and, if possible, to give them the means to recover.
Internet Crimes Against Children Task Force works alongside state Child Protective Services, the Division of Child and Family Services and the Children's Justice Centers to make sure that children aren't victimized again and that they get the medical care and therapy they need.
And for many children and their families, that's where Primary Children's Center for Safe and Healthy Families comes in.
Pediatrician Lori Frazier, director of the center's medical assessment team, says a child may have "horrible injuries" that need surgical repair, but that's rarely the case. Up to 95 percent have no physical signs; their tiny bodies are flexible enough to endure what they're subjected to.
And, she says, abusers often are people the children know.
"It's a progressive grooming," she says. "The perpetrator designs it to be gentle and progressive."
He -- most pedophiles are men -- may sedate the child with drugs or alcohol. "When [the child is] interviewed, they have no memory of it," Frazier says.
But for those who do remember, and bear the psychic scars of their abuse, the center's therapists and psychologists are prepared to work for as long as it takes to help them recover.
However, says Julie Bradshaw, a licensed clinical social worker and the center's director, the process is complicated by the fact that children may have been exposed to multiple forms of violence -- sexual, domestic or physical -- or pornography.
"That makes sense, if they have backgrounds that expose them to all kinds of things," she says. "Our ability to sort out what caused what impact ... just doesn't exist."
In any case, the therapists use a treatment called trauma-focused cognitive behavioral therapy, which has been specifically researched with victims of sexual abuse.
"In layman's terms, when you think about something bad or extraordinary that has happened to you, your normal way of dealing with it is to talk about it," Bradshaw says. "You tell everyone you know about it, until you get tired of the story and then you're done."
That, she said, is a "trauma narrative," a way to externalize what happened and get the brain used to the event.
The children's therapy begins with relaxation techniques that build resilience, "and then we teach them how to tell their story in the language of whatever age the child is," Bradshaw says.
A child can draw her story, or write it -- express it in whatever way she can -- "until the power of the story is gone, and it doesn't haunt them anymore."
The technique is all about correcting erroneous thinking, as when a child thinks what happened was all his or her fault, "so it helps when thinking and behavior are linked," Bradshaw says.
The therapists also work with the child's parents, teaching ways to support their kids, to work with them in their healing.
Sometimes, though, therapists can't help the children. The center offers only out-patient care, so the next step would be daily therapy. From there, a child may have to go to a group home, where they stay night and day.
If that isn't working, the child may go to in-patient care at a psychiatric unit.
In the meantime, the family of any abused child can be traumatized too, and need counseling and education to help the child and themselves work through what has happened to them.
All of this, of course, means nothing to the people who produce child pornography and to the countless others who inexplicably find pleasure in watching a screaming, writhing child.
Second installment: Crime and punishment in child pornography, sexual abuse
First installment: Child pornography - A ubiquitous problem with horrific consequences
