When discussing the counselling of adult survivors of childhood sexual abuse, several basic issues or questions arise.
Counsellor's Qualifications
Many counsellors ask whether the unique needs of the adult survivor require that he or she be seen by a sexual abuse 'specialist', a professional who works with adult survivors as a primary clinical focus. Although it is important for counsellors to recognize that survivors' needs are unique and complex, to suggest that they need to see a 'specialist' might convey the message that their needs are extremely complicated or unusual - thereby increasing their sense of isolation and their view of themselves as being different.
Counsellors do need to develop skills and competencies to meet the needs of survivors effectively. For example, the development of self-awareness regarding one's attitudes and beliefs related to the issue of childhood sexual abuse is essential. Counsellors need to examine their own values and attitudes that could interfere with effective counselling (e.g. denial, disgust, blaming the victim). They must also question whether they accept any myths that research and clinical experience have consistently disproved. These myths include the following: sexual abuse occurs only in certain subgroups of the population (e.g. poor, isolated families), if a child does nothing to stop the abuse he or she must therefore have welcomed it, and mothers often �collude� with the abusers and so share responsibility for the abuse.
In addition to evaluating their beliefs and attitudes, counsellors need training and supervision in counselling adult survivors. A counsellor who is inexperienced in dealing with this clinical issue needs to develop and maintain competencies as one would when faced with any special clinical concern (e.g. treating substance abuse or counselling individuals from varied cultural backgrounds). Training can include classroom or workshop instruction and supervised clinical experience. Because counselling survivors is an intensely emotional experience that can provoke numerous personal issues, supervision or professional consultation is recommended even for counsellors who are experienced in this area.
Counsellor's Gender
Another question that frequently arises is whether counsellors should be of the same gender as the survivors with whom they are working. Some clinicians have concluded that, at least initially, a female counsellor is preferable for female survivors. Faria and Belohlavek (1984) suggested that while a male therapist would allow survivors to learn to develop healthy relationships with men, a female counsellor is preferable as she can serve as a role model. Blake-White and Kline (1985) argued that female therapists are more effective as leaders of incest therapy groups because it is usually easier for survivors to trust women. These authors also suggested that introducing a male co-therapist at a later point could benefit the group by providing the survivors with an opportunity to explore their attitudes toward men. While Hall and Lloyd (1989) identified the advantages of a female counsellor ' they also acknowledged that a male counsellor provides survivors with an opportunity to establish a healthy relationship with a male. Others have maintained that the gender of the counsellor is not a significant issue. For example, Westerlund (1983) emphasized that counselling style is more influential than the gender of the counsellor in determining how issues of power are handled within the relationship.
Less has been written regarding the gender of counsellors working with male survivors. Bruckner and Johnson (1987) recommended the use of mixed-gender co-leaders for male survivor groups because having a female present can facilitate the discussion of issues and feelings. Evans (1990: 71), who discussed the treatment of male sexual assault survivors, stated that 'the key issue in gender identification with the client ... is not the gender of the client and the survivor but the gender attitudes'. The ability of counsellors to examine their own gender-related issues, and the ways in which power issues are handled within the counselling relationship, therefore, may ultimately be more important than the gender mix between counsellor and client.
A commonly raised question is how the counselling needs of males differ from those of females. Many female and male responses to childhood sexual abuse are similar (e.g. guilt, shame, anger), but because the socialisation of males and females differs, it can be expected that males will be confronted with different sexist biases, exhibit gender-specific presentations of symptoms and have specific treatment needs.
A review by Draucker and Petrovic, 1996, 1997; Hunter and Gerber, 1990, on the initial and long term effects of childhood sexual abuse on boys, it was stated that although several effects were similar to those experienced by women an girls eg self concept disturbance, somatic complaints, it however identified two areas that 'stood out' for males: disturbances of conduct and acting out of compulsive sexual behaviours. The authors suggested that these effects are related to gender-based differences in coping with trauma - most specifically, the use of externalising behaviours by males.
Counsellors of male survivors, therefore, need to be sensitive to gender specific issues. As Sepler (1990) pointed out, male victims inevitably experience their abuse from a different worldview and self-view than do females. By failing to acknowledge the male's view and by working from a model of victimization based primarily on women's experiences, counsellors could increase the male survivor's sense of isolation and alienation (Draucker and Petrovic, 1996, 1997).
* Preparing for exploration of childhood sexual abuse
| * Effects of exploration
| * The Goal Of Exploratory Work
| * Reinterpreting Sexual Abuse
| * A framework for male survivors
| * Group Counselling
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(Lionel Richie - "Truely")
