Utilizing disclosure in the treatment of the sequelae of childhood sexual abuse: A theoretical and empirical review

Although disclosure is a component of many therapeutic approaches to treating the long-term symptoms associated with child sexual abuse (CSA), the ameliorative mechanisms of this approach are still unclear. This review investigates the expected benefits of disclosure in therapy by looking at the theoretical and empirical support for its effectiveness in treating the specific psychopathological sequelae associated with a history of CSA. In order to accomplish this task, a core group of sequelae associated with sexual abuse are presented. The components of disclosure as a therapeutic process are divided into three processes: disclosure-through-description, disclosure-through-rethinking, and disclosure-in-relationship. The review describes the ways in which these elements of disclosure are used within different therapeutic approaches. The treatment outcome literature is then reviewed in terms of the elements of disclosure included in the treatment approaches and the symptoms improved by treatment. In conclusion, implications are presented concerning the appropriate uses of disclosure in psychotherapy directed at alleviating the long-term sequelae associated with a history of CSA. (C) 2000 Elsevier Science Ltd.