A clinician's personal history and treatment issues of childhood sexual abuse: A survey of Vermont clinicians
Liza Little (1992)
The purpose of this study was to examine the effects of four variables (gender, theoretical orientation, years since obtaining a degree, and a personal history of sexual abuse) on a therapist's clinical perspectives concerning the treatment issues of childhood sexual abuse. An anonymous mailed questionnaire was sent to 1,251 clinicians in the state of Vermont using the professional mailing lists for psychiatrists, psychologists, social workers, mental health counselors, and psychiatric clinical nurse specialists. Participants rated 30 questions concerning the difficulties encountered in the treatment of childhood sexual abuse, assessment of harm, diagnostic formulations, the importance of the gender of the therapist, countertransference experiences, coping strategies, in addition to questions concerning their own histories of sexual abuse, its impact personally and professionally, and the importance of their recovery experiences. Five hundred and one or 40% of the surveys were returned. Despite some interpretative limitations, the results generally support the hypothesis that personal and professional variables influence the clinical perspectives and perceptions of therapists on the treatment of childhood sexual abuse. The majority of respondents believe that the treatment of childhood sexual abuse is much more difficult than many other clinical problems. The percentage of clinicians indicating a history of childhood sexual abuse fell in the upper range of estimates of incidence (32%). Gender differences were more important in determining differences in clinical perspectives than having a personal history of sexual abuse. All the gender differences were due to women clinicians expressing a stronger and more articulated treatment perspective on childhood sexual abuse issues than male clinicians. Individuals with a history of sexual abuse differed only in their reported countertransference reactions and coping strategies. Psychoanalysts and feminists differed significantly from one another in their clinical perspectives on the treatment issues of childhood sexual abuse. Implications for further research are reviewed. Mandatory training in the assessment and treatment of childhood sexual abuse at the core curriculum level and the requirement for personal therapy for students of psychology are recommended.