An accurate, comprehensive personal history is crucial for therapists to get to the root of a client’s challenges, and it helps them look beyond surface-level symptoms to understand how past events and relationships have shaped the client’s harmful behaviors. By connecting current issues with past experiences, therapists can identify recurring patterns and provide the necessary context for accurately assessing a client’s treatment needs and reducing the risk of misdiagnosis.

Research suggests a correlation between past trauma and subsequent sexual offending. Indeed, many individuals convicted of sexual offenses perceive their own victimization experiences as “100% linked” or “very integral” to their offending behavior (Grady et al., 2022).

By incorporating factors from a client’s personal history, a treatment provider can:

• Address underlying issues contributing to the client’s offending behavior
• Develop a more individualized, effective treatment plan
• Move beyond focusing solely on the offense itself

Obtaining an accurate, comprehensive personal history of a client allows for a more nuanced understanding of the individual and their path to offending, potentially improving the client’s treatment outcome and reducing the risk that the client will recidivate.

Challenges to Obtaining Personal Histories in Cases of Sexual Abuse

Many mental health professionals recognize that effective treatment relies on gaining a comprehensive understanding of the client during the intake process prior to the treatment itself. However, eliciting a thorough and accurate personal history from a client can be challenging. This is particularly evident in cases involving those who have committed sexual offenses. Psychological, legal, and social barriers often hinder open communication in these cases. Overcoming these challenges requires patience, skills, and a focus on building trust between the client and the professional.

As Steven Sawyer, a Licensed Clinical Social Worker with extensive expertise in sexual abuse prevention, said in a recent training with Safer Society:

“Our clients are defended. Naturally. It’s human nature to walk in cautious and maybe a little afraid. It’s painful for them, and oftentimes they’re not fully truthful in the beginning. Also, their anxiety gets in the way of memory… not to mention resistance or anger or resentment at the criminal justice system or grief about loss that they experienced during the investigation and prosecution process.”

Additional challenges in collecting thorough personal histories include:

• Fear of Self-Incrimination – Clients involved in sexual offense cases may withhold information due to concerns that their words could be used against them in legal proceedings.
• Shame and Guilt – Intense feelings of embarrassment, remorse, or self-condemnation over their actions can make it difficult for clients to discuss their past openly.
• Denial or Minimization – Some clients may refuse to acknowledge the allegations against them, or they may distort details, making it difficult to obtain an accurate history.
• Distrust of Authority Figures – The perception of previous negative experiences with law enforcement, the legal system, or mental health professionals may make clients reluctant to be forthcoming with their therapist.
• Defensive or Resistant Attitude – Some clients enter therapy only because it is court-mandated, and so they may resist meaningful engagement because they view the process as punitive rather than helpful.

Unique Features of the Your Personal History Workbook

Steven Sawyer has extensive experience working with clients in need of structured psychosexual assessments and understands the importance of asking highly personal questions during evaluations and court proceedings. To address the challenges of obtaining personal histories, Sawyer offers some clients the option to provide written responses to questions before discussing them in a session. This approach serves multiple purposes: it allows clients to reflect and respond to difficult questions in a less pressured environment while enabling clinicians to use face-to-face time more efficiently—focusing on follow-up questions and clarification rather than spending valuable session time taking detailed notes.

Building on his experience with these client issues, Sawyer created Your Personal History, a workbook designed to help professionals obtain comprehensive and accurate personal histories while guiding clients toward their goals. Sawyer has incorporated unique approaches into this resource to help therapists overcome common challenges in gathering sensitive information. By providing tools that facilitate understanding of a client’s past and actionable steps for their future, this workbook stands out as an invaluable aid for practitioners striving to make meaningful progress with their clients. The workbook includes:

• Carefully Structured Exercises: Sawyer is aware of the factors that contribute to client hesitancy to be fully open in their disclosures to therapists. This is why the exercises are structured in such a way that they begin with basic personal and health information before asking clients to reflect on and discuss more sensitive topics such as alcohol and drug use, sexual abuse histories, pornographic use, and their involvement with the law.

• Age Table: A unique feature of this book is Sawyer’s use of an “age table.” The table serves as a memory aid to help individuals recall and organize life events based on different stages in their lives. For example, before being asked about long-term intimate relationships, clients use the table to recall and organize which relationships occur at what particular points in their lives.

• Detailed and Specific Questions: The workbook includes pointed questions about family dynamics, past traumas, addictions, legal history, and sexual behavior. These targeted prompts reduce ambiguity and encourage more honest and thorough responses.

Sawyer emphasizes three aspects of treatment with which a tool such as Your Personal History can be of use:

1. Self-reflection. The process of answering the array of questions will
   cause the client to think about their situation and prompt self-assessment.
2. Intake. When given to the client prior to intake, the responses will
   provide invaluable information to support the intake process.
3. Evaluations. Client responses to these comprehensive questions will be
   available for court-ordered and psycho-sexual evaluations in one convenient
   reference.

“The workbook questions set the stage for self-reflection. I want my clients to, from the moment they start, be engaged and looking at themselves. This is a step where we can start to peel away some of that armor that they’ve had up for so long. – Steven Sawyer

Train with Steven Sawyer!

• Clients’ Personal Histories – Collecting Helpful Information

References:

• Grady, M. D., Levenson, J. S., Glover, J., Kavanagh, S., & Carter, K. (2022). “Hurt people hurt other people“: The link between past trauma and sexual offending. Sexual Offending: Theory, Research, and Prevention, 17, Article e7361. 
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