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How much treatment does a survivor of childhood sexual abuse by a priest need?

Updated: Sep 23, 2018

by Dr. Peter Jaffe

How much treatment does a survivor of childhood sexual abuse by a priest need? I wanted to offer my reflections in response to the recent media discussions. I am a clinical psychologist with 45 years experience and extensive involvement in assessments on an individual and class action basis in these court cases. I have several thoughts about the nature and length of treatment required. There is no formula and definitive number of years or sessions that survivors need. The short answer is that it all depends. The long answer is that there is usually a complex set of needs that requires extensive counselling over many years. I also acknowledge some survivors find informal support, while others would rather avoid counselling and are very reluctant to revisit the trauma.

Everyone suffers from the abuse. The victim and their family as well as members of the parish. There is a common harm related to a sense of institutional betrayal. The betrayal comes from the abuse itself, the lack of acknowledgment on a timely basis as well as the cover-up and learning of other victims by the same perpetrator. In my court work with colleagues pertaining to 46 victims of Father Charles Sylvestre in the Chatham area, we interviewed 46 victims between the ages of 30 and 60 whose lives had been forever changed because of the abuse. You can imagine the questions of a 60-year-old woman who wondered how this abuse could have gone on for so many years in the same diocese. You can imagine the questions of a 30-year-old woman who wondered how she was not spared the abuse given the documented history known to the church.

The common impact may include depression, anxiety, loss of faith, and trauma related to feeling hopeless and helpless. If the church is not a safe refuge, what is? There may be a range of individual reactions that depend on the severity and length of the abuse, the age of the victim, the support available, and compounding problems or challenges. Therapy can be expensive and lengthy – the current hourly rate set by the Ontario Psychological Association is $220 an hour – and you have to find a psychologist that specializes in this area. There are no bargain therapists.

Then there is the complex process of therapy. Many survivors may be too distrustful of authority figures or have a chaotic life that makes a therapeutic relationship difficult to establish. Dealing with the past trauma may lead to things getting worse before they get better. Part of the process may be confronting life-long problems related to mental health issues and addictions. There are often painful histories of lost opportunities and a chain of events that lead to poor educational and vocational outcomes. For example, victims’ distrust of authority may have led them to drop out of school as teens and then unable to secure employment. This kind of impact may require many years of treatment and remediation. There is also a developmental aspect of treatment. The issues at 15 are different from 25 or 35 or 60 years of age. For example, the survivor who benefited from counselling at 25 may suffer a relapse at 40 when her children are the same age she was when she was abused and may need to return to counselling. The past trauma is triggered again and the parent becomes very protective and afraid to even send their children to school.

What makes it hard for researchers and therapists to say that survivors need X number of years of treatment, is the profound nature of the harm. It is not just depression and anxiety. It is the fundamental questions about how “my life could have been had it not been for the abuse." There may be a need for residential treatment and then outpatient care. There may be a need for comprehensive clinical, vocational and educational assessment and a multi-year plan for a second chance at life. There is no formula or maximum numbers of years for treatment.

Peter Jaffe PhD

Academic Director, Centre for Research and Education on Violence Against Women and Children

Professor, Faculty of Education, Western University

Photo by NeONBrand @neonbrand

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