Factors that influence therapy completion in a child sexual abuse counselling service

Abstract

Background

Child sexual abuse is a widespread problem with far-reaching impacts for survivors that can extend into adulthood. Engagement in therapeutic intervention can reduce the negative impacts of child sexual abuse, however little is known about rates of referral to, engagement in, and completion of therapeutic interventions following the disclosure or detection of abuse.

Objective

This research aimed to explore factors relating to completion of therapy, and barriers to therapy completion, among clients of a child sexual abuse counselling service.

Participants and setting.

Participants were 581 child clients who engaged in therapeutic treatment at Bravehearts, an Australian non-government child protection organisation that specialises in the treatment and prevention of child sexual abuse.

Methods

Client demographic, referral, engagement, sexual abuse-specific and symptomology/presentation data was examined in relation to therapy completion rates, and specific reasons for disengagement were explored among subgroups of clients.

Results

Parental engagement in the child’s therapeutic treatment was shown to be a key factor associated with therapy completion, with clients who had a parent or carer engage being four times more likely to complete than those who did not. First Nations clients, those who experienced abuse by a sibling or by multiple perpetrators, and those who presented with more behavioural concerns at intake were less likely to complete therapy. Clients who were engaging at the time of an upcoming or current criminal court case were more likely to complete.

Conclusion

This research highlights the complexity of factors associated with therapy engagement, and the co-existing and complicating familial and environmental issues that may present as barriers to therapy completion. Implications for therapeutic practice with children and families following disclosure or detection of child sexual abuse are discussed.