Trauma services for youth victims of sexual abuse- does one size fit all? A qualitative study among service providers in Ontario, Canada

Background: Despite a range of interventions available to treat mental health symptoms experienced by youth with a history of child sexual abuse (CSA), limited empirical work has examined practitioner delivery of these interventions in real-world practice. Objective: This paper aimed to qualitatively explore the delivery of trauma-based interventions in community settings in Ontario, Canada. Participants and settings: Using qualitative description, a purposeful sample of service providers (N = 51; 92 % female) were recruited from nine community-based organizations located in Southern Ontario, Canada providing psychotherapeutic trauma-based interventions to youth with a history of child sexual abuse. Methods: Semi-structured one-on-one (n = 17), joint (n = 3) and focus group (n = 5) interviews elicited provider descriptions of their strategies and approaches for addressing trauma-related symptoms in this population. Data were interpreted using conventional content analyses. Results: Eclectic delivery of interventions and multifactorial decision-making processes were identified as core elements of treatment planning and intervention delivery among providers. Eclectic treatment was described to involve the consideration of four core elements (provider judgement; youth voice; youth characteristics; and clinical team discussion) of intervention and three key principles (meeting youth needs; providing client-centered care; addressing safety and stability). Conclusions: Research capable of characterizing the efficacy of client-centered, eclectic approaches to treat symptoms experienced by youth with a history of CSA is needed.