How Families Respond to Child Sexual Abuse Disclosure "The Impact of Child Sexual Abuse Discovery on Caregivers and Families: A Qualitative Study"
Research in Practice
Tuesday, October 31, 2017
This qualitative study from the US explores the impact of child sexual abuse (CSA) discovery on non-offending caregivers and their families.
- Fong et al
- Journal of Interpersonal Violence (2017)
The study describes the emotional and psychological distress experienced after learning that their child may have been sexually abused. It also discusses caregivers' attitudes about mental health services for themselves.
Existing evidence
Support from a non-offending caregiver is associated with better emotional and behavioural adjustment in sexually abused children. However, caregivers may experience a number of challenges (such as emotional, psychological, social, financial) that can make it difficult for them to support their children following the discovery of sexual abuse. Research by Kelley (1990) showed how symptoms of caregiver distress where there has been CSA were comparable in severity to those of female psychiatric outpatients and can persist up to two years after disclosure.
Study methods
Non-offending caregivers were recruited to the study when they accompanied their children (aged less than 13 years) for a forensic interview at the Philadelphia Children's Alliance (PCA). They were interviewed three to five months after the visit to PCA. Following completion of the interviews, researchers administered a series of standardised instruments to assess the frequency and severity of caregiver depression and co-occurring psychosocial challenges (such as intimate partner violence and substance abuse).
Out of a possible 247, 51 caregivers gave their consent to take part in the study, with 22 of these fully participating. The majority of caregivers were female (91 per cent), black (73 per cent) and reported histories of their own maltreatment (68 per cent). The majority of children who had been/were suspected to have been sexually abused were female (59 per cent), with a mean age of 6.5 years (range three to 12 years).
Interview themes
Caregivers reported experiencing significant emotional and psychological distress after learning that their child may have been sexually abused. This was generally expressed through anger, depressed mood and guilt in relation to four themes:
- Concerns about their child's physical and mental health
- Negative beliefs about their parenting ability
- The actions and behaviours of family members
- Memories of their past maltreatment experiences.
There were mixed responses on the impact of sexual abuse discovery on caregivers' families. Some caregivers reported that it worsened relationships within their family, while others reported that their family became closer following the sexual abuse discovery.
Four of the caregivers were receiving mental health services at the time of the CSA discovery. All of these four continued receiving services after the CSA discovery, while only one of the 18 caregivers not receiving services initiated them after the abuse discovery.
The findings are consistent with other studies which have demonstrated high levels of distress and feelings of anger, depression, guilt and sense of failure among non-offending caregivers of sexually abused children (Hill, 2001).
Limitations of the study
There are number of limitations to the study which need to be taken into consideration when interpreting the findings:
- The study was conducted in the US with very different child welfare arrangements
- Most of the caregivers were black, female and had personal histories of maltreatment and the findings may not be applicable to other populations
- A large number of caregivers were referred to the study but did not participate, creating potential bias
- Caregivers' perspectives were assessed in the first few months after the discovery of CSA and may not be applicable to their perspectives over a longer period of time.
Implications for practice
- The study highlights the emotional, psychological and social problems experienced by caregivers in response to the discovery of CSA.
- Where there is inadequate support from family and friends, there may be disruptions in family functioning, which can interfere with caregivers' ability to cope with their feelings of distress.
- Health and child welfare practitioners are important for identifying, assessing and addressing the emotional and psychological needs of non-offending caregivers. This is critical because of the relationship between caregiver wellbeing and child mental health outcomes.
- Helping caregivers link to other services, including mental health services, could help to improve caregiver and child wellbeing and outcomes after CSA.
The research section for this special report is based on a selection of academic studies which have been explored and summarised by Research in Practice, part of the Dartington Hall Trust.
This article is part of CYP Now's special report on intrafamilial abuse. Click here for more