How do people with a history of sexual abuse experience talking therapies for sexual trauma? A systematic review of qualitative findings.

Abstract

Objectives: This systematic review investigated the qualitative experiences of sexual abuse survivors in talking therapy treatments with respect to the helpful and hindering aspects of therapy.

Methods: Searches were conducted on five databases; PubMed, Web of Science, PyscInfo, PsycArticles and PsycExtra and through searching reference lists. Papers were included where they provided qualitative primary data of client experiences of therapy, did not involve specialist clinical populations and were written in English. Papers were included irrespective of whether study participants had experienced sexual abuse in childhood, adulthood or both. Studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist. Meta-study was used to analyse the results.

Results: Four themes were generated: (1) helpful therapy relies on choice, autonomy, and the freedom to choose when to speak and what to speak on, (2) engagement relies on considerations of the complexity of recovery from sexual abuse, (3) feeling cared for and connected with the therapist is important and (4) a sensitive and thoughtful end of therapy can bring positive holistic emotional and lifestyle changes.

Conclusions: This study provides clinical insights into the helpful aspects of therapy, facilitating a safe therapeutic engagement, and managing an effective and sensitive transition into recovery. These themes are considered in relation to understanding supportive factors in therapy.