Health Care and Female Survivors of Childhood Sexual Abuse: Health Professionals' Perspectives

The present study explored health professionals' experiences with adult survivors of child sexual abuse in New Zealand. Face-to-face, semistructured interviews of up to an hour took place with 13 health professionals. The participants were asked about training, screening practices, their response to disclosures, and advice to other health professionals. A model—transition to ethical practice—emerged from the data, where delivering more sensitive health care to child sexual abuse survivors sits on a continuum from lack of awareness of child sexual abuse to delivery of care where all patients are comfortable. We recommend making sensitive care for all as the standard care of practice and providing training for health professionals on how to deal with disclosures.     

The Effect of Severe Child Sexual Abuse and Disclosure on Mental Health during Adulthood

This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy.     

Psychological and Physical Health of Nonoffending Parents After Disclosure of Sexual Abuse of Their Child

Disclosure of child sexual abuse can be traumatic for nonoffending parents. Research has shown its impact on mothers’ mental health, which includes heightened psychological distress, depression, and post-traumatic stress disorder. Very little is known, however, about its impact on their physical health or on fathers’ health. The self-perceived mental and physical health of nonoffending parents after child sexual abuse disclosure was compared to determine gender-related differences in this regard. Interviews were conducted with 109 mothers and 43 fathers of 6- to 13-year-old sexually abused children. Bivariate analyses revealed that a fair proportion of parents reported psychological and physical problems after disclosure. However, proportionally more mothers than fathers reported psychological distress, depression, and use of professional services. Fathers were more likely to resort to health services instead of social services and to use medication for depression. Study findings provide leads for health and social service providers for the development of intervention protocols and referral procedures sensitive to gender issues, and they shed new light on specific needs of nonoffending parents.     

Positive Reaction to Disclosure and Recovery from Child Sexual Abuse

ABSTRACT

Factors associated with improvement in the behavioral-emotional functioning of sexually abused children, from 6 to 18 years of age, were investigated. Children were classified by their therapist according to current level of disclosure regarding past abuse. Ratings of degree of support offered by significant people in the children's lives were also made. Findings showed children who were in an actively disclosing stage to be exhibiting significantly less externalizing behavior problems than non-disclosing children. Children who were fully disclosing without recantation showed significantly lower dissociation than did all other subjects. Children who recanted with or without re-disclosure showed significantly more post-traumatic stress symptomatology. As all the subjects were in foster care, the reactions to disclosure of foster parents proved to be most salient with respect to current functioning. Children who received full support from foster parents showed significantly lower depression scores than did children who received only partial support.

Other significant findings pertain to the effects of time since initial disclosure, age of subjects, and type of sexual abuse on behavioral-emotional functioning. Implications for developing structured training programs for foster parents and their caseworkers are discussed. Recommendations are made for future study using the present design with a non-foster care population and investigating the effect that the timing of supportive reactions to disclosure has.     

Disclosure of Child Sexual Abuse as a Life‐Long Process: Implications for Health Professionals

One of the aims of this research project was to develop a fuller understanding of the process of disclosure of child sexual abuse. Face‐to‐face in‐depth interviews were conducted with 22 men and women aged 25 to 70 years old, who had an early sexual experience at the age of 15 or under with someone of 18 or over. Narrative inquiry methodology was used and data was analysed using Rosenthal and Fischer‐Rosenthal's (2004) process of data analysis. Disclosure can be conceptualised as a complex and life‐long process, and most participants did not make a selective disclosure until adulthood. The findings extend Alaggia's (2004) model of disclosure to include the life stage and the person to whom the disclosure is being made. The main barriers to disclosure and possible gender differences are discussed. Family therapists need to manage the challenges inherent in disclosure of child sexual abuse at any age.     

A Psychosocial Understanding of Child Sexual Abuse Disclosure Among Female Children in South Africa

Child sexual abuse is endemic in South Africa, driven by high levels of gender-based violence and underscored by structural and social factors. This article aims to develop an understanding of the process of disclosure in a sample of female children and their caregivers. In-depth semistructured interviews were conducted with 31 female children aged 8–17 years and their caregivers at 3 intervals after presentation to a sexual assault treatment center. Nearly half of the children failed to disclose the sexual abuse immediately, fearing caregivers’ reaction. Most children purposefully disclosed to a confidant through a process of identifying an intermediary to tell caregivers on their behalf. The process of disclosure was influenced by multiple factors, such as a fear of the caregiver’s reaction and disbelief, which is related to parental style. Disclosure was found to be a dynamic process that unfolds and not a single or static event and influenced by multiple factors which all impact on recovery. Our findings highlight the need to address social norms on sexual abuse in order to improve responses to disclosure to facilitate post-sexual-abuse adjustment for the child and the family.     

The Impact of a History of Child Sexual Abuse on Maternal Response to Allegations of Sexual Abuse Concerning Her Child

Mothers exhibit a wide range of emotional responses to the discovery that their children may have been sexually abused. The clinical lore suggests that a personal history of child sexual abuse (CSA) may influence maternal reactions to such a discovery. Interestingly, however, while the impact of a history of CSA has been examined in many different populations, the impact of such a history has rarely been studied with respect to nonoffending mothers of CSA victims. The current investigation, therefore, aimed to compare nonoffending mothers with and without a history of CSA with respect to demographic variables, psychosocial functioning, and personal responses to the CSA allegations concerning their children. Nonoffending mothers with a history of CSA exhibited more general symptom distress as measured by the SCL-90-R and reported greater feelings of aloneness in facing the crisis of the CSA allegations. However, maternal history of CSA did not differentiate the groups with respect to demographic variables or maternal responses to the CSA allegations concerning their children. Implications of these findings are discussed.     

