Is trust an essential therapeutic goal in working with childhood sexual abuse (CSA)? – a body of empirical research

Impaired ability to develop trusting relationships, self-dysregulation, poor emotional regulation, poor self valuation, and relational sensitivity are key challenges for survivors of Childhood Sexual Abuse. These increase the risk of ruptures in the therapeutic relationship and dropouts. Nevertheless, there is little evidence of the role of therapeutic trust in CSA. We collectively present the findings of a 15-year research journey into CSA recovering. Central to recovering was the establishment and maintenance of trust. Trust was also key for client satisfaction and facilitating the recovering process. Trust mediated regulation of threat responses, facilitated empathy, and enabled accurate symbolisation and re-contextualisation of traumatic narratives. In an increasingly traumatogenic world, more clinicians will be called to respond to disclosures of abuse and maintain engagement. Given the lack of effective interventions for CSA/complex trauma, trust-based person-centred psychotherapies are a promising alternative for managing dropouts, supporting the therapeutic relationship, and facilitating change.