Abstract
Increasing numbers of survivors of childhood sexual abuse (CSA) are now seeking psychological therapy; yet little evidence currently exists concerning optimum treatment formats, especially when re-victimization has occurred in adulthood. This study reports an exploratory investigation of re-victimization, and of the use of cognitive analytic therapy (CAT) with seven CSA survivor women, six of whom had experienced re-victimization and five of whom were self-abusive. Results of single element and dyad grids administered before and after therapy were consistent with the exploratory hypothesis that abuse forms a central component of the women's relationships, hence making recurrence of abuse a real possibility. Outcome of therapy using CAT was positive, although the considerable and significant symptomatic changes observed were accompanied by significant change in only a relatively small number of the women's constructs, suggesting the persistence of the centrality of abuse despite therapy. For two women, levels of disturbance remained high after termination, and some evidence of relapse was also evident at three-month follow-up.

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