Obfuscating Child Sexual Abuse II: Listening to Survivors

The reality of the extent and experience of child sexual abuse cannot be revealed while children are unable to ‘stand up and be counted’. Limited alternatives, lack of information and dependence on adults prevent the true scale of the problem being appreciated. Similarly, media and legal treatment of abused children also operate to suppress the truth. The expertise and knowledge of those who have suffered abuse need to be acknowledged and utilized in order that child sexual abuse can no longer be obfuscated. © 1997 John Wiley & Sons, Ltd.     

Recantation of Sexual Abuse Disclosure Among Child Victims: Accommodation Syndrome

Background: Disclosing the sexual abuse may be related on many individual and/or environmental factors in all age groups. The sociocultural context is the most influential factor of the disclosing process especially for those living in patriarchal cultural values. This study compares the impacts of sexual abuse and other sociodemographic variables between recanting and non-recanting victimized groups in Adana city from Turkey.

Methods: The samples attending our department were divided into two groups: group 1 comprised victims who recanted their first abuse disclosure, and group 2 comprised victims who insisted on the veracity of their first report at further evaluations. The characteristics of the child, family, and abuser were compared between recanting victims and non-recanting victims by retrospective data.

Results: Each group included 27 children, for a total of 54 subjects. All adverse social reactions after the sexual abuse, including keeping secrets and a repressive family attitude, were higher among group 1 victims than group 2 victims (p < 0.0001).

Conclusions: Although they are victimized by protecting family integrity, victims may show a tendency to keep secrets and to not immediately disclose an abuse event.     

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

Caregiver Needs Following Disclosure of Child Sexual Abuse

Caregiver support is vital in improving outcomes for child sexual abuse victims; however, the disclosure can significantly affect caregivers, thus impacting their ability to meet their children’s needs. To maximize the support from caregivers, their own needs following disclosure need to be met. This study investigated the impact of child sexual abuse disclosure and associated needs as identified by caregivers. Sixty needs assessment forms were collected from families who accessed a parenting support pilot program run in New Zealand. These forms were completed by nonoffending caregivers during an assessment session with their counselor and consisted of both open-ended and Likert scale questions focusing on both the needs of the child and the family. Caregivers identified a range of impacts of the disclosure on their children, themselves, and other families members and the related support that may be needed. In particular, caregivers identified that they needed support with child behavior management and with their own coping. The findings suggest that interventions with caregivers following disclosure of child sexual abuse may be a valuable adjunct to therapy provided directly to the child.     

Practical Ways Psychotherapy Can Support Physical Healthcare Experiences for Male Survivors of Childhood Sexual Abuse

This pilot study was conducted to examine older child molestation victims' self-report of their long-term psychological adjustment at least 12 months after the date of their initial clinic evaluation. Female participants were assesed using the Piers-Harris Children's Self-Concept Scale, Children's Depression Inventory, and the Hopelessness Scale which were also administered during their first evaluation. T-ratios revealed that scores on all measures, including five of the six Piers-Harris subscales showed significant improvement. The high rate of noncompliance associated with this population is also discussed in terms of removal from the home, type of abuse, and age of the perpetrator.     

Disclosure of Sexual Abuse in Sport Organizations: A Case Study

The disclosure of sexual abuse in the world of sports is a process that has not been widely documented. This article presents the results of a document analysis of sport organization policies and interviews conducted with 27 sport stakeholders. The interviews focus on these stakeholders' perceptions of how the disclosure process would unfold if a case of sexual abuse were to arise in their organization and their perceptions of the actual cases experienced in the sport organizations participating in this study. The results reveal several problems affecting the disclosure of sexual abuse in sport organizations.     

Male Child Sexual Abuse: A Phenomenology of Betrayal

Being deeply understood relies on the ability of the social work clinician to have authentic and genuine empathy for their client. This phenomenological study sought to understand the lived experience of men sexually abused as boys in their childhood, and what life is like for them as sexual abuse survivors in adulthood. Analyses of fourteen male survivors’ narratives into the abuse they experienced as children, and the meaning they make of that experience today, offer insights for therapists. Findings suggest that therapists have a responsibility to ask male clients about sexual victimization, even when this is not the presenting problem but they exhibit sexual abuse related problems; an obligation to educate one’s self on responding therapeutically to disclosure; a duty to receive training to counsel sexually victimized males; a responsibility to advocate for the development of men’s services; and taking an active role in shifting attitudes towards men’s vulnerabilities.

Mental Health Professionals' Exposure to Clients with Problematic Internet Experiences

ABSTRACT

This paper examines clients' exposure to problematic Internet experiences among a national sample of 2,098 social workers, psychologists, marriage and family therapists, and other mental health professionals. This analysis finds that mental health professionals are working with clients experiencing a range of problems related to Internet use. However, these professionals have generally not been exposed to training or information in the professional literature on the topic of working with clients with problematic Internet experiences. We identify several areas in which additional training is needed and review practical implications for mental health professionals.     

At Risk: The Relationship between Experiences of Child Sexual Abuse and Women's HIV Status in Papua New Guinea

Child sexual abuse in Papua New Guinea is a human rights issue as well as an indicator of HIV risk in women. This study aimed to develop knowledge about the link between violence experienced by women and their HIV status. The study used a mixed method approach to collect quantitative and qualitative data through structured interviews with a sample of 415 women across four provinces of Papua New Guinea: National Capital District, Western Highlands, Western, and Morobe. Participants were asked about violence they had experienced as children and in their adult relationships and the impact of the violence. The quantitative data was analyzed using SPSS, and qualitative data was coded using a thematic approach. Child sexual abuse was reported by 27.5% of the sample (n?=?114). Women reporting child sexual abuse were more likely to live in violent relationships, be HIV positive, and have a higher number of sexual partners.