Therapists' experiences with children and adolescents who are victims of sexual abuse

Autumn L. Porubsky (2007)

There are up to 80,000 reports of child sexual abuse each year (AACAP, 1994), and it is estimated that up to 50 percent of the victims of child sexual abuse receive mental health treatment (Miller, Cohen, & Wiersema, 1996). However, it is unclear how many of these children receive the most current, well researched, abuse-specific mental health treatment (Saunders, 2004). This is a qualitative study of therapists' experiences working with victims of sexual abuse as well as children who are engaging in problem sexual behaviors. The study explores the ways in which therapists work with these children, therapists' own understandings of sexual behaviors in children, the experiences of therapists doing this work, the effects of this work on therapists, and therapists' personal reactions to working with this population. Ten therapists from different locations across the United States were interviewed via telephone about their experiences with this population. Results indicate that none of these clinicians was aware of guidelines for treatment of victims of sexual abuse, or offenders. In addition, all except for one of the clinicians received no training in their graduate school programs on working with children who are victims or offenders. They also received little, if any training in recognizing the differences between normal sexual behaviors, and abusive, or problem sexual behaviors. Clinicians indicated that their views of the children, which ranged from "vulnerable" to "resilient," could affect their approach to treatment. Therapists described numerous experiences with these children that affected them in many ways, ranging from positive effects such as good feelings about their work, to negative effects such as vicarious traumatization. The symptoms and effects of vicarious traumatization are also discussed.