Abuse-focused therapy is an umbrella term for a range of clinical models used in treating the impacts of childhood sexual abuse and trauma. Abuse-focused therapy originated in the late 1980s as an alternative to therapies that viewed abuse survivors’ trauma specific coping strategies as evidence of intrapsychic pathology and maladaptive reactions, and trauma therapies, which narrowly focused on catharsis and flooding techniques. In contrast to these therapies, abuse-focused therapy considered posttraumatic stress reactions and other trauma-related symptoms as legitimate reactions to situations that were or are threatening and oppressive.
Initially, abuse-focused therapy was developed only for adults and children who had been victims of childhood sexual abuse. However, subsequently, abuse-focused therapy became the therapy of choice for practitioners working with adult and child victims of childhood sexual abuse, other types of abuse, and trauma. Abuse-focused therapy’s popularity has been based on a manifest philosophical orientation toward (a) emphasizing clients’ agency and strengths, and (b) utilizing a flexible, integrated framework of interventions for addressing bio psychosocial issues emerging throughout the course of treatment.
Feminist ideology and humanistic philosophy inform both the practitioner–client relationship and the treatment structure in abuse-focused therapy. Feminist ideology’s focused attention on the societal, local, and familial discourses about oppression, gender, and power contextualizes abuses and trauma in past, present, and ongoing beliefs about relationships. This nuanced understanding of the broader social influences surrounding abusive and traumatic events is a perspective rarely accessible to clients as they engage in the arduous process of healing. This attention to beliefs about power and gendered violence also separates the abuse and trauma from the inherent characteristics of the client, and allows for validation of the client’s self-protective strategies during and after the abuse or trauma.
Influences from humanistic philosophy encourage appreciation for the various types of self and situational knowledge that clients display as they determine the pacing and direction of their healing. The practitioner assumes that the knowledge clients used to survive the abuse or trauma is still available to them during the healing process. In addition, this philosophical perspective invites active client investment in the treatment process and outcomes in order to decrease the probability of inadvertently replicating any oppressive power dynamics that might have accompanied the trauma. Similar to feminist ideology, a humanistic orientation depathologizes clients’ past and current coping strategies and invites clients’ expertise on their own healing process.
Abuse-Focused Therapeutic Interventions
Abuse-focused therapies focus on a group of clinical interventions rather than on a specific intervention or technique. In addition to grounding the treatment process in feminist and humanist ideologies, practitioners integrate many of the following clinical techniques and strategies into their work: cognitive behavioral therapy, grief/loss work, systemic concepts (i.e., roles, rules, boundaries, holism), desensitization and hypnotherapeutic practices, and understandings of traumatic stress and victimization, as well as transference and countertransference from psychoanalytical theory. The introduction and fit use of techniques is contingent on the perceived and stated needs of the client as determined by the client and the practitioner. Most work occurs individually; however, some work may occur in group, couple, and family therapy settings.
- Lanktree, C. B., & Briere, J. (1995). Outcome of therapy for sexually abused children: A repeated measures study. Child Abuse & Neglect, 19, 1145–1155.
- McGregor, K. (2000). Abuse-focused therapy for adult survivors of child sexual abuse: A review of the literature. Centre Report Series No. 51 (pp. 1–279). Auckland, New Zealand: Injury Prevention Research Centre, University of Auckland.
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