Childhood Sexual Trauma: Impacts and Counselor Competencies
Keywords:
Child sexual abuse, Intrafamilial childhood sexual abuse, counseling, counselor competenciesAbstract
Objective: The Rape, Abuse, & Incest National Network (RAINN) reports one in nine girls and one in 53 boys under 18 experience childhood sexual abuse. This review explores literature on childhood sexual abuse in the U.S., focusing on intrafamilial abuse and its impact on mental health, emphasizing the role of counselors.
Methods and Materials: A systematic review of relevant studies on childhood sexual abuse, risk factors, effects, therapy perceptions, and the common factors model was conducted, with a specific focus on intrafamilial abuse.
Findings: Risk factors, such as family dynamics, contribute to intrafamilial abuse, which results in long-lasting psychological effects like PTSD, depression, and anxiety. Survivors' perceptions of therapy vary, but effective treatment often involves strong therapeutic relationships. The common factors model emphasizes empathy and client-centered approaches in therapy.
Conclusion: Intrafamilial abuse requires specialized therapeutic interventions. Further research on the treatment of adult female survivors is necessary to improve therapeutic outcomes.
Downloads
References
Adams, S. A., & Riggs, S. A. (2008). An exploratory study of vicarious trauma among therapist trainees. Training and Education in Professional Psychology, 2(1), 26-34. https://doi.org/10.1037/1931-3918.2.1.26
Aponte, D. A., & Patrick, S. (2017). Narrative approaches to counseling survivors of child sexual abuse. Wisdom in Education, 7(2), 1-9. https://scholarworks.lib.csusb.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1059&context=wie
Atwood, J. D. (2007). When love hurts: Preadolescent girls' reports of incest. The American Journal of Family Therapy, 35(4), 287-313. https://doi.org/10.1080/01926180701389644
Ballantine, M. W. (2012). Sibling incest dynamics: Therapeutic themes and clinical challenges. Clinical Social Work Journal, 40(1), 56-65. https://doi.org/10.1007/s10615-011-0331-8
Beard, K. W., Griffee, K., Newsome, J. E., Harper-Dorton, K. V., O'Keefe, S. L., Linz, T. D., Young, D. H., Swindell, S., Stroupe, W. E., Steele, K., Lawhon, M., & Nichols, A. N. (2017). Father-daughter incest: Effects, risk-factors, and a proposal for a new parent-based approach to prevention. Sexual Addiction & Compulsivity, 24(1-2), 79-107. https://doi.org/10.1080/10720162.2017.1306467
Beard, K. W., O'Keefe, S. L., Swindell, S., Stroebel, S. S., Grieffee, K., Young, D. H., & Linz, T. D. (2013). Brother-brother incest: Data from an anonymous computerized survey. Sexual Addiction & Compulsivity, 20(3), 217-253. https://www.tandfonline.com/doi/abs/10.1080/10720162.2013.807483
Becker, C. J. (2015). Integrating art into group treatment for adults with post-traumatic stress disorder from childhood sexual abuse: A pilot study. Art Therapy: Journal of the American Art Therapy Association, 32(4), 190-196. https://doi.org/10.1080/07421656.2015.1091643
Boynton-Jarrett, R., Wright, R. J., Putnam, F. W., Hibert, E. L., Michels, K. B., Forman, M. R., & Rich-Edwards, J. (2014). Childhood abuse and age at menarche. Journal Adolescent Health, 52(2), 241-247. https://doi.org/10.1016/j.jadohealth.2012.06.006
Brewerton, T. D. (2007). Eating disorders, trauma, and comorbidity: Focus on PTSD. Eating Disorders, 15(4), 285-304. https://doi.org/10.1080/10640260701454311
Broadduss-Shea, E. T., Scott, K., Reijnders, M., & Amin, A. (2018). A review of the literature on good practice considerations for initial health system responses to child and adolescent sexual abuse. Child Abuse Neglect. https://pubmed.ncbi.nlm.nih.gov/31711682/
