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Glucklich T, Attrash-Najjar A, Massarweh N, Katz C. What do adults who experienced child sexual abuse want to convey about therapy? CHILD ABUSE & NEGLECT 2023; 146:106435. [PMID: 37722294 DOI: 10.1016/j.chiabu.2023.106435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Child sexual abuse (CSA) studies have significantly advanced the understanding of its prevalence and adverse consequences. Tremendous efforts worldwide have been devoted to CSA interventions. However, surprisingly, there is a lack of research dedicated to learning about experiences with therapy among adults who experienced CSA. OBJECTIVE This study was designed to address this gap by exploring the perspectives and experiences with therapy among adults who experienced CSA. METHODS Thirty-nine written testimonies comprised the current sample. All of the testimonies were provided to the Israeli Independent Public Inquiry into CSA by adults who experienced CSA and received therapy at one point in their lives. A qualitative inductive thematic analysis guided the exploration of the testimonies. RESULTS The testimonies provided an important glance into significant characteristics of therapy, such as the timing and reasons leading to therapy, and perceptions regarding what constitutes appropriate therapy. Although beneficial and rehabilitating therapy experiences were mentioned by some of the participants, the majority of the testimonies focused on experiences related to the obstacles and challenges to accessing and engaging in therapy faced by those who experienced CSA. CONCLUSIONS The testimonies not only addressed essential aspects of therapy, but also highlighted the importance of thoroughly comprehending the broad context of a person's life that leads them to seek therapy. The discussion points to grave social and policy lacunas that prevent people who experienced CSA from receiving therapy that is accessible, timely, subsidized, stigma-free and multifaceted.
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Affiliation(s)
- Talia Glucklich
- The Haruv Institute, The Hebrew University, Mount Scopus, Jerusalem 9765418, Israel
| | - Afnan Attrash-Najjar
- The Bob Shapell School of Social Work at Tel Aviv University, Tel Aviv 69978, Israel
| | - Nadia Massarweh
- The Al-Qasemi Educational College of Education, Baqa-El-Gharbia 3010000, P.O. Box 124, Israel
| | - Carmit Katz
- The Bob Shapell School of Social Work at Tel Aviv University, Tel Aviv 69978, Israel.
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Viliardos L, Murphy N, McAndrew S. Mental health challenges facing male survivors of child sexual abuse: Implications for mental health nurses. Int J Ment Health Nurs 2023; 32:490-501. [PMID: 36344441 DOI: 10.1111/inm.13087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/09/2022]
Abstract
Child sexual abuse (CSA) is an issue of epidemic proportions in the United Kingdom (UK) and an international public health problem. Evidence suggests that in the UK one in 20 children have been sexually abused, with one in three not telling anyone about it at the time of the abuse. Conservative estimates suggest that around one in six men have experienced sexual abuse before the age of 18. CSA has been correlated with the development of numerous mental health problems, abused men often displaying externalizing behaviours, including substance misuse, 'risky' sexual behaviours, anti-social behaviour, and offending. This article reports on one aspect of a research study focusing specifically on male survivors of CSA and its effect on their mental health. Using narrative research, face-to-face interviews were used to collect the stories of four men who participated in the research. Interviews were audio-recorded and transcribed verbatim. Analysis used a two-phase approach; initially, each narrative was analysed as a whole, with an across transcripts analysis then being carried out identifying shared themes emerging from the individual stories. Whilst findings from the second phase of the analysis identify four themes, it is the theme of 'Blocking the Memories' that is the focus for this article. Making a valuable contribution to existent knowledge regarding the experiences of men who were sexually abused as children, this article will help to inform mental health practitioners who are likely to deliver care to male survivors of CSA.
