Detecting Childhood Sexual Abuse in Couples Therapy

Abstract

The authors seek to heighten therapists' awareness of the possibility of childhood sexual abuse as a contributing but often unrecognized factor in couple dysfunction. Guidelines are given for detecting an abuse history in one or both members of a couple when it is not disclosed by the partners. The authors also present techniques for introducing and integrating the issue of sexual abuse into ongoing therapy.

The Effectiveness of Therapy with Couples Reporting a History of Childhood Sexual Abuse: An Exploratory Study

“…Since both groups reported similar presenting problems, what these results might indicate is that these problems get resolved in roughly the same amount of time and with the same ease regardless of a history of abuse. This preliminary evidence, which must be interpreted cautiously, contradicts the assertions made by many that unless sexual abuse is addressed in therapy, therapy will be ineffective (Busby et al, 1993;Feinauer, 1989aFeinauer, , 1989bJohnson & Williams-Keeler, 1998;Mennen & Pearlmutter, 1993;Miller & Sutherland, 1999). However, some might say that, although therapy with this group was just as effective in the short term, long-term gains will be lower among the abuse group.…”

“…First, clinicians have noted that it is normative for survivors of abuse not to disclose this history to their therapist (Busby et al, 1993;Johnson, 1989;Josephson & Fong-Beyette, 1987;McCarthy, 1997;Mennen & Pearlmutter, 1993;Miller & Sutherland, 1999;Nelson & Wampler, 2000;Reid, Taylor, & Wampler, 1995;Roche, Runtz, & Hunter, 1999;Sheldon, 1988). Without knowledge of the abuse or without appreciation for how abuse might affect a couple, the therapist will not have the information necessary to optimize treatment (Busby et al, 1993;Cobia, Sobansky, & Ingram, 2004;Feinauer, 1989b;Gelinas, 1983).…”

Do Occupational Therapists Feel Equipped to Deal with the Adult Legacy of Childhood Sexual Abuse?

“…However, if screening clients for possible abuse is implemented, this should not be done by inexperienced staff or students (Babiker 1993). If the therapist suspects CSA, the topic should be gradually introduced because clients may be unaware of the link with their present problems (Mennen and Pearlmutter 1993) and direct questioning could cause them to 'clam up' (R9).…”

The Single-Trauma Couple

“…The trauma survivor's PTSD symptoms have been the primary focus of the clinical and empirical trauma literature. Although trauma affects the survivor through individual trauma symptoms, survivors often experience interpersonal problems as well, including marital disruption (Finkelhor, Hotaling, Lewis, & Smith, 1989;Harkness & Zador, 2001;, sexual dysfunction (Chauncey, 1994;Maltz, 1991;Mennen & Pearlmutter, 1993;Wilson & James, 1992), communication problems (Reid, Wampler, & Taylor, 1996), and interpersonal aggression (Byrne & Riggs, 1996;Orcutt, King, & King, 2003).…”