Relationships in therapy: Perspectives of practitioners, carers, and young people affected by child sexual abuse

Abstract

The importance of the “therapeutic relationship” in the process of therapeutic change has long been recognised in psychotherapy literature and in recent years has also been evidenced in empirical research. Using a social constructionist framework, this study considers relationships formed in a therapeutic intervention for children and young people affected by child sexual abuse. The intervention is based primarily on a psychodynamic model of recovery informed by trauma, attachment and resilience theories. Based on interviews with six children and young people, seven carers and thirteen practitioners, the thesis explores the individual perspectives of children and young people, their carers and practitioners involved in the intervention. In addition, data collected during the evaluation of the intervention from 85 completed Carer Feedback Questionnaires and 148 responses on the Therapeutic Alliance Scale for Children (Shirk and Saiz, 1992) is presented.
Perceptions of change within the therapeutic relationship are explored, including participants’ recollections of conversations and events. The thesis examines how children, young people and carers made connections with practitioners, agreed therapeutic goals and activities within the relationship and how they transferred activities and learning beyond the therapy into their everyday spaces. Major themes discussed are confidentiality, trust, safety, choice, power, non-judgemental attitudes and hope for the future. An unanticipated but connected theme links maternal responses to social constructions of “bad” mothers, and highlights the importance for parents of feelings of safety and trust in the practitioner-parent relationship following child sexual abuse. The findings demonstrate the importance for service users of sharing a relational space, and provide insight into the relational processes in therapeutic work with young people and their parents.