BMJ 1995;310:1175-1178 (6 May)

General practice

Adults with a history of child sexual abuse: evaluation of a pilot therapy service

David Smith, director of Breakfree,a Linda Pearce, coordinator of Breakfree,a Mike Pringle, professor of general practice,b Richard Caplan, consultant psychiatrist c

a Breakfree Service for Adult Survivors, Lincoln LN2 2JP, b Department of General Practice, Queen's Medical Centre, Nottingham NG7 2UH, c Department of Psychiatry, Southern General Hospital, Glasgow G51 4TF

Correspondence to: Professor Pringle.

Abstract

Objective: To evaluate a pilot service offering therapy specifically to adults with a history of child sexual abuse.
Design: Questionnaire survey.
Setting: Specialised therapy unit, Breakfree, which offers care, therapy, and support.
Subjects: 116 clients presenting to the service who were offered therapy.
Main outcome measures: Scores from three psychological questionnaires--the social activities and distress scale, the general health questionnaire, and the delusions, symptoms, and states inventory--and from questionnaires about the clients' abuse, previous use of health services, and opinion of the Breakfree service.
Results: Clients had received previous help from health services and other agencies without apparent effect; they were highly distressed according to their psychological scores; and they were very frequent users of the health services. The clients showed significant improvement in their psychological scores (Wilcoxon's matched pairs signed ranks test): social activities and distress scale, z=-3.3, P=0.001; general health questionnaire, z=-5.8, P<0.00001; delusions, symptoms, and states inventory, z=-4.8, P<0.00001). This was most pronounced for those who had completed 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 among those who had finished therapy).
Conclusions: This group of adults with a history of child sexual abuse were highly disturbed and previous high users of the health service. The specialist service Breakfree was effective in the short term and, if the benefits are sustained, would yield a net cost saving to the health service.

Key messages

  • Key messages

  • Breakfree was set up as a pilot service to offer help to adults with such a history

  • The clients presenting to this service reported that conventional services had failed them

  • Adults who have been sexually abused as children are high users of the health service and are highly distressed psychologically

  • A specialist service offers a highly effective therapy, which, if the benefits are sustained, will be cost effective


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Relevant Article

Adult survivors of child sex abuse
Zaida Hall, Mark A Mullee, and Chris Thompson
BMJ 1995 311: 748. [Extract] [Full Text]

This article has been cited by other articles:

  • Andersson, S.-O., Mattsson, B., Lynoe, N. (1995). Patients frequently consulting general practitioners at a primary health care centre in Sweden -- A comparative study. Scand J Public Health 23: 251-257 [Abstract]  
  • Hall, Z., Mullee, M. A, Thompson, C. (1995). Adult survivors of child sex abuse. BMJ 311: 748a-748 [Full text]  



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