Child and adolescent psychotherapists experiences of working with children, young people and families affected by online and technology-facilitated sexual risks and harms: An exploratory study

Introduction: This qualitative research study explores how child and adolescent psychoanalytic psychotherapists experience, understand, and manage clinical work with children, young people and families who have been affected by online and technology-facilitated sexual risks and harms. It aims to add to the limited research base that relates to clinical practice in this area. Methods: Data was collected from seven qualified child psychotherapists who were UK-based. Individual semi-structured interviews were conducted. Reflexive thematic analysis of the data yielded four main themes and 11 sub-themes. Main themes: 1) A significant and complex problem 2) “Are we protecting our children here?” 3) The affordances of digital technologies and the interaction with vulnerability 4) Therapeutic processes and relationship. Key Findings: Participants experienced working with this issue as a complex and sometimes disturbing task. Generational differences were highlighted between participants and young people over access to technology when growing up. Protections for children were perceived to be needed but lacking at various levels of young peoples’ interface with online risk. When sufficient internal emotional regulation and external regulation are not available to young people, risks increase. Working effectively with parents and professional networks is often key to risk management. Online sexual risks and harms were understood in relation to the developmental tasks of early adolescence. Pathways from risk to harm seem most likely to occur when young people have pre-existing vulnerabilities, such as early experiences of relational trauma. For vulnerable young people, the affordances of digital technologies may amplify the risk of experiencing harm. Space and time are needed to build trust and address complex difficulties at a manageable pace for the young person. Group and individual treatments are effective, and longer-term psychoanalytic work has value in this area.