Therapists’ Work with Survivors of Sexual Abuse: An Exploration using Traumagenic Framework
Childhood sexual abuse (CSA) is a globally prevalent issue, affecting approximately 1 in 4 children worldwide (Finkelhor, Turner and Colburn, 2024; Radford, et al. 2011; Kessler et al., 2010). The severity and breadth of the psychological issues of CSA survivors creates a challenge in CSA research in defining the CSA survivor experience. To address this challenge, Finkelhor and Browne (1985) developed a CSA traumagenic model to create a universal CSA survivor experience template for researchers and therapists. The model consists of four traumagenic factors. Each factor is an ongoing dynamic process a CSA survivor may experience. This model is widely regarded as the most popular model to apply to CSA survivors (Canton-Cortes, Cortes and Canton, 2012; Kallstrom-Fuqua, Weston and Marshall, 2004). Research into CSA treatment is an emergent area of research, within CSA therapy literature. CSA therapist experiences have been previously researched; however, the perspectives focused on the therapist’s views on themselves within CSA therapy. This study aims to fill in the gap in knowledge by exploring therapists' experiences with CSA clients, focusing on therapeutic modalities and utilising Finkelhor and Browne's (1985) traumagenic framework. Interpretative Phenomenological Analysis (IPA) was employed to explore CSA therapist specialists’ experience of working with CSA survivors. The researcher adopts a social constructivist epistemological position. The IPA generated the following group experiential themes: ‘How traumagenic dynamics present in session’, ‘Ways of practice, exploring therapeutic modalities’, ‘Who we are impacts therapy’, ‘Beyond therapeutic modality’. The narratives within these themes address existing gaps in CSA research, particularly in relation to how therapeutic modalities are applied in practice and the challenges therapists face when working with the four traumagenic dynamics. This study identified several influential factors that extend beyond the choice of therapeutic modality, with particular emphasis on the role of therapist identity and the integration of psychoeducation in enhancing the effectiveness of CSA therapy. These findings offer novel contributions to the field and are discussed within the context of Counselling Psychology, highlighting key implications for clinical practice, therapist training, and future research.
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