Child sexual abuse is both a global problem and a crime to which there are seldom any witnesses and which more often than not remains undetected. Disclosure by sexually abused children is the most effective method by which assistance and intervention can be provided in a timely fashion. However, there are several barriers to such disclosure.
The purpose of this paper is to review and describe the major barriers to disclosure of child sexual abuse and explore the methods to overcome these barriers. The paper reviews literature about child sexual abuse and disclosure with a key focus on identifying the barriers to disclosure and the methods to eliminate such barriers.
2.1 Search Strategy
Searches were made of databases containing scientific peer-reviewed articles including
Medline and Google Scholar. Key words used in the search terms included “child sexual abuse”
or “child sexual assault” and, “disclosure” or “telling” or “revealing” or “talking about”
2.2 Qualitative Research
The following research methodology is proposed. A sample of physicians and social workers shall be selected with the help of the city council. As a first step they shall be asked to respond to a questionnaire that gives the researcher an informed idea of how many cases each member of the sample population has handled and what was their initial response to the cases. With this information, the population shall be divided into two groups – group which had biased initial responses and another group which chose to make informed response to the victim. Following this, one-on-one interviews shall be conducted with members of the same group. Post interview, their responses shall be clubbed into smaller subgroups based on the similarity of case and the response to it. This data shall then be used to infer whether there was willing disclosure; if yes, then in how many cases and why. And in cases where there was no willing disclosure, then in how many cases and why. This method will help the researcher understand the barriers to disclosure in child sexual abuse. Once the barriers are identified, methods can be implemented to overcome them.
3. Literature Review
Child sexual abuse or CSA remains one of society’s silent problems that needs attention from the scientific community. Abuse is established if there in non-consensual relations between a child and anyone 5 or more years older than the child. While social authorities and the police have systems to address sexual abuse issues, the starting point of intervention and assistance is disclosure. Studies around the world have revealed a common denominator – most child sexual abuse remains undisclosed. There are various causes for non-disclosure including fear of authority, family environment, confusion, gender of the victim and perceived societal roles . Even when there is disclosure, not all cases are reported to the authorities and even when they are reported, the difficulty in accurately diagnosing CSA (due to the lack of or inconclusiveness of definitive medical and physical evidence) proves to be a major impediment for social authorities . Depending on the nature of abuse, child sexual abuse is generally categorized broadly as non-contact, contact-based and penetrative . The classification is not applied to the severity of the abuse as any one type of abuse may have a severe impact on the child who experiences it. While fairly extensive research is available in the area of child sexual abuse, a major challenge that presents itself to research is that abuse is not reported or in the cases that it is reported, a majority of the times it may not be visible to the adult society. Most children end up disclosing the abuse to one of their peers and no one else. It has also been observed that while girls are likely to disclose to someone, boys may never disclose to anyone at all. This result in few children getting access to the professional system but what has also been observed is that even in cases where disclosure has happened, social authorities and the police may not be contacted. It is also seen that while a caring and protective family does not exclude the chances of abuse, unstable family structures lead to greater chances of CSA . Children from such families are also less likely to disclose CSA than in families where parents are perceived as caring and protective but not over protective.
Therefore the major barriers to disclosure can be identified as fear, confusion, perceived societal roles, gender, family environment, physician/social worker response and lack of knowledge of what constitutes sexual abuse.
Fear, confusion and gender, perceived societal roles
The first major obstacle to disclosure is fear – fear of being not believed, fear of being seen as homosexual (in male children), and fear of retribution from authorities or peers (Sorsoli et al, 2008). Children also have the fear that abusers have the ability to hurt their families, and the fear that they might be taken away from their families because they are to blame . Studies have also shown that children maybe confused about who was responsible for the abuse. Older children, more than younger ones, are likely to hold themselves responsible for the abuse (London et al, 2008). This leads to mistrust; children don’t know whom they can trust with the disclosure. Gender differences also form a key component of barriers to disclosure. Boys more than girls are likely to not report abuse mostly due to the belief that boys are never the victims (Sorsoli et al, 2008). Girls on the other hand may disclose abuse more than boys, but even then girls from different backgrounds disclose at different rates (London et al, 2008).
Family environment and cultural barriers
The family plays a critical role in both the occurrence of CSA and its disclosure. In families where there is abuse of other nature including substance abuse and domestic violence, the chances of CSA correspondingly increase (Allnock & Miller, 2013). If the abuse is by a family member or members, children tend to delay disclosure (London et al, 2008). A supportive family on the other hand results in earlier disclosure, especially when there is more maternal support.
In addition there are significant cultural barriers as well. Both London et al (2008) and Gilligan & Akhtar (2006) have noted that children growing up in Eastern culture families are more inclined to conceal abuse than those raised in Western culture. Eastern cultures emphasize on the collective over the individual whereas it is the opposite in the Western culture. London et al (2008) noted that African American children may have more maternal support than Hispanic children and therefore tend to disclose earlier. In the Asian communities the concepts of honor and modesty are given a lot of emphasis which create severe impediments in the disclosure and response to CSA. In some communities there is also a minority outlook that CSA is perpetrated only in white communities. Even within non-white communities, in the UK, black communities are represented more in the children receiving child protection services. Asian communities are under-represented; lack of disclosure leads to victims of CSA not receiving timely and relevant services and interventions. Apart from this, there are gender-based cultural perceptions that lead to lack of disclosure (RCIRCSA); boys don’t disclose abuse so they won’t be labeled homosexual. In some cultures girls don’t disclose because they will become unsuitable for marriage. In addition to a society’s culture, there is also institutional culture that stops children from disclosing abuse. If children perceive an institution as being non-responsive, they will not open up. Support institutions are more often than not, ill-equipped to manage the cultural differences. Support personnel like social workers, physicians and police officials may not be sensitized to the victims culture (RCIRCSA), (Gilligan & Akhtar, 2006).
