Adults with a history of child sexual abuse: evaluation of a pilot therapy service

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Abstract
Objective: To evaluate a pilot service offering therapy specifically to adults with a history of child sexual abuse. Design: Questionnaire survey. Setting: Specialised therapy unit, Breakfree, which offers care, therapy, and support. Subjects: 116 clients presenting to the service who were offered therapy. Main outcome measures: Scores from three psychological questionnaires—the social activities and distress scale, the general health questionnaire, and the delusions, symptoms, and states inventory—and from questionnaires about the clients' abuse, previous use of health services, and opinion of the Breakfree service. Results: Clients had received previous help from health services and other agencies without apparent effect; they were highly distressed according to their psychological scores; and they were very frequent users of the health services. The clients showed significant improvement in their psychological scores (Wilcoxon's matched pairs signed ranks test): social activities and distress scale, z=-3.3, P=0.001; general health questionnaire, z=-5.8, PConclusions: This group of adults with a history of child sexual abuse were highly disturbed and previous high users of the health service. The specialist service Breakfree was effective in the short term and, if the benefits are sustained, would yield a net cost saving to the health service. Key messages Breakfree was set up as a pilot service to offer help to adults with such a history The clients presenting to this service reported that conventional services had failed them Adults who have been sexually abused as children are high users of the health service and are highly distressed psychologically A specialist service offers a highly effective therapy, which, if the benefits are sustained, will be cost effective