https://doi.org/10.4081/ripppo.2022.583
Psychotherapeutic change in children and adolescents who have been sexually abused: a model from participants’ perspectives
Submitted: September 14, 2021
Accepted: February 14, 2022
Published: March 4, 2022
Accepted: February 14, 2022
Abstract Views: 3141
PDF: 576
HTML: 27
HTML: 27
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Introduction: Change in psychotherapy research in cases of child sexual abuse (CSA) has mainly emerged from a symptomatologic view, which needs to be complemented by a subjective perspective of change. Thus, this article aim is to describe different outcomes and stages of change during psychotherapy in children and adolescents who have been sexually abused, from the subjective perspectives of those involved in the process. Methods: A longitudinal qualitative study was developed. Qualitative interviews were conducted at different moments of the psychotherapeutic process (at around 6 months of therapy, 12 months and at the end of therapy) with 28 children and adolescents aged 6 to 17, with their caregivers and therapists. All children and adolescents attended and then completed psychotherapy due to sexual abuse in natural settings, in public specialized centres in Santiago, Chile. Sexual abuse occurred mainly in an intrafamilial context or by acquaintances. Data analysis was conducted using narrative analysis. Results: Three stages of therapy were identified: (1) settling into therapy, (2) approaching CSA and (3) healing from abuse. Three different outcomes of psychotherapeutic change were also identified: (1) protective and psychosocial changes, (2) changes related to diminishing the effects of abuse and (3) changes related to healing from abuse. Psychosocial characteristics of the cases and features of the therapeutic process are described in each group. Discussion: The outcomes of change and the stages of therapy are interrelated in a dynamic and gradual process where change is linked with the case’s psychosocial characteristics and the features of the therapeutic process. Results allowed the authors to situate the voices of the participants within a proposed model of psychotherapeutic change for CSA, with clinical practical implications.
Águila, D., Lama, X., Capella, C., Rodríguez, L., Dussert, D., Gutiérrez, C. & Beiza, G. (2016). Narratives from therapists regarding the process of psychotherapeutic change in children and adolescents who have been victims of sexual abuse / Narrativas de terapeutas sobre el proceso de cambio psicoterapéutico en niños, niñas y adolescentes que han sido víctimas de agresiones sexuales. Estudios de Psicología, 37(2-3), 344-364. doi:10.1080/02109395.2016.1204780.
DOI: https://doi.org/10.1080/02109395.2016.1204780
Alamo, N. (2019). Contenidos y evolución del cambio en la psicoterapia con niños y niñas [Content and evolution of change in psychotherapy with children]. (Doctoral Thesis). Pontificia Universidad Católica de Chile, Santiago, Chile.
Altimir, C., Krause, M., de la Parra, G., Dagnino, P., Tomicic, A., Valdés, N. & Vilches, O. (2010). Clients’, therapists’, and observers’ agreement on the amount, temporal location, and content of psychotherapeutic change and its relation to outcome. Psychotherapy Research, 20(4), 472-487. doi:10.1080/10503301003705871.
DOI: https://doi.org/10.1080/10503301003705871
Areas, M., Olivera, J., & Roussos, A. (2020). Cambio y psicoterapia: la perspectiva del niño [Change and Psychotherapy: The Child’s Perspective]. Diversitas: Perspectivas en Psicología, 16(2). doi:10.15332/22563067.5553.
DOI: https://doi.org/10.15332/22563067.5553
Banyard, V., & Williams, L. (2007). Women’s voices on recovery: A multi-method study of the complexity of recovery from child sexual abuse. Child Abuse and Neglect, 31(3), 275-290. doi:10.1016/j.chiabu.2006.02.016.
DOI: https://doi.org/10.1016/j.chiabu.2006.02.016
Barth, J., Bermetz, L., Heim, E., Trelle, S., & Tonia, T. (2013). The current prevalence of child sexual abuse worldwide: A systematic review and meta-analysis. International Journal of Public Health, 58(3), 469-483. doi:10.1007/s00038-012-0426-1.
