Adolescents’ experiences of psychotherapy following child sexual abuse

Submitted: April 27, 2022
Accepted: May 6, 2023
Published: July 4, 2023
Abstract Views: 1470
PDF: 610
HTML: 97
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.

Authors

The aim of this study was to explore adolescents’ experiences of psychotherapy following sexual abuse, complementing those studies that focus on outcomes and measurement of symptom change across the course of therapy and building on recent studies that focus on the process of psychotherapy for young people who have experienced sexual abuse, from their perspective. Recent reviews have highlighted the need for tailored approaches to therapy. Research is needed that focuses on young people’s experiences of therapy to help develop such tailored approaches. In this study, 16 young people aged 15-18 years who were attending specialist sexual violence therapeutic services were interviewed. Using thematic analysis, six themes were identified as reflecting their experiences of therapy following sexual abuse. Young people spoke of not wanting to attend; the importance of choice and not feeling pressured in both initially attending and in how the therapy unfolded; how helpful it was to talk; the centrality of the relationship with their therapist; the benefit of attending a specialist service; how helpful it was when the therapist explained things; and finally, the coping skills they learned in the therapeutic work. A key learning from the study is the importance of respecting young people's autonomy following such violations of trust and psychological integrity. The study highlights how engagement in therapy may be experienced as a re-enactment of an experience that was forced on the young person. Further qualitative research exploring this phenomenon could guide therapists on how to minimise such re-enactments in therapeutic work.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Allnock, D., Hynes, P., & Archibald, M. (2015). Self reported experiences of therapy following child sexual abuse: messages from a retrospective survey of adult survivors. Journal of Social Work, 15(2), 115-137. DOI: https://doi.org/10.1177/1468017313504717
Anwar Jaffrani, A., Sunley, T., & Midgley, N. (2020). The building of epistemic trust: An adoptive family’s experience of mentalization-based therapy. Journal of Infant, Child, and Adolescent Psychotherapy, 1-12, doi: 10.1080/15289168.2020.1768356. DOI: https://doi.org/10.1136/bmjopen-2021-QHRN.42
Barnett, M. L., Brookman-Frazee, L., Gonzalez, J. C., Zhan, C., Rodriguez, A., Stadnick, N. A., (2019). Qualitative reports of how and when therapists adapt children’s evidence-based practices during community implementation. Journal of Clinical Child and Adolescent Psychology, 48(6), 894-905. doi: 10.1080/15374416.2018.1485107. DOI: https://doi.org/10.1080/15374416.2018.1485107
Beiza, G., Capella, C., Dussert, D., Rodrìguez, L., & Lama, X. (2015). Institutionalized adolescents in therapy: Narratives of psychotherapy and healing from sexual abuse. Research in Psychotherapy: Psychopathology, Process and Outcome. 18(2), 62-71. doi: 10.7411/RP.2016.004. DOI: https://doi.org/10.4081/ripppo.2015.190
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. DOI: https://doi.org/10.1191/1478088706qp063oa
Campbell, A. F., & Simmonds, J. G. (2011). Therapist perspectives on the therapeutic alliance with children and adolescents. Counselling Psychology Quarterly, 24(3), 195-209. DOI: https://doi.org/10.1080/09515070.2011.620734
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., Rodríguez, L., & Gómez, C. (2018a). 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., Rodríguez, L., Águila, 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: https://doi.org/10.1080/10538712.2015.1088915
Capella, C., Rodríguez, L., Azócar, E., Lama, X., Núñez, L., Águila, D., Gómez, Beiza, C., Espeleta, M., & Vania Vásquez, 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, 89-101. Doi: 10.4081/ripppo.2022.583. DOI: https://doi.org/10.4081/ripppo.2022.583
