Recollections of Sexual Abuse: Treatment Principles and Guidelines

Rating:
Summary: Trauma treatment may not be what you think it is
Review: This book directly takes on the treatment of abuse survivors today, when so much publicity is given to "false memories". Recollections of Sexual Abuse is balanced and fair. This is a significant achievement given the highly controversial nature of the subject matter.

It is best described as a three-way tie among a scientific treatise, a quasi-legal document (Dr. Courtois is not a lawyer, but she directly takes on therapist fears of being sued), and a guidance manual. All of this information is provided to assist therapists who treat people who either definitely were or who may have been sexually abused in childhood. (This is really most if not all therapists, because as Dr. Courtois points out, many people in the mental health system have sexual abuse histories.)

In reviewing the literature, Dr. Courtois is presenting her understanding of the nature of memory and the scientific validity of post-traumatic therapy. Her extensive discussion of legal issues is intended to calm therapists down and convince them that they can treat this group of patients without getting sued. Finally, her proposed treatment guidelines for treating survivors are laid out to show therapists how to deal with abuse recovery in a responsible way.

She calls the treatment method "the evolving consensus model of posttrauma treatment: sequenced, titrated, focused on symptom relief and functioning". This model is described "in three main phases:
(1) the initial or early phase of stabilization, safety, alliance-building, support, and self functions;
(2) the middle phase of deconditioning, mourning, and resolution of past trauma and associated losses (past and present); and
(3) the late phase of reconsolidation consisting of self and relational development and life enhancement." (p. 188)

If you became familiar with the stereotyped view of trauma treatment as lots of abreactions, followed by lawsuits and much unhappiness all around, please consider reading this book. The method she recommends is not like that at all. As usual, good books do not get enough publicity.

Rating:
Summary: Trauma treatment may not be what you think it is
Review: This book directly takes on the treatment of abuse survivors today, when so much publicity is given to "false memories". Recollections of Sexual Abuse is balanced and fair. This is a significant achievement given the highly controversial nature of the subject matter.

It is best described as a three-way tie among a scientific treatise, a quasi-legal document (Dr. Courtois is not a lawyer, but she directly takes on therapist fears of being sued), and a guidance manual. All of this information is provided to assist therapists who treat people who either definitely were or who may have been sexually abused in childhood. (This is really most if not all therapists, because as Dr. Courtois points out, many people in the mental health system have sexual abuse histories.)

In reviewing the literature, Dr. Courtois is presenting her understanding of the nature of memory and the scientific validity of post-traumatic therapy. Her extensive discussion of legal issues is intended to calm therapists down and convince them that they can treat this group of patients without getting sued. Finally, her proposed treatment guidelines for treating survivors are laid out to show therapists how to deal with abuse recovery in a responsible way.

She calls the treatment method "the evolving consensus model of posttrauma treatment: sequenced, titrated, focused on symptom relief and functioning". This model is described "in three main phases:
(1) the initial or early phase of stabilization, safety, alliance-building, support, and self functions;
(2) the middle phase of deconditioning, mourning, and resolution of past trauma and associated losses (past and present); and
(3) the late phase of reconsolidation consisting of self and relational development and life enhancement." (p. 188)

If you became familiar with the stereotyped view of trauma treatment as lots of abreactions, followed by lawsuits and much unhappiness all around, please consider reading this book. The method she recommends is not like that at all. As usual, good books do not get enough publicity.