DOI: https://doi.org/10.1007/s00038-012-0426-1
Capella, C. & Boddy, J. (2021). Listening to the opinista? Relational understandings of voice and silence in a multiperspective narrative study of child psychotherapy. Children & Society, 35, 835-849. doi:10.1111/chso.12458.
DOI: https://doi.org/10.1111/chso.12458
Capella, C. & Gutiérrez, C. (2014). Psicoterapia con niños/as y adolescentes que han sido víctimas de agresiones sexuales: Sobre la reparación, la resignificación y la superación. Psicoperspectivas, 13(3), 93-105. doi:10.5027/PSICOPERSPECTIVAS-VOL13-ISSUE3-FULLTEXT-348.
DOI: https://doi.org/10.5027/psicoperspectivas-Vol13-Issue3-fulltext-348
Capella, C., Gutiérrez, C., Rodríguez, L. & Gómez, C. (2018). Change during psychotherapy: the perspective of children and adolescents who have been sexually abused. Research in Psychotherapy: Psychopathology, Process and Outcome, 21(1), 24-39. doi:10.4081/ripppo.2018.288.
DOI: https://doi.org/10.4081/ripppo.2018.288
Capella, C., Lama, X., Rodriguez, L., Aguila, D., Beiza, G., Dussert D. & Gutierrez, C. (2016). Winning a race: Narratives of healing and Psychotherapy in children and adolescents who have been sexually abused. Journal of Child Sexual Abuse, 25(1), 73-92. doi:10.1080/10538712.2015.1088915.
DOI: https://doi.org/10.1080/10538712.2015.1088915
Capella, C., Núñez, L., Vásquez, V. & Fuentes, S. (2020). Adherencia o deserción de adolescentes en psicoterapia por agresiones sexuales: la perspectiva de sus terapeutas. Revista CES Psicología, 13(3), 124-141. doi:10.21615/cesp.13.3.8.
DOI: https://doi.org/10.21615/cesp.13.3.8
Capella, C., Rodriguez, L., Aguila, D., Dussert, D., Lama, X., Gutierrez, C. & Beiza, G. (2015). Storied images of psychotherapeutic change: Approaching children´s voices through drawings. Research in Psychotherapy: Psychopathology, Process and Outcome, 18 (2), 141-151. doi:10.7411/RP.2015.109.
DOI: https://doi.org/10.4081/ripppo.2015.188
Carlberg, G., Thorén, A., Billström, S., & Odhammar, F. (2009). Children’s expectations and experiences of psychodynamic child psychotherapy. Journal of Child Psychotherapy, 35(2), 175-193. doi:10.1080/00754170902996130.
DOI: https://doi.org/10.1080/00754170902996130
Castrillón, C. (2020). Momentos significativos en psicoterapia con niños: un estudio sobre procesos de cambio [Significant Moments in Psychotherapy with Children: A Study on Change Processes]. Rev. CES Psico, 13(3), 88-106. doi:10.21615/cesp.13.3.6.
DOI: https://doi.org/10.21615/cesp.13.3.6
Cohen, J. A., & Mannarino, A. P. (1998). Interventions for sexually abused children: Initial treatment outcome findings. Child Maltreat, 3(1), 17-26. doi:10.1177/1077559598003001002.
DOI: https://doi.org/10.1177/1077559598003001002
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (Eds.). (2012). Trauma-focused CBT for children and adolescents: Treatment applications. New York, NY: The Guilford Press.
Draucker, C. B., Martsolf, D. S., Roller, C., Knapik, G., Ross, R., & Stidham, A. W. (2011). Healing from childhood sexual abuse: A theoretical model. Journal of Child Sexual Abuse, 20(4), 435-466. doi:10.1080/10538712.2011.588188.