Capella, C., Rodríguez, L., Lama, X., & Beiza, G. (2018b). Passing on the experience of psychotherapy and healing: Letters of adolescents who have been victims of sexual abuse to another. Narrative Inquiry, 28(1), 119-138. DOI: https://doi.org/10.1075/ni.17001.cap
Carpenter, J., Jessiman, P., Patsios, D., Hackett, S., & Phillips, J. (2016). Letting the Future In: A therapeutic intervention for children affected by sexual abuse and their carers, an evaluation of impact and implementation. NSPCC.
Cary, C. E., & McMillen, J. C. (2012). The data behind the dissemination: A systematic review of trauma-focused cognitive behavioral therapy for use with children and youth. Children and Youth Services Review, 34(4), 748-757. doi: 10.1016/j.childyouth.2012.01.003 DOI: https://doi.org/10.1016/j.childyouth.2012.01.003
de Arellano, M. A., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Huang, L., & Delphin-Rittmon, M. E. (2014). Trauma-focused cognitive-behavioral therapy for children and adolescents: assessing the evidence. Psychiatric Services, 65(5), 591-602. doi: 10.1176/appi.ps.201300255 DOI: https://doi.org/10.1176/appi.ps.201300255
Dittmann, I., & Jensen, T. K. (2014). Giving a voice to traumatized youth: Experiences with trauma-focused cognitive behavioral therapy. Child Abuse & Neglect, 38(7), 1221-1230. DOI: https://doi.org/10.1016/j.chiabu.2013.11.008
Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51(3), 372-380. doi: 10.1037/a0036505 DOI: https://doi.org/10.1037/a0036505
Gilmartin, D., McElvaney, R. & Corbally, M. (2022). “Talk to me like I’m a human” An interpretative phenomenological analysis of the psychotherapy experiences of young people in foster care in Ireland, Counselling Psychology Quarterly doi: 10.1080/09515070.2022.2062702 DOI: https://doi.org/10.1080/09515070.2022.2062702
Goldman Fraser, J., Lloyd, S. W., Murphy, R. A., Crowson, M. M., Casanueva, C., Zolotor, Viswanathan, M. (2013). Child exposure to trauma: Comparative effectiveness of interventions addressing maltreatment. Comparative Effectiveness Review No. 89. Agency for Healthcare Research and Quality. Retrieved on 30th May, 2020. Available from: www.effectivehealthcare.ahrq.gov/reports/final.cfm.
Finkelhor, D., Vanderminden, J., Turner, H., Hamby, S. & Shattuck, A. (2013). Upset among youth in response to questions about exposure to violence, sexual assault and family maltreatment. Child Abuse & Neglect, 38, 217-223. doi:10.1016/j.chiabu.2013.07.021. DOI: https://doi.org/10.1016/j.chiabu.2013.07.021
Greenspan, F., Moretzsohn, A. G., & Silverstone, P. H. (2013). What treatments are available for childhood sexual abuse, and how do they compare. International Journal of Advances in Psychology, 2(4), 232-241. DOI: https://doi.org/10.14355/ijap.2013.0204.07
Gul, H., Gul, A., E. Yurumez, E & Öncü, B. (2020). Voices of adolescent incest victims: a qualitative study on feelings about trauma and expectations of recovery. Archives of Psychiatric Nursing, 34(2), 67-74. doi: 10.1016/j.apnu.2020.02.003. DOI: https://doi.org/10.1016/j.apnu.2020.02.003
Hailes, H. P., Yu, R., Danese, A., Fazel, S. (2019). Long-term outcomes of childhood sexual abuse: A umbrella review. The Lancet Psychiatry, 6(10), 830-839. doi: 10.1016/S2215-0366(19)30286-X. DOI: https://doi.org/10.1016/S2215-0366(19)30286-X
Jessiman, P., 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
Kazdin, A. E., & Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65, 453-463. DOI: https://doi.org/10.1037/0022-006X.65.3.453
Knox, J. (2016). Epistemic mistrust: a crucial aspect of mentalization in people with a history of abuse? British Journal of Psychotherapy, 32(2), 226-236. doi: 10.1111/bjp.12212. DOI: https://doi.org/10.1111/bjp.12212
Leenarts, L. E. W., Diehle, J., Doreleijers, T. A. H., Jansma, E. P., & Lindauer, R. J. L. (2013). Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: a systematic review. European Child & Adolescent Psychiatry, 22(5), 269–283. doi: 10.1007/ s00787-012-0367-5. DOI: https://doi.org/10.1007/s00787-012-0367-5
