“what factors would a therapist take into account when planning treatment for a psychologically abused client”
Introduction: I feel that dealing with clients who are the survivors or current victims of abuse is the most intricate and sensitive subject I have studied. Emotional and physical abuse of children and adults can take place at any age, in any country or culture and at any level of society. Forms of abuse are massively varied and can be motivated by many factors including sexual gratification, control, fear or even love. In addressing this issue I will try to give a definition of what I understand or perceive psychological abuse to be and then highlight as many ideas and ethical considerations as my word count will allow.
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For example; if the client is female, was she brought up in an environment where she was led to believe that women were inferior? (or was led to believe that she deserved no better), if the client is male does he have imposed beliefs that he is not a real man if he was unable to defend himself from bullying or sexual assault? No matter how outdated and damaging these points of view are, I feel the therapist must be aware of the fact that these attitudes may be in place from a very early age and may meet resistance if questioned directly. I feel that no matter how obvious it seems to the therapist that a client has suffered abuse, it is important to remember that they may not even be ready to use (or even accept) the term abuse. I feel that the appropriate response to such an attitude would not be to question the client as this would be a huge disregard to their phenomenology. Instead, the appearance of such attitudes could be an opportunity to encourage the client to explore the origins of these beliefs (which may have resulted in shame, blaming of self etc) with open questions. Draucker and Martsolf (1992) describe this technique as facilitative questioning. For example; if a sexually abused female client were to make a statement such as: “I feel I am a slut and I deserved what happened to me” the correct response would be to ask “when is the first time you remember