DOI: https://doi.org/10.1080/10538712.2011.588188
Dussert, D., Capella, C., Lama, X., Gutiérrez, C., Águila, D., Rodríguez, L. & Beiza, G. (2017). Narrativas de Padres de Niños, Niñas y Adolescentes que Han Finalizado Psicoterapia por Agresiones Sexuales: Un Proceso de Superación Conjunta. Psykhe, 26(1), 1-14, doi:10.7764/psykhe.26.1.916.
DOI: https://doi.org/10.7764/psykhe.26.1.950
Echavarrí, O., González, A., Krause, M., Tomicic, A., Pérez, C., Dagnino, P., De la Parra, G., et al., (2009). Cuatro terapias psicodinámicas breves exitosas estudiadas a través de los indicadores genéricos de cambio [Four successful brief psychodynamic therapies studied through the generic change indicators]. Revista Argentina de Clínica Psicológica, 28(1), 5-19.
Elliott, R. (2008). Research on client experiences of therapy: Introduction to the special section. Psychotherapy Research 18(3), 239-242. doi:10.1080/10503300802074513.
DOI: https://doi.org/10.1080/10503300802074513
Farr, J., Edbrooke-Childs, J., Town, R., Pietkiewicz, D., Young, I., & Stapley, E. (2021). Counseling for Young People and Families Affected by Child Sexual Exploitation and Abuse: A Qualitative Investigation of the Perspective of Young People, Parents, and Professionals. Journal of Child Sexual Abuse. doi:10.1080/10538712.2020.1848959.
DOI: https://doi.org/10.1080/10538712.2020.1848959
Fernandez, O.M., Krause, M., & Pérez, J.C. (2016). Therapeutic alliance in the initial phase of psychotherapy with adolescents: different perspectives and their association with therapeutic outcomes. Research in Psychotherapy: Psychopathology, Process and Outcome, 19(1), 1-9. doi:10.4081/ripppo.2016.180.
DOI: https://doi.org/10.4081/ripppo.2016.180
Foster, J. & Hagedorn, B. (2014). Through the Eyes of the Wounded: A Narrative Analysis of Children’s Sexual Abuse Experiences and Recovery Process. Journal of Child Sexual Abuse, 23, 538-557. doi:10.1080/10538712.2014.918072.
DOI: https://doi.org/10.1080/10538712.2014.918072
Guerra, C., Farkas, C. & Moncada, L. (2018). Depression, anxiety and PTSD in sexually abused adolescents: Association with self-efficacy, coping and family support. Child Abuse & Neglect, 76, 310-320. doi:10.1016/j.chiabu.2017.11.013.
DOI: https://doi.org/10.1016/j.chiabu.2017.11.013
Gómez, E., Cifuentes, B. & Sieverson, C. (2010). Características asociadas al abuso sexual infantil en un programa de intervención especializada en Santiago de Chile [Characteristics associated to child sexual abuse in a specialized intervention program from Santiago, Chile]. SUMMA Psicológica UST, 7(1), 91.104. doi:10.18774/448x.2010.7.114.
DOI: https://doi.org/10.18774/448x.2010.7.114
Gonçalves, M., Matos, M., & Santos, A. (2009). Narrative therapy and the nature of ‘innovative moments’ in the construction of change. Journal of Constructivist Psychology, 22(1), 1-23. doi:10.1080/10720530802500748.
DOI: https://doi.org/10.1080/10720530802500748
Guha, A., Luebbers, S., Papalia, N., Ogloff, J. (2019). A follow-up study of mental health service utilisation in a cohort of 2433 sexually abused Australian children utilising five years of medical data. Child Abuse & Neglect, 90, 174-184. doi:10.1016/j.chiabu.2019.01.015.
DOI: https://doi.org/10.1016/j.chiabu.2019.01.015
Hetzel-Riggin, M., Brausch, A., & Montgomery, B. (2007). A meta-analytic investigation of therapy modality outcomes for sexually abused children and adolescents: An exploratory study. Child Abuse and Neglect, 31(2), 125-141. doi:10.1016/j.chiabu.2006.10.007.
