Experiences with sexual abuse can be very difficult to talk about. Once someone has disclosed sexual abuse, and has potentially talked to several authorities about what happened, it is natural to not want to talk about it anymore. This is what one of the leading experts on child sexual abuse, Dr. John Briere of the University of Southern California, calls the “paradox of helping.” The paradox is that those who have been abused do not want to talk about the abuse, and yet talking about it lessens the impact of the trauma-producing aspects of abuse.

Those who have been abused do not want to talk about the abuse, and yet talking about it lessens the impact of the trauma-producing aspects of abuse.

Many youth and some therapists think the purpose of abuse-specific therapy is talking over and over about the sexual abuse. It is not. While it is important for the therapist to know what the youth experienced, what’s more important is to discuss the trauma-producing aspects of the abuse and the impact of the abuse on the youth.

Trauma-informed therapy

All youth who have been sexually abused should be evaluated by a trauma-informed therapist. An evaluation can help the youth clarify and verbalize an understanding of what factors led to the sexual abuse, how grooming may have reduced the youth’s capacity to resist the abuse, and the potential negative impacts of the abuse. 

Therapy that is trauma-informed has the following aspects: 

• Safety. The therapist works with the youth to create a space where the youth is personally, culturally, emotionally, and physically safe.
• Understanding of abuse and trauma. The therapist understands the real experience a youth who has been abused has gone through and knows the research and professional literature on abuse effects and trauma treatment.
• Collaboration. The therapist and youth create a working relationship in which the youth determines the pace of therapy while the therapist provides support, information, and guidance.
• Evidence-based. Forms of therapy that are “evidence-based” have been shown through research to have beneficial effects on the issues they help treat. There are several evidence-based therapies for the various effects of sexual abuse. Today, many therapists are trained in evidence-based treatments and if a youth’s therapist is not, they can help the youth find one who is. 

The healing purpose of therapy

Sexual abuse can impact a youth’s emotional or behavioral functioning, their relationships with family and peers, and their own self-perceptions. Altering negative thoughts and beliefs resulting from the abuse, such as about one’s responsibility, helplessness, hopelessness, and others, is important to set the stage of healthy future development.

Altering negative thoughts and beliefs resulting from the abuse is important to set the stage of healthy future development.

Other goals of therapy include:

• Being sure that the youth has emotional regulation skills to manage their feelings associated with being sexually abused
• Unpacking these complex feelings
• Placing responsibility on the perpetrator
• Understanding the role of risk factors leading to the abuse
• Resolving any feelings of guilt, shame, sadness, etc. 
• Eliminating any of the negative effects of sexual abuse

Sexual abuse is somewhat like being hit by a car: recovery and rehabilitation can take various periods of time depending on the nature of the injury. Many evidence-based treatments are effective in relatively short periods of time. More complex situations may take a bit longer, but when the therapist does a good job of creating a supportive and collaborative therapy environment with the youth, many youth actually come to like the process of therapy. 

Many youth actually come to like the process of therapy. 

It is important that the youth controls the length of therapy, although the therapist and those who love the youth should also ensure that the youth understands what can and cannot be done in therapy. 

For more information on why to talk about abuse, see the video 3 Good Reasons to Talk About Abuse at Stop the Secrets That Hurt.