finding care and support
Research tells us that nobody is "magically" resilient. Everyone needs a network of supportive people around them in order to enjoy psychological and emotional health. Many adult survivors of child abuse lack that network: they may not be able to rely on their families, and they may find it difficult to establish and maintain friendships and relationships.
Many health professionals acknowledge the impact of child abuse in their everyday work with adult clients in a range of contexts, from general practice, to mental health services, to alcohol and drug services, and beyond. Nonetheless, Australia has yet to develop a trauma-informed public health system that provides adequate care to adult survivors of child abuse. Australia's mental health system is underfunded, with far fewer dedicated beds and services than comparable Western countries. In Australia, patients with psychoses and/or otherwise "acute needs" are prioritised over patients with complex, chronic mental health problems, such as those that adult survivors of child abuse can display.
This section of our website provides a comprehensive overview of your options for care and support. Please contact us to discuss any questions or concerns you may have and we will try and help you as best we can. ASCA is currently actively seeking funding to expand services for adult survivors of child abuse through the formation of therapeutic alliances, and education and training.
At times, there are big hurdles and sometimes you don’t feel like dredging up any more crap. You get tired of the gut churning feelings, but the pain is just below the surface at all times anyway and facing it has really helped it to lose its powerful hold over me. Sometimes it is hard to talk about things. I just allow the emotions and pain to come up and I try to ride with it. Then when I feel comfortable enough I speak of why I am feeling the way I am… (study participant in van Loon & Kralik, 2005c).
There are some professionals who feel there is nothing to be gained by going back over past experiences, nor delving into them. Others believe that telling your story relieves the burden of you carrying your abuse history around, as though it is the sum total of who you are. Your abuse is not your whole story. Talking externalises those past experiences, and disentangles the issues they invoke from who you are, making it possible to separate yourself from the abuse experiences (van Loon & Kralik, 2005c). In relation to exploring the past, some survivors conclude that they do not need to dig too deep because the process of exploring may become re-traumatising (van Loon & Kralik, 2005b). Some survivors explain that it is important to acknowledge that the abuse happened and speak about the aspects of the abuse story that relate to the impacts of the abuse, rather than the details of what happened (van Loon & Kralik, 2005b).
It is important only to share your story when and if you feel ready to do so, and only within a safe environment, with a person you can trust. If you don’t want to talk about your abuse experiences, you may not be ready to do, in which case it might be preferable not to.
Many survivors feel that they have few people to whom they can talk, or from whom they can seek and receive support. However, it is important not to try to recover from your abuse in a vacuum. Learning to trust others and to turn to them for support is a crucial step in recovery. Doing so challenges one of the basic notions arising from a history of abuse: namely, that people are dangerous. Trust your own feelings. Choose people who are interested in you and who can engage with your situation.
Professional help can be of tremendous value to survivors attempting to overcome the negative impacts of their abuse. Recovery usually proceeds more quickly and more safely if you are working with a skilled professional. In a relationship with an ethical and clinically appropriate therapist, the client experiences safety, respect for boundaries, sensitivity to needs and validation of both the abuse that occurred and the role of recovery in creating a happy and meaningful life.
Disclosing your experiences will rob the abuse of its potency. Even though the effects of abuse cannot be completely erased, they can certainly be diminished, and coped with in a healthier way.
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ASCA is currently expanding its referral database to help you identify suitably qualified therapists in your area. It is recommended that you choose a therapist who holds a recognized qualification in counselling, psychology or a similarly skilled area. In addition, particular experience and expertise in working with survivors of childhood abuse is vital. Make sure you feel safe in the consulting rooms of the health care professional you choose and that they are sensitive and encouraging. Your chosen therapist would ideally answer any questions you have about their experience, models of working, professional memberships and qualifications. So, feel free to ask!
Once you have entered into a therapeutic relationship with a professional, if you feel yourself being pushed too hard, or you are uncomfortable with suggested therapeutic methods, try to discuss your concerns with your therapist. If the therapist’s suggestions aren't compatible with your feelings or beliefs about your abuse, then try to discuss this as well. You should be comfortable with the pace of your therapy and be able to discuss your progress openly with your therapist. If you are not comfortable after discussing your concerns consider choosing a different therapist.
Even though you may need support to reclaim your capacity to make decisions, a good therapist will allow you to keep control of your life and encourage you to join in decisions about your care. You may want your therapist to make a decision for you while you are in a state of crisis, and doing so may be necessary at times, but it is still important that you are offered that choice (van Loon & Kralik, 2005c).
