Program Description

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Adult survivors of childhood sexual abuse (CSA) frequently present with complex and enduring psychological sequelae that extend beyond fear-based trauma symptoms to include profound shame, self-blame, and disturbances in moral identity. These experiences are increasingly understood through the lens of moral injury, in which violations of fundamental ethical expectations particularly betrayal, abuse of power, and silencing, disrupt meaning-making and the individual’s sense of self.

This program offers an integrative, trauma-informed framework for working with adult survivors of childhood sexual abuse, drawing on Eye Movement Desensitization and Reprocessing (EMDR) therapy and the Adaptive Information Processing (AIP) model, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Compassion-Focused Therapy (CFT), and Testimony Therapy. 

EMDR/AIP targets maladaptively stored traumatic memory networks that underpin shame-based beliefs and somatic distress.

 

TF-CBT provides structured cognitive and behavioral strategies to address distorted appraisals of responsibility, danger, and self-worth. 

CFT is integrated to cultivate affiliative affect, self-compassion, and emotional regulation, particularly in relation to harsh self-criticism and entrenched shame. 

Testimony Therapy is introduced as a meaning-making, narrative-based intervention that supports survivors in reclaiming authorship of their lived experience, bearing witness to injustice, and restoring moral coherence. 

These modalities are not arbitrarily combined but reflect a theoretically coherent argument: that shame-based moral injury in adult survivors of CSA demands intervention across four interlocking levels (1) cognitive reappraisal, (2) affective regulation, (3) traumatic memory reprocessing, and (4) narrative meaning-making, and that no single framework alone is sufficient to address the full depth of the wound.

Emphasis is placed on phased, ethically attuned clinical practice that recognizes the role of power asymmetry, developmental vulnerability, and social silence in CSA. This program aims to equip clinicians with conceptual clarity and practical tools to support moral repair, restore dignity, and facilitate the adaptive integration of traumatic experiences, while avoiding individualizing or pathologizing responses to what were fundamentally violations of trust and care.

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SESSION 1

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Understanding the Wound — Moral Injury, Shame, and Cognitive-Behavioral Approaches

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This session will focus on the nature of CSA as a fundamentally moral violation, not simply a traumatic event but a betrayal of care, power, and trust.
 

Participants will be able to:

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1. Analyze childhood sexual abuse as a moral injury, recognizing the roles of power asymmetry, betrayal, and developmental vulnerability in shaping shame-based trauma responses.

2. Use at least two (2) Trauma-Focused Cognitive Behavioral Therapy  (TF-CBT)  strategies to identify and modify maladaptive trauma-related cognitions concerning responsibility, trust, and self-worth.

3. Apply at least two (2) Compassion-Focused Therapy  (CFT)  interventions to address shame, self-criticism, and threat-based affect regulation, fostering self-compassion and affiliative emotional systems.

4. Compare between fear-based PTSD symptoms and shame-based moral injury, and tailor intervention strategies accordingly across therapeutic modalities.