Non-recent (historic) childhood sexual abuse is an important issue to research, though often regarded as taboo and frequently met with caution, avoidance or even opposition from research ethics committees. Sensitive research, such as that which asks victim-survivors to recount experiences of abuse or harm, has the propensity to be emotionally challenging for both the participant and the researcher. However, most research suggests that any distress experienced is usually momentary and not of any clinical significance. Moreover, this type of research offers a platform for voices which have often been silenced, and many participants report the cathartic effect of recounting their experiences in a safe, non-judgemental space. With regard to the course of such research, lines of inquiry which ask adult participants to discuss their experiences of childhood sexual abuse may result in a first-time disclosure of that abuse by the victim-survivor to the researcher. Guidance about how researchers should respond to first-time disclosure is lacking. In this article, we discuss our response to one research ethics committee which had suggested that for a qualitative study for which we were seeking ethical approval (investigating experiences of pregnancy and childbirth having previously survived childhood sexual abuse), any disclosure of non-recent (historic) childhood sexual abuse which had not been previously reported would result in the researcher being obliged to report it to relevant authorities. We assess this to be inconsistent with both law and professional guidance in the United Kingdom; and provide information and recommendations for researchers and research ethics committees to consider.
Objectives: To explore the pregnancy and childbearing experiences of women-survivors of childhood sexual abuse [CSA]. We aimed to generate a theory explaining those experiences for this population (women), this phenomenon (pregnancy and childbirth), and this context (those who have survived CSA). Method: Participants (N=6) were recruited to semi-structured interviews about their experiences of CSA and subsequent pregnancy and childbirth. Data saturated early, and were analysed using Grounded Theory (appropriate to cross-disciplinary health research). Coding was inductive and iterative, to ensure rigour and achieve thematic saturation. Results: Open and focused coding led to the generation of supercategories, which in-turn were collapsed into three distinct, but related themes. These themes were: Chronicity of Childhood (Sexual) Abuse; Pregnancy and Childbirth as Paradoxically (Un)safe Experiences; Enduring Nature of Survival Strategies. The relationship between these themes was explained as the theory of: (Re) activation of Survival Strategies during Pregnancy and Childbirth following Experiences of Childhood Sexual Abuse. Conclusion: Pregnancy and childbirth can be triggering for women-survivors of CSA. Survival strategies learnt during experiences of CSA can be (re)activated as a way of not only coping, but surviving (the sometimes unconsented) procedures, such as monitoring and physical examinations, as well as the feelings of lack of control and bodily agency.
Mental health problems have been established as one of the leading causes of the global burden of disease. Approximately a quarter of all people worldwide will experience a mental disorder during their lifetime. With depression and anxiety becoming the leading causes of mental ill health globally, the numbers of people reporting mental health complaints are set to grow. The dramatic increase in reporting and diagnosis of mental health disorders has been in parallel to a decline in the ability to cope with mental health symptoms and a rise in the incidence of self‐harm and suicidal ideation. While mental health assessment and diagnoses are usually the responsibility of general practitioners (family doctors) or psychiatrists, the frontline provision of mental health care is often delegated to counsellors and psychotherapists. Publicly funded counselling and psychotherapy services vary across the globe, but are commonly under‐resourced and lacking in adequate funding. This may lead to insufficient clinical supervision and compressed time to complete continuing professional development, which are both vital for new counsellors and psychotherapists to feel confident in providing care, and to learn new skills. Newly qualified counsellors and psychotherapists may also experience emotional, physical, and mental exhaustion or ‘burn‐out’. This position paper aims to critically appraise available cross‐cultural literature on the experiences of ‘burn‐out’ by newly qualified counsellors and psychotherapists, globally. Finally, we make recommendations for how best to support the mental health and psychological well‐being of newly qualified practitioners.
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