Choosing a therapist can be intimidating, confusing and time-consuming. It is often advisable to ‘shop around’ before you make your choice.
The following advice might help you:
- Seek personal recommendations from other survivors.
- Seek recommendations from ASCA.
- Prepare a list of questions to ask the therapist you have chosen, eg. What is his/her experience in working with survivors (particularly with issues that are relevant to you)?
- What approach(es) does he/she use in therapy?
- How much will it cost?
- Is there any possibility of a concession rate?
- What are the options for payment?
- How available is he/she?
- What form do the sessions take?
- How long are the sessions?
- What are the rules about cancelling a session?
- Is there any facility for contact between sessions?
- What are the arrangements for holidays?
- What is the process followed when therapy finishes?
- Will you be given the option of returning?
- Will you be involved in the decision-making process?
- Beware of therapists who stress a particular approach or technique, or who are dogmatic about issues such as forgiveness, confrontation, etc.
- Beware of therapists who give hugs, shake hands too readily, or sit too close without invitation. If you do feel uncomfortable when interviewing a therapist, trust your instincts.
- Beware if your therapist seems overly interested in your sexual history and questions you in detail, especially when the questioning appears irrelevant.
- Beware if your therapist avoids sensitive issues and talks in generalities. Is your therapist able to handle the feelings and content that you bring to therapy?
Ask yourself the following:
- Do I feel intimidated by this therapist?
- Does he/she listen to me?
- Do I believe that I can disagree with him/her?
The therapist you choose should be a good listener, who is both empathetic and non-judgmental. Your therapist needs to be a trusted partner in your process.
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Psychotherapy
Psychotherapy is the umbrella term for a set of healing techniques practised by accredited psychologists, psychiatrists,and psychoanalysts. There are many different forms of psychotherapy, and they are often combined within a therapeutic program that is developed between a therapist and their client.
Psychotherapy is now accessible through Medicare, and so you are able to access free, or discounted, psychotherapeutic services once you have been given a referral through your local doctor. A therapeutic alliance with a well trained and sensitive psychotherapist is an important resource for adult survivors of child abuse.
Ideally, a psychotherapist working with an adult survivor of child abuse should have a basic understanding of abuse and trauma, or else be open to further education and training on the matter. Unfortunately, abuse and trauma remains a specialised area of psychotherapy, and many psychologists complete their training without a basic understanding of the dynamics of trauma, and how to work effectively with adult survivors of child abuse.
Research has found that the strongest predictor of good outcomes in psychotherapy is not the type of therapy that is being practiced, but rather the ability of the psychotherapist to establish a strong rapport with their clients. It is natural to, at times, for uncomfortable during psychotherapy, however, it is crucial that you feel comfortable and safe with your psychotherapist, and that they are working with you to build on your strengths, and providing you with new tools to cope with day-to-day life.
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Counselling is a broader term than "psychotherapy" and refers to any professional guidance in resolving personal conflicts and emotional problems. There are many different counselling approaches, and they often draw on psychological theory and techniques. Many counsellors have related qualifications and accreditations. However, counselling remains a largely unregulated field of care at this time. It is a good idea to check the qualifications and expertise of any counsellor before establishing an ongoing professional relationship with them.
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Sexual assault services exist in all states and territories of Australia. While their main focus is on recent sexual assault victims, adult survivors of child abuse comprise approximately a quarter of clients seen by these services. In 60% of these cases, the time between the assault and presentation at the service was more than 10 years*
Sexual assault services are excellent resources for adult survivors of child abuse. Many such services provide phone counselling, one-on-one counselling, online counselling, as well as group programs and referral options for adult survivors of child sexual abuse. It is worth noting, however, that these services are chronically underfunded, and are often forced to prioritise services to recent victims of sexual assault.
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Complementary therapies, or alternative therapies, refer to a range of practices and techniques outside of those usually practiced by accredited psychotherapists and counsellors. Complementary therapies have become increasingly popular in many different areas of health over the last thirty years, and mental health is no exception. Examples of complementary therapies in mental health include practices based on yoga, reiki and other meditative traditions, as well as techniques that incorporate dance, massage or other physical activities.
When investigating complementary therapies, it is important to note that practitioners are not necessarily bound by the same standards of conduct and care as psychotherapists and other accredited mental health care professionals. Psychotherapeutic techniques are regularly evaluated and tested for their effectiveness, whereas complementary therapies are often not. It is often preferable to maintain a therapeutic relationship with a qualified and experienced mental health professional whilst exploring complementary and alternative therapies.
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