Conceptualizing child sexual abuse in interpersonal context: recovery of people, not memories.

The controversy regarding delayed recall of childhood sexual abuse (CSA) has deflected> attention from the question of whether memory recovery and other trauma-focused treatment approaches are effective for abuse survivors. More than a decade of clinical experience has convinced many experts that as a primary treatment strategy, this approach often leads to decompensation among CSA survivors. However, few treatment alternatives have been clearly articulated. One such alternative, contextual therapy, is grounded in evidence that many CSA survivors grow up in an interpersonal context that fails to transmit the capacities needed for effective daily functioning. Contextual therapy retains trauma-focused interventions as one component of a broader framework aimed at helping survivors develop adaptive capacities that, rather than having been disrupted by trauma, may never have been attained in the first place. From this perspective, abuse trauma is seen as compounding these deficits, rather than as a sole cause of them.