ADULTS WITH A HISTORY OF CHILD SEXUAL ABUSE - EVALUATION OF A PILOT THERAPY SERVICE

Objective-To evaluate a pilot service offering therapy specifically to adults with a history of child sexual abuse. Design-Questionnaire sur vey. Setting-Specialised therapy unit, Breakfree, which offers care, t herapy, and support. Subjects-116 clients presenting to the service wh o were offered therapy. Main outcome measures-Scores from three psycho logical questionnaires-the social activities and distress scale, the g eneral health questionnaire, and the delusions, symptoms, and states i nventory-and from questionnaires about the clients' abuse, previous us e of health services, and opinion of the Breakfree service. Results-Cl ients had received previous help from health services and other agenci es without apparent effect; they were highly distressed according to t heir psychological scores; and they were very frequent users of the he alth services. The clients showed significant improvement in their psy chological scores (Wilcoxon's matched pairs signed ranks test): social activities and distress scale, z=-3.3, P=0.001; general health questi onnaire, z=-5.8, P<0.00001; delusions, symptoms, and states inventory, 2=-4.8, P<0.00001). This was most pronounced for those who had comple ted therapy by the end of the study. Whereas 82/88 clients had a score for the general health questionnaire that indicated clinical distress at the start, only 28/58 did so at the end of the study (only 17/35 a mong those who had finished therapy). Conclusions-This group of adults with a history of child sexual abuse were highly disturbed and previo us high users of the health service. The specialist service Breakfree was effective in the short term and, if the benefits are sustained, wo uld yield a net cost saving to the health service.