Brown, D., Reyes, S., Brown, B., & Gonzenbach, M. (2013). The effectiveness of group treatment for female adult incest survivors. Journal of Child Sexual Abuse, 22(2), 143-152. https://doi.org/10.1080/10538712.2013.737442
Chouliara, Z., Karatzias, T., Scott-Brief, G., Macdonald, A., Macarthur, J., & Frazer, N. (2012). Adult survivors of childhood sexual abuse perspectives of services: A systematic review. Counselling & Psychotherapy Research, 12(2), 146-161. https://doi.org/10.1080/14733145.2012.656136
Cleary, M., & Hungerford, C. (2015). Trauma-informed care and the research literature: How can the mental health nurse take the lead to support women who have survived sexual assault. Issues in Mental Health Nursing, 36(5), 370-378. https://doi.org/10.3109/01612840.2015.1009661
Colangelo, J. J., & Keefe-Cooperman, K. (2012). Understanding the impact of childhood sexual abuse on women's sexuality. Journal of Mental Health Counseling, 34(1), 14-37. https://doi.org/10.17744/mehc.34.1.e045658226542730
Cortoni, F., Hanson, R. K., & Coache, M. E. (2010). The recidivism rates of female sexual offenders are low: A meta-analysis. Sexual Abuse: A Journal of Research and Treatment, 22(4), 387-401. https://doi.org/10.1177/1079063210372142
Coyle, E., Karatzias, T., Summers, A., & Powers, M. (2014). Emotions and emotion regulation in survivors of childhood sexual abuse: The importance of "disgust" in traumatic stress and psychopathology. European Journal of Psychotraumatology, 5, 1-9. https://doi.org/10.3402/ejpt.v5.23306
Crow, M., & Bunclark, J. (2000). Repeated self-injury and its management. International review of psychiatry, 12, 48-53. https://doi.org/10.1080/09540260074120
Cyr, M., Wright, J., McDuff, P., & Perron, A. (2002). Intrafamilial sexual abuse: Brother-sister incest does not differ from father-daughter and stepfather-stepdaughter incest. Child Abuse and Neglect, 26(9), 957-973. https://doi.org/10.1016/S0145-2134(02)00365-4
Day, A., Thurlow, K., & Woolliscroft, J. (2003). Working with childhood sexual abuse: A survey of mental health professionals. Child abuse & neglect, 27(2), 191-198. https://doi.org/10.1016/S0145-2134(02)00540-9
Eisikovits, Z., Lev-Wiesel, R., & Tener, D. (2016). Adult women survivors of intrafamilial child sexual abuse and their current relationship with the abuser. American Orthopsychiatric Association, 87(3), 216-225. https://doi.org/10.1037/ort0000185
Falcao, V., Jardim, P., Dinis-Oliveria, R. J., & Magalhães, T. (2014). Forensic evaluation in alleged sibling incest against children. Journal of Child Sexual Abuse, 23(7), 755-767. https://doi.org/10.1080/10538712.2014.949394
Farber, B. A., Feldman, S., & Wright, A. J. (2014). Client disclosure and therapist response in psychotherapy with women with a history of childhood sexual abuse. Psychotherapy Research, 24(3), 316-326. https://doi.org/10.1080/10503307.2013.817695
Fergusson, D. M., McLeod, G. F., & Horwood, L. J. (2013). Childhood sexual abuse and adult developmental outcomes: Findings from a 30-year longitudinal study in New Zealand. Child abuse & neglect, 37(9), 664-674. https://doi.org/10.1016/j.chiabu.2013.03.013
Fletcher, K. (2021). A systematic review of the relationship between child sexual abuse and substance use issues. Journal of Child Sexual Abuse, 30(3), 258-277. https://doi.org/10.1080/10538712.2020.1801937
Foster, J. M. (2017). A survey of students' knowledge about child sexual abuse and perceived readiness to provide counseling services. The Journal of Counselor Preparation and Supervision, 9(1), 111-139. https://doi.org/10.7729/91.1165
Foster, J. M., & Hagedorn, W. B. (2014). A qualitative exploration of fear and safety with child victims of sexual abuse. Journal of Mental Health Counseling, 36(3), 243-262. https://doi.org/10.17744/mehc.36.3.0160307501879217
