Revisions to the therapeutic relationship: A qualitative inquiry into sexual abuse therapists' theories for practice as a mitigating factor in vicarious traumatisation

This article reports a qualitative study which explores sexual abuse counsellors’ theories for practice and how they say they develop and use an array of theoretical approaches to support their well-being and clinical effectiveness over time. Half the sample of Accident Compensation Commission (ACC) registered therapists were social workers who subsequently trained in other professions such as counselling and psychotherapy. The findings suggest that social workers who engage with traumatic disclosures from their clients actively evolve strategies and resources that act to buffer the more negative effects of the work with sexual abuse survivors, which is a means of ameliorating vicarious traumatisation.

Whilst there was little theory specific to trauma work in the early 1980s when the research participants were practising, they developed a framework for their practice based in practice and personal experiences. These developed insights and reference to diverse strands of theory together constitute a framework for practice that assists the counsellors’ in their understanding of their clients, the dynamics of the therapeutic relationship, organisational constraints on funding that surround their work, and their own self care. The theoretical frameworks that the participants preferred to use derive from social justice principles, feminist, narrative theories and the ‘New Trauma Therapy’ (Coffey 1998). Recommendations for clinician self care in dealing with traumatic disclosures with reference to a range of theoretical approaches are suggested.