Childhood sexual abuse is a prevalent but taboo topic in society. Conservatively 80,000 new cases are reported each year with many more either unreported or unsubstantiated within the legal system. Survivors of childhood sexual abuse often times seek counseling assistance to manage the variety of short- and long-term emotional issues that may arise as a result of their abuse. Professional counselors listen to the stories of the survivors and attempt to assist survivors in making sense of this horrific act of personal violence. This study examines the meaning-making experience of master's level professional mental health counselors who work with childhood sexual abuse survivors. A phenomenological qualitative research design was utilized to better understand the process that these counselors use to make sense of their work. Fifty participants were selected from a national data-base of professional mental health counselors who work with survivors. Telephone interviews were conducted with 10 participants. The study revealed that the stories of abuse had a profound impact on the counselors and that there was a significant evolution in how they felt about their work and the survivors they helped. The participants shared that a strong belief system and their theoretical orientation as counselors were essential in their meaning-making process. Other issues such as supervision and mentoring and the development of increased empathy proved to be important to the counselor's meaning-making process.

Post-traumatic stress theory applied to the experience of female incestuous childhood sexual abuse survivors (ICSA) suggests that the trauma may result in negative psychological consequences affecting relationships in adulthood. This study sought to explore the relational consequences of ICSA, specifically focusing on conflict resolution styles (CRS), relationship satisfaction, and relationship stability. This research used data from the RELATionship Evaluation questionnaire. Participants included 487 heterosexual couples in which only the female partner experienced ICSA compared to a comparison group of 1827 couples in which neither partner experienced ICSA. Analyses tested for differences in the frequencies of reported CRS (Gottman 1994) for ICSA and non-ICSA groups. A path analysis also explored the mediating effects of CRS on the relationship between ICSA, and self and partner reported relationship satisfaction and stability. Significant differences in the reports of types of CRS were found for ICSA versus non-ICSA groups. Path analysis showed that although ICSA and CRS were negatively related to relationship satisfaction and stability, the mediating effects of CRS types were not found. Ways clinicians may want to focus on CRS when treating these types of couples reporting low relationship satisfaction are discussed.

Few studies have been conducted to determine relationships between maternal childhood sexual abuse (CSA) history and parenting practices. Furthermore, no studies have attempted to understand how cultural coping methods dynamically impact the relationship between maternal CSA history and parenting outcomes. The purpose of this study is to understand if maternal coping mediates the relation between maternal CSA history and mother-daughter relational outcomes in a sample of African American mothers. The Strong Black Woman (SBW) Cultural Coping Scale, which consists of caretaking, affect regulation, and self-reliance factors, was used to represent maternal coping, and the Parent-Child Relationship Questionnaire (PCRQ) was used to assess warmth, personal relationship, possessiveness, and power assertion. Results showed that maternal CSA history was significantly related to SBW Cultural Coping total scores in the positive direction (i.e., mothers with CSA history reported higher scores). Mediation and indirect effects analyses revealed maternal CSA history was associated with mother-daughter possessiveness and power assertion through SBW Cultural Coping total scores. Additional analyses revealed a significant relation between maternal CSA history and subscales of the SBW, specifically caretaking and self-reliance. The meditational analyses, utilizing SBW subscale scores, revealed significant relations between maternal CSA and maternal warmth in the inverse direction via SBW caretaking, CSA and possessiveness in the positive direction via SBW self-reliance, and CSA and power assertion in the positive direction via both SBW caretaking and self-reliance factors. The results of this study highlight that specific types of trauma (i.e., CSA) can have significant implications for familial functioning within minority populations based on culturally-driven coping.

