Exploration of the changing relationship with shame and guilt for survivors of complex trauma whilst accessing therapy: a research portfolio
Buckley, Deirdre Maria
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Aims: The experience of abuse in childhood can lead to psychological distress later in life. In particular the impact of trauma on the development of the self can render survivors more vulnerable to chronic feelings of shame and guilt. The aims of this research portfolio are twofold. First, a systematic review examines the impact of therapeutic interventions on depression outcomes for survivors of Childhood Sexual Abuse. Second, a research study explores experiences of shame and guilt for this population. More specifically, the study examines those factors in the therapeutic process which survivors find helpful in their changing relationship with these emotions. Method: To address the first aim a systematic review of the literature was carried out. The methodology employed strict inclusion criteria and ten Randomised Control Studies were identified and included in the review. A prospective longitudinal qualitative study was conducted to explore the experiences of shame and guilt for survivors of childhood abuse. Participants (n=10) were interviewed at two different time intervals whilst accessing psychological therapy. Data was analysed using the Framework Method. Results: Findings from the systematic review show existing studies are mostly of poor to medium methodological quality; but that therapeutic interventions do improve depression outcomes for survivors of Childhood Sexual Abuse. Results from the empirical study suggest feelings of shame more so than guilt are core emotions in the experience of psychological distress for survivors. Conclusion: Evidence-based therapeutic interventions for the range of complexities experienced by survivors of CSA are still to be established and more strong methodological trials are required. Shame is a core emotion in psychological distress for survivors and requires to be assessed and addressed routinely in therapeutic interventions.