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Counseling adult women who experienced incest in childhood or adolescence

Courtois, C. & Watts, D. (1982, January). Counseling adult women who experienced incest in childhood or adolescence. The Personnel and Guidance Journal.


Although this article deals with issues in the adult counselee, it provides important background information and principles helpful with younger females. The changing social climate for discussion of this sensitive issue and definitions of incest, legal and psychiatric, is noted.

Fear is the main reason most women wait to adulthood to disclose sexual molestation. The presenting issues of these counselees involve symptoms around the category of self (identity and self-esteem), physical complaints, sexual functioning, and relationships with others. Clients who present issues associated with early incest or molestation may be asked the question in a "calm, straightforward, matter-of-fact manner, but the timing and approach should vary by client."

The author lists the most prominent features of the incest experience which "influence the severity of effect."

  • Duration. Short- or long-term.
  • Age at onset. Pre- or post-puberty.
  • Frequency.
  • Covert versus overt. Disclosed, assumed, or hidden to the family.
  • Kinship or relationship of perpetrator. Close or distant relative, step-parent or parent’s lover, brother’s friend, etc.
  • Consent or nonconsent. Many authors and professionals argue that a child is never really free to choose against authority, but the attitude of the victim is important.
  • Use of force. Further dimension of variable of consent.

The article continues with treatment issues and approaches. It discusses the pain associated with incest and the importance of the client-counselor relationship, because the client’s trust is destroyed. "Many clients are caught in significant conflict and trust no one because no one was trustworthy in their family."


  1. The counselor must be patient, understanding, and sensitive.
  2. A working alliance may be difficult to form due to the client’s mistrust.
  3. Group counseling, alone or in conjunction with individual counseling, can be very effective.