"Holding the badness": Therapists' experiences of treating incestuous abuse continuing into adulthood

This study aimed to explore the experience of therapists whose clients report incestuous abuse continuing into adulthood.

Ten Australian therapist-participants were recruited through professional forums. After giving informed consent, they completed a semistructured interview. Therapists were asked about their experiences of providing therapy to people who disclosed incestuous abuse that continued into adulthood and their experiences of training, peer support, and supervision in relation to these cases. The interviews were recorded, transcribed, labeled with a pseudonym, and deidentified. The transcripts were subjected to reflexive thematic analysis (TA) following the guidelines of Braun and Clarke (2006, 2022).

The study found that three overarching themes described the therapeutic experience and response to this client group: (1) the therapist's emotional distress, vicarious traumatization, and moral injury at the extent of abuse and suffering disclosed by the client; (2) the need to adjust therapeutic goals and their reactions to this; and (3) feelings of professional isolation and a lack of support within mainstream services.

The study describes therapeutic experience of a sample of practitioners and concludes that this work is distressing and demanding, requiring therapists to find their own coping methods, training, and supervision. The study points to needs for changes in practitioner training, service delivery, and policy to enable more holistic care of clients reporting complex ongoing abuse. (PsycInfo Database Record (c) 2026 APA, all rights reserved).