Weaver P L, Varvaro F F, Connors R, Regan-Kubinski M J
Carlow College, Pittsburgh, Pennsylvania 15210, USA.
J Psychosoc Nurs Ment Health Serv. 1994 Dec;32(12):19-25. doi: 10.3928/0279-3695-19941201-10.
Recent literature pertinent to adult survivors suggests that childhood sexual abuse is a serious problem, and that disclosure is on the rise. The aftereffects of childhood sexual abuse can cause dysfunction in various aspects of the survivor's physical and mental health. Understanding the traumagenic dynamics of childhood sexual abuse and its aftereffects provides direction for the nurse therapist during both the client's disclosure and intervention planning. This knowledge assists the therapist in promoting mental health and healing, as well as providing comfort for the therapist. The nurse therapist's reactions to the client's disclosure can affect the way the client feels about disclosure and the therapeutic relationship. If a negative message is conveyed to the survivor at the time of disclosure, the feelings of betrayal, stigmatization, and powerlessness that the survivor experienced as a child will be replicated. This can damage the therapeutic relationship and delay the healing process. When disclosure is received and acted upon in a sensitive, therapeutic manner, the survivor is empowered and can enter with the nurse therapist into an effective therapeutic alliance. Nurse therapists should gain awareness of the types of emotional responses that can be engendered in the health professional during disclosure. Awareness of these emotional reactions can lead to the identification of coping strategies useful to both the therapist and the adult survivor. Coping strategies useful to the therapist include maintaining adequate boundaries, understanding oneself and one's responses to sexual-abuse issues, utilizing ongoing consultation or supervision, and preventing burnout.(ABSTRACT TRUNCATED AT 250 WORDS)
近期与成年幸存者相关的文献表明，儿童期性虐待是一个严重问题，且披露率呈上升趋势。儿童期性虐待的后遗症会导致幸存者身心健康的各个方面出现功能障碍。了解儿童期性虐待的创伤性动态及其后遗症，可为护士治疗师在患者披露情况及干预计划制定过程中提供指导。这些知识有助于治疗师促进心理健康与康复，同时也能为治疗师提供慰藉。护士治疗师对患者披露情况的反应，会影响患者对披露及治疗关系的感受。如果在披露时向幸存者传达负面信息，幸存者儿时所经历的背叛、污名化和无力感将会重现。这会破坏治疗关系并延缓康复进程。当以敏感、治疗性的方式接收并处理披露信息时，幸存者会获得力量，并能与护士治疗师建立有效的治疗联盟。护士治疗师应意识到在披露过程中卫生专业人员可能产生的各种情绪反应类型。了解这些情绪反应有助于确定对治疗师和成年幸存者都有用的应对策略。对治疗师有用的应对策略包括保持适当的界限、了解自己及自身对性虐待问题的反应、利用持续的咨询或督导以及防止职业倦怠。（摘要截选至250词）