Godbout, N., Briere, J., Sabourin, S., & Lussier, Y. (2014). Child sexual abuse and subsequent relational and personal functioning: The role of parental support. Child abuse & neglect, 3(2), 317-325. https://doi.org/10.1016/j.chiabu.2013.10.001
Gonzalez, C. (2017). Recovering process from child sexual abuse during adulthood from an integrative approach to solution-focused therapy: A case study. Journal of Child Sexual Abuse, 26(7), 785-805. https://doi.org/10.1080/10538712.2017.1354954
Greydanus, D. E., & Merrick, J. (2017). Incest: Child sexual abuse within the family. International Journal of Child Adolescent Health, 10(3), 295-304. https://psycnet.apa.org/record/2018-08780-005
Griffee, K., Swindell, S., O'Keefe, S. L., Stroebel, S. S., Beard, K. W., Kuo, S. Y., & Stroupe, W. (2016). Etiological risk factors for sibling incest: Data from an anonymous computer-assisted self-interview. Sexual Abuse: Journal of Research and Treatment, 28(7), 620-659. https://doi.org/10.1177/1079063214558941
Hatchard, C. J., Goodwin, J. L., Siddall, E., & Muniz, L. (2017). Perceptions of abusive parenting behaviors: A preliminary exploration into the underrecognition of mother-daughter sexual abuse. Journal of Child Sexual Abuse, 26(4), 428-441. https://doi.org/10.1080/10538712.2017.1300971
Herman, J. L. (2012). Shattered shame states and their repair. In In J. Yellin & K. White (Eds.), Shattered states: Disorganized attachment and its repair (pp. 157-170). Karnac Books. https://doi.org/10.4324/9780429480140-4
Hetherington, E. M., & Nunnally, M. (2019). Access to the civil court system for survivors of child sexual abuse in Georgia: Observations and recommendations from the clinical legal education experience. Georgia Law Review Online, 53, 35-54. https://digitalcommons.law.uga.edu/fac_artchop/1302/
Hodges, E. A., & Myers, J. E. (2010). Counseling adult women survivors of childhood sexual abuse: Benefits of a wellness approach. Journal of Mental Health Counseling, 32(2), 139-154. https://doi.org/10.17744/mehc.32.2.t537j335522kx62q
Hornor, G., & Zeno, R. (2018). Child sexual abuse perpetrators: What forensic nurses need to know. Journal of Forensic Nursing, 14(4), 206-213. https://doi.org/10.1097/JFN.0000000000000222
Hotte, J. P., & Rafman, S. (1992). The specific effects of incest on prepubertal girls from dysfunctional families. Child abuse & neglect, 16(2), 273-283. https://doi.org/10.1016/0145-2134(92)90034-O
Jones-Smith, A. (2018). Therapists' perceptions of eye movement desensitization and reprocessing treatment for women survivors of child sexual abuse. Dissertation Abstracts International Section A: Humanities and Social Sciences, 79(10-A(E)). https://scholarworks.waldenu.edu/dissertations/5356/
Kealy, D., Spidel, A., & Ogrodniczuk, J. S. (2017). Self-conscious emotions and suicidal ideation among women with and without history of CSA. Counselling and Psychotherapy Research, 17(4), 269-275. https://doi.org/10.1002/capr.12140
Kearney-Cooke, A., & Striegel-Moore, R. H. (1993). Treatment of childhood sexual abuse in anorexia nervosa and bulimia nervosa: A feminist psychodynamic approach. International Journal of Eating Disorders, 15(4), 305-319. https://doi.org/10.1002/eat.2260150402
Kiselica, M. S., & Morrill-Richards, M. (2007). Sibling maltreatment: The forgotten abuse. Journal of Counseling & Development, 85(2), 148-160. https://doi.org/10.1002/j.1556-6678.2007.tb00457.x
Knapp, A. E., Knapp, D. J., Brown, C. C., & Larson, J. H. (2016). Conflict resolution styles as mediators of female child sexual abuse experience and heterosexual couple relationship satisfaction and stability in adulthood. Journal of Child Sexual Abuse, 26(1), 58-77. https://doi.org/10.1080/10538712.2016.1262931
Kristensen, E., & Lau, M. (2011). Sexual function in women with a history of intrafamilial childhood sexual abuse. Sexual and Relationship Therapy, 26(3), 229-241. https://doi.org/10.1080/14681994.2011.622264
