Advocacy vs. Therapy Considerations for Child Sexual Abuse Survivors



Date of Publication
June, 2018

Therapists can be a critical component of a child's support system and healing process following abuse. However, many children are reluctant to participate in counseling because they don't want to talk about what happened or they may believe that going to therapy means something is wrong with them. While there are significant areas of overlap between a therapist and an advocate, it is because of their differences that they are both important members of a child's professional team after a disclosure.

There is no one way to heal from sexual trauma. Psychotherapy and support groups might be great healing tools for a survivor you are working with, but they are not a replacement for what you can offer as an advocate.

Self-determination and autonomy, feeling heard, and social support are important factors in healing that advocates can provide. Advocates are in a unique position to engage with young survivors from different cultures who may require specialized cultural support outside of therapy or in addition to therapy.

Differences between Advocacy and Therapy

Advocacy Therapy
  • Crisis intervention
  • Coping with symptoms
  • Normalizes and validates
  • Provides information and options
  • Identifies cognitive distortions
  • Broad focus on all potential elements of victimization
  • Processing trauma
  • Alleviate symptoms
  • Deeper exploration of feelings
  • Gives specific advice
  • Resolution of cognitive distortions
  • Specific focus on emotional and behavioral responses only

What does this look like in practice?

It is the role of a therapist to address the underlying emotions that lead to the physical and psychological expressions. An advocate's role includes active listening, validating emotions, and exploring concepts with open-ended questions (avoid 'why'; questions as they require a client to justify their statement).

However, advocates can address concerns and worries with children when observed, and provide information and exploration; this is a very powerful tool to promote healing in children. In doing so, advocates are also modeling this intervention for parents so they are better able to respond when they hear the child using a negative thought pattern.

Here are some common concerns child survivors may express and ways that an advocate can respond:

Expressed Concern Advocate Response
It's my fault. I hear you saying something is your fault. What do you feel like is your fault? Has someone told you it's your fault or do you feel that way on your own?
Everyone knows what happened to me. Some people will know what happened to you, that's true. Like the police. But we can talk about who you're okay with knowing and who you don't want to know. Then, if you want, we can talk to your parent and let them know what you want. How does that sound?
When will I be normal? When will this be over? That's a big question. When do you think it would be over? Like after trial? Or when you 'feel normal?' What does normal feel like for you? How would we know when you got there?
What's going to happen to my offender? Or their family? I'm not sure what will happen. Things will likely be different. You might not be able to go to your aunt's house anymore. And the offender might go to jail. Or they might not. How do you feel about your offender? What do you want to happen?
What if they don't believe me? Why doesn't my parent/teacher/cousin believe me? Sometimes it's hard for people to believe someone they care about can hurt kids. It doesn't mean you're lying or your cousin doesn't love you. But it can be very hard to have your cousin not believe you. Do you want to do anything to try to get them to believe you? (Make sure you address that they don't have control over how someone else responds or believes, in an age appropriate way.) Who do you think believes you? Is it enough that your parent and sister believe you?