Academic journal article Journal of Mental Health Counseling

Counseling Adult Women Survivors of Childhood Sexual Abuse: Benefits of a Wellness Approach

Academic journal article Journal of Mental Health Counseling

Counseling Adult Women Survivors of Childhood Sexual Abuse: Benefits of a Wellness Approach

Article excerpt

Adult women survivors of childhood sexual abuse may face numerous lifelong challenges. Recommended therapeutic interventions for survivors assume that the process of reliving and exploring the abuse experience leads to psychological healing. Yet such therapeutic approaches may be traumatizing for both client and counselor, and seem to be somewhat limited in affecting change in the numerous areas of concern of many survivors. Strength-based wellness counseling interventions may help survivors develop coping skills to enhance both overall quality of life and everyday functioning across multiple domains, while also providing a healthy foundation from which to explore and reframe their abuse experiences. A case example demonstrates this approach.


Sedlak (1996) reported that the incidence of childhood sexual abuse doubled between 1986 and 1993. Sexual abuse has since reached epidemic proportions, with one in four women worldwide experiencing sexual violence from an intimate partner and as many as one-third of all adolescent girls reporting forced encounters as their first sexual experience (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002). The American Academy of Child and Adolescent Psychiatry (2004) noted that statistics concerning childhood sexual abuse (CSA) vastly underestimate prevalence because most children are afraid to report abuse and the legal procedures for validating abuse are at best cumbersome.

Still, the reported rates are staggering: For example, in 2000, 67% of all sexual assault victims were juveniles, 34% were younger than 12, and about 15% (one in seven) were younger than 6 (Bureau of Justice Statistics, 2000). The National Center for Victims of Crime (2007) reported that girls are victimized at least three times more often than boys, and one in four adolescent girls will experience CSA before reaching 18. The consequences include serious, pervasive, and lifelong damage to physical and mental health and functioning, leading Noll (2008) to state unequivocally that "the covariation between childhood abuse and maldevelopment is currently above dispute" (p. 1).

A number of authors have noted the challenges mental health counselors face in working with adult women survivors of CSA, such as self-mutilation, eating disorders, dissociative disorders, and antisocial behavior (Wise, Florio, Benz, & Geier, 2007). Further, listening to the stories of trauma survivors places the professional at risk of empathy fatigue (Stebnicki, 2008) and secondary trauma (Etherington, 2000; Lev-Wiesel, 2008). Treatment for CSA survivors requires multiproblem intervention strategies because of the sheer number of symptom possibilities (Lev-Wiesel), as well as peer supervision for the counselor to promote personal self-care and attention to boundary issues (Stebnicki). Typical strategies used include cognitive-behavioral, trauma-focused, and emotion-focused approaches (Wise et al.). Lev-Wiesel reviewed research on interventions for adult women CSA survivors and concluded that such interventions require unique approaches because the core issues relate to the separation of body and soul and the perception of the body as "worthless, weak, and helpless, meaning there is no hope for a better future" (p. 671). The integration of body and soul is the goal of wellness counseling interventions (Carney, 2005; Myers & Sweeney, 2005c); however, wellness approaches have not yet been applied to issues specific to adult women CSA survivors.

The results of several recent outcome studies using wellness counseling suggest that these interventions can help increase holistic wellness and foster the integration of body, mind, and spirit (see Myers & Sweeney, 2008; Tanigoshi, Kontos, & Remley, 2008; Villalba & Myers, 2008). Although wellness approaches have not been used with trauma survivors, we propose that holistic, strength-based interventions may be useful to help these clients de-pathologize their self-perceptions, provide them with a positive focus for growth, and help them build a healthy foundation from which to explore and heal from their experiences of abuse. …

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