Counselling survivors of childhood sexual abuse (CSA)

Childhood sexual abuse (CSA) often goes unnoticed and underreported and what compounds this further is shame.

The NSPCC (2014) define CSA as 'persuading or forcing a child to take part in sexual activities or encouraging a child to behave in sexually inappropriate ways'.

The survivor at the time of the sexual abuse is powerless, as abuse is a misuse of both power and authority, often combined with fear and coercion. These traumatic experiences create huge shifts in an individual's sense of self, sense of meaning and psychological safety. Resulting in a worldview that is unsafe and distrustful of others. Long after these experiences, survivors sustain feelings of shame, responsibility, guilt and self-loathing. This can often manifest in anxiety, depression, eating disorders and post-traumatic stress disorder (PTSD). It is essential to bare in mind that every individual is affected differently.

In counselling work, providing a safe and trustworthy space is fundamental- abuse invades the boundaries of self and is an assault on the integrity of the person. Trust needs to be developed and the client's space respected, with the counsellor acting as a witness. Often survivors have developed remarkable coping strategies or defence mechanisms. Counselling needs to engender empowerment, working towards a positive self-view and letting the client set the pace of their therapy is crucial.

Offering survivors empathy, respect, and a non-judgmental environment helps promote growth and resolution. The embodiment of hope is significant too. And hope can be embodied in reflecting back a client's implicit strengths and resources. Current research concludes that it is the nature of the 'therapeutic relationship'  that promotes change.

In short, principles of respect, trust, empathy, and autonomy are crucial in working with survivors of CSA. Helping clients navigate through feelings of guilt, shame, anger or grief are all important aspects of the work - providing a safe and trusting therapeutic relationship is fundamental to this process.

Further Help

• Rape crisis
• The Survivors Trust
• Galop

If you’ve just been sexually abused, you are not to blame and you are not alone. The Rape Crisis website has advice about what to do immediately after being abused, such as reporting it to the police.

Bibliography

Butler, C. Et al, (2010) Sex, Sexuality and therapeutic Practice: a manual for therapist and trainees. London: Routledge.

Draucker, C and Martsoff, D (2006) 3rd ed Counselling Survivors of Childhood Sexual Abuse. sage, London.

Hampson, S and Nelson, S. (2008) Yes You Can! Working with Survivors of Childhood Sexual Abuse 2ed Scottish Gov: Edinburgh.

Rogers, C (1961) On Becoming a Person. London, Constable.

Vernart,E and Webber. J. (2011) Healing Trauma Through Humanistic Connection. In Humanistic Perspectives in Contemporary Counselling Issues.