Asking women survivors about thoughts or actions involving sex with children: an issue requiring therapist sensitivity.

This article reports findings from the qualitative phase of a mixed-methods study exploring whether current counseling practices with women survivors of child sexual abuse include inquiry about thoughts and behavior involving sex with children. Following an online survey of therapists across Canada, telephone interviews were conducted with a subgroup of 22 therapists. Two main themes emerged: (a) the dilemma for the therapist and (b) strategies to explore the issue. The "dilemma" refers to the therapeutic reasons and ethical responsibility to have this discussion versus the possible negative effects on the client and/or the therapeutic relationship, the discomfort of the therapist, and inadequate training. Strategies to explore the issue are presented including normalizing, ensuring client understanding, and using different types of inquiry.