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Sunday, April 1, 2012

Child Sexual Abuse Disclosures

Two recent studies have offered some very important information on the issues of disclosures in child sexual abuse. The first is an Irish study which uses a qualitative grounded theory approach. This study of 22 children looked at the process of disclosure. They conclude that:

The process of confiding experiences of child sexual abuse is not linear and sequential as suggested in the early literature on child sexual abuse, but is, as Staller and Nelson-Gardell (2005) suggested, a dialogical process that is renegotiated and influenced by each experience of disclosure. (p.1169)

As they note, the disclosure process is a “stop-start” experience that occurs over the lifetime.

This research by McElvaney, Greene & Hogan, offered 3 overarching themes which will be of assistance to child protection and police investigators as well as therapists.

1.     Active Withholding – This included the subthemes of not wanting people to know; denying when asked and even experiencing difficulty saying that it did occur.  The latter is the experience of wanting to let something out but just not being able to do it.
2.     Pressure Cooker Effect – there was a build up of tension between wanting and not wanting to tell. There was also the effect of being in a state of distress about actively withholding. Telling may be the result of either an opportunity presenting itself of an unplanned disclosure.
3.     Confiding – Who to tell became important with the notion that telling needed the ability to confide in another person. Thus who was chosen was careful and might include the sharing of confidences or a need for confidentiality.

These researchers also noted that disclosure wasn’t a single event. There would be a number of occasions over the life span when the story may need to be retold or told in more or different detail. Thus, for the victim, it may well be an unfolding part of their lives.

The researchers also note in their literature review that there can be powerful influences which help us to understand why children do not disclose or may delay disclosure until later in life. These might include fear of the perpetrator or fear of the consequences of telling. Other factors might include other pressures not to tell. The child’s own guilt that they may be responsible for the abuse as well as considering the costs and benefits of telling. It is important that disclosing always comes with some level of internal and / or external costs.

The second important piece of research is by Allen & Tussey who conduct a systematic review of whether or not projective drawings can be effectively used to detect if a child has been sexually abused. Given the research above, that would be helpful if it could. There have certainly been claims from various corners that this is possible.  This research review carefully considers the literature and concludes:

The current literature review demonstrates that attempts to identify projective indicators of sexual and physical abuse in drawings completed by children are not supported by the existing evidence. (p.12)

This conclusion has very significant legal implications for mental health professionals. This really means that projective drawings should not be used and that any such use is unlikely to meet the Daubert or Frye tests in the United States. They are also not likely, in my view, to meet the Mohan test in Canada. This is:

(1) Test for Admission of Expert Evidence

[13] The test for the admission of expert evidence is well-established and undisputed on this appeal. At the first stage of the admissibility inquiry, the party seeking to tender expert evidence must establish on a balance of probabilities that the proffered evidence is: (1) relevant; (2) necessary; (3) not subject to any applicable exclusionary rule; and (4) to be advanced through the testimony of a properly qualified expert. Where these four preconditions to admissibility are satisfied, the second stage of the admissibility inquiry obliges the trial judge to engage in a contextual weighing of the probative value and significance of the proffered evidence to the case against the potential prejudice that could flow from its admission. See R. v. Abbey (2009), 97 O.R. (3d) (C.A.), leave to appeal refused (2010), 409 N.R. 397 (note); R. v. Mohan, [1994] 2 S.C.R. 9. (as cited in R. v. Boswell, 2011 ONCA 283)

While the Canadian test is different, the qualified expert must still tender evidence that is reliable. An expert relying on these projective tools may now well be more directly challenged on the credibility of the evidence when the research of Allen & Tussey is considered.


Allen, B. & Tussey, C. (2012). Can projective drawings detect if a child experienced sexual or physical abuse?: A systematic review of the controlled research. Trauma, Violence & Abuse, published online first. doi: 10.1177/1524838012440339

McElvaney, R., Greene, S. & Hogan, D. (2012). Containing the secret of child sexual abuse. Journal of Interpersonal Violence, 27 (6), 1155-1175. doi: 10.1177/0886260511424503

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