The experiences of relationships and self-esteem development in an expressive self-esteem group intervention for adolescent females who have been sexually abused

Abstract

South Africa has a high prevalence of sexual abuse committed against children and adolescents. Among the numerous adverse consequences of sexual abuse is the difficulty survivors may experience in developing a positive self-esteem and maintaining positive relationships. To address these issues the researcher conducted a ten-week expressive self-esteem group intervention tailored for adolescent females who have been sexually abused. The research was conducted at the Itsoseng clinic in Mamelodi east. The six group members met for weekly sessions which included an expressive art activity followed by a reflective group discussion for ten consecutive weeks. The value of the intervention was assessed using a qualitative research design. Group processes and a group exercises were used to assess their experience of the group process. Semi-structured interviews were conducted with participants before and after the intervention. The interviews focused on their experiences of the effects of the abuse on their self-esteem and how they experienced the intervention. Within the framework of Interpretive Phenomenological Analysis, thematic analysis was used to as a means of exploring and interpreting the participants‟ interviews before and after the group intervention. The facilitators‟ process notes were analysed to understand the group dynamics. The main themes from the interviews were the following: isolation verse belonging; experience of not being alone; modelling behaviour to one another; emotional repression verse emotional expression; improved self-awareness; improved self-esteem and relationships. Based on the themes identified from the interviews the researcher identified three components of the intervention that helped to bring about change and growth in the participants. Firstly, the group dynamics created an accepting group environment. The participants realized that they were not the only ones who had been through trauma. Members modelled behaviour to one another and accepted one another without judgment. Secondly, the expressive activities encouraged self-awareness and emotional expression amongst members. This gave members a platform to do self-exploration and to learn more about themselves which increased self-awareness. Lastly, the expressive art activities created a platform for the participants to express difficult emotions and have challenging group discussions. These discussions helped members to get a different perspective and to express some negative experiences, as well as strengths and coping mechanisms. This allowed for a holistic exploration of the member‟s self-esteem as well as receiving feedback on how others experienced them. The development of healthy relationships within a non-judgmental environment encouraged self-awareness and emotional expression, which had a positive impact on self-esteem. The intervention helped members find meaning in their pain so that they could not only heal from their wounds, but grow from their pain. The group exercises and discussions acted as indirect ways to reconstruct lives and facilitate meaning making and mastery. The participants reported that the group intervention was an enriching experience that improved their self-esteems, their relationships, and their ability to cope with negative emotions. This research proposes an alternative strategy to working with trauma (specifically sexual abuse) in resource restricted areas. The focus need not only be on re-telling the story as the main focus. Expressive self-esteem group interventions can thus be seen as interventions that encourage mastery and creation of meaning amongst members. Therefore, research that explores the benefits of such groups for the treatment of sexual trauma (as opposed to individual counselling) may result in more effective group interventions aimed at survivors of sexual abuse.