The topic of memory for childhood sexual abuse (CSA) is currently one of great controversy within and between the mental health field and academic psychology. One recently expressed concern is that some clinicians are engaging in therapeutic practices, designed to help clients recover memories, which may inadvertently lead to the creation of false memories of CSA. Two recent studies (Polusny & Follette, 1996; Poole, Lindsay, Memon, & Bull, 1995) provide the first published empirical data regarding how common such practices actually are.
In both studies, the researchers designed questionnaires assessing a wide range of therapists' beliefs, practices, and experiences working with survivors or possible survivors of sexual abuse. Polusny and Follette randomly surveyed 1,000 psychologists who were members of APA Divisions 12 (clinical) and 17 (counseling); 22% of the surveys were returned. Poole et al. conducted 2 separate surveys: One was sent to 300 psychotherapists from the U.S. who were selected from the National Register of Health Service Providers in Psychology (NRHSPP), and a second was sent to 300 additional doctoral-level members of the NRHSPP and to 300 chartered clinical psychologists listed in the Register of Chartered Clinical Psychologists from the British Psychological Society. The response rates for these 3 samples were 43%, 35%, and 38%, respectively.
Practices Regarding Memory Recovery
Both surveys asked participants (clinicians) how often they used a variety of techniques with abuse survivors or possible abuse survivors. Poole et al. (1995) included hypnosis, age regression, dream interpretation, guided imagery, use of family photographs, 'ournaling, and interpreting physical symptoms in their I ist. Polusny and Follette included most of the above and also bibliotherapy, body massage, eye movement desensitization reprocessing (EMDR), inner child exercises sodium amytal interviews, referral to sexual abuse survivors' groups, and "a specific form of repressed memory therapy" (p. 45). Although a limitation of the Poole et al. methodology was that they only asked participants how often they used any of the techniques "with abuse victims" (p. 430) rather than with suspected abuse victims, Polusny and Follette specifically asked about use of the strategies "with adult clients who have no specific memory of childhood sexual abuse but whom you strongly suspected were sexually abused"(p. 45).
Poole et al. reported that 71% of the respondents reported using at least 1 technique aimed at helping clients to remember abuse, and 58% reported using 2 or more. Although British clinicians reported using a smaller number of memory recovery techniques overall, approximately two-thirds of the respondents from each country reported using at least 1 technique. Polusny found that only 1% of their respondents reported using "repressed memory therapy," but that at least one quarter reported using dream interpretation (47%), guided imagery (27%), bibliotherapy (33%), or referral to a sexual abuse survivors group (29%).
Frequency of Apparent Memory Recovery
Poole et al. found that 85% of respondents reported at least some cases of memory recovery among clients who initially claimed no memory for abuse. In contrast, Polusny and Follette found that only 28% of respondents reported encountering such cases. The reasons for this discrepancy are unclear. Polusny and Follette suggested that some variability may be due to the time frame sampled (they asked respondents about the past year, whereas Poole et al. asked about the past 2 years).
Although neither of these studies indicate the likelihood that memory retrieval techniques lead to the techniques lead to the creation of false memories, both studies suggest that practices aimed at helping clients recover memories of abuse are fairly common among highly trained psychologists. An important conclusion from both studies is that there remains a high degree of disagreement among clinicians over the use of specific memory.
The two studies also discuss other critical issues, including therapists' beliefs about childhood sexual abuse and memory, the connection between therapist variables (theoretical orientation or personal history of abuse) and practices, estimated percentages of clients who report various types of abuse, and the effect of the recent controversy on clinical practice and clients' behavior.
REFERENCES
Polusny, M. A., & Follette, V. M. [Dept. of Psychology, Uniy. of Neyoda, Mail Stop 296, Reno, NV 89557].(1996). Remembering childhood sexual abuse: A national survey of psychologists' clinical practices, beliefs, and personal experiences. Professional Psychology. Research and Practice, 27, 41-52.
Poole, D. A. [Dept. of Psychology, Central Michigan Uniy., Mount Pleasant, Ml 488591, Lindsay, D. S., Memon, A., & Suit, R. (199S). Psychotherapy and the recovery of memories of childhood sexual abuse. U.S. and British practitioners' opinions, proctkes, and experiences. Journal of Consul#ng and Clinical Psychology, 63,426-437.
The Harvard Mental Health Letter, May 1995
