{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:04:23Z","timestamp":1793131463548,"version":"4.5.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T00:00:00Z","timestamp":1700179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["Canadian Graduate Scholarship (Canadian Institutes of Health Research)"],"award-info":[{"award-number":["Canadian Graduate Scholarship (Canadian Institutes of Health Research)"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Difficulties in access to therapy were highlighted by COVID-19 measures restricting in-person gatherings. Additional challenges arise when focusing on caregivers of child sexual abuse (CSA) survivors in particular, which are a population that has been historically difficult to engage with due to issues of stigma and confidentiality.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To present preliminary qualitative results from caregivers of CSA survivors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This study was conducted with caregivers of CSA survivors. Two hybrid webinar\/focus groups were conducted using a video conferencing platform in fall of 2021 with two groups of stakeholders (11 caregivers and 5 moderators\/clinical staff at Little Warriors, an intensive episodic treatment facility). Sessions were recorded, transcribed, and thematically-analyzed using standard qualitative methodology.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 11 caregivers contributed to the data. Themes include: (1) Challenges of starting and maintaining treatment (i.e., emotional impact of intake day, challenges of enrolling), (2) Therapeutic benefits of specialized treatment (i.e., feeling safe and supported and the importance of trauma-informed care), and (3) Barriers and facilitators of treatment (i.e., avenues to scale-up and self-care).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The importance of a strong therapeutic alliance was highlighted by both caregivers\/clinical staff and further support is needed for families post-treatment. The present hybrid webinar\/focus group also achieved engagement goals in a population that is typically difficult to reach. Overall, the response rate (12%) was equivalent to reported registrant attendance rates for general business to consumer webinars and the recommended focus group size. This preliminary approach warrants replication in other populations outside our clinical context.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0294686","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T18:24:42Z","timestamp":1700245482000},"page":"e0294686","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Access to therapy for child sexual abuse survivors: Preliminary dialogue of barriers and facilitators between caregivers"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7264-7215","authenticated-orcid":true,"given":"Jonathan","family":"Jin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huda","family":"Al-Shamali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Smith-MacDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Reeson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanda","family":"Polzin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifeng","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Pazderka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Silverstone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9097-900X","authenticated-orcid":true,"given":"Andrew J.","family":"Greenshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,11,17]]},"reference":[{"key":"pone.0294686.ref001","article-title":"Fact sheet on child maltreatment [Internet","author":"World Health Organization","year":"2022"},{"issue":"12","key":"pone.0294686.ref002","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1177\/0706743719861387","article-title":"Child sexual abuse among a representative sample of Quebec high school students: prevalence and association with mental health problems and health-risk behaviors.","volume":"64","author":"M H\u00e9bert","year":"2019","journal-title":"The Canadian Journal of Psychiatry"},{"issue":"6","key":"pone.0294686.ref003","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1177\/0004867416667232","article-title":"The long-term co-occurrence of psychiatric illness and behavioral problems following child sexual abuse","volume":"51","author":"NL Papalia","year":"2017","journal-title":"Australian & New Zealand Journal of Psychiatry"},{"issue":"2","key":"pone.0294686.ref004","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.chc.2014.01.003","article-title":"Child sexual abuse.","volume":"23","author":"LK Murray","year":"2014","journal-title":"Child and Adolescent Psychiatric Clinics."