The adverse childhood experiences of caregivers of children who have been victims of sexual assault: their relationship with the parental alliance in child psychotherapy (Experiencias adversas tempranas de cuidadores de niños/as que han sido víctimas de agresiones sexuales: su relación con la alianza parental en la psicoterapia infantil)

Abstract

The role of caregivers for the treatment of sexually assaulted children has been widely discussed. Objective: to explore the influence of caregivers’ variables and the interaction between the therapeutic alliance with their children’s psychologists, in a sample of 58 children undergoing psychotherapy for sexual assault. Method: We explore the relationship between caregivers’ adverse childhood experiences (ACEs), post-traumatic symptomatology and initial therapeutic alliance using descriptive, correlational and moderation analyses. Results: 51.7% of caregivers reported ACEs. The greater the presence of ACEs, the lower the quality of the initial therapeutic alliance. Caregivers who experienced ACEs and reported fewer symptoms of post-traumatic stress presented a lower quality of therapeutic alliance. Discussion: The findings suggest that ACEs may provoke dissociative mechanisms in adults and that this appears to interfere with the emotional response to their child’s abusive experience and with the possibility of establishing a positive therapeutic alliance with the child’s therapist. This emphasizes the need that these adults have for therapeutic support as part of a comprehensive and specialized care model.

Neglected caregivers: Analysis of the technical guidelines of child maltreatment and child sexual abuse programs

“…To render the subjectivity and context of caregivers visible, we believe it is also important to highlight the asymmetry in the distribution of caregiving responsibilities between men and women reported by other studies, which indicate that women mainly assume the role of the "protective adult" (Gabriel-Vacher et al, 2022). The greatest burden falls on women, negatively affecting their mental health after sexual assaults on children (Cyr et al, 2016).…”

“…The subject is portrayed as someone whose sole function is the well-being of the child who has been maltreated or sexually abused. Although studies have revealed that 52% of caregivers of sexually abused children have experienced adversity in their own childhood, and 44% show symptoms of post-traumatic stress disorder (Gabriel-Vacher et al, 2022), these regulations omit these personal trajectories and the impact of the traumatic experience on their subjectivity.…”

“…Internationally, it has been observed that caregivers who have been sexually victimized in childhood also faced other adverse childhood experiences (Langevin et al, 2021), with cumulative impacts on mental, physical, and behavioral health, and social, cognitive, and relational dimensions (Narayan et al, 2019). A national study revealed that 52% of caregivers of children in CSA therapy reported adverse childhood experiences, with 33% of them being victims of CSA in their childhood (Gabriel-Vacher et al, 2022). Given the prevalence and negative consequences of adverse childhood experiences, the implementation of trauma-informed systems is suggested internationally (Armstrong et al, 2022) to restructure the organizations that support those who have experienced trauma, incorporating concrete measures to identify and address the effects of adverse childhood experiences.…”

Practice-based evidence: bridging the gap between research and routine clinical practice in diverse settings (Evidencia basada en la práctica: construyendo puentes entre la investigación y la clínica rutinaria en entornos diversos)

“…In the same line of research on psychotherapy with children, Gabriel-Vacher et al (2022) focus on the relevance that the alliance between caregivers and therapists has been shown to have for the process and outcomes of child psychotherapy. The authors examine the influence of adverse childhood experiences (ACE) and current post-traumatic symptomatology of responsible adults (or caregivers) in the establishment of the initial therapeutic alliance with the therapists responsible for the therapeutic process of sexually assaulted children.…”

“…En la misma línea de investigación sobre psicoterapia en niños y niñas, Gabriel-Vacher et al (2022) se sitúan desde la relevancia que la alianza entre los cuidadores y los terapeutas ha mostrado tener para el proceso y resultados de la psicoterapia infantil. Los autores examinan la influencia de las experiencias adversas tempranas (EAT) y la actual sintomatología postraumática de los adultos responsables (o cuidadores), en el establecimiento de la alianza terapéutica inicial con los terapeutas a cargo del proceso terapéutico de niño/as agredidos sexualmente.…”