title: Adults with a history of child sexual abuse: evaluation of a pilot therapy service.
abstract: OBJECTIVE
  To evaluate a pilot service offering therapy specifically to adults with a history of child sexual abuse.
  
  
  METHODS
  Questionnaire survey.
  
  
  METHODS
  Specialised therapy unit, Breakfree, which offers care, therapy, and support.
  
  
  METHODS
  116 clients presenting to the service who were offered therapy.
  
  
  METHODS
  Scores from three psychological questionnaires--the social activities and distress scale, the general health questionnaire, and the delusions, symptoms, and states inventory--and from questionnaires about the clients' abuse, previous use of health services, and opinion of the Breakfree service.
  
  
  RESULTS
  Clients had received previous help from health services and other agencies without apparent effect; they were highly distressed according to their psychological scores; and they were very frequent users of the health services. The clients showed significant improvement in their psychological scores (Wilcoxon's matched pairs signed ranks test): social activities and distress scale, z = -3.3, P = 0.001; general health questionnaire, z = -5.8, P < 0.00001; delusions, symptoms, and states inventory, z = -4.8, P < 0.00001). This was most pronounced for those who had completed therapy by the end of the study. Whereas 82/88 clients had a score for the general health questionnaire that indicated clinical distress at the start, only 28/58 did so at the end of the study (only 17/35 among those who had finished therapy).
  
  
  CONCLUSIONS
  This group of adults with a history of child sexual abuse were highly disturbed and previous high users of the health service. The specialist service Breakfree was effective in the short term and, if the benefits are sustained, would yield a net cost saving to the health service.
authors.affiliation: Breakfree Service for Adult Survivors, Lincoln.
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: L
authors.initials: L
authors.lastname: Pearce
authors.forename: M
authors.initials: M
authors.lastname: Pringle
authors.forename: R
authors.initials: R
authors.lastname: Caplan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D003156:Community Mental Health Services; D004739:England; D005069:Evaluation Studies as Topic; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000628:therapy*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation; D012919:Social Behavior