Examination of psychotherapeutic change process of sexually assaulted women: A schema-focused approach

Sexual assault is one of the most traumatic experiences that can cause many psychological symptoms, especially the symptoms of post-traumatic stress disorder (PTSD). Considering the limitations and the criticisms of the psychotherapy approaches commonly used in the psychotherapy of sexually assaulted women, it is important to propose an alternative intervention model. Although schema therapy has been shown an effective treatment of many psychological disorders, it is noteworthy that studies on PTSD, especially interventions for sexual assault have been limited. From this point of view, the aim of this study is to examine the psychotherapeutic change process by quantitative and qualitative methods in a short-term psychotherapy protocol which includes frequently used techniques of schema therapy (imagery rescripting, chair works, limited re-parenting, and empathic confrontation). For this purpose, there were 6 female participants who were exposed to sexual assault. PTSD-Self-Report Scale (PSS-SR), Beck Depression Inventory and SCL-90 were applied to all participants before, during and after therapy, and the scores of the participants were evaluated among these stages. According to the descriptive statistical results, it is observed that the scores of the participants in the post-test and follow-up decreased according to the scores of the pre-test. In addition, the analysis carried out for PSS-SR led to the conclusion that the change in all the participants had a clinical significance. Narrative analysis was used to examine how the change in participants took place in schema-focused psychotherapy and how the stories associated with the sexual assault were re-constructed with the psychotherapist in the session. It was seen that the psychotherapy processes of the clients were completed in three stages: The stages were called 'the first authors of the traumatic story'; 're-authors of the traumatic story'; 'co-authors of the traumatic story' respectively. All findings were discussed in detail and a model was proposed for schema-focused psychotherapy intervention.