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Contextualising therapeutic care for child survivors of sexual violence in situations of war: a reflection on theory, context and practice

机译：在战争情况下性暴力儿童幸存者的语境感官治疗：关于理论，背景与实践的思考

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In this article, the author sought to raise awareness of and discuss ways to effectively address contextual challenges faced by mental health workers who provide therapeutic services to child rape survivors in war-affected regions, in general, and in the cultural context of the eastern region of the Democratic Republic of Congo, in particular, where rape is considered a sexual taboo, causing or amplifying attachment issues for survivors. A qualitative analysis of current literature review and therapeutic practice has been conducted in this article. Two cases are presented to illustrate contextual challenges. The analysis of case one focuses on ethical dilemmas between asserting professional boundaries and addressing clients’ needs in situations wherein there are no alternative resources beyond the therapist’s scope of practice, whereas the analysis of case two focuses on relationship and attachment challenges for survivors because of the interpretation of rape as sexual taboo. It was observed that, given extraordinary contextual challenges, therapists who assist child survivors in war-affected zones interact with their clients beyond their offices. Connecting at an empathy level alone is not enough. It also takes the therapists’ ability to demonstrate compassion and creativity in their effort to facilitate the healing journey of their clients. Key implications for practice This article draws attention to wartime child rape and its context-specific consequences on the survivors' attachment security. Awareness is raised of the cultural context and ethical challenges surrounding the practice of therapeutic care for child survivors in war-affected regions. Observed limitations are reported to the Western model of therapeutic relationship and the requirement of compassion and solution-driven creativity by therapists beyond empathy for a more contextualised and effective support of their clients.
机译：在本文中，提交人士试图提高认识，并讨论有效地满足心理卫生工作者面临的情境挑战，他们在受战争影响的地区的儿童强奸幸存者提供治疗服务，以及东部地区的文化背景下特别是刚果民主共和国，特别是强奸被认为是性禁忌，造成或放大幸存者的附件问题。本文进行了对当前文献综述和治疗实践的定性分析。提出了两种情况以说明上下文挑战。对案件的分析侧重于在主张专业界限和寻求客户的情况下对伦理困境进行了思考，其中没有超出治疗师的实践范围的替代资源，而两个案例的分析侧重于幸存者的关系和附着挑战解释强奸为性禁忌。据观察，鉴于非凡的背景挑战，在受战争影响的地区帮助儿童幸存者的治疗师与他们的客户相互作用。单独连接到同情级别是不够的。它还采取了治疗师的能力，努力促进客户的治疗旅程。对实践的关键影响本文提请注意战时儿童强奸及其对幸存者依恋安全性的具体背景的后果。提出了围绕战争影响地区儿童幸存者治疗治疗实践的文化情报和道德挑战的认识。观察到的局限性向西方的治疗关系模型和同情和解决方案驱动的创造力的要求，以外的同情，以获得更加内容和有效的客户。

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