A new study at Duke University may help therapists find better ways to treat adult victims of childhood sexual abuse who are dealing with emotions avoided for years following the traumatic experience.

The study, which began enrolling participants last week, aims to learn about both victims' experiences and their methods for coping through a series of writing sessions.

"We're trying to understand the process of coping with difficult emotions related to childhood sexual abuse," explained Elizabeth Krause, a third-year graduate student in psychology working on her doctorate and lead investigator in the study, which is being conducted at the Duke Psychology Clinic. "We're interested in survivors' own words about their trauma-related emotions, as well as in the impact of writing on their recovery."

According to Krause, a recent surge of research studies has found some health benefits -- both psychological and physical -- from writing about traumatic life experiences, but few have been conducted with a clinical population.

"There are competing theories on what it is about writing that may help," Krause said. The study will involve not only qualitative analyses of "what participants write, their insights through the process, changes in their perspective," but also evaluation of reported psychological symptoms.

The study grew from Krause's participation in a project with Susan Roth, social psychology department chairman and Krause's clinical supervisor, to write a book chapter on gender differences in coping with sexual trauma. The project gave Krause's own research some focus, her adviser said, and spurred the student to develop the study.

"We're trying to collect narratives from male and female survivors," Krause said, who developed an interest in coding personal narrative as an undergraduate in English literature at Cornell. "We want to look at the role of gender in a person's adaptation to sexual trauma. Do men and women cope differently? Is gender socialization a factor in how individuals make sense of their abuse?"

According to Roth, she expects Krause's study to provide some insight into how therapists can help trauma survivors express difficult emotions, such as anger and guilt, which as children they buried and as adults may be crippling if not faced.

"There's a lot of ambivalence in approaching trauma-related emotions directly. It can be overwhelming to people," Roth said. "Beth's work is a beginning of studying how these emotions may be narrated differently by men and women and how they can be systematically incorporated into broader attempts to give the trauma some meaning. The ultimate goal would be to understand what the best way is for male and female survivors to approach this with a therapeutic end."

The study will be conducted at the department's clinic, which serves as a training program for students in their second to fifth year of work toward their doctoral degrees. Established more than 20 years ago, the clinic developed a reputation for treatment of clients suffering from post-traumatic stress, particularly that caused by childhood sexual abuse, since both Roth and clinic director Dr. Ron Batson specialize in that area of research and treatment. However, the clinic offers treatment for a variety of other problems as well.

"In the past few years, the clinic has broadened its focus," said clinic coordinator Kimberlea Schiro-Osman. "We treat bereavement, stress, work inhibition - graduate students, undergraduates, even people in the professional sphere may have trouble getting motivated, which is usually stress related - and also do marriage or couples counseling."

The clinic serves clients from both on and off campus; about half its clients are Duke students, faculty or employees and half from the surrounding community. Unlike short-term programs like Duke's Personal Assistance Service (PAS) or Counseling and Psychological Services (CAPS), the clinic provides long-term treatment for clients, typically six to nine months, though longer as needed.

Krause expects the study, funded by an Arts & Science Research Council grant, to continue for a year or longer. To find out about becoming a participant, contact the clinic coordinator at 660-5771.

Written by Karen Hines.