TREATMENT FOR THE
PSYCHOSEXUAL IMPACT OF
This chapter reviews the treatments that can be offered to help people overcome the sexual problems and dysfunctions that might arise from the experience of sexual assault. The patient or client can be either male or female, but will generally be referred to as 'she' for brevity, as therapists are still more likely to be asked to treat females who have been assaulted than males, though the specific problems and needs of male patients will be considered. The case histories used to illustrate the types of problem encountered are composite accounts with significant details altered to protect confidentiality.
Although common sense predicts that the experience of being sexually assaulted is likely to cause sexual dysfunction, there has been relatively little research in this area compared with the rapidly growing evidence of the long-term harm that can be attributed to childhood sexual abuse. Research design is difficult, as gathering information from clinic populations is likely to overestimate levels of sexual dysfunction, given that only those people who are experiencing difficulties will be referred for help. Becker, Skinner, Abel, and Treacy (1982) tried to overcome this by advertising for subjects from a range of clinical and non-clinical sources. They interviewed a very mixed population of women who had experienced sexual assault or incest. Of the 22 women who had been raped, around 60% reported a fear of sex, arousal dysfunction, and desire dysfunction which they attributed to the impact of the assault.
This study suggests quite high levels of psychosexual morbidity in this group, but a comparison is needed with the background levels of sexual