Adult Disclosure of a History of Childhood Sexual Abuse: Implications for Behavioral Psychotherapy

Abstract

This article presents a behavioral conceptualization of the difficulties associated with adult disclosure in psychotherapy of a history of childhood sexual abuse. Using a contemporary behavioral perspective and a functional analysis of various clinical presentations, we examine the factors that may contribute to nondisclosure of a history of abuse. Traumagenic dynamics are used to frame a discussion of childhood factors that may further influence disclosure of abuse. The construct of stigma is linked to aspects of experiential avoidance, which is considered to be a core mediator of the difficulties associated with a history of abuse. Acceptance and commitment therapy and functional analytic psychotherapy, 2 “third-wave” behavioral treatments, are presented generally with specific discussions of these therapies as they relate to the issue of disclosure. Important therapist factors as well as implications for future investigations are presented.

KEYWORDS:

• sexual abuse
• self-disclosure
• avoidance
• behavior therapy
• trauma