Frequency and impact of childhood sexual and physical abuse on people using IAPT services

Abstract

Objectives: This study explored the prevalence of childhood sexual/physical abuse (CSA/CPA) as identified by practitioners in Improving Access to Psychological Therapies (IAPT) services and clarified differences in clients' characteristics with and without a history of CSA/CPA.

Methods: A retrospective analysis of a large dataset comprised of IAPT routine data and data from a local service evaluation reporting on clients' presenting problems.

Results: 14% of IAPT clients (n = 1,315) were identified with a record of CSA/CPA. CSA/CPA history was associated with longer duration and earlier age of onset of condition(s), greater number of presenting problems and post-traumatic stress disorder co-occurrence, higher intensity treatment delivery, and lower recovery rates.

Conclusions: CSA/CPA history appears as an important feature in a sizable minority of IAPT clients; further work is required to meet clients' trauma-related needs.

Practitioner points: A sizable minority of IAPT clients (14%) present with a history of CSA/CPA as recorded in clinical notes. CSA/CPA history is associated with more complex and enduring presentations in IAPT clients. The reported CSA/CPA frequency is likely to be underestimates of the actual prevalence and impact of adverse childhood experiences in IAPT clients. Trauma-informed inquiry and trauma-specific screening tools would help practitioners to meet clients' trauma-related needs.

Keywords: anxiety; childhood abuse; complexity; depression; improving access to psychological therapies.