Research supports a link between poor body esteem, depression, and sexual dysfunction among childhood sexual abuse (CSA) survivors. Though the interplay of these factors also impacts nonabused women, it is possible that the impact is differentially affects these populations. The present study examined the degree to which body esteem may act as psychological mechanism through which CSA impacts adult sexuality, while controlling for the effects of depression – a problem that affects many abuse survivors. Data were collected from 108 women, 73 of who reported CSA. Women with CSA reported poorer body esteem, lower sexual functioning, less sexual satisfaction, and higher depression than women without CSA. Multivariate regression analysis revealed that body esteem significantly predicted sexual functioning and sexual satisfaction and there were significant interactions between body esteem and abuse history, and among body esteem and marital status. Depressive symptom severity was not a moderator in the relationship between body esteem and sexual functioning-satisfaction. These findings suggest that treatments for CSA survivors with sexual difficulties might benefit from addressing body esteem concerns. / text

While much is known about the long-term effects of childhood sexual abuse (CSA) on women in adulthood, little is currently known about their self-care efforts. Given the paucity of research on self-care for survivors, particularly those who are also mothers, and the potential importance of self-care for both themselves and their children, the main goal of the present study was to explore these women’s perceptions and practices of self-care. A grounded theory approach was chosen for this exploration as it provided a sensitive and open-ended methodology which garnered an in-depth understanding of self-care for survivor mothers. The current study combined classic grounded theory (GT) research methods with photovoice methods to explore self-care from the perspective of CSA survivor mothers. Analyses of interview and photograph data from 14 survivor mothers resulted in an original basic social process for understanding how these women care for themselves, feel better, and engage in healing in the context of past violence and trauma. Complex interactive behavioural patterns were identified that recreated a whole self out of damaged fragments; these were conceptualized as “reconstituting a damaged self”. This basic social process was comprised of three main stages, including: emotional de-paining, safetying, and authenticating and returning to self. Several substages within each of these main stages were also identified. Findings were discussed in relation to four theoretical frameworks. Future research directions and clinical implications for this neglected population were suggested. Reconstituting a damaged self can be a long process for sexual abuse survivor mothers involving taking small safe steps, for the most part, on one’s own.

While much is known about the long-term effects of childhood sexual abuse (CSA) on women in adulthood, little is currently known about their self-care efforts. Given the paucity of research on self-care for survivors, particularly those who are also mothers, and the potential importance of self-care for both themselves and their children, the main goal of the present study was to explore these women’s perceptions and practices of self-care. A grounded theory approach was chosen for this exploration as it provided a sensitive and open-ended methodology which garnered an in-depth understanding of self-care for survivor mothers. The current study combined classic grounded theory (GT) research methods with photovoice methods to explore self-care from the perspective of CSA survivor mothers. Analyses of interview and photograph data from 14 survivor mothers resulted in an original basic social process for understanding how these women care for themselves, feel better, and engage in healing in the context of past violence and trauma. Complex interactive behavioural patterns were identified that recreated a whole self out of damaged fragments; these were conceptualized as “reconstituting a damaged self”. This basic social process was comprised of three main stages, including: emotional de-paining, safetying, and authenticating and returning to self. Several substages within each of these main stages were also identified. Findings were discussed in relation to four theoretical frameworks. Future research directions and clinical implications for this neglected population were suggested. Reconstituting a damaged self can be a long process for sexual abuse survivor mothers involving taking small safe steps, for the most part, on one’s own.

