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How to treat someone suffering with PTSD following rape in adulthood

Published online by Cambridge University Press:  26 March 2025

Kerry Young ,
Sameena Akbar ,
Francesca Brady ,
Sophie Burrows ,
Zoe J. Chessell Open the ORCID record for Zoe J. Chessell [Opens in a new window] ,
Amy Chisholm ,
Lucinda Dixon ,
Menah Raven Ellison ,
Nick Grey  and
Emily Hall
...Show all authors
Kerry Young*
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK
Sameena Akbar
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK
Francesca Brady
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK
Sophie Burrows
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK
Zoe J. Chessell
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK
Amy Chisholm
Affiliation:
Freedom From Torture, London, UK
Lucinda Dixon
Affiliation:
Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Menah Raven Ellison
Affiliation:
West London NHS Trust, UK
Nick Grey
Affiliation:
Sussex Partnership NHS Foundation Trust, UK
Emily Hall
Affiliation:
Centre for Anxiety Disorders and Trauma, South London & Maudsley NHS Foundation Trust, UK
Fareeha Khan
Affiliation:
Freedom From Torture, London, UK
Deborah Lee
Affiliation:
Berkshire NHS Foundation Trust, UK
Reem Michael
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK
Alice Paton
Affiliation:
Alice Paton Psychological Therapies, UK
Helen Penny
Affiliation:
Aneurin Bevan University Health Board, UK
Anna Roberts
Affiliation:
Wellbeing Norfolk and Waveney Talking Therapies, UK
Khadija Rouf
Affiliation:
Northamptonshire Healthcare NHS Foundation Trust, UK
Glorianne Said
Affiliation:
The Havens, King’s College Hospital NHS Foundation Trust, UK
Karina Soubra
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK Traumatic Stress Clinic, Camden & Islington NHS Foundation Trust, UK
Craig Steel
Affiliation:
Oxford Health NHS Foundation Trust, Oxford, UK
Courtney Stich
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK South Camden Recovery & Rehabilitation, Camden & Islington NHS Foundation Trust, UK
Millay Vann
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK
Tamina Wells
Affiliation:
Woodfield Trauma Service, Central & North West London NHS Foundation Trust, UK Croydon Talking Therapies, South London and Maudsley NHS Trust, UK
Savani Bartholdy
Affiliation:
Combat Stress, Leatherhead, UK Royal Holloway, University of London, London, UK
*
Corresponding author: Kerry Young; Email: [email protected]
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Abstract

Abstract

Cognitive behavioural therapists and practitioners often feel uncertain about how to treat post-traumatic stress disorder (PTSD) following rape and sexual assault. There are many myths and rumours about what you should and should not do. All too frequently, this uncertainty results in therapists avoiding doing trauma-focused work with these clients. Whilst understandable, this means that the survivor continues to re-experience the rape as flashbacks and/or nightmares. This article outlines an evidence-based cognitive behavioural therapy (CBT) approach to treating PTSD following a rape in adulthood. It aims to be a practical, ‘how to’ guide for therapists, drawing on the authors’ decades of experience in this area. We have included film links to demonstrate how to undertake each step of the treatment pathway. Our aim is for CBT practitioners to feel more confident in delivering effective trauma-focused therapy to this client group. We consider how to assess and formulate PTSD following a rape in adulthood, then how to deliver cognitive therapy for PTSD (CT-PTSD; Ehlers and Clark, 2000). We will cover both client and therapist factors when working with memories of rape, as well as legal, social, cultural and interpersonal considerations.

Key learning aims

  1. (1) To understand the importance of providing effective, trauma-focused therapy for survivors of rape in adulthood who are experiencing symptoms of PTSD.

  2. (2) To be able to assess, formulate and treat PTSD following a rape in adulthood.

  3. (3) How to manage the dissociation common in this client group.

  4. (4) To be able to select and choose appropriate cognitive, behavioural and imagery techniques to help with feelings of shame, responsibility, anger, disgust, contamination and mistrust.

  5. (5) For therapists to learn how best to support their own ability to cope with working in a trauma-focused way with survivors of rape and sexual violence.

Keywords

Cognitive behavioural therapy (CBT)dissociationimagerypost-traumatic stress disorder (PTSD)rapesexual assault
Type
Invited Paper
Information
the Cognitive Behaviour Therapist , Volume 18 , 2025 , e19
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Chessell, Z. J., Brady, F., Akbar, S., Stevens, A., & Young, K. (2019). A protocol for managing dissociative symptoms in refugee populations. The Cognitive Behaviour Therapist, 12, e27. https://doi.org/10.1017/S1754470X19000114 Google Scholar
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345. https://doi.org/10.1016/S0005-7967(99)00123-0 Google ScholarPubMed
Lee, D., & James, S. (2012). The Compassionate Mind Approach to Recovering from Trauma: Using Compassion Focused Therapy. Constable & Robinson: London.Google Scholar
Murray, H., & El-Leithy, S. (2022). Working with Complexity in PTSD: A Cognitive Therapy Approach. Routledge: Oxfordshire, UK.Google Scholar
Schauer, M., & Elbert, T. (2010). Dissociation following traumatic stress. Zeitschrift für Psychologie/Journal of Psychology, 218, 109–127. https://doi.org/10.1027/0044-3409/a000018 CrossRefGoogle Scholar
Young, K., Chessell, Z. J., Chisholm, A., Brady, F., Akbar, S., Vann, M., Rouf, K., & Dixon, L. (2021). A cognitive behavioural therapy (CBT) approach for working with strong feelings of guilt after traumatic events. the Cognitive Behaviour Therapist, 14, e26. https://doi.org/10.1017/S1754470X21000192 CrossRefGoogle Scholar

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