},{"issue":"2","key":"pone.0294686.ref005","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1177\/1524838017697312","article-title":"Facilitators and barriers to child sexual abuse (CSA) disclosures: A research update (2000\u20132016).","volume":"20","author":"R Alaggia","year":"2019","journal-title":"Trauma, Violence, & Abuse."},{"key":"pone.0294686.ref006","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.chiabu.2015.09.009","article-title":"Caregiver perceptions about mental health services after child sexual abuse.","volume":"51","author":"HF Fong","year":"2016","journal-title":"Child Abuse & Neglect."},{"issue":"5","key":"pone.0294686.ref007","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1177\/1524838016673601","article-title":"\u201cI still feel like I am not normal\u201d: A review of the role of stigma and stigmatization among female survivors of child sexual abuse, sexual assault, and intimate partner violence.","volume":"19","author":"AC Kennedy","year":"2018","journal-title":"Trauma Violence Abuse."},{"issue":"5","key":"pone.0294686.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/3234942","article-title":"Social support, reciprocity, and anonymity in responses to sexual abuse disclosures on social media","volume":"25","author":"N Andalibi","year":"2018","journal-title":"ACM Transactions on Computer-Human Interaction (TOCHI)."},{"issue":"2","key":"pone.0294686.ref009","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/car.2617","article-title":"What helps children tell? A qualitative meta\u2010analysis of child sexual abuse disclosure.","volume":"29","author":"E Brennan","year":"2020","journal-title":"Child Abuse Rev."},{"issue":"23\u201324","key":"pone.0294686.ref010","doi-asserted-by":"crossref","first-page":"4765","DOI":"10.1177\/0886260519871530","article-title":"A trauma-informed approach to sexual violence research ethics and open science","volume":"34","author":"R Campbell","year":"2019","journal-title":"J Interpers Violence"},{"issue":"12","key":"pone.0294686.ref011","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1016\/S0145-2134(97)00095-1","article-title":"Focus groups with children: A resource for sexual abuse prevention program evaluation.","volume":"21","author":"LW Charlesworth","year":"1997","journal-title":"Child Abuse Negl."},{"key":"pone.0294686.ref012","doi-asserted-by":"crossref","first-page":"105926","DOI":"10.1016\/j.chiabu.2022.105926","article-title":"Child sexual abuse survivors: Differential complex multimodal treatment outcomes for pre-COVID and COVID era cohorts.","volume":"134","author":"M Reeson","year":"2022","journal-title":"Child Abuse Negl."},{"issue":"8","key":"pone.0294686.ref013","doi-asserted-by":"crossref","first-page":"e0203127","DOI":"10.1371\/journal.pone.0203127","article-title":"Recruitment and retention strategies in mental health trials\u2013a systematic review.","volume":"13","author":"Y Liu","year":"2018","journal-title":"PLoS One."},{"issue":"9","key":"pone.0294686.ref014","doi-asserted-by":"crossref","first-page":"454","DOI":"10.3390\/educsci11090454","article-title":"Examining recruitment practices for servingness during COVID-19: Perspectives from institutional agents at an emerging Hispanic-serving institution (HSI).","volume":"11","author":"N Deeb-Sossa","year":"2021","journal-title":"Education Sciences."},{"key":"pone.0294686.ref015","article-title":"39 Webinar Statistics 2022 \u2013Effectiveness, Attendance and All [Internet].","author":"S. Bennett"},{"key":"pone.0294686.ref016","first-page":"185","volume-title":"InHealthcare Management Forum","author":"J Cowell","year":"2012"},{"issue":"8","key":"pone.0294686.ref017","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1080\/0142159X.2020.1755030","article-title":"Thematic analysis of qualitative data: AMEE Guide No. 131.","volume":"42","author":"ME Kiger","year":"2020","journal-title":"Med Teach."},{"issue":"2","key":"pone.0294686.ref018","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology.","volume":"3","author":"V Braun","year":"2006","journal-title":"Qual Res Psychol."},{"issue":"1","key":"pone.0294686.ref019","doi-asserted-by":"crossref","first-page":"1609406917733847","DOI":"10.1177\/1609406917733847","article-title":"Thematic analysis: Striving to meet the trustworthiness criteria.","volume":"16","author":"LS Nowell","year":"2017","journal-title":"Int J Qual Methods."