Thesis advisor: Matthew Monnig / Thesis (STL) — Boston College, 2023. / Submitted to: Boston College. School of Theology and Ministry. / Discipline: Sacred Theology.

Background: Sexual abuse is a highly distressing traumatic experience that negatively affects the lives of sexual abuse survivors. The number of individuals who reported sexual abuse has increased, which makes it a public and global concern. As a result, survivors of sexual abuse turn to counselling to cope with the traumatic impacts. Counsellors, psychotherapists, and psychologists engage in deep and meaningful explorations of the sexual abuse in order to support survivors. However, very little is known about the impacts and coping strategies involved in this type of work. Objectives: The objective of this study, therefore, was to explore the experiences of UK-based counselling professionals who counsel survivors of sexual abuse. The research questions were as follows: 1. What is the impact of counselling survivors of sexual abuse? and 2. What self-care strategies and coping techniques have been beneficial when counselling survivors of sexual abuse? Method: An inductive qualitative design was used for the purposes of this study. Semi-structured interviews were conducted with twelve UK-based counselling professionals who provided counselling to individuals who had experienced sexual abuse. The collected data were then analysed using thematic analysis. Findings: The themes developed from the first research question revealed a number of ways in which counselling survivors of sexual abuse affected counselling professionals. Three main themes emerged from the data analysis: work-related impacts, impacts on personal wellbeing and relationship impacts. These themes encompassed a total of fourteen sub-themes. Another two main themes were developed when exploring participants' self-care techniques and coping strategies: holistic self-care and work environment selfcare. Both of these main themes incorporated twelve more sub-themes. These are introduced and outlined in depth in turn. Conclusions: This research has provided a unique insight into the impacts and coping strategies of UK-based counselling professionals working with survivors of sexual abuse. The findings suggest that the counsellors experienced a number of negative impacts, some of which were perceived as traumatic in nature. Further, the impacts were not limited to the counsellors themselves; partners, children, extended family, and friends were also affected by the work. Such far-reaching impacts of sexual trauma have not been sufficiently explored previously. Contrary to the negative tendencies expressed in the research literature, some of the findings indicate positive aspects, such as high job satisfaction and evolved personal growth. The findings of this study provide a rare insight into the useful self-care techniques and copings strategies specific for counselling survivors of sexual abuse. Although the strategies are similar to those used in other areas of counselling, they emphasize organisational and educational responsibilities to support counsellors' wellbeing. Suggestions are proposed for research, educational, organisational, and ethical developments.

Violence against women and children is a pervasive challenge across the globe. Research has shown that survivors of interpersonal violence, such as child maltreatment and intimate partner violence, may develop a complex form of post-traumatic stress disorder accompanied by, for example, difficulties in regulating emotions and relating to others. Additional mental health and social problems contribute to survivors' long-term impairment. Therefore, it is imperative that we understand the key elements and processes that facilitate trauma recovery. The majority of research places survivors as individuals at the core of understanding trauma and recovery, which makes it an intrapsychic problem focused on, for example, the individual's cognitive bias, maladaptive interpersonal behaviour, or emotion dysregulation which need repairing, rather than considering appropriately the role of context, external factors and social processes. Thus, trauma recovery may be more complicated. The current study explored key elements and processes of trauma recovery in female adult survivors with a focus on emotional and interpersonal skills, within the narratives of individuals constructing their own recovery within an interpersonal context. Fifteen female adult survivors were recruited from a statutory clinical service and a third-sector community project. Participants were interviewed individually, and data were analysed qualitatively using grounded theory. The study constructed a framework of four key components. Women survivors initially disengaged from feelings, other people and themselves (1), gradually made hidden experiences visible (2) and examined these (3), and eventually reconstructed their reality (4). Although not always a linear process, this framework revealed a transition from self-guided to supported self-management. Women survivors sought out relationships, were impacted by relationships, and these relationships changed the way survivors responded. Thus, female trauma survivors reconstructed abuse, trauma and identity through various supportive others. Similarly, female survivors reframed emotional and interpersonal difficulties and gradually managed these through relationships. Future research as well as theories, practices and policies need to consider the multifaceted and relational nature of interpersonal trauma recovery. Guidelines and practices, for instance, could include community-focused strategies that provide a larger network of support to survivors and, thus, would offer multiple opportunities to experience positive interactions. Equally, mandatory training of health care staff about interpersonal violence and subsequent trauma as well as training in relating positively to survivors would make a real difference.

abstract: Decades of research and empirical studies support the belief that traumatic life events lead to a multitude of negative outcomes (Tedeschi & Calhoun, 1996), however, new research suggests that some survivors of trauma experience significant psychological growth, known as posttraumatic growth (PTG) (Tedeschi, Park, & Calhoun, 1998). The current study focused on the trauma of a traumatic brain injury (TBI) and its relation to the development of PTG. A TBI is both a psychological trauma and a type of acquired brain injury that occurs when physical injury causes damage to the brain (National Institutes of Health [NIH], 2013). Empirical studies examining TBIs and PTG are minimal. The current study focused on survivors who have sustained a TBI from a motor vehicle accident to help control for contextual factors of the injury that are known to affect outcomes. The aim of this study was to elucidate the physical, sociodemographic, contextual, and psychological factors that helped predict the development of PTG among a population of TBI survivors. In addition, another aim of this study was to gain a better understanding of the relationship between PTG and posttraumatic stress disorder (PTSD) symptomatology. Cross-sectional data from self-identified TBI survivors of motor vehicle accidents (n = 155) were used to construct a model of prediction of PTG. Preliminary analyses revealed a reliability issue with the measure that assessed participants’ personality, and these variables were not used in planned analyses. Results revealed that the majority of participants were female, Caucasian, highly educated, and unemployed. Overall, the sample indicated significant injury severity, disability, and lower than average mental and physical functioning. The final model accounted for approximately 15% of the variance in PTG and significant predictors included: gender, time since injury, and the interaction between PTSD symptoms and time since injury. The findings of this research can help inform treatment programs and rehabilitation services as well as funding that can aim to improve outcomes from survivors of TBI. Study limitations included the use of cross-sectional data, a homogenous and unrepresentative sample of TBI survivors, recruitment concerns, and low reliability observed in one of the integral measures of the study. / Dissertation/Thesis / Doctoral Dissertation Counseling Psychology 2016

Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility in the design of study methodology. To inform such considerations, we conducted a secondary analysis of a mixed-methods study that explored 16 Deaf trauma survivors’ help-seeking experiences. Our objective was to identify key findings and qualitative themes from consumers' own words that can be applied to the design of behavioral clinical trials methodology. In many ways, the themes that emerged are what we would expect of any research participant, Deaf or hearing – a need for communication access, empathy, respect, strict confidentiality procedures, trust, and transparency of the research process. However, additional considerations must be made to better recruit, retain, and engage Deaf trauma survivors. We summarize our findings in a “Checklist for Designing Deaf Behavioral Clinical Trials” to operationalize the steps researchers should take to apply Deaf-friendly approaches in their empirical work.