Towards curing the unthinkable : reflections on the process of working with survivors of child sexual abuse

There is little consistency into the how a history of sexual abuse is assessed in clinical settings. Although some research has explored therapists' attitudes towards this issue, none has yet examined this in relation to clients' attitudes. This study explored attitudes towards routine enq...

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Bibliographic Details
Main Author: Sotrilli, Stamatia
Published: City University London 2005
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Online Access:http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440740
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Summary:There is little consistency into the how a history of sexual abuse is assessed in clinical settings. Although some research has explored therapists' attitudes towards this issue, none has yet examined this in relation to clients' attitudes. This study explored attitudes towards routine enquiry of child sexual abuse during initial assessment in both clients and therapists in order to test whether therapists act in a way that is consistent with clients' views. The study also explored professionals' feelings about this work- and its impact on them. Method: Seventy- two mental health professionals, and sixty clients from outpatient clinics within South London and Maudsley NHS Trust completed a questionnaire that asked about their exTerience and attitudes towards, enquiry of sexual abuse. Professionals also completed measures of professional competence as well as the Traurna and Attachment Belief Scale (TABS) and the Compassion Satisfaction and Fatigue Scale (ProQol). A combination of quantitative (cbi-squared analyses, Pearson correlations and ANOVA) and qualitative (inductive method of coding open-ended questions) analyses were used. Results: The results of this study showed that most professionals did not routinely ask- their clients about a possible history of sexual abuse in spite of the fact that they reported feeling competent and comfortable doing so. Clients on the other hand revealed that they would not mind being asked during an assessment and in fact indicated that they preferred to be asked directly by the professional rather than for the profcssional to wait for the client to initiate disclosure. In addition, professionals reported more negative than positive feelings regarding such work- but, as a result of this work-, they were at greater risk of developing a vicarious traurnatisation than compassion fatigue/secondary trauma. Discussion: The results of this study show there are still barriers that prevent professionals from routinely enquiring about sexual abuse during an initial assessment. They also highlight the specific nature of sexual abuse work and the risks to professionals. Clients' responses contradict clinicians' concerns regarding routine enquiry and suggestions for future research are made. The need to incorporate the topic into professional courses is highlighted and farther implications for clinical practice are discussed.