Why is it that 33% to 53% of HIV-infected people have histories of childhood sexual abuse?
Many symptoms commonly found among survivors of childhood sexual abuse, such as helplessness, low self-esteem, dissociation, denial, and self-destructiveness are also often seen in conjunction with HIV risk behavior.
Studies show that childhood sexual abuse is associated with avoidant coping, which can lead to increased traumatic symptoms.
So perhaps changing the coping strategy of people who experienced childhood sexual abuse could be useful?
Duke University professor Kathleen J. Sikkema, PhD conducted a study to examine whether a coping intervention could reduce traumatic stress and poor health outcomes in adult survivors of childhood sexual abuse living with HIV.
First, Dr. Sikkema and her colleagues recruited 247 HIV-positive participants who had experienced sexual abuse as a child or adolescent.
Next, participants completed a computer-assisted interview and took part in follow-up assessments every 4 months over a 16-month period. After the first interview, participants were randomly assigned to one of two groups.
The experimental group participated in an intervention called Living in the Face of Trauma (LIFT). LIFT uses cognitive appraisal and coping skills training to help people deal with the stress related to childhood sexual abuse and HIV. The participants in the control took part in HIV support group sessions.
In between the first and second assessments, both groups attended fifteen 90-minute weekly sessions conducted by therapists in a community health center.
During each of the five assessments, participants completed self-report measures of traumatic stress symptoms and the use of avoidant coping strategies.
Was the coping intervention more successful than the support group intervention?
Subjects who participated in the LIFT coping intervention reported a greater decrease in traumatic stress and avoidant coping than subjects in the support intervention.
And because both interventions were conducted in a group setting, it is likely that the significant reductions in avoidant coping in the LIFT group were a result of the focus on developing coping skills and not just the social support.
However, one limitation of this study is that the sample had a very small number of heterosexual men, and therefore, we have to be careful about how far we generalize these results. We can’t conclude that the same intervention will be equally as effective across gender and sexual orientation.
But for people living with HIV who have experienced childhood sexual abuse, the LIFT intervention may help them focus on current stressors and develop better coping skills to improve their health and reduce traumatic stress.
To learn more about this study, you can find it in the Journal of Consulting and Clinical Psychology, Volume 81, No. 2.
If you want to learn more about some of the latest interventions that are being used in the treatment of trauma click here.
How have you worked with avoidant patients to improve their coping strategies? Please leave a comment below.
I would like to hear about good art projects. Thanks
For more on “avoidant” coping and how it manifests, consider checking out Dr. Robert Muller’s book called “Trauma and the Avoidant Client”. Now that I think of it, he’d be a good speaker to feature on NICABM.
Hi Ruth,
Would you be willing to be more specific about “avoidant coping” and give some examples of behavior that you would identify as fitting in that catagory? Is avoidant coping related to anxious/avoidant attachment? Thanks for some more info about this!
Ellen
I am an OT interested in working with childhood/adolescent trauma victims.
If you are an OT working with PTSD clients please email me; emscholnick@gmail.com
Thank you,
Emily