Judy presents as an adult suffering from shame and headaches resulting from her previous encounters of sexual intercourse with her father. She seeks help from a professional counselor. The counselor reviews the issues involved with an incest patient, as well as therapeutic approaches used to deal with these conflicts. Client-centered therapy is considered as a modality best able to help Judy.
Many women entering therapy will present a problem other than incest, with the past trauma partially or fully repressed. This places the responsibility on the therapist to be even more aware of issues for the incest victim. The therapist must become aware that control and autonomy are key issues concerning incest. The victim will be frightened away by a controlling therapist as he/she would be too similar to the incestuous abuser. The therapist must ensure trust and safety which is often difficult to do with an incest victim (O'Hare & Taylor, 1983; Westerlund, 1983).
A non-directive approach to therapy is needed. A confrontational approach may be perceived as attacking and may result in an overwhelming sense of fear and helplessness. These women are extremely sensitive to intrusiveness and they need to have their boundaries respected. At the same time they often have difficulty knowing when and how to prevent boundary violations (Westerlund, 1983).
Counselors need to recognize the intense pain that may surface with the remembering of the past traumas. It may be helpful for the counselor to view the client as a whole person who has strength and survival skills and who is able to resolve the experiences. The needs of the victim have been identified as: emotional catharsis, confrontation assimilation, self-identification, self-management, self-acceptance, externalizing quilt, rage, shame, fear, confusion, and learning that she does not have to be psychologically crippled for the rest of her life (Courtois & Watts, 1982).
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