Meeting a survivor where they are…
Psychotherapists are offered an insight into a survivor’s life at the point they meet, as well as making contact with their past. The impact of barriers to accessing specialist support (waiting times, funding or lack thereof, practical accessibility needs, the impact of blame/shame/guilt, etc.) should form part of the context of meeting and working together.
Once they meet, it is standard to focus on specific elements of the client’s presenting concerns in line with what they would like to be different. Ethically, this is acting in accordance with a client’s needs or wishes.
The work may be limited to only their initial requests, even as breadth or depth of conversations increase over time. This may be due to the practicalities of what is on offer from the psychotherapist, which in many services may be time-limited or non-specialist talking therapy. Psychotherapists may also meet a survivor unexpectedly, for example when a disclosure is made after a referral or assessment is completed.
With any client in any setting there are agreements to be made on how to proceed with the work on offer to maximise the efficacy of psychotherapy as a joint endeavour.
There is always a careful balance to be found between focusing on what is emerging for the client, including in an urgent way whilst bearing in mind their overall presentation, history, and relational or attachment style. Interventions can then be tailored according to each client and takes into account their specific needs rather than providing a standardised service.
From my book ‘Psychotherapy with Survivors of Sexual Violence: Inside & Outside the Room’. Click here to order your copy of my book.