Navigating unconditional positive regard: Counsellors’ perspectives on client disclosures of child sexual abuse offending

Objective
This study explores counsellors' perceptions of working with clients who disclose thoughts regarding, or experience of perpetrating, sexual abuse of a child. Counselling of such clients is often framed as emotionally draining, distressing and a challenge for the core conditions of a productive therapeutic relationship, specifically unconditional positive regard (UPR).

Method
In-depth semi-structured interviews were conducted with 12 counsellors working privately or within the National Health Service within the United Kingdom. Interviews were recorded and transcribed verbatim and the data were explored using reflexive thematic analysis.

Results
Findings highlighted three themes: (1) The capacity to offer UPR is limited, highlighting the perceived limitations of working with UPR for counsellors, including issues such as incongruence and values conflict; (2) We have a duty of care to clients and victims, illustrating the motivations for working with this client group, including a feeling of duty to both the client and potential future victims; and (3) Working with ‘the hurt person underneath’, which illustrates how counsellors facilitate their ability to adhere to core conditions through the ways in which they view and position these clients.

Conclusion
While encounters may be uncommon, these findings illustrate a need to support therapists working with this population within routine therapeutic practice. This support is needed to overcome barriers to UPR and to build and maintain effective therapeutic relationships for this client group.