A qualitative analysis of conjoint therapy with adult survivors of childhood sexual abuse and their partners

The purpose of this research was to understand the lived experience of childhood sexual abuse survivors and their partners who participated in conjoint therapy as a part of the treatment protocol for addressing issues related to the abuse. Theorists have been proposing models of therapy to address abuse recovery issues, but little evidence exists regarding the efficacy of conjoint therapy with this population and even less is understood about change mechanisms that are meaningful to the individuals who are being served.

A phenomenological research model was utilized to understand the experience of four couples who had participated in conjoint therapy as part of a larger therapeutic process. Conjoint therapy as a specific approach with this population is a relatively new phenomenon and the exploratory nature and rich information gathered through the use of qualitative methods made it the most appropriate research model.

Participants were interviewed using a two step approach whereby in-depth conjoint interviews were completed and then one to three weeks later individual interviews with each participant were conducted. Including two interview formats provided triangulation of information and allowed meaning creation to happen individually and in the context of conversation between the two partners.

Participants experienced transformation as the core essence of experience with conjoint therapy. Three transformative dimensions of experience and one facilitative dimension of experience were extracted from the data. Participant narratives reflected significant transformation in the level of trust within the couple, the effectiveness of communication, and their ability to set boundaries both within their relationship and between their relationship and outside systems such as the survivors’ families of origin. The fourth dimension was the facilitative dimension of therapeutic fit. Participants consistently focused on their relationship with their therapist as the most meaningful change mechanism in therapy and identified a multitude of therapeutic factors which influenced the strength and direction of this fit.