Abstract
BackgroundTalking about experiences of sexual abuse in therapy is difficult for children and adolescents, amongst others due to a lack of vocabulary to describe the situation, avoidance, or feelings of shame, fear, and self-blame. The serious game Vil Du?! was developed to help children open up about sexual experiences. Vil Du?! is a non-verbal communication game, which resembles a dress-up game, in which children can show the therapist what happened to them. The current study examined how and for which therapy components Vil Du?! was used by therapists.MethodsWe used a mixed-methods triangulation design. Therapists filled out online surveys about the use of Vil Du?! with 23 clients (Mage = 11.38 years, SD = 3.96; 61 % female). We also conducted semi-structured interviews with 10 therapists. The data were analyzed in SPSS (quantitative) and Nvivo (qualitative) following the stepwise guidelines of Zhang and Wildemuth.ResultsMerged qualitative and quantitative data revealed that therapists acknowledged the usefulness of Vil Du?! mostly for the therapy components trauma narration and processing, and psycho-education about sexuality. In addition, Vil Du?! might be most useful for clients who have difficulty with disclosing sexual abuse experiences, due to limited verbal abilities or feelings of guilt, shame, avoidance, and tension.ConclusionsRecommendations from this study were incorporated in a user manual as a first step toward more systematic and broad implementation of Vil Du?! in the treatment of young sexual abuse victims. A next step is to test whether implementing Vil Du?! in therapy is effective in reducing the negative mental health consequences of sexual abuse for children and adolescents.
Highlights
Talking about experiences of sexual abuse in therapy is difficult for children and adolescents, amongst others due to a lack of vocabulary to describe the situation, avoidance, or feelings of shame, fear, and self-blame
Cognitive behavior therapy (CBT) components in which Vil Du?! was used Table 2 lists the CBT components for which Vil Du?! was used, ordered from most to least used by therapists
Combining data from questionnaires and semistructured interviews, we found that Vil Du?! was used for several CBT components in psychotherapy for Child sexual abuse (CSA) victims
Summary
Talking about experiences of sexual abuse in therapy is difficult for children and adolescents, amongst others due to a lack of vocabulary to describe the situation, avoidance, or feelings of shame, fear, and self-blame. Early treatment of victims of child sexual abuse experiencing mental health symptoms appears to be effective in reducing the negative consequences of CSA [8, 9]. Therapies including cognitive-behavioral components (CBT) are the most often used and recommended forms of psychotherapy for CSA victims experiencing psychiatric symptoms [10,11,12,13]. CBT relies heavily on abstract thinking about one’s cognitions and detailed verbal narration of one’s experiences. These tasks might be difficult for children who have limited verbal capacities or a lack of vocabulary to describe the sexual and intimate acts they were part of [8]
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