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Viliardos L, McAndrew S, Murphy N. Exploring male childhood sexual abuse survivors' experiences of specialist counselling services. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Laura Viliardos
- School of Health and Society University of Salford Salford UK
| | - Sue McAndrew
- School of Nursing Midwifery and Social Work University of Salford Manchester UK
| | - Neil Murphy
- School of Health and Society University of Salford Salford UK
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A systematic review that evaluates the extent and quality of involving childhood abuse survivors in shaping, conducting and disseminating research in the UK. RESEARCH FOR ALL 2022. [DOI: 10.14324/rfa.06.1.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Despite a well-established understanding of the mental and physical health consequences associated with exposure to childhood abuse, the active voices of survivors are rarely present in shaping, conducting and disseminating research. To explore the extent and quality of involvement with adult survivors of childhood abuse in the UK, we performed a systematic review of research conducted ‘with’ or ‘by’ survivors, and analysed involvement against a new instrument, the Survivor Research Involvement Ladder, which was co-produced drawing from the principles of the Survivors Voices Charter. A search of relevant grey and peer-reviewed literature was conducted, which retrieved 662 sources after removing duplicates. Of these, 116 full-text articles on adult survivors of childhood abuse in the UK were subsequently assessed for involvement (beyond participation as ‘subjects’), of which only 15 (12.9 per cent) reported activities led, co-produced, advised or consulted on by survivors, and these were included in the review. From evaluations and analysis using the ladder, consumerist models were found to be the dominant form of involvement, with survivors filling advisory roles at isolated stages. Survivor-led research was scarce but emerged when survivor-researchers planned, conducted and disseminated their work. This review finds considerable opportunity for improvements in the level, quality and subsequent reporting of research activities involving survivors. The use of the instrument needs replication, validation and further field-testing.
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Coleman AM, Chouliara Z, Currie K. Working in the Field of Complex Psychological Trauma: A Framework for Personal and Professional Growth, Training, and Supervision. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:2791-2815. [PMID: 29557712 DOI: 10.1177/0886260518759062] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of this article is to explore the positive and negative impacts of working therapeutically in complex psychological trauma (CPT), particularly the field of gender-based violence (GBV) and childhood sexual abuse (CSA), from the clinicians' perspective. The focus was on the prospect of positive gains and growth for therapists. Twenty-one clinicians (n = 21; counselors/psychotherapists and psychologists) from National Health Service (NHS) specialist trauma services, a community mental health team, and specialist sexual assault counseling organization participated. Interpretative phenomenological analysis (IPA) was utilized to conduct single one-off interviews and analysis. Six themes were identified: Called to the work; Connection, Separation, and Oneness; Into and out of the darkness; Chaos into meaning; Reparation not repetition; and Expansion and growth. The first "Therapist Led Framework of Growth in Trauma Work" is presented. Vicarious posttraumatic growth (VPTG) was a key finding, with CPT therapists experiencing a "challenge/benefit/change" growth process. Adoption of actively relational strategies to enhance clinicians' growth process through trauma work is being proposed. The benefits of conceptualizing both the positive and negative impacts of such work for supervision, training, shaping the formal curricula, service management, and continuing professional development (CPD) are being discussed. The need for good practice guidelines on self-care internationally is highlighted.
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Chouliara Z, Karatzias T, Gullone A, Ferguson S, Cosgrove K, Burke Draucker C. Therapeutic Change in Group Therapy For Interpersonal Trauma: A Relational Framework for Research and Clinical Practice. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:2897-2916. [PMID: 29294731 DOI: 10.1177/0886260517696860] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Our understanding of therapeutic change processes in group therapy for complex interpersonal trauma has been limited. The present study aimed at addressing this gap by developing a framework of therapeutic change in this field from a survivor and therapist perspective. This is a qualitative study, which utilized semistructured individual interviews. Transcripts were analyzed using interpretative phenomenological analysis (IPA) to identify recurrent themes. A final sample of n = 16 patients and n = 5 facilitators completed the interview. Main change processes identified by survivors were as follows: self versus others, trust versus threat, confrontation versus avoidance, and "patching up" versus true healing. Therapeutic processes identified by therapist facilitators included managing group dynamics, unpredictability and uncertainty, and process versus content. The proposed framework explains therapeutic change in group therapy in relational terms, that is, therapeutic dissonance, the dynamic interaction of self and experience as well as building empathic trusting relations. The importance of managing dissonance to aid personally meaningful recovery was highlighted. These findings have implications for the usefulness of relational and person-centered approaches to clinical practice in the area of interpersonal and complex trauma, especially in the early identification, prevention, and management of dropouts.
