Working with adult survivors of child sexual abuse requires dealing with issues such as:
Assessment – engaging a client (on their terms), learning to talk, learning to trust, and confidentiality. Client safety the key factor.
Client safety – environment, relationships, triggering events, sexuality and self-care (as opposed to self-harm or suicidal ideation). Gaining a sense of choice & control.
Being believed and validated – dominant narratives, validating narratives, deconstructing self-blame narratives, identifying strengths. Immediacy will the therapist reject or abandon me?
Identifying traumas – challenging denying, minimising, blame shifting, rationalising of traumas. Recognising the impact of trauma & harmful lies the client believes.
Effects of trauma reduced – identifying triggers, affect regulation, memories, insomnia, hypervigilance, addictions, self-blame, shame, self-harm. Review of client self-assessment at intake compared to now.
Mental health issues – diagnosis stigma, what does this diagnosis mean? Shame issues. True vs false guilt. Fear of abusing (especially for males.
Identity – who am I? Grieve loss of sense of self, Gender & sexuality issues, co-dependency issues, and self-character strengths identification. Emotional intelligence.
Integration – reconstruction of alternate narrative, communication how-to’s, assertiveness vs aggression, sexuality (what is ok for me), boundaries in relationships. Where am I now?
Reconnection – with self (acceptance), significant others (understood), children (safe, competent parenting) and society (work, study, socialising feeling ok).