Tuesday, 6 August 2013

Treatment plan for working with sexual abuse - Bob Cooke


Treatment plan for working with Sexual Abuse.


Many years ago I wrote an article for Psychotherapists and Counsellors on how to work with people who have been sexually abused and traumatised at a deeper level.               This blog is taken from part of the article
People presenting from sexual abuse trauma will present with some  or more of the features below.
1— fear and mistrust
2— panic attacks and anxiety
3— nightmares and flashbacks
4— poor self image
5— self esteem issues
6— A feeling of self worthlessness and no value
7— depression
8— cumulative trauma
9— paranoia

Treatment plan for working with Sexually abused clients.
First stage— Establishing a strong working alliance between clients and therapist. This may take many months and in fact may be a hallmark of the psychotherapy process. But it is  essential  in terms of psychotherapy process being successful. The psychotherapist will have to be patient and earn the client’s trust.
The second stage– Retrieval of memory— in this stage the Therapist will concentrate on phenomenological Inquiry ,this means helping the client going further into their history and helping them understanding of how the past is played out in the  present- to make connections.
As she makes these connections she will be hopefully allowing yourself to retrieve memories that she had cut off from in order to protect herself from feeling and remembering the abuse.
The third stage—-  The Emergency stage– it is characterised by the client getting in touch with and emotions, and often a flood of emotions.
In this stage  the therapist needs to be fully supportive, and be prepared ,to offer more therapy sessions and indeed be more accessible for the client as she works through her confused emotions.
The fourth stage— New  decisions and Integration  — in this stage new decisions are taken and there is more integration for the client. She comes from a more integrated adult ego state
The fifth stage— Endings and  Termination—- in this stage we give time for the client to end with the therapist and the therapist to end with the client. This stage must not be rushed and a full account of the whole process needs to be reviewed and celebrated.
On a final  point, please note that though this treatment is written in order, it is in fact ,a morefluid process where the Therapist may, with the client visit, many different stages, at different times, and indeed may re-visit the particular stages more than once for more therapeutic work to be done.

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