Theory, sequencing, and strategy in treating adult survivors

The process of treatment of the long-term aftereffects of child sexual abuse has been delineated by a number of clinicians and researchers. Specific theoretical models have been identified, as have techniques derived from these models. A strong consensus exists concerning the general goals of the process and the fact that treatment must be individually tailored within the suggested guidelines. Treatment for the aftereffects of child sexual abuse is usually of a year's duration or longer because of the nature of the material being considered. It is widely acknowledged that symptoms get worse before they get better in this treatment, and that to engage the trauma prematurely and without adequate preparatory work is to cause regression, re-repression, or dissociation. Conducted slowly and carefully according to the prescribed guidelines, this treatment has great potential to ameliorate symptoms of long duration and severity. The trauma is treated directly because the trauma and its untreated effects are held to be the root of later distress and dysfunction. Following trauma resolution, other symptoms and difficulties become the focus of treatment.