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Quetzal Counsellors share their perspective as to Why Female Survivors Do Not Attend Their Counselling Sessions

On Sunday 4th December 2021, Quetzal ran a focus group with counsellors to understand from their perspectives the reasons why female survivors of childhood sexual abuse do not attend the counselling sessions and what we can do to support them further in their journey.

The meeting was organised as part of the Quetzal initiative – Improving access to psychological therapies for female survivors of childhood sexual abuse –

Below are the results from the discussion and emails received from counsellors who could not attend the session

Why Female Survivors Do Not Attend (DNA) their Counselling Sessions

There are many reasons why female survivors at Quetzal DNA their counselling sessions. Though most beneficiaries, when they disengage with Quetzal, do not say why. Counsellors were able to share a few insights on why they withdraw from their therapy:

  • They forgot (and from a psychodynamic perspective, you could hypothesize that there are lots of reasons why clients forget and not just because they have a poor memory, and that might include all of the reasons listed below)
  • They, their family or their children were ill.
  • They were a sudden death in the family.
  • They aren’t ready to engage in therapy yet.
  • They are upset somehow from what happened in a previous session.
  • They did not attend (DNA) after the counsellor went on holiday or was absent.
  • They were attending a hospital / psychiatric / GP appointment.
  • Work called them in.
  • They did not have privacy within their home to conduct the counselling session.
  • They don’t have the bus fare to travel.
  • They missed the bus.
  • They are too embarrassed to say that they can’t come.

Some beneficiaries embrace a pattern of attending a session, cancelling, then re-attending. The beneficiary behaviour lengthens the therapy, harms the counselling process, and does not allow beneficiaries on the waiting list to start counselling sooner.

What Can Quetzal do Better to support beneficiaries in their decision to attend their counselling sessions?

The participants discussed the importance of maintaining and promoting the beneficiaries’ independence and autonomy in deciding to attend or not their therapy. Some participants highlighted those principles central to the recovery process and the relationship with the counsellor. Subsequently, they suggested that any structure to support female survivors in attending their counselling sessions shall happen before starting their counselling sessions. The participants shared the following suggestions:

  • Produce resources accessible on the website, so those who haven’t had the experience of counselling would better understand what counselling involves and the reasons why their commitment to attend each week is primordial to yield the most benefits from the counselling process.
  • Send an email to clarify the number of allocated sessions for the therapy.
  • Give a 15min call to beneficiaries to let them know: 
    • What they can expect in the first session, 
    • Where they can park or where the Quetzal building is 
    • The name of the counsellor
  • During the 15min call, assess their availability and commitment. 
      • If the beneficiaries are not ready to start therapy, suggest resources and useful numbers they can access on the website.
  • Send an email before the 15min call to signpost them to resources on the website about what to expect from the counselling sessions and let them know that Quetzal will give them a call.

Who else can support beneficiaries to engage with counselling?

The participants discussed who else could support the beneficiaries to engage with counselling. They agreed that promoting the independence and autonomy of the beneficiaries in deciding to attend or not to attend therapy is primordial. Counsellors raised situations where external partners (support workers, mentors) forced beneficiaries to come to counselling. It impacted the therapy as the beneficiaries felt compelled to attend and did not want to. Support workers and mentors are still essential to support individuals. However, the person that decides to participate in their counselling sessions is the beneficiary. When starting therapy, the counsellor asks the beneficiary if they have a relationship with a support worker, mental health nurse or mentor currently. Only if necessary, the counsellor will ask the beneficiary if they are OK to contact their external support. 

Participants suggested that when receiving a referral from an external party, Quetzal needs to communicate that they will not share if the beneficiary started counselling or not.

How to support beneficiaries who disengage with Quetzal altogether?

Participants shared that some beneficiaries are not yet ready to start counselling. It is acceptable for beneficiaries to withdraw from Quetzal if they are not ready. To support them in their journey towards recovery from the trauma of childhood sexual abuse, participants suggested that Quetzal expands on the list of useful numbers on their website. Quetzal could also email the beneficiaries who disengage with links to resources such as the self-help guide and number to other support services (e.g. KWELL, Victim Links, Richmondhouse links). They can also remind them that they are always welcome to re-engage with Quetzal when they want to. 

What’s next

As the result of the discussion with the beneficiaries, Quetzal will 

  • develop and trial Get Ready to Counselling calls to beneficiaries before they start counselling to give them information on what to expect and assess their availability and commitment,
  •  look for funding and ask for donations to develop some short movies to share what to expect from the counselling sessions,
  • continue to monitor the number of beneficiaries who attend and do not attend their session

How can you support this project?

  • Please fill out our survey to let us know the reasons why you withdrew from therapy, cancelled or DNA your counselling session,
  • Donate to Quetzal to help us develop further resources to support female survivors in their journey towards recovery.

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