Client disclosure and therapist response in psychotherapy with women with a history of childhood sexual abuse

This study investigated the perceptions of adult clients (N=98; M age=32) with a history of childhood sexual abuse (CSA) of the costs and benefits of disclosure of this material. Significant benefits of disclosing included a sense of relief from sharing bottled-up emotions, and feeling more accepted and understood by one's therapist; significant negative consequences included feeling emotionally overwhelmed, and feeling uncomfortably vulnerable and exposed. Linear regressions indicated that CSA patients who generally disclose more have a greater tendency to experience both positive and negative effects of disclosure about abuse. In addition, a hierarchical regression analysis indicated that higher levels of symptomatology were predictive of higher levels of anxiety related to disclosure in therapy, suggesting that clinicians need to be cautious in encouraging disclosure about CSA with patients with severe pathology.