5 Steps that institutions can take to protect children

We have been seeing in the media, more and more stories about the abuse of children involved with various institutions.  A recent story tells how the Jehova's Witnesses covered up abuse. In Australia, there has been a Royal Commission looking into institutional abuse. It seems each  chapter of their work reveals more breadth and depth of abuse.

In the United Kingdom, there has been the Rotherham story where 1400 children have been exploited. Authorities failed to act.

The reality is that children typically do not disclose abuse and when they do, they are telling the truth the vast majority of the time - we need to listen. So what can institutions do to better manage - here are 5 thoughts:

The long term impacts of child abuse in institutions is well documented. One only need to look at the impact of the Residential Schools in Canada. One recent story shows how one community is still tackling the impact of the St. Michael's school in Alert Bay, B.C. 

Institutions owe a duty to those in their care.

Why disclose abuse?

Child protection workers are often faced with the dilemma of abuse cases where the child simply won't confirm that the abuse took place. Part of the reason can lie in the way in which the child is asked. In an article by Reder and Duncan (2004) in the UK, they note that CPS workers are often not properly trained in how to actually talk with and interview a child. This may partially explain why some of the really high profile cases of child protection failures have included a failure to see and/or interview the child.

Yet, there is more to it. In a rather interesting article soon to be published in the journal Child Abuse and Neglect Israeli authors Katz & Barnetz remind us of some very important issues but place a new light upon them. Those children who are the recipients of physical abuse seem to less likely to dispose as the are so reliant on the parent for the essentials of life. More resistance may be encountered as the child ages. What I found rather disturbing in the research, is the ways in which some victims of physical abuse incorporate the abuse into their life - accommodating it and taking ownership of it.  They gave as examples:

“Daddy was yelling on me because I didn’t do my homework, so I told him I am sorry you are right and brought himhis belt.”

“I knew that after he is drinking he will be looking for me, so I went there and set next to him. . .after he finishedhitting me I took him to his room so he will rest a bit.”

One can hardly see a child who has so accommodated the abuse into their living reality being easily open to disclosing the abuse. As the authors go on to state:

These narratives stress the unbearable situation for the children: they know when the abuse will take place, by whom,and how, and they have no real power to end it or to prevent it from occurring. In other words, they expect their fate andlive with/near this tragedy  

They also found that when a child is being sexually abused by a parent, the child will have a greater tendency to accommodate the abuse. This seems to be particularly true when the sexual abuse is of higher severity. Lower levels may see more fight or flight behaviours.

Thus, when a child is going to be interviewed about abuse, it is vital to understand that the child may well be accommodating the abuse as they do not feel a power to do otherwise. This can have profound implications for interviewing the child. It also strongly re-enforces that the interview should be done by someone who is skilled in the task. Poorly done, one can easily imagine how that child will lose faith in the potential value of disclosing.

It would require a great deal of effort for a child to disclose when they have accommodated the abuse into their reality. They may not believe that it can be otherwise and would see no reason to try and create change given that.

Katz, C., & Barnetz, Z. The behavior patterns of abused children as described in their testimonies. Child Abuse & Neglect (2013), http://dx.doi.org/10.1016/j.chiabu.2013.08.006 

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