DOI: https://doi.org/10.1016/j.chiabu.2006.10.007
Jessiman, T., Hackett, S., & Carpenter, J. (2017). Children’s and carers’ perspectives of a therapeutic intervention for children affected by sexual abuse. Child and Family Social Work, 22(2), 1024-1033. doi:10.1111/cfs.12322.
DOI: https://doi.org/10.1111/cfs.12322
Krause, M. (2011). Psicoterapia y cambio. Una mirada desde la subjetividad [Change and psychotherapy. A look from the subjetivity] (2°ed). Santiago: Ediciones Universidad Católica.
Krause, M., De la Parra, G., Arístegui, R., Dagnino, P., Tomicic, A., Valdés, N., Echávarri, O., et al. (2007). The evolution of therapeutic change studied thtough generic change indicators. Psychotherapy Research, 17(6), 673-689. doi:10.1080/10503300601158814.
DOI: https://doi.org/10.1080/10503300601158814
Levitt, H., Butler, M., Hill, T. (2006). What clients find helpful in psychotherapy: Developing principles for facilitating moment to moment change. Journal of Counseling Psychology, 53(3), 314-324. doi:10.1037/0022-0167.53.3.314.
DOI: https://doi.org/10.1037/0022-0167.53.3.314
Midgley, N. (2004). Sailing between Scylla and Charybdis: Incorporating qualitative approaches into child psychotherapy research. Journal of Child Psychotherapy, 30(1), 89-111. doi:10.1080/0075417042000205814.
DOI: https://doi.org/10.1080/0075417042000205814
Midgley, N., et al. (2018). Introduction to the special section on child and adolescent psychotherapy research. Psychotherapy Research, 28(1), 1-2. doi:10.1080/10503307.2017.1380864.
DOI: https://doi.org/10.1080/10503307.2017.1380864
Narang, J. (2016). A Grounded Theory Analysis of Therapeutic Interventions Practiced by Professionals in India and the UK with Child and Adolescent Survivors of Sexual Abuse (Doctoral Thesis). University of Edinburg.
Nelson-Gardell, D. (2001). The voices of victims: surviving child sexual abuse. Child and Adolescent Social Work Journal, 18(6), 401-416. doi:10.1023/A:1012936031764.
DOI: https://doi.org/10.1023/A:1012936031764
O'Keeffe, S., Martin, P., Target, M. & Midgley, N. (2019). I just stopped going: A mixed methods investigation into types of therapy dropout in adolescents with depression. Frontiers in Psychology, 10(75), 1-14. doi:10.3389/fpsyg.2019.00075.
DOI: https://doi.org/10.3389/fpsyg.2019.00075
Riessman, C. (2008). Narrative methods for the human sciences. California, USA: Sage Publications.
Rodríguez, G., Gil, J. & García, E. (1999). Metodología de la Investigación Cualitativa [Methodology of the Qualitative Research]. Málaga: Aljibe.
Sánchez-Meca, J., Rosa-Alcázar, A., & López-Soler, C. (2011). The psychological treatment of sexual abuse in children and adolescents: A meta-analysis. International Journal of Clinical and Health Psychology, 11(1), 67-93.
Stapley, E., O'Keeffe, S. & Midgley, N. (2021). Essentials of ideal-type analysis: A qualitative approach to constructing typologies. American Psychological Association. doi:10.1037/0000235-001.
DOI: https://doi.org/10.1037/0000235-000
Servicio Nacional de Menores [SENAME] (2019). Orientación técnica: línea programas de Protección Especializada en Maltrato y Abuso Sexual Grave (PRM) [Technical guidelines: specialized protection programs in maltreatment and sexual abuse (PRM)] . Available from: https://www.sename.cl/web/wp-content/uploads/2019/05/Orientaciones-Tecnicas-PRM.pdf Accessed: 30th August 2021.
Tichelaar, H., Deković, M., & Endendijk, J. (2020). Exploring effectiveness of psychotherapy options for sexually abused children and adolescents: a systematic review of randomized controlled trials. Children and Youth Services Review, 119. doi:10.1016/j.childyouth.2020.105519.
