Refusing to be Marginalized: Groupwork in Mental Health Services for Women Survivors of Childhood Sexual Abuse

Abstract

Childhood sexual abuse is a major aetiological factor in the development of mental health difficulties experienced by women. Although this conclusion is supported by two decades of extensive research, it has had little impact on the provision of mainstream mental health services. It remains exceptional for there to be specialist therapy or counselling provision for women survivors of childhood sexual abuse within statutory mental health services. This represents a serious gap in service provision and, it is argued, results in extended and inappropriate treatment for women survivors using mental health services. In this article, the development of a multi-agency approach to the provision of groupwork for women survivors of childhood sexual abuse within mental health service is described. A women-centred model of groupwork is outlined. Evaluation and funding are discussed. It is argued that, as a timelimited and effective treatment option, groupwork for women survivors of childhood sexual abuse should form a central part of service provision within statutory adult mental health services.

Mental Health Services for ‘Difficult’ Women: Reflections on Some Recent Developments

“…Though there are dedicated staff working within mainstream psychiatric services who have made it their business to develop the skills to provide effective help to women (e.g. Watson et al, 1996;Gorsuch, 1999), our impression is that they are far fewer than service providers would like to imagine. Meanwhile women are passed from service to service some through increasing levels of security.…”

Bordering on insanity: misnomer, reviewing the case of condemned women

“…The significance of childhood sexual abuse in the lives of many women who may later use mental health services has been widely recognized (Crowe 2004, Warne & McAndrew 2005a). However, the lack of appropriate response from many mental health professionals noted 10 years ago by Watson et al . (1996) remains largely the same (Barnes et al .…”

Service Responses to Women with Mental Health Needs

“…Despite the lack of central support for the improvement and development of women's mental health services during the last two decades there has been a great deal of innovation in this country and elsewhere. Within the UK such developments in services and working practices can be found within mainstream provision (for example, Holland, 1995;Watson et al, 1996:), but have flourished within the independent and voluntary sector (Coleman & Guildford, 2001;GPMH, 1994;Perkins et al, 1996;Williams, 1996). Although these services do not always have the necessary resources to document their efforts and achievements, published work is steadily growing and constitutes a valuable resource.…”

“…s choice of help and support to women who are experiencing mental health problems, or at risk of developing mental health problems s access to women-only services and choice of sex of any mental health worker with whom they will have a close relationship s help during crisis including access to trained staff and, if necessary, asylum in a communitybased crisis house s services and help which are empowering and which do not foster dependency. These include opportunities -to explore the potential of self-help and mutual help approaches to mental health problems, especially non-stigmatising opportunities for women to support each other through group work, befriending and advocacy schemes (Coleman & Guildford, 2001;GPMH, 1994;Perkins et al, 1996) -to take part in community development projects that have mental health promotion or support within their aims -for example, opportunities to take action about common causes of psychological distress, and art and drama initiatives (Holland, 1995) -to access and share relevant information easily -for example, through a helpline, factsheets, newlettter (Coleman & Guildford, 2001) -to have a holistic assessment of their mental health needs (Williams et al, 2001a) -to have care management that is informed by an understanding of the effects of social inequalities on women's lives -to be referred to a range of relevant services, not simply to be prescribed psychotropic medication -to access housing, educational programmes and training courses, support with parenting, practical help with childcare, employment support and appropriate medical care (Coleman & Guildford, 2001;Williams, 1999; -to access well-trained and experienced help in dealing with past trauma including childhood sexual abuse and domestic violence (Harris 1998;Root, 1992;Watson et al, 1996) -to access community-based, non-medical and non stigmatising support for mental health problems rooted in isolation, exclusion, poverty, and discrimination and which may be manifest as depression and anxiety, eating disorders, self-harm, as well as more serious disruptions in identity, thinking and emotional life (Abel et al, 1996;Babiker & Arnold, 1997;Levin et al, 1998).…”