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Treatment strategies

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Thought stopping

Some survivors have obsessive victimizing thoughts that are both negative and destructive which result in unpleasant feelings that can lead to dysfunctional behaviours. Among these obsessive thoughts are self-doubt and self-criticism, conflicts with others, fear of making decisions, and negative performance evaluations about oneself and the future. These patients can also experience obsessive memories of the abuse, and excessive criticism and/ self-destructive thoughts.

The thought-stopping technique involves the therapist teaching the patient to focus on the negative thought for a few seconds and then thinking the word STOP  to interrupt the chain of dysfunctional thoughts. The next important step involves the patient substituting the thought with a positive or functional coping statement and think it over and over again.

This technique works relatively quickly if initially practiced by the patientfive to seven days a week over a few weeks. The patient will need to repeat this process as soon as destructive, negative thoughts begin.

 

Journal writing

Patients who have difficulty verbalizing orally to the therapist may be desirable candidates for this form of therapy. A patient needs to be consistent as well as self-motivated to properly obtain benefits from this therapeutic tool, sine most of the work takes place outside of therapy sessions.

Journal writing provides a valuable account of abuse memories, thoughts, affect, beliefs, physiological sensations, experiences and so forth. Depending on the patients needs, this material can be explored, validated, facilitated, challenged, interpreted or enhanced alone or shared, with the therapist. It becomes the victimes chronicle of the therpeutic treatment process. Writing allows the patient to discharge formerly repressed emotions and thoughts in a safe context. It is a procedure that can inhance the patients ability to calm, contain and soothe themself.

 

Expressive therapies

Expressive therapies provide patients with an alternative to, or can be used in conjunction with, the traditional verbal therapies for victims who are unable to discuss their traumatic material directly. Art, dance, writing, music, and drama are viable options to aid the patient in working through their abuse experiences.

Relaxation training

There is a high likelihood that many victims of childhood abuse will  manifest symptons of PTSD, anxiety, overwhelming fears, panic attacks, or psychosomatic problems. Therefore it can be very beneficial for the therapist to teach the patient an assortment of appropriate relaxation techniques.

The patient and the therapist begin by setting realistic and obtainable goals. Next, careful attention is focused on changing the observable specific behavioual sympton. The strategies include a variety of breathing exercises, guided imagery, progressive relaxation training, meditation, autogenic training, and visualisation.

 

Behavioural rehearsal (role playing) and covert modeling

One method of enabling our patients to eliminate and replace maladaptive behaviours with more appropriate ones is by acting out various new behaviours and actions. Using this technique, behavioural rehearsal, the patient and therapist may repeatedly anticipate, try on and experiment with different behaviours and roles in innumerable social settings, both actual and expected. Role playing permits the patient to confront and deal with all manner of possible reactions to any given situation.

Covert modeling is used to accomplish the same purpose. This technique differs from role playing in that it encourages the patient to imagine and visualise a process that might be useful to fulfill a task, together with feelings concomitant with its successful completion.

 

Assertiveness training

Many survivors who enter treatment are suffering from a sense of helplesness related to a specific problem, secretiveness, and isolation. Therefore, it becomes necessary for the therapist to implement a threefold treatment approach. Firstly, the patient needs to be educated about their basic individual rights, which serves as permission for the exercise of these rights. Second, the therapist needs to enhance the patients feeling of safety, which helps gives them personal power and permits them to have an open, free and secure environment for self-expression. Third, the therapist can teach the necessary repertoire of assertiveness skills to patients to assist them in building and mastering this comprehensive adaptive coping skill.

 

Body-image information

Many adult survivors struggle with a distorted body image manifested by expressions of personal dissatisfaction with their bodies and by self-destructive behaviour. Treatment by therapists can focus on helping victims increase their knowledge and understanding as well as create a sense of self-control with these issues, assisting them to break out of their negative perceptions.

The therapist can also help patients to increase their awareness of distortions of body image by clarifying associations between a devalued body image and their abusive childhood experiences.

 

Group psychotherapy

It has been determined that the group treatment approach can be a beneficial component of the therapeuctic process. It provides survivors a unique opportunity to share and alliviate emotional wounds.

The primary goals of the group experience are several: to see isolation evolve into intimacy with others, to establish trust in interpersonal relationships, to change powerlessness and helplessness into empowerment, and to transfor stigmatization into health self-esteem.

The group therapy permits corrective emotional experience in which members can resolve boundary, sibling, role, communication, and other issues. Other goals common to the clinical group experience may include decreasing feelings of shame, irrational guilt, and self blame; developing hope for healing; learning functional skill building; and process group transference issues.

 

Self-help groups

Usually self-help groups are established by members who themselves successfully dealt with a particular problem and can be an important personal resource for others with a similar plight.

The need to help others who have ben abused, or the need to make the world a safer place, seems to be an important part of the resolution process for many survivors. Survivors fell that as a result from their own experiences, they are able to help others in a way that non-abused individuals could not, because they had acquired a special ability to emphasize with those who were suffering, the courage to speak out against injustice, a unique skill to protect their own children from child abuse.  Survivors who establish these groups need to have learned to define their own boundaries and to have set interpersonal limits.

 

(Cruz & Essen, 1994)  (Bierker, 1989)