BASW Cymru Safeguarding Conference: Investing in therapeutic services for adult survivors of child sexual abuse

The devastating and life-long impact of childhood sexual abuse was detailed in a workshop at the BASW Cymru conference by the Wrexham-based charity Stepping Stones, started 20 years ago by three social workers.

Covering North Wales, the counselling service works with adult survivors of childhood sexual abuse, and typically receives referrals from a range of different sources such as NHS, GPs, consultants, and mental health professionals. Many clients also self-refer to access Stepping Stones’ services.

Pat Davies, an ex-mental health social worker and counsellor who works for the charity, explained how memories of abuse can be uncovered from apparently unrelated health issues “It isn’t always evident that sexual abuse is a factor. A lot of referrals from GP surgeries are initially as a result of depression.”, she said.

Using a mix of individual and group work counselling, staff at Stepping Stones attempt to help people to uncover and come to terms with childhood abuse. “Disassociation”, where the mind distances itself from the experience in order to cope with the trauma, is common amongst survivors. “A lot of people don’t have a memory, it’s repressed. They know there’s something but they don’t really know what it is.”, Ms Davies said.

This repressed experience can easily be awakened by everyday “triggers” that provoke a memory, such as a particular smell, taste or sound that can unleash painful and terrifying feelings in adult survivors.

Often, survivors resort to a range of harmful behaviours as a coping mechanism, which can be substance misuse, self-harm or abusive relationships.

Stepping Stones feels that providing supportive counselling is a safeguarding issue, because if individuals can recognise triggers and understand what is making them feel that way then they can protect themselves better from harm.

Workshop participants were engaged in a number of tasks to encourage empathy with how people who have suffered the trauma of sexual abuse might respond both to triggers in their personal life and also to undergoing the counselling process.

The charity, currently working on pre-trial therapy for an independent investigation examining claims of historical child abuse at children's homes in North Wales, Operation Pallial, emphasises the need for trust and client confidentiality.

While each experience is different, survivors commonly experience effects detailed in the Four Traumagenic Dynamics Model, which suggests that child sexual abuse results in the following trauma; traumatic sexualisation , a sense of betrayal , powerlessness and stigmatisation.

Counsellors need to tread carefully and build supportive relationships with clients, conference delegates were told.  Stepping Stones chair Jennie Henderson explained the charity’s counsellors do not ask people to give details of the abuse they have suffered unless they wish to, and instead talk in terms of commonalities that survivors share, in order to let them  know that they are “not the only one this happened to”.

Stepping Stones are keen to work with other groups and the Welsh Assembly to move their cause higher up the political agenda. Service Manager Joy Kett said: “There are five or six groups in Wales who specialise in working with adults survivors, all of whom struggle to get funding,”

The lack of understanding of the plight of adult survivors of sexual abuse is something that needs to change, Ms Kett continued, “It is difficult to get funding, there is a perhaps a perception, with cases of adults reporting historic abuse ‘why didn’t they say anything sooner? They must be making it up’. With child victims there may be more empathy”.

The financial cost to public services of failing to properly address the underlying counselling needs of survivors should also not be underestimated. Ms Kett said, “Our main commissioners, local authorities and health services, have been consistent in providing us with financial support because it has an impact on wider services.”

“If we can support our survivors then that reduces pressure on substance misuse services, mental health, and childcare services. I think it’s a case of recognising the impact and the benefit of the work that we do.

Chair Jennie Henderson agreed that adults and children need support from society: “Despite the disparity in funding, it’s really important to work with adults and children who have been abused equally, so they are not holding on to that experience for all those years.”