Maniglio, R. (2013). Child sexual abuse in the etiology of anxiety disorders: A systematic review of reviews. Trauma, Violence, & Abuse, 14(2), 96-112. https://doi.org/10.1177/1524838012470032
McElvaney, R., Lateef, R., Collin-Vezina, D., Alaggia, R., & Simpson, M. (2022). Bringing shame out of the shadows: Identifying shame in child sexual abuse disclosure processes and implications for psychotherapy. Journal of interpersonal violence, 37(19-20). https://doi.org/10.1177/08862605211037435
Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent psychopathology: Results from the national comorbidity survey. American Journal of Public Health, 91(5), 753-760. https://doi.org/10.2105/AJPH.91.5.753
Morrill, M. (2014). Sibling sexual abuse: An exploratory study of long-term consequences for self-esteem and counseling considerations. Journal of family violence, 29(2), 205-2013. https://doi.org/10.1007/s10896-013-9571-4
Murray, C. D., Macdonald, S., & Fox, J. (2008). Body satisfaction, eating disorders and suicide ideation in an Internet sample of self-harmers reporting and not reporting CSA. Psychology, Health, and Medicine, 13(1), 29-42. https://doi.org/10.1080/13548500701235757
Murray, L. K., Nguyen, A., & Cohen, J. A. (2014). Child Sexual Abuse. Child Adolescent Psychiatric Clinical North America, 23(2), 321-337. https://doi.org/10.1016/j.chc.2014.01.003
Nasim, R., & Nada, Y. (2013). Couples therapy with childhood sexual abuse survivors (CSA) and their partners: Establishing a context for witnessing. Family Process, 52(3), 368-377. https://doi.org/10.1111/famp.12026
National Center for Victims of Crime. (2012, Retrieved March 7, 2020). Child Sexual Abuse Statistics. https://victimsofcrime.org/child-sexual-abuse-statistics/
National Children's Advocacy Center. (2018). Child Sexual Abuse Perpetrators: manipulation-disclosure-prevention: infographic. https://calio.org/images/CSA-Perpetrators.pdf
Nielsen, B. F. R., Wind, G., Tjornjoj-Thomsen, T., & Martinsen, B. (2017). A scoping review of challenges in adult intimate relationships after childhood sexual abuse. Journal of Child Sexual Abuse, 27(6), 718-728. https://doi.org/10.1080/10538712.2018.1491915
Nixon, B., & Quinlan, E. (2021). Asking the hard questions: Psychologists' discomfort with inquiring about sexual abuse histories. Violence Against Women, 28(5), 1358-1376. https://doi.org/10.1177/10778012211014558
Parry, S., & Simpson, J. (2016). How do adult survivors of childhood sexual abuse experience formally delivered talking therapy? A systematic review. Journal of Child Sexual Abuse, 25(7), 793-812. https://doi.org/10.1080/10538712.2016.1208704
Rahm, G., Renck, B., & Ringsberg, K. C. (2013). Psychological distress among women who were sexually abused as children. International Journal of Social Welfare, 22(3), 269-278. https://doi.org/10.1111/j.1468-2397.2012.00898.x
RAINN. (2020). Children and Teens: Statistics. https://www.rainn.org/statistics/children-and-teens
Read, J., Harper, D., Tucker, I., & Kennedy, A. (2018). Do adult mental health services identify child abuse and neglect? A systematic review. International journal of mental health nursing, 2791, 7-19. https://doi.org/10.1111/inm.12369
Ross, G., & O'Carroll, P. (2004). Cognitive behavioral psychotherapy intervention in childhood sexual abuse: Identifying new directions from the literature. Child Abuse Review, 13(1), 51-64. https://doi.org/10.1002/car.831
Sharaby, R. (2019). An anthropological view on the taboo incest as a means for maintaining social and family order. Advances in Anthropology, 9(4). https://doi.org/10.4236/aa.2019.94012