Lester, S., Khatwa, M., & Sutcliffe, K. (2020). Service needs of young people affected by adverse childhood experiences (ACEs): a systematic review of UK qualitative evidence. Child Youth Service Review, 118, 105429. doi: 10.1016/j.childyouth.2020.105429. DOI: https://doi.org/10.1016/j.childyouth.2020.105429
Lewey, J. H., Smith, C. L., Burcham, B., Saunders, N. L., Elfallal, D., & O’Toole, S. K. (2018). Comparing the effectiveness of EMDR and TF-CBT for children and adolescents: a meta-analysis. Journal of Child & Adolescent Trauma, 11(4), 457-472. DOI: https://doi.org/10.1007/s40653-018-0212-1
Macdonald, G., Livingstone, N., Hanratty, J., McCartan, C., Cotmore, R., Cary, M., ... & Bowes, L. (2016). The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis. Health Technology Assessment; 20 (69). DOI: https://doi.org/10.3310/hta20690
Mudaly, N., & Goddard, C. (2006). The truth is longer than a lie: Children's experiences of abuse and professional interventions. Jessica Kingsley Publishers.
Nuñez, L., Fernández, S., Alamo, N., Midgley, N., Capella, C., & Krause, M. (2022). The therapeutic relationship and change processes in child psychotherapy: a qualitative, longitudinal study of the views of children, parents and therapists. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(1), 103-117. doi: 10.4081/ripppo.2022.556. DOI: https://doi.org/10.4081/ripppo.2022.556
O’Keeffe, N. & McElvaney, R. (2022). Forensic medical examinations: The body as gateway to healing after child sexual abuse, Child Abuse Review, 31(4). doi: 10.1002/car.2750. DOI: https://doi.org/10.1002/car.2750
Putnam, F. W. (2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 269–278. doi: 10.1097/00004583-200303000-00006. DOI: https://doi.org/10.1097/00004583-200303000-00006
QSR International Pty Ltd. (2018). NVivo Pro qualitative data analysis software, Version 12. QSR.
Solomonov, N., Kuprian, N., Zilcha-Mano, S., Gorman, B.S., & Barber, J.P. (2016). What do psychotherapy experts actually do in their sessions? An analysis of psychotherapy integration in prototypical demonstrations. Journal of Psychotherapy Integration, 26(2), 202. doi:10.1037/int0000021. DOI: https://doi.org/10.1037/int0000021
Sprince, J. (2002). Developing containment: Psychoanalytic consultancy to a therapeutic community for traumatized children Journal of Child Psychotherapy, 28(2), 147-161. doi:10.1080/0075417021014378 0. DOI: https://doi.org/10.1080/00754170210143780
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
Tiwari, A., Smith, S., Wekerle, C., Kimber, M., Jack, S.M., MacMillan, H., & Gonzalez, A. (2021). Trauma services for youth victims of sexual abuse- does one size fit all? A qualitative study among service providers in Ontario, Canada. Child Abuse & Neglect, 112, 104903. doi: 10.1016/j.chiabu.2020.104903 DOI: https://doi.org/10.1016/j.chiabu.2020.104903
Visser, M., & du Plessis, J. (2015). An expressive art group intervention for sexually abused adolescent females. Journal of Child and Adolescent Mental Health, 27 (3), 199-213. doi:10.2989/17280583.2015.1125356. DOI: https://doi.org/10.2989/17280583.2015.1125356

Supporting Agencies

Tusla Child and Family Agency
Andrina Monaghan, Dublin City University

Andrina Monaghan is a psychotherapist and was working as a research assistant in Dublin City University at the time of this study.

Christina Treacy, Dublin City University

Christina Treacy is a psychotherapist who was working as a research assistant in Dublin City University at the time of this study.

Naoise Delaney, Dublin City University

Naoise Delaney is an educational psychologist in training who was working as a research assistant in Dublin City University at the time of this study.

How to Cite

McElvaney, R., Monaghan, A., Treacy, C., & Delaney, N. (2023). Adolescents’ experiences of psychotherapy following child sexual abuse. Research in Psychotherapy: Psychopathology, Process and Outcome, 26(2). https://doi.org/10.4081/ripppo.2023.630

Similar Articles

<< < 19 20 21 22 23 24 25 26 27 28 > >> 

You may also start an advanced similarity search for this article.