Childhood sexual abuse (CSA) is prevalent among women. Person-centered counseling (PCC) is an effective core therapeutic approach to use when treating women with this issue. This article provides (a) an overview of CSA, (b) an orientation to PCC, and (c) a case example illustrating the primary application of this approach.
The incidence of child sexual abuse (CSA) among women is prevalent in the United States. It is estimated that I of every 3 women has experienced some form of CSA (Kinnear, 1995), and these women often experience feelings of depression, guilt, shame, mistrust and fear of intimacy more so than women who have not been sexually abused (Feerick & Snow, 2005). Because of the nature of this traumatic experience and its damaging effects, person-centered counseling (PCC; Rogers, 1961) is presented as a primary therapeutic approach to be used when counseling women with a history of CSA. More specifically, the core theoretical constructs of PCC (unconditional positive regard, congruence, and empathy) are offered as therapeutic catalysts for clients to experience more productive and healthy functioning.
Although CSA has a long history, it was not until the 1980s and 1990s that the understanding, awareness, prevalence, and effects of CSA increased dramatically (Meekums, 2000). In the late 1900s, organizations such as the National Center on Child Abuse and Neglect were established to conduct research to aid communities in addressing the problems of child abuse. Also during this time, the U.S. Congress passed a number of Child Protection Acts with the aim of preventing further harm to children (Kinnear, 1995).
The statistics regarding CSA are alarming, reflecting the indiscriminate influence of this behavior on individuals and families regardless of class or race (McGuffey, 2005), and the reported incidents of CSA have risen significantly (Nance & Daniel, 2007). It should be noted, however, that this increase may only represent a small portion of the actual occurrences of CSA because cases are often unreported (Lambie, 2005). It is estimated that one third of all children are sexually abused before the age of 18, which includes 40% of all females. The vast majority of these reports involve children under the age of 7 years (Bogorad, 1998).
The potential impact of sexual abuse on women is significant, affecting all aspects of their lives. Although no universal definition of CSA exists, certain elements are present in almost every incident, including the "exploitation of the child; use of coercion, gentle though it may be; and some level of gratification by the adult" (Kinnear, 1995, p. 1). This then leads to women with a history of CSA experiencing challenges related to the abuse. These women have a significant increased propensity to experience (a) sexual problems, (b) sleep disturbances, (c) guilt, (d) appetite changes, and (e) work-related difficulties (Bartoi, Kinder, & Tomianovic, 2000). According to Molnar, Buka, and Kessler (2001), CSA is a risk factor for anxiety, mood, and personality disorders and lower overall physical, emotional, and social well-being. Additionally, Randolf and Reedy (2006) found the experience of CSA to be notably correlated with increased rates of posttraumatic stress disorder (PTSD) and depression; other researchers have concluded that the sexual abuse experienced during childhood has significant and long-lasting effects on women's adult functioning (Neumann, Houskamp, Pollock, & Briere, 1996; Nishith, Mechanic, & Resick, 2000). Furthermore, Johnson, Pike, and Chard (2001) found that women with a history of CSA had higher rates of suicide, dissociative disorders, and anxiety.
In addition to psychological issues, women with a history of CSA often experience interpersonal challenges. Rellini and Meston (2006) found that women with a history of CSA tended to have issues related to sexual functioning and difficulties with significant and intimate relationships. …