Past research on adult memory for childhood sexual abuse (CSA) has provided support for the phenomenon of forgetting and subsequent recovery of the memories, after a period of time. This phenomenon, however, remains a source of debate and is still not fully understood by researchers and psychological and legal practitioners. The research has provided conflicting evidence about the factors which are thought to lead to CSA forgetting for extensive periods of time, in addition to the processes involved in forgetting, triggering and later remembering of the abuse memories by adult survivors. This study utilised a mixed method to investigate and explore the factors and processes associated with CSA forgetting, triggering and later remembering, in a sample of Australian adult CSA survivors (N = 77). Participants were asked to complete a test booklet, containing the Traumatic Events Questionnaire (TEQ), Symptom Checklist-90-Revised (SCL-90-R), Dissociative Experiences Scale II (DES II), Impact of Events Scale - Revised (IES-R), a scale designed to measure persistence of memory (Loftus), and a scale designed to measure emotional intensity at the time of the abuse and now (Williams). Participants were then asked to participate in a semi-structured interview. Seventy-one participants completed the interview process. Five separate analyses were conducted on the data. Methodological issues, such as the use of retrospective data and corroboration of the abuse were outlined. All participants were asked to provide details about any corroboration they had received that the abuse had occurred. The participants were streamed into one of three categories of forgetting (Always Remembered, n = 28; Partial Forgetting, n = 16; and Extensive Forgetting, n = 33). The first analysis (Stage One Analysis One) examined the factors thought to be associated with CSA forgetting, such as abuse parameters (TEQ), current psychological functioning (SCL-90-R), persistence of memory (Loftus), emotional intensity at the time of the abuse and now (Williams), the trauma response experienced at the time of the abuse (IES-R), and current dissociation (DES II), to determine the significant differences between the three groups. A significant difference was found regarding the age at which the abuse commenced, with the Extensive Forgetting group reporting an earlier age at which the abuse commenced. Significant differences were found on the variable that related to being abused by an aunt or uncle, and on the current experience of hostility (SCL-90-R sub-scale), and on the current levels of anger (Williams Emotional Intensity) experienced by the participants. Significant differences between the groups were also found on two of the Persistence of Memory items, namely clarity of memory and participants' memory of the tastes related to the abuse. Finally, a significant difference was found on the participants' current dissociation levels, with the Extensive Forgetting group reporting higher levels of current dissociation than the other two groups. Statistical profiles for each of the three groups were constructed, based on the mean scores of the SCL-90-R, IES-R and DES II, for use in the Stage Two, Analysis Two, profile comparison. Stage Two, Analysis One, provided a qualitative analysis relating to the experience of always remembering the abuse. The aim of this analysis was to provide a deeper understanding of why some participants (n = 23) did not forget about their abuse, when other participants reported being able to forget for a period of time. The results indicated that participants' responses formed clusters, such as older age at abuse onset, failed dissociative mechanisms, constant reminders, and others. Stage Two, Analysis Two, presented and compared each participant's profile against the statistical profiles constructed in Stage One. The participant's profiles included a summary of their TEQ responses and interview responses, in addition to their Stage One test booklet scores. The comparison was made, firstly, on a specific basis against the mean scores obtained by each category of forgetting, and secondly, on a broader basis, against the score range for each measure of the statistical profile. This was done to determine if there was a "typical" member of each category of forgetting and to investigate the within-group differences. The specific profile comparison demonstrated that there was no "typical" member of any of the three groups, with participants varying widely in their scores and patterns of scores. However, when the profile comparison was broadened to include score ranges, 61% of participants, who always remembered the abuse, 44% of participants who partially forgot the abuse, and 47% of participants who extensively forgot their abuse, matched the profile of a "typical" member of their relevant category of forgetting. Stage Two, Analysis Three, provided an in-depth qualitative exploration on the process involved in CSA forgetting, triggering and later remembering, for a selection of participants who reported partially forgetting the abuse (n = 6), and extensively forgetting the abuse (n = 10). Participants' interview responses were transcribed verbatim and analysed, using Interview Analysis. This analysis explored the differences between participants, from the two categories of forgetting, on their experiences of CSA forgetting, triggering and later remembering, in addition to exploring how these participants were able to forget about the abuse; what events triggered their abuse memories; and how the initial memories returned. Issues of memory recovery, while in therapy or under hypnosis, were also explored. Stage Two, Analysis Four, presented the case study of a participant, who had been identified as an "outlier", due to her high score on the DES II, claims of being able to remember abuse incidents that occurred prior to the age of two years, diagnosis of DID, and the substantiated conviction and sentencing of her abuser, based on her recovered memories of the abuse and corroboration from her sister and mother. Her case was examined against some of the criticisms often made by false memory supporters. This thesis found that some CSA survivors forgot about their abuse, either partially or extensively. The thesis also found support for some, but not all, of the factors that previous researchers have identified as being associated with CSA forgetting by adult survivors, specifically the individual's age at the time the abuse commenced and the individual's ability to dissociate from the abuse. The research then explored, in-depth, the issues of: CSA remembering, CSA survivor profiling, and the "how" of CSA forgetting, triggering and later remembering, by adult survivors.

