Counselling survivors of childhood sexual abuse (CSA)

Childhood sexual abuse (CSA) often goes unnoticed and under reported 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 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 world view 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 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, as abuse invades the boundaries of self and is an assault on the integrity of the person. Trust needs to be developed and the clients 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 clients 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 and providing a safe and trusting therapeutic relationship is fundamental to this process.


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.

Counselling Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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