Capella Claudia, Rodríguez Loreto, Azócar Estrella, Lama Ximena, Núñez Lucía, Águila Daniela, Gomez Camila, Espeleta Macarena, Vasquez Vania
Department of Psychology, Faculty of Social Sciences, University of Chile.
Res Psychother. 2022 Mar 4;25(1):583. doi: 10.4081/ripppo.2022.583.
Change in psychotherapy research in cases of child sexual abuse (CSA) has mainly emerged from a symptomatologic view, which needs to be complemented by a subjective perspective of change. Thus, this article aim is to describe different outcomes and stages of change during psychotherapy in children and adolescents who have been sexually abused, from the subjective perspectives of those involved in the process.
A longitudinal qualitative study was developed. Qualitative interviews were conducted at different moments of the psychotherapeutic process (at around 6 months of therapy, 12 months and at the end of therapy) with 28 children and adolescents aged 6 to 17, with their caregivers and therapists. All children and adolescents attended and then completed psychotherapy due to sexual abuse in natural settings, in public specialized centres in Santiago, Chile. Sexual abuse occurred mainly in an intrafamilial context or by acquaintances. Data analysis was conducted using narrative analysis.
Three stages of therapy were identified: (1) settling into therapy, (2) approaching CSA and (3) healing from abuse. Three different outcomes of psychotherapeutic change were also identified: (1) protective and psychosocial changes, (2) changes related to diminishing the effects of abuse and (3) changes related to healing from abuse. Psychosocial characteristics of the cases and features of the therapeutic process are described in each group.
The outcomes of change and the stages of therapy are interrelated in a dynamic and gradual process where change is linked with the case's psychosocial characteristics and the features of the therapeutic process. Results allowed the authors to situate the voices of the participants within a proposed model of psychotherapeutic change for CSA, with clinical practical implications.
儿童性虐待（CSA）案例中的心理治疗研究变化主要源于症状学观点，还需要从变化的主观视角进行补充。因此，本文旨在从参与治疗过程者的主观视角，描述遭受性虐待的儿童和青少年在心理治疗期间不同的变化结果和阶段。
开展了一项纵向定性研究。在心理治疗过程的不同阶段（治疗约6个月、12个月以及治疗结束时），对28名6至17岁的儿童和青少年及其照顾者和治疗师进行了定性访谈。所有儿童和青少年均因在智利圣地亚哥的公共专业中心遭受性虐待而接受并完成了自然环境下的心理治疗。性虐待主要发生在家庭内部或熟人之间。采用叙事分析法进行数据分析。
确定了三个治疗阶段：（1）适应治疗，（2）直面儿童性虐待，（3）从虐待中康复。还确定了心理治疗变化的三种不同结果：（1）保护性和心理社会变化，（2）与减轻虐待影响相关的变化，（3）与从虐待中康复相关的变化。每组都描述了案例的心理社会特征和治疗过程的特点。
变化结果和治疗阶段在一个动态渐进的过程中相互关联，其中变化与案例的心理社会特征和治疗过程的特点相关。研究结果使作者能够将参与者的声音置于一个针对儿童性虐待的心理治疗变化模型中，具有临床实践意义。