Aims: The experience of abuse in childhood can lead to psychological distress later in life. In particular the impact of trauma on the development of the self can render survivors more vulnerable to chronic feelings of shame and guilt. The aims of this research portfolio are twofold. First, a systematic review examines the impact of therapeutic interventions on depression outcomes for survivors of Childhood Sexual Abuse. Second, a research study explores experiences of shame and guilt for this population. More specifically, the study examines those factors in the therapeutic process which survivors find helpful in their changing relationship with these emotions. Method: To address the first aim a systematic review of the literature was carried out. The methodology employed strict inclusion criteria and ten Randomised Control Studies were identified and included in the review. A prospective longitudinal qualitative study was conducted to explore the experiences of shame and guilt for survivors of childhood abuse. Participants (n=10) were interviewed at two different time intervals whilst accessing psychological therapy. Data was analysed using the Framework Method. Results: Findings from the systematic review show existing studies are mostly of poor to medium methodological quality; but that therapeutic interventions do improve depression outcomes for survivors of Childhood Sexual Abuse. Results from the empirical study suggest feelings of shame more so than guilt are core emotions in the experience of psychological distress for survivors. Conclusion: Evidence-based therapeutic interventions for the range of complexities experienced by survivors of CSA are still to be established and more strong methodological trials are required. Shame is a core emotion in psychological distress for survivors and requires to be assessed and addressed routinely in therapeutic interventions.

abstract: The present study examined whether a history of childhood sexual abuse would be related to attachment to mother, to father, and to friends, mattering to parents and to friends, and coping behaviors. In addition, whether use of force, duration of abuse, and severity of abuse were related to perceived negative impact of childhood sexual abuse was examined. Gender differences among survivors were also investigated. Specifically, from the initial sample of 258 young adults, 186 who met the age requirement were included in the tests of the hypotheses. All participants were between the ages of 18 and 25. Compared to those with no history of childhood sexual abuse (n = 109), survivors (n = 77) reported lower attachment to father and less mattering to parents. There were no differences in attachment and mattering to friends or in emotion-focused and problem-focused coping. When gender differences were examined among survivors, females reported greater use of problem-focused coping and perceiving their childhood sexual abuse experiences as more negative than did the male survivors. There were no differences among male and female survivors of childhood sexual abuse on emotion-focused coping. Force and severity, but not duration, were linked to more negative perceptions of the childhood sexual abuse. Attachment to mother emerged as a key variable in that attachment to mother was positively related to attachment to friends, mattering to friends, and the use of problem-focused coping. Stronger attachment to mother and attachment to father, but not a history of childhood sexual abuse, were related to more perceived mattering to parents. These results highlight the importance of attachment to caregivers in developing peer attachment and a sense of mattering to friends, problem-focused coping skills, and perceiving childhood sexual abuse as having a less negative impact on their lives. Clinical and research implications and suggestions for future directions are discussed. / Dissertation/Thesis / Ph.D. Counseling Psychology 2011

There is a significant volume of research evidence documenting the sexual problems experienced by women survivors of childhood sexual abuse (CSA). Accordingly, existing treatment paradigms for sexual problems in this population tend to equate the absence of symptoms with adequate sexual functionality, implying that CSA survivors can aspire to sexual functionality at best. However, this false dichotomy reinforces a medicalized, genital-focused view of women's sexuality, and provides no information about what connotes a positive sexual experience for CSA survivors. The current mixed-methods study is centered on the research question, “how do women survivors of CSA experience 'good sex'?” Semi-structured interviews were conducted with 15 women who self-identified as CSA survivors and self-reported having experienced good sex. Participants were also asked to complete standardized quantitative measures of women's sexual functioning, sexual satisfaction, and sexual self-schema. Using interpretative phenomenological analysis (IPA), four themes emerged from the qualitative portion of the study. The women expressed a clear definition of good sex (theme one), identified factors that contributed to their experience of good sex (theme two), conceptualized good sex within a developmental context (theme three), and discussed similarities in the experience of good sex between survivors and non-survivors, though noted that the pathways to this experience were different for survivors (theme four). Participants' scores on the quantitative portion of the study varied widely from each other and were inconsistent across individual scores of sexual functioning and sexual satisfaction. These findings demonstrate that women survivors of CSA can and do experience good sex, and this experience of good sex may not be captured accurately by constructs of sexual functioning, sexual satisfaction, and sexual self-schema as depicted in commonly-used questionnaires. Implications for health practitioners, clinicians and researchers are discussed. / Graduate