Negotiating Therapeutic Boundaries with Childhood Sexual Abuse Survivors: Choices in Decision-Making

Abstract

This qualitative study explored therapeutic boundary processes during individual therapy from the perspectives of adult childhood sexual abuse survivors and therapists. Interviews exploring the context, process, and effects of negotiating boundaries were conducted with 11 survivors (8 female and 3 male) after or upon completing individual therapy, and with 11 therapists (8 female and 3 male) who were working with survivors other than those interviewed in this study. Participants reported that their abilities to negotiate boundary modifications were affected by personal beliefs, such as preconceived ideas about the utility of the boundary, and interpersonal relationships that impinge on both survivors' and therapists' capacities to refuse requests for boundary modifications. Although discussion between survivors and therapists about boundary decisions before they are made may not always preclude negative consequences, participants also stated that it is helpful to understand boundaries in the context of the therapeutic relationship. Implications for practice are discussed.

KEYWORDS:

• childhood sexual abuse survivors
• individual therapy
• qualitative research
• therapeutic boundary modifications

ACKNOWLEDGEMENT

The author would like to thank Dr. Michael Holosko, School of Social Work, University of Windsor, for reviewing this article prior to submission.