Search

Background: Research shows that only around half of all survivors of child sexual abuse (CSA) disclose the abuse during childhood and adolescence. This is worrying, as CSA is related to substantial suffering later in life. The proportion of children and adolescents who have been exposed to CSA is significantly higher in Child and Adolescent Psychiatry (CAP) than in the general population. Healthcare professionals report that uncovering CSA is a complex and challenging task. However, we know little about how they proceed when uncovering CSA. More knowledge of healthcare personnel's experience is therefore necessary to facilitate and increase CSA disclosure. The study aims to explore how CAP healthcare professionals in Norway proceed when assessing and detecting CSA, how they experience this work, and what hinders or facilitates their efforts., Methods: The study employed a mixed method approach. Data was collected through an anonymous online survey, generating both quantitative and qualitative data. The sample consisted of 111 healthcare professionals in CAP, of whom 84% were women, with a mean age of 40.7 years (range 24-72; sd = 10.8). Mean years of CAP clinical experience were 8.3 years (range 0-41; sd = 7.5). The quantitative data was analysed using descriptive statistics, correlations, and independent sample t-tests, while the qualitative data was analysed using a team-based qualitative content analysis., Results: The results showed that detection of CSA was viewed as an important, but complex task in CAP, and the existing procedures were deemed to be insufficient. The therapists mostly felt confident about how to proceed when they suspected or detected CSA, yet they seldom detected CSA. In their initial assessment they applied standardised procedures, but if their suspicion of possible CSA persisted, they seemed to rely more on clinical judgement. Specific challenges and facilitators for CSA detection were identified, both in the individual and in the organisation., Conclusions: The study highlights the challenges and complexities healthcare professionals and the CAP system face when assessing CSA, which may account for the low detection rate. The results show that healthcare professionals believe room for clinical autonomy and targeted competence development may improve CSA detection. Additionally, the findings suggest a need for CAP to define roles and responsibilities within and between agencies., (© 2024. The Author(s).)

Objective: To draw implications for training of therapist responsiveness from a sequential mixed-methods study on challenging clinical situations., Method: Study 1: online survey mapping frequency and perceived difficulty of 15 clinical situations in a representative sample of psychologists. Study 2: online survey mapping frequency and perceived difficulty of 19 clinical situations among therapists in child and adolescent psychiatry. Study 3: focus group study exploring the situations identified through study 1 and 2., Results: Study 1 and 2 showed that ratings of each situation varied between individuals and context. Study 3 showed that the degree to which a situation was challenging was described as depending on the characteristics of the therapist and the context. Experientially, challenging situations were characterized by lacking access to necessary information, falling short, and disturbing arousal. Perceiving therapeutic opportunities despite the challenging nature of the situation, collegial support, self-knowledge, and engagement were important resources., Conclusion: Six implications of the results from the three studies for training of responsiveness are discussed: (1) building self-awareness and conceptualization skills; (2) personalizing training; (3) transforming disturbing arousal into engagement; (4) being exposed to a broad range of clinical situations; (5) training on commonly encountered situations; and (6) building tolerance for uncertainty and capacity to seek support., (© 2024. The Author(s).)

Background: Trauma-related symptoms are common and there is a need for treatment interventions targeting underlying core vulnerabilities regardless of the client's diagnosis. Mindfulness and Compassion interventions have shown promising results in trauma treatment. However, little is known of how clients experience such interventions. Objective: This study describes clients' experiences of change after participating in a transdiagnostic group intervention, Trauma-sensitive Mindfulness and Compassion Group (TMC). Method: All 17 participants from two TMC groups were interviewed within one month of completing treatment. Transcripts were analysed using reflexive thematic analysis with a focus on how the participants experienced change and change mechanisms. Results: Three main themes of experienced change were developed: Becoming empowered; A new relationship to oneself and one's body; and Gaining more freedom in relationships and life . Four main themes were developed to capture clients' experiences of change mechanisms: New perspectives give understanding and hope ; Accessing tools facilitates agency ; Significant moments of awareness open up to new possibilities, and Circumstances in life that facilitate change . Conclusion: We discuss and reflect upon participants' experiences of the effects of participating in a TMC group and the mental and emotional costs of doing the work and present a broader perspective on change processes overall.