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Affiliation(s)
| | - Thanos Karatzias
- Edinburgh Napier University, Scotland
- NHS Lothian, Edinburgh, Scotland
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Ng SM, Leng LL, Xie QW, Chan JSM, Chan CHY, So KF, Li A, Po KKT, Yuen LP, Ku KS, Choi AWM, Chouliara Z, Cheung ACY, Chan CLW, Emery C. Trust as a mediator in the relationship between childhood sexual abuse and IL-6 level in adulthood. PLoS One 2020; 15:e0232932. [PMID: 32413063 PMCID: PMC7228092 DOI: 10.1371/journal.pone.0232932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/25/2020] [Indexed: 12/20/2022] Open
Abstract
Childhood sexual abuse (CSA) has been shown to predict the coupling of depression and inflammation in adulthood. Trust within intimate relationships, a core element in marital relations, has been shown to predict positive physical and mental health outcomes, but the mediating role of trust in partners in the association between CSA and inflammation in adulthood requires further study. The present study aimed to examine the impact of CSA on inflammatory biomarkers (IL-6 and IL-1β) in adults with depression and the mediating role of trust. A cross-sectional survey data set of adults presenting with mood and sleep disturbance was used in the analysis. CSA demonstrated a significant negative correlation with IL-6 level (r = -0.28, p<0. 01) in adults with clinically significant depression, while trust showed a significant positive correlation with IL-6 level (r = 0.36, p < .01). Sobel test and bootstrapping revealed a significant mediating role for trust between CSA and IL-6 level. CSA and trust in partners were revealed to have significant associations with IL-6 level in adulthood. Counterintuitively, the directions of association were not those expected. Trust played a mediating role between CSA and adulthood levels of IL-6. Plausible explanations for these counterintuitive findings are discussed.
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Affiliation(s)
- Siu-Man Ng
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Ling-Li Leng
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Qian Wen Xie
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Jessie S. M. Chan
- Laboratory of Neuropsychology, The University of Hong Kong, sai wan, Hong Kong
- Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, sai wan, Hong Kong
| | - Celia H. Y. Chan
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Kwok Fai So
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, Guangdong, China
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, sai wan, Hong Kong
- State Key Laboratory of Brain and Cognitive Science, The University of Hong Kong, sai wan, Hong Kong
| | - Ang Li
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, Guangdong, China
| | - Kevin K. T. Po
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, sai wan, Hong Kong
| | - L. P. Yuen
- International Association for Health and Yangsheng, sai wan, Hong Kong
| | - Kam-Shing Ku
- District Elderly Community Service, Haven of Hope Haven of Hope Christian Service, sai wan, Hong Kong
| | - Anna W. M. Choi
- Department of Social and Behavioral Sciences, City University of Hong Kong, sai wan, Hong Kong
| | - Zoë Chouliara
- Division of Mental Health and Counselling, Abertay University, Dundee, United kingdom
| | - Amos C. Y. Cheung
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Cecilia L. W. Chan
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Clifton Emery
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
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Wright C, Gabriel L. Perspectives of Adult Survivors of Child Sexual Abuse: An Exploration of the Adjustments to Self-Structure through Meaning-Making in Therapy. JOURNAL OF CHILD SEXUAL ABUSE 2018; 27:663-681. [PMID: 30071187 DOI: 10.1080/10538712.2018.1496961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This critical literature review explored how adult survivors of child sexual abuse experienced adjustments to their self-structure through meaning-making in therapy. Following extensive searches of academic databases, 15 studies were identified for review. Using thematic analysis, eight themes emerged. The eight identified themes of trust, acknowledgement, evolution, acceptance, integration, congruence, relational, and agency represented distinct but interrelated components of self-structure. The findings also indicated that self-structure components may be both intra- and interrelational in nature and that movement in one theme may facilitate movement in another. While recognizing that the nature of the research captured a composite of experiences, it was found that there was a consistent movement and fluidity as to how participants arrived at an adjusted position for each of the themes. A suggested theoretical framework was developed showing the components of the self-structure impacted by meaning-making and the nature of the adjustments made. Recommendations are made regarding future research.
