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Tuesday, December 24, 2013

What supports sexual abuse disclosure?

In 2011, I had the privilege of delivering the annual lecture sponsored by the Tulir Centre for the Prevention and Healing of Child Sexual Abuse. They are located in Chennai, India. I was speaking on the sexual abuse by a sibling or juvenile. An individual in the audience found it hard to believe that the majority of victims are not disclosing the abuse almost immediately after it happens. I was reminded of this upon reading a newly published study in the Journal of Interpersonal Violence. McElvaney, Greene & Hogan have raised a number of very fascinating points. The article is well worth a read including their literature review in the introduction.


These researchers helped to identify that there may be a difference in the data from studies that have been done on a prosecution sample (where there has been disclosure in some way) and in studies where there has not been the involvement of the criminal justice system. They note that in research studies, there is a substantial group who has never told prior to being asked in the study - this ranged from 19% up to 47%. Silence is real.

The longer the delay in telling, the harder it may be to seek help. Further, given the link between child sexual abuse and subsequent traumatization through sexual assault and abuse, it may be even harder as trauma builds upon trauma.  There are many barriers to disclosure which the authors identify including shame, guilt, the risk to the family or the perpetrator and fear of reactions by others. I was particularly interested in the notion of the victim needed to weigh the consequences of a disclosure creating a pressure cooker effect - the wish to tell and the wish to keep it secret. This is a wonderful insight that serves as a useful reminder that disclosure is often an extremely challenging decision.

These authors found 5 themes from they qualitative research with both victims and parents:


  1. The fear of not being believed although those fears often turned out to be unfounded once the disclosure was made;
  2. Being asked is a way in which disclosure occurs.There were also those in the study who felt that someone (an adult) must have known it was happening;
  3. Shame and Self Blame was another theme;
  4. Fear and concerns for self and others - for example the fear that a disclosure would break up the family or that the victim would be unsafe or get int trouble; and
  5. Peer influence in that first disclosures often happened to a peer.
There is a need to be aware of these barriers when working with those who may have been abused. As the researchers noted, many parents were "incredulous" when the child disclosed. It was not something that was meant to happen in their own family. 

A child who has yet to disclose may have some or all of these barriers in place - each one of them being quite powerful in and of themselves. Imagine the impact of several at once.

In my own work, I have seen time and time again, various disclosures simply because I have asked. This research affirms that. 

An already hurt and wounded child does not want to spread the pain - hurt the family; cause a family member to be gone; create more vulnerability as well as the fear of retaliation. One feature that may be useful in creating disclosure, beyond creating safety for the child, is to ensure that the perpetrator does not hurt others. Thus, disclosure can protect siblings or other children. This seemed to matter. But, of course, little will occur if the child believes that disclosure will create a further lack of safety.

Reference:

McElvaney, R., Greene, S. & Hogan, D. (2013). To tell or not to tell? Factors influencing young people's informal disclosures of child sexual abuse. Journal of Interpersonal Violence, published online 27 November 2013. http://dx.doi.org//10.1177/0886260513506281 


3 comments:

  1. Thanks for the article. I'm researching the incidence of sexual abuse that initiates during bath time when it is considered not only normal but necessary to be with a naked child, touch the private areas of a naked child (when washing), sometimes be naked with a naked child (co-bathing between siblings or between child and adult caregiver), all in a private room often with a closed door. Have you ever had any such incidences and have you ever asked about bathtime during interviews? az@teamlgs.com

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  2. I am aware that such allegations do emerge and have seen a few cases. I am not aware of any research on the topic.

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  3. Good stuff again, Peter. Thanks!

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