Adults traumatized by child abuse: What survivors need from community-based mental health professionals

Aims: To understand, from the "insider" perspectives of adults abused as children, the aspects of community mental health interventions that are experienced as helpful and less helpful after discharge from inpatient trauma treatment. Method: In-depth interviews were conducted with 30 child abuse survivors, six months after discharge from a specialized trauma treatment program. Results: Participants reported difficulties managing intense feelings that surfaced after inpatient treatment, which became more problematic when they could not talk about them honestly with their community-based therapists. Therapists who were patient, understanding, and respectful of survivors' needs for a sense of control in working toward their own solutions were most helpful. Participants emphasized the need for accessible trauma-based treatment from clinicians. Conclusions: Many communities in Canada, due to lack of resources, are not providing trauma-specific services. This study indicates that community-based therapists need to become more knowledgeable about trauma issues, to increase their ability to work collaboratively with adults abused as children in assessing their therapeutic needs, and to ensure that survivors have some control in the treatment process. Declaration of interest: The Social Sciences and Humanities Research Council of Canada, Grant # 410-98-0092 and the Homewood Foundation, Guelph, Ontario, provided funding for this study.