Guter Michal, Einat Tomer, Gueta Keren
Department of Criminology, Bar-Ilan University, Anna & Max Webb, 52900, Ramat-Gan, Israel.
School of Criminology, Haifa University, Haifa, Israel.
Arch Sex Behav. 2025 Jun 19. doi: 10.1007/s10508-025-03172-9.
Male sexual victimization is more commonly examined in the context of child sexual abuse than adult sexual assault (ASA; 18+), with therapeutic research largely centering on female survivors, who constitute the main focus of scholarly attention. Consequently, this study explored how the therapeutic alliance is built and what in-session therapy needs emerge for male ASA survivors, as shaped by masculinity and adulthood. Data were collected from 39 in-depth interviews with Jewish Israeli participants, comprising two distinct groups: 19 male ASA survivors and 20 sexual trauma therapists. The data were analyzed separately through reflexive thematic analysis, and only at the final stage were the two groups examined together. Three key findings were identified: (1) facilitators of therapeutic alliance with male ASA survivors include awareness of how age and masculinity shape their experiences, psychoeducation for bonding, and present-focused listening; (2) barriers to therapeutic alliance include an overemphasis on the traumatic event itself, with a therapeutic focus that prioritizes trauma details at the expense of attending to the survivor's broader identity, current needs, and lived experiences; and (3) in-session therapy needs include psychoeducation, present-focused therapy, and changing the therapeutic setting (e.g., stepping out of the therapy room or going for walks). Accordingly, we conclude that the therapeutic alliance and in-session therapy needs of male ASA survivors are shaped by the dual lenses of age and masculinity, highlighting the necessity of adapting therapeutic approaches to address these factors.
与成人性侵犯（18岁及以上）相比，男性性侵害在儿童性虐待背景下受到的研究更多，治疗研究主要集中在女性幸存者身上，她们是学术关注的主要焦点。因此，本研究探讨了治疗联盟是如何建立的，以及对于成年男性性侵犯幸存者而言，受男性气质和成年因素影响，治疗过程中会出现哪些治疗需求。数据收集自对以色列犹太参与者的39次深度访谈，包括两个不同群体：19名成年男性性侵犯幸存者和20名性创伤治疗师。数据通过反思性主题分析分别进行分析，仅在最后阶段将两个群体放在一起研究。确定了三个关键发现：（1）与成年男性性侵犯幸存者建立治疗联盟的促进因素包括意识到年龄和男性气质如何塑造他们的经历、建立联系的心理教育以及关注当下的倾听；（2）治疗联盟的障碍包括过度强调创伤事件本身，治疗重点优先考虑创伤细节而忽视幸存者更广泛的身份、当前需求和生活经历；（3）治疗过程中的治疗需求包括心理教育、关注当下的治疗以及改变治疗环境（例如，走出治疗室或去散步）。因此，我们得出结论，成年男性性侵犯幸存者的治疗联盟和治疗过程中的治疗需求受到年龄和男性气质这两个因素的影响，这凸显了调整治疗方法以应对这些因素的必要性。