Professionals like social workers and physicians
Professionals like social workers, teachers and physicians who work closely with children also face certain barriers when taking abuse histories and reports . In many cases it is because of the victim’s preferences (professional should be of same gender or of same culture) or it could be because of victim’s needs and concerns or because of the psychological condition of the victim. In other cases, the professionals find they may not be equipped to initiate or continue with the disclosure process. Some fear inducing false memories or additional memories of abuse, some find the process embarrassing, some professionals like teachers and even clinicians may not be trained to handle a CSA disclosure (Young et al, 2001). As discussed in the previous section, an initial failure to handle disclosure might result in the child perceiving the entire institution as unresponsive to their disclosure. This translates to further barriers to disclosure.
Overcoming the barriers
The key component to overcoming barriers to disclosure is education, both for the victim and the professionals involved. Children need to be empowered to speak up about abuse (RCIRCSA). They need to be educated on what all constitutes abuse, who they should reach out to and what happens after disclosure. Fear and confusion needs to be addressed by building trust and in a manner that is sensitive to the victims, their families and their cultures. The aim should be to ensure that the victims receive appropriate care and support at the earliest.
Training caregivers and other professionals
Caregivers and other professionals who regularly work with children need to be trained to look out for signs of abuse and to address concerns by listening, believing and responding appropriately. For example school teachers should be made aware that children are more likely to disclose CSA to their peers and therefore teachers need to be open to addressing the concerns raised by friends of the victims (Priebe & Svedin, 2008). Awareness of CSA and how to address the issue should become part of the school curriculum.
Sensitizing professionals on disclosure and CSA
Professionals also need to be trained on how to sensitively deal with victims from various cultural backgrounds so that the disclosure process continues uninterrupted (Gilligan & Akhtar, 2006). It is essential the victims (RCIRCSA) and their families (Gilligan & Akhtar, 2006) feel that they are in control of the disclosure process. Families and victims often worry about the consequences of disclosure. Support personnel need to be able to clearly state what will happen after disclosure and how it will make things better. Gender sensitization is also required as boys and girls respond differently to disclosure about CSA (Sorsoli et al, 2008).
The culture of institutions like the police and social services needs to become more responsive to the victims. Institutions must train their personnel in techniques to identify CSA and how to manage the disclosure process. In fact, institutions instead of working in isolation should develop interdisciplinary training methods and policies (Young et al, 2001). Institutions must confirm that victims will be heard no matter who perpetrated the crime (RCIRCSA). Institutions must equip themselves to manage disclosures from different types of victims, namely, victims with disabilities, victims from conservative cultures, and victims from disadvantaged backgrounds.
4. Anticipated Findings
Following the review of the literature on the subject, it is expected that the proposed research shall bring forward data that shows what are the current practices in management of CSA disclosure. By comparing the current practices with the literature, the gaps in the disclosure process will become apparent.
5. Implications for Future Research
Once the gaps in the current process can be identified, the next step would be to address the gaps. Further research can be conducted with a focus on gender and culture and how the differences in disclosure that arise from these two factors can be addressed both by the families of the victims and the institutions that are designed to provide intervention and support.
Allnock, D., & Miller, P. (2013). No one noticed, no one heard: a study of disclosures of childhood abuse. NPSCC .
Gilligan, P., & Akhtar, S. (2006). Cultural barriers to the disclosure of child sexual abuse in Asian communities. Retrieved April 10, 2016, from University of Bradford: https://bradscholars.brad.ac.uk/bitstream/handle/10454/2718/Gilligan%20Cultural%20barriers%202004.pdf?sequence=3&isAllowed=y
London, K., Bruck, M., Ceci, S., & Shuman, D. (2005). DISCLOSURE OF CHILD SEXUAL ABUSE: What Does the Research Tell Us About the Ways That Children Tell. Psychology, Public Policy, and Law , 194–226.
Priebe, G., & Svedin, C. G. (2009). Child sexual abuse is largely hidden from adult society. Child abuse & neglect .
RCIRCSA. (n.d.). Royal Commission into Institutional Responses to Sexual Abuse. Retrieved April 12, 2016, from childabuseroyalcommission.gov.au: http://www.childabuseroyalcommission.gov.au/
Sorsoli, L., Kia-Keating, M., & Grossman, F. K. (2008). “I Keep That Hush-Hush”: Male Survivors of Sexual Abuse and the Challenges of Disclosure. Journal of Counseling Psychology , 333–345.
Young, M., Read, J., Barker-Collo, S., & Harrison, R. (2001, August). Evaluating and overcoming barriers to taking abuse histories. Professional Psychology Research and Practice .