},{"key":"pone.0294686.ref020","doi-asserted-by":"crossref","DOI":"10.1016\/0147-1767(85)90062-8","volume-title":"Naturalistic inquiry","author":"YS Lincoln","year":"1985"},{"issue":"5","key":"pone.0294686.ref021","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1111\/j.1365-2648.1994.tb01177.x","article-title":"Establishing rigour in qualitative research: the decision trail.","volume":"19","author":"T. Koch","year":"1994","journal-title":"J Adv Nurs."},{"issue":"9","key":"pone.0294686.ref022","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations.","volume":"89","author":"BC O\u2019Brien","year":"2014","journal-title":"Academic medicine."},{"key":"pone.0294686.ref023","article-title":"Are we there yet?","author":"PI Fusch","journal-title":"Data saturation in qualitative research"},{"key":"pone.0294686.ref024","article-title":"Consensus conference manual.","author":"AP Nielsen","year":"2006","journal-title":"LEI, onderdeel Wageningen UR"},{"issue":"5","key":"pone.0294686.ref025","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1192\/bja.2018.29","article-title":"A paradigm shift: relationships in trauma-informed mental health services.","volume":"24","author":"A Sweeney","year":"2018","journal-title":"BJPsych Adv."},{"key":"pone.0294686.ref026","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.brat.2018.05.008","article-title":"Treatment processes and demographic variables as predictors of dropout from trauma-focused cognitive behavioral therapy (TF-CBT) for youth.","volume":"107","author":"C Yasinski","year":"2018","journal-title":"Behav Res Ther."},{"issue":"12","key":"pone.0294686.ref027","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1037\/ccp0000147","article-title":"In-session caregiver behavior predicts symptom change in youth receiving trauma-focused cognitive behavioral therapy (TF-CBT).","volume":"84","author":"C Yasinski","year":"2016","journal-title":"J Consult Clin Psychol."},{"key":"pone.0294686.ref028","doi-asserted-by":"crossref","first-page":"101418","DOI":"10.1016\/j.avb.2020.101418","article-title":"Identifying and addressing barriers to treatment for child sexual abuse survivors and their non-offending caregivers.","volume":"52","author":"K Theimer","year":"2020","journal-title":"Aggress Violent Behav."},{"issue":"5","key":"pone.0294686.ref029","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1177\/1744987107079791","article-title":"Conducting focus groups with children and young people: strategies for success","volume":"12","author":"F. Gibson","year":"2007","journal-title":"Journal of research in nursing"},{"issue":"10","key":"pone.0294686.ref030","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1111\/jgs.15437","article-title":"Development of a clinically feasible process for identifying individual health priorities","volume":"66","author":"AD Naik","year":"2018","journal-title":"J Am Geriatr Soc"},{"issue":"6","key":"pone.0294686.ref031","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1080\/13645579.2017.1281601","article-title":"Comparing focus groups and individual interviews: findings from a randomized study.","volume":"20","author":"G Guest","year":"2017","journal-title":"Int J Soc Res Methodol."},{"issue":"2","key":"pone.0294686.ref032","article-title":"Strategies to improve recruitment to randomised trials.","author":"S Treweek","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"issue":"3","key":"pone.0294686.ref033","doi-asserted-by":"crossref","first-page":"e6980","DOI":"10.2196\/jmir.6980","article-title":"Virtual versus in-person focus groups: Comparison of costs, recruitment, and participant logistics","volume":"19","author":"DJ Rupert","year":"2017","journal-title":"Journal of Medical Internet Research"},{"issue":"3","key":"pone.0294686.ref034","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1177\/002076409604200303","article-title":"Focus groups in mental health research: enhancing the validity of user and provider questionnaires.","volume":"42","author":"RA Powell","year":"1996","journal-title":"Int J Soc Psychiatry."},{"issue":"3","key":"pone.0294686.ref035","first-page":"256","article-title":"Focus group discussion: a tool for health and medical research.","volume":"49","author":"LP Wong","year":"2008","journal-title":"Singapore Med J."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294686","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T18:25:03Z","timestamp":1700245503000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294686"}},"subtitle":[],"editor":[{"given":"Ayi Vandi","family":"Kwaghe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,11,17]]},"references-count":35,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0294686","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,17]]}}}