Survivor, family and professional experiences of psychosocial interventions for sexual abuse and violence: a qualitative evidence synthesis

What is the aim of this review?

The aim of this review was to explore the experiences of survivors of sexual abuse and violence who received interventions to support them and improve their health and well-being, as well as experiences of their family members and the professionals who delivered such interventions. To do this, we analysed 37 studies that described views and experiences of an intervention.

Key messages

  • Survivors, their family members and professionals highlighted that the organisational settings (e.g. their locations and the approach of all staff in the organisation) within which interventions were delivered were very important for their experience of the interventions and the benefits they drew from them.
  • Participants talked about positive outcomes from therapies and interventions, such as improved physical and mental health, mood, interpersonal relationships, understanding of trauma, and their abilities to re-engage in a wide range of areas of their lives.
  • Participants explained that features of interventions and their settings that best enabled them to benefit from interventions were often features that could be a barrier. For example, the relationship with the therapist when open and warm was a benefit, but if such a relationship could not be achieved, it was a barrier.
  • Aspects of interventions relevant to subgroups of survivors (e.g. for faith-based interventions) and the extent to which they made all survivors (e.g. survivors who were men, had a disability or were from other minority communities) feel a sense of inclusion were also important to enable each survivor to gain the most benefit from them.

What was studied in this review?

We looked for studies that explored the experiences of survivors and professionals who took part in interventions that supported survivors of sexual abuse and violence, or family members who supported survivors who completed these interventions.

We included studies that:

  • treated survivors who were sexually abused when they were children or adults, or both; and
  • involved participants of any age, gender, sexuality, ethnicity, or [dis]ability.

We included studies from any country and setting.

What are the main findings of this review?

We analysed 37 of the 97 studies that were relevant to our review. Most of the 37 studies were from high-income countries and included survivors. There was a wide range of interventions that supported and responded to those who had experienced sexual abuse and violence included in these studies, with only one type of intervention examined in more than one study.

Our review highlighted that people did not discuss the features of the different types of interventions (e.g. aspects related to mindfulness therapy, or rape counselling) but rather, referred to a wide range of features associated with the interventions they considered important. For example:

  • they emphasised that a good relationship with the therapist was vital; and
  • that other members of the group (where interventions were delivered in groups) could make them feel more or less included.

They also stressed that features of the wider setting of the intervention, such as the location and friendliness of a receptionist and other staff, had an important impact on them being able to benefit from interventions.

The review showed that survivors benefitted from the interventions in a wide range of ways, most of which have not been examined in more quantitative research studies that look at how effective these interventions are. Such studies tend to examine mental health, but our review found that survivors thought interventions had also benefitted their:

  • physical health;
  • mood;
  • relationships with others;
  • confidence; and
  • ability to set boundaries and be assertive.

How up to date is this review?

This review includes studies published up to May 2021.

Read the full review here on the Cochrane Library.