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Parry S, Simpson J. How Do Adult Survivors of Childhood Sexual Abuse Experience Formally Delivered Talking Therapy? A Systematic Review. JOURNAL OF CHILD SEXUAL ABUSE 2016; 25:793-812. [PMID: 27653789 DOI: 10.1080/10538712.2016.1208704] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This systematic review explored how adult survivors of child sexual abuse experienced nonspecific and trauma-focused talking therapies. Following extensive systematic searches of academic databases, 23 qualitative empirical studies were chosen for review. Using a line-by-line thematic synthesis, four analytical themes developed. These themes were: The Therapeutic Process as a Means for Forming Connections, which discusses therapeutic relationships; Developing a Sense of Self Through the Therapeutic Processes, which identifies stages of developmental recovery; Therapeutic Lights and Black Holes in the Shadows of child sexual abuse, which reflects on how a history of child sexual abuse influenced experiences of therapy; and Healing or Harrowing: Connecting With Others and First-time Experiences, which explores what was helpful, hindering, and new throughout the therapeutic journey. Findings related to participants developing new options for interpersonal relationships through the experience of authentic trust and the experiential learning of control and choice. Recommendations are discussed in relation to developing therapeutic practice and future research.
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Affiliation(s)
- Sarah Parry
- a Department of Psychology , Manchester Metropolitan University , Manchester , UK
| | - Jane Simpson
- b Division of Health Research , Lancaster University , Lancaster , UK
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de Visser RO, Badcock PB, Rissel C, Richters J, Smith AMA, Grulich AE, Simpson JM. Experiences of sexual coercion in a representative sample of adults: the Second Australian Study of Health and Relationships. Sex Health 2014; 11:472-80. [PMID: 25377000 DOI: 10.1071/sh14103] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 08/22/2014] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background It is important to have current reliable estimates of the prevalence, correlates and consequences of sexual coercion among a representative sample of Australian adults and to identify changes over time in prevalence and consequences. METHODS Computer-assisted telephone interviews were completed by a representative sample of 20094 Australian men and women aged 16-69 years. The participation rate among eligible people was 66.2%. RESULTS Sexual coercion (i.e. being forced or frightened into sexual activity) was reported by 4.2% of men and 22.4% of women. Sexual coercion when aged ≤16 years was reported by 2.0% of men and 11.5% of women. Correlates of sexual coercion were similar for men and women. Those who had been coerced reported greater psychosocial distress, were more likely to smoke, were more anxious about sex and more likely to have acquired a sexually transmissible infection. Few people had talked to others about their experiences of sexual coercion and fewer had talked to a professional. There were no significant differences between the First and Second Australian Study of Health and Relationships in whether men or women had experienced coercion, talked to anyone about this or talked to a counsellor or psychologist. CONCLUSION Sexual coercion has detrimental effects on various aspects of people's lives. It usually occurs at the ages at which people become sexually active. There is a need to reduce the incidence of sexual coercion, better identify experiences of sexual coercion, and provide accessible services to minimise the detrimental effects of sexual coercion.
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Affiliation(s)
| | - Paul B Badcock
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Chris Rissel
- Sydney School of Public Health, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW 2006, Australia
| | - Juliet Richters
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Anthony M A Smith
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Andrew E Grulich
- The Kirby Institute, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia
| | - Judy M Simpson
- Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney, NSW 2006, Australia
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