Shaw, J. A., Lewis, J. E., Loeb, A., Rosado, J., & Rodriguez, R. A. (2000). Child on child sexual abuse: Psychological perspectives. Child abuse & neglect, 24(12), 1591-1600. https://doi.org/10.1016/S0145-2134(00)00212-X
Sigurdardottir, S., & Halldorsdottir, S. (2013). Repressed and silent suffering: Consequences of childhood sexual abuse from a women's health and well-being perspective. Scandinavian Journal of Caring Sciences, 27(2), 422-432. https://doi.org/10.1111/j.1471-6712.2012.01049.x
Sigurdardottir, S., Halldorsdottir, S., & Bender, S. S. (2012). Deep and almost unbearable suffering: Consequences of childhood sexual abuse for men's health and well-being. Scandinavian Journal of Caring Sciences, 26(4), 688-697. https://doi.org/10.1111/j.1471-6712.2012.00981.x
Stroebel, S. S., O'Keefe, S. L., Beard, K. W., Kuo, S. Y., Swindell, S. V. S., & Kommor, M. J. (2012). Father-daughter incest: Data from an anonymous computerized survey. Journal of Child Sexual Abuse, 21(2), 176-199. https://doi.org/10.1080/10538712.2012.654007
Stroebel, S. S., O'Keefe, S. L., Grief, K., Kuo, S. Y., Beard, K. W., & Kommor, M. J. (2013). Sister-sister incest: Data from an anonymous computerized survey. Journal of Child Sexual Abuse, 22(6), 695-719. https://doi.org/10.1080/10538712.2013.811140
Tadros, E., & Daifallah, N. (2025). Clinical Implications for Childhood Psychological Trauma and Mental Illness. Counseling and Psychology Nexus, 3(1), 4-11. https://doi.org/10.61838/kman.cp.psynexus.3.1
Tener, D. (2018). The secret of intrafamilial child sexual abuse: Who keeps it and how? Journal of Child Sexual Abuse, 27(1), 1-21. https://doi.org/10.1080/10538712.2017.1390715
Thompson, K. M. (2009). Sibling incest: A model for group practice with adult female victims of brother-sister incest. Journal of family violence, 24(7), 531-537. https://doi.org/10.1007/s10896-009-9251-6
Underwood, L., Stewart, S. E., & Castellanos, A. M. (2007). Effective practices for sexually traumatized girls: Implications for counseling and education. International journal of behavioral consultation and therapy, 3(3), 403-419. https://doi.org/10.1037/h0100815
Van der Kolk, B. A., Perry, C., & Herman, J. L. (1991). Childhood origins of self-destructive behavior. The American journal of psychiatry, 148(12), 1665-1671. https://doi.org/10.1176/ajp.148.12.1665
Vera-Gray, F. (2023). Key messages from research on the impacts of child sexual abuse. London.
Wagenmans, A., Van Minnen, A., Sleijpen, M., & Jongh, A. D. (2018). The impact of childhood sexual abuse on the outcomes of intensive trauma-focused treatment for PTSD. European Journal of Psychotraumatology, 9(1), 1-11. https://doi.org/10.1080/20008198.2018.1430962
Walker, E. C., Holman, T. B., & Busby, D. M. (2009). Childhood sexual abuse, other childhood factors, and pathways to survivors' adult relationship quality. Journal of family violence, 24(6), 397-406. https://doi.org/10.1007/s10896-009-9242-7
Wise, L. A., Palmer, J. R., Rothman, E. F., & Rosenberg, L. (2009). Childhood abuse and early menarche: Findings from the Black Women's Health Study. American Journal Public Health, 99(2), S460-S466. https://doi.org/10.2105/AJPH.2008.149005
Wonderlich, S., Crosby, R. D., Mitchell, J. E., Roberts, J. A., Haseltine, B., DeMuth, G., & Thompson, K. M. (2020). Relationship of childhood sexual abuse and eating disturbance in children. Journal of the American Academy of Child & Adolescent Psychiatry, 39(10), 1277-1283. https://doi.org/10.1097/00004583-200010000-00015
Yates, P., & Allardyce, S. (2021). Sibling sexual abuse: A knowledge and practice overview. London. https://researchonline.gcu.ac.uk/en/publications/sibling-sexual-abuse-a-knowledge-and-practice-overview
Downloads
Additional Files
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 Eman Tadros (Corresponding Author); Shawn Wunderlich (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