DOI: https://doi.org/10.1016/j.childyouth.2020.105519
Valles, M. (2003). Técnicas cualitativas de investigación social [Qualitative techniques of social research]. Madrid: Editorial Síntesis.
Zarrella, I., Russolillo, L., Caviglia, G. & Perrella, R. (2017). Continuity and discontinuity between psychopathology of childhood and adulthood: a review on retrospective and prospective studies. Research in Psychotherapy: Psychopathology, Process and Outcome, 20, 101-109. doi:10.4081/ripppo.2017.248.
DOI: https://doi.org/10.4081/ripppo.2017.248
How to Cite
Capella, C., Rodríguez, L., Azócar, E., Lama, X., Núñez, L., Águila, D., … Vasquez, V. (2022). Psychotherapeutic change in children and adolescents who have been sexually abused: a model from participants’ perspectives. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(1). https://doi.org/10.4081/ripppo.2022.583
Copyright (c) 2022 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Cecilia Serena Pace, Ester D'Onofrio, Viviana Guerriero, Giulio Cesare Zavattini, A proposal for a brief-term post-adoption intervention in the attachment-perspective: a single case study with a late-adopted child and his adoptive mother , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 19 No. 1 (2016): Special issue on Qualitative and Quantitative Research in Child and Adolescent Psychotherapy: part 2
- Christin Janine Grevenhaus, Christoph Flückiger, Lea Theimer, Cord Benecke, Does technique matter? A multilevel meta-analysis on the association between psychotherapeutic techniques and outcome , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 27 No. 2 (2024)
- Marta Vecchiato, Chiara Sacchi, Alessandra Simonelli, Nicola Purgato, Evaluating the efficacy of psychodynamic treatment on a single case of autism. A qualitative research , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 19 No. 1 (2016): Special issue on Qualitative and Quantitative Research in Child and Adolescent Psychotherapy: part 2
- Osmano Oasi, Laura Buonarrivo, Alberto Codazzi, Margherita Passalacqua, Gio Matteo Risso Ricci, Francesca Straccamore, Roberto Bezzi, Assessing personality change with Blatt's anaclitic and introjective configurations and Shedler-Westen Assessment Procedure profiles: two case studies in psychodynamic treatment , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 20 No. 1 (2017)
- Kelsey Armusewicz, Miriam Steele, Howard Steele, Anne Murphy, Assessing therapist and clinician competency in parent-infant psychotherapy: The REARING coding system (RCS) for the group attachment based intervention (GABI) , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 25 No. 1 (2022)
- Mariagrazia Di Giuseppe, Tracy A. Prout, Lauren Ammar, Thomas Kui, Ciro Conversano, Assessing children’s defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 24 No. 3 (2021)
- Andrzej Werbart, Siri Aldèn, Anders Diedrichs, Changes in the anaclitic-introjective personality configurations following psychoanalytic psychotherapy with young adults , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 20 No. 1 (2017)
- Eunice Barbosa, Maria Amendoeira, Tiago Ferreira, Ana Sofia Teixeira, José Pinto-Gouveia, Joào Salgado, Immersion and distancing across the therapeutic process: relationship to symptoms and emotional arousal , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 20 No. 2 (2017)
- Giovanna Esposito, Viviana Perla, Raffaella Passeggia, Erik Fertuck, Erhard Mergenthaler, Reflective functioning and personal recovery process of users with borderline personality disorder on Instagram: an explorative study using computerized and thematic analysis , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 23 No. 3 (2020)
- Hubert de Condé, Emmanuelle Zech, Jochem Willemsen, The person behind the therapist: a recall study on significant events that contribute to therapists’ personal and professional development , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 27 No. 2 (2024)
<< < 1 2 3 4 5 6 7 8 9 10 > >>
You may also start an advanced similarity search for this article.
