Perceptions of the Role of Mothers in the Disclosure and Nondisclosure of Child Sexual Abuse: A Qualitative Study.

One of the aims of this research was to develop an understanding of the role mothers were perceived to play during the process of disclosure of child sexual abuse. Using narrative inquiry methodology, face-to-face in-depth interviews were conducted with 22 men and women who had an early sexual experience. Even though a mother's support and protection is known to be important, this study showed that many mothers were seen as unable to offer such support, which had an important influence on nondisclosure. The heterogeneity of perceptions of mothers among adults who experienced child sexual abuse and gender differences are described. Health professionals need to manage complex relational dynamics between adult survivors and their mothers.

The Fly-in Fly-out and Drive-in Drive-out model of health care service provision for rural and remote Australia: benefits and disadvantages.

CONTEXT: Rural Australians experience poorer health and poorer access to health care services than their urban counterparts, and there is a chronic shortage of health professionals in rural and remote Australia. Strategies designed to reduce this rural-urban divide include fly-in fly-out (FIFO) and drive-in drive-out (DIDO) services. The aim of this article is to examine the opportunities and challenges involved in these forms of service delivery. This article reviews recent literature relating to FIFO and DIDO healthcare services and discusses their benefits and potential disadvantages for rural Australia, and for health practitioners. ISSUES: FIFO and DIDO have short-term benefits for rural Australians seeking healthcare services in terms of increasing equity and accessibility to services and reducing the need to travel long distances for health care. However, significant disadvantages need to be considered in the longer term. There is a potential for burnout among health professionals who travel long distances and work long hours, often without adequate peer support or supervision, in order to deliver these services. A further disadvantage, particularly in the use of visiting medical practitioners to provide generalist services, is the lack of development of a sufficiently well-resourced local primary healthcare system in small rural communities. LESSONS LEARNED: Given the potential negative consequences for both health professionals and rural Australians, the authors caution against the increasing use of FIFO and DIDO services, without the concurrent development of well-resourced, funded and staffed primary healthcare services in rural and remote communities.

Walking in sacred spaces in the therapeutic bond: therapists' experiences of compassion satisfaction coupled with the potential for vicarious traumatization.

The therapeutic bond is at the heart of effective therapy, yet few studies have examined therapists' experience of this bond. Using a qualitative study design, this exploratory study examines the experiences of couple and family therapists in relation to their perceptions of the satisfactions and risks involved in the therapeutic bond. The research was conducted using grounded theory methodology and eight in-depth interviews were conducted with therapists working in five counseling agencies in Sydney, Australia. Therapists described the importance of the 3 component parts of the therapeutic bond: the empathic connection between therapist and client; the role investment of the client; and the mutual affirmation experienced by both therapist and client in the therapeutic process. Walking in sacred spaces with the client was seen as both enriching and challenging for the therapist. The therapeutic bond gave therapists intense satisfaction and posed risks for them, especially when working with traumatic client experiences. However, the findings suggest that the experience of compassion satisfaction and the development of vicarious resilience counter-balanced the intense difficulty of bearing witness to clients' traumatic experiences and the potential for vicarious traumatization. The implications for sustaining couple and family therapists in their work are discussed.