Stifled Voices: Barriers to Help-Seeking Behavior for South African Childhood Sexual Assault Survivors

Smith, Kimberly; Bryant-Davis, Thema; Tillman, Shaquita; Marks, Alison J.

doi:10.1080/10538711003781269

Cited by 26 publications

(15 citation statements)

References 46 publications

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“…Within South Africa, qualitative research suggests that professional services are not designed to facilitate abuse disclosure and service access for children (Bray, Gooskens, Kahn, Moses, & Seekings, 2010). Some of the perceived barriers are logistical and practical obstacles, such as transport or money (Lankowski, Siedner, Bangsberg, & Tsai, 2014); inadequate and badly designed services and poor service delivery (Roehrs, 2011); lack of faith in a timely and positive outcome (Smith, Bryant-Davis, Tillman, & Marks, 2010); fear of repercussions such as re-victimisation (Akal, 2005); and stigma and coercion within the family (Akal, 2005;Bray et al, 2010). The low numbers of children disclosing directly to professionals and receiving services in our present study support these qualitative findings.…”

Section: Service Provisionmentioning

confidence: 99%

Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces

Meinck

Cluver

Loening-Voysey³

et al. 2017

Psychology, Health & Medicine

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Physical, emotional and sexual child abuse are major problems in South Africa. This study investigates whether children know about post-abuse services, if they disclose and seek services, and what the outcomes of help-seeking behaviour are. It examines factors associated with request and receipt of services. Confidential selfreport questionnaires were completed by adolescents aged 10-17 (n = 3515) in South Africa. Prevalence of frequent (>weekly) physical abuse was 7.4%, frequent emotional abuse 12.4%, and lifetime contact sexual abuse 9.0%. 98.6% could name one suitable confidante or formal service for abuse disclosure, but only 20.0% of abuse victims disclosed. Of those, 72% received help. Most common confidantes were caregivers and teachers. Of all abuse victims, 85.6% did not receive help due to non-disclosure or inactivity of services, and 14.4% received help: 4.9% from formal health or social services and 7.1% through community vigilante action. Emotional abuse, sexual abuse and female gender were associated with higher odds of help-seeking. While children in South Africa showed high knowledge of available services, access to and receipt of formal services among abused children was low. Notably fewer children received help from formal services than through community vigilante action. Urgent action is needed to improve service access for child abuse victims."I went to the police to tell them that that boy who had raped me was harassing me. They laughed and said I should not bother them. So now, every time he rapes me I won't go to the police because they won't believe I am telling the truth. " (Girl, 17, Mpumalanga)

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Section: Service Provisionmentioning

confidence: 99%

Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces

Meinck

Cluver

Loening-Voysey³

et al. 2017

Psychology, Health & Medicine

View full text Add to dashboard Cite

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“…However, research indicates that having one traumatic experience signifi cantly increases the likelihood of having another (Roodman and Clum, 2001;Sadavoy, 1997;Smith et al, 2010), making it diffi cult, and potentially misleading, to attempt to determine the specifi c trigger for drinking behavior. As a result, research has explored the cumulative effect of traumas on psychological and behavioral outcomes.…”

mentioning

confidence: 99%

Posttraumatic Stress Disorder Symptoms Mediate the Relationship Between Traumatic Experiences and Drinking Behavior Among Women Attending Alcohol Serving Venues in a South African Township

Watt

Ranby

Meade

et al. 2012

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: South Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazardous drinking. This article examines the relationship between traumatic events and hazardous drinking among women who patronized alcohol-serving venues in South Africa and examines PTSD as a mediator of this relationship. Method: A total of 560 women were recruited from a Cape Town township. They completed a computerized assessment that included alcohol consumption, history of traumatic events, and PTSD symptoms. Mediation analysis examined whether PTSD symptoms mediated the relationship between the number of traumatic event categories experienced (range: 0-7) and drinking behavior. Results: The mean Alcohol Use Disorders Identifi cation Test score in the sample was 12.15 (range: 0-34, SD = 7.3), with 70.9% reaching criteria for hazardous drinking (AUDIT ≥ 8). The mean PTSD score was 36.32 (range: 17-85, SD = 16.3), with 20.9% meeting symptom criteria for PTSD (PTSD ChecklistCivilian Version ≥ 50). Endorsement of traumatic experiences was high, including adult emotional (51.8%), physical (49.6%), and sexual (26.3%) abuse; childhood physical (35.0%) and sexual (25.9%) abuse; and other types of trauma (83%). All categories of traumatic experiences, except the "other" category, were associated with hazardous drinking. PTSD symptoms mediated 46% of the relationship between the number of traumatic categories experienced and drinking behavior. Conclusions: Women reported high rates of hazardous drinking and high levels of PTSD symptoms, and most had some history of traumatic events. There was a strong relationship between traumatic exposure and drinking levels, which was largely mediated by PTSD symptoms. Substance use interventions should address histories of trauma in this population, where alcohol may be used in part to cope with past traumas. (J. Stud. Alcohol Drugs, 73, 549-558, 2012)

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“…Furthermore, most evidence-based treatments for sexual abuse were developed in resource-rich contexts (Radford et al 2014). In South Africa there are many social and economic barriers that prevent survivors of sexual abuse from gaining access to the treatment they need (Smith et al 2010). Given the limited therapeutic resources and lack of trained professionals, systematic and resource-effective treatment programmes are needed which are context appropriate (Petersen et al 2005).…”

mentioning

confidence: 99%

An expressive art group intervention for sexually abused adolescent females

Visser

Plessis

2015

Journal of Child & Adolescent Mental Health

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Objective: South Africa has a high prevalence of sexual abuse of children and adolescents.Among the numerous adverse consequences of sexual abuse is the difficulty survivors may experience in developing a positive self-esteem and maintaining positive relationships. In a low resource setting, an expressive art group intervention tailored for female adolescents who have been sexually abused was implemented and its value explored.Method: Six adolescents met for ten weekly sessions which included expressive art activities, followed by reflective group discussions. The value of the intervention was explored using a qualitative research design with limited quantitative data. Results:The participants reported that the group intervention relieved their sense of isolation and contributed to their ability to express emotions and develop self-awareness. Participants reported more positive self-esteem and improved interpersonal closeness. The intervention helped participants to find new meaning in painful experiences which contributed to personal growth. Conclusions:The group dynamics, expressive art activities and reflective group discussions contributed to the therapeutic value of the intervention. The expressive art group intervention showed value as an alternative therapeutic strategy in a low resource setting for female adolescents that have experienced sexual abuse. An experimental design could follow to confirm the effectiveness of the intervention.

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Stifled Voices: Barriers to Help-Seeking Behavior for South African Childhood Sexual Assault Survivors

Cited by 26 publications

References 46 publications

Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces

Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces

Posttraumatic Stress Disorder Symptoms Mediate the Relationship Between Traumatic Experiences and Drinking Behavior Among Women Attending Alcohol Serving Venues in a South African Township

An expressive art group intervention for sexually abused adolescent females

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