Doctor of Philosophy (PhD)
Lyle S. Hallman Faculty of Social Work
This qualitative study examined how childhood sexual abuse survivors and therapists manage therapeutic boundaries in individual therapy and the effect these boundaries have on the survivor, the therapist, and the quality of the therapeutic relationship. A grounded theory approach was used to explore the types of boundary issues that arose in sexual abuse therapy, the context in which these issues arose, how they were managed, and how the participants experienced them. In-depth interviews with 11 survivors (8 female and 3 male) and 11 therapists (8 female and 3 male) revealed participants' perceptions, feelings, and understandings of memorable boundary situations. A wide range of boundary issues, such as therapists' actions with respect to survivor safety, use of touch in therapy, therapist-client contact between sessions, extending sessions, dual relationships, and therapist self-disclosure were identified and explored. Overall, participants in this study perceived boundary decisions as central to childhood sexual abuse therapy. Many boundary management issues are discussed under the categories of boundary management when survivors are distraught and the ability of survivors and therapists to exercise choice with respect to boundaries. Other boundary management issues that are discussed include survivor autonomy in therapy, ending therapy, therapists who were not willing or able to discuss the sexual abuse, and the impact of previous and concurrent work with other professionals. The socio-economic, cultural, and community environments, and personal life experiences of survivors are discussed in relation to therapeutic boundary management. Themes related to the reasons for entering therapy, the therapeutic relationship, and survivor life changes that result from therapy are also considered. A preliminary model of sexual abuse therapy with respect to therapeutic boundaries is presented as a step toward the ultimate goal of helping therapists to develop a safer and more helpful therapeutic environment for childhood sexual abuse survivors. Implications for social work practice and directions for future research are presented.
Harper, Kim, "Therapist-client boundaries in childhood sexual abuse therapy: A qualitative investigation" (2003). Theses and Dissertations (Comprehensive). 236.