What Helps Children Tell? A Qualitative Meta‐Analysis of Child Sexual Abuse Disclosure

Abstract

The increasing use of qualitative methodologies to explore experiences of child sexual abuse (CSA) disclosure has led to the need to synthesise these findings. Recent reviews have tended to focus on the barriers to disclosure more than the facilitators or to conflate findings from studies of adults and studies of children and adolescents. This paper focuses on a qualitative meta‐analysis of studies conducted in the past 20 years (1998–2018) that addresses the question of what helps children disclose experiences of CSA. An analysis of 20 studies that met the inclusion criteria suggests that six key themes are important facilitators of disclosure: access to someone you can trust; realising it's not normal; inability to cope with emotional distress; wanting something to be done about it; expecting to be believed; and being asked. These can be conceptualised as representing two key dynamics that help children tell: needing to tell (pressure cooker effect), and opportunity to tell. Professionals and carers can facilitate the process of disclosure through building trusting relationships with children, recognising their distress and initiating conversations with children about their wellbeing. Key Practitioner Messages There is a need for the focus to be on what helps children tell rather than what hinders children telling. Children need those around them to notice when they need to talk about themselves and what is happening in their lives – when they are unable to cope with their distress, when they want something done about it. Professionals and adults interacting with children need to ask children about their lives and wellbeing, in order to: help create opportunities for children to tell; help them access someone they can trust; let them know they will be taken seriously; and help them to understand that abusive behaviour is not normal.

Children’s Disclosures of Physical Abuse in a Population-Based Sample

“…As earlier studies (e.g. Thulin et al 2019; Reitsema & Grietens, 2016;Brennan & McElvaney, 2020;Jensen et al, 2005) have shown, disclosures of both CPA and CSA are often facilitated by addressing the topic at school or watching a TV program dealing with abuse. In addition, if the recipients of disclosure are peers (as they often are), they are probably faced with a moral dilemma of not disclosing confidential information and need guidance on how to report to a trusted adult (McGuire & London, 2020).…”

Child Protection and Contexts of Recognition

“…Like Brennan and McElvaney's (2020) article on disclosure, the survey data in this paper suggest that contexts which value the views of young people cannot be created through guidance or process alone. Organisational cultures need to promote young people's participation and demonstrate this in their decision‐making processes: should this be achieved, Everley (2020, p. 126) argues that ‘the environment for children becomes more secure and practitioners benefit from the reflection that this provides them with’.…”

“…Our first paper, by Emma Brennan and Rosaleen McElvaney (2020) from Dublin City University, Ireland, reports the results of a meta‐analysis of qualitative studies into CSA disclosure conducted from 1998 until 2018 to provide insights into what enables disclosure. Through a process of thematic analysis, six facilitators of disclosure emerge which the authors organise into two categories: dynamics that result in children ‘needing to tell’; and those where children have an ‘opportunity’ to tell.…”

“…In making recommendations for policy and practice, the authors stress that the quality of relationships appear most important at facilitating disclosures, rather than an individual having the correct set of ‘skills’ to receive a disclosure. They reflect that such a focus might mitigate the risks of adults avoiding conversations about sexual abuse for fear of making a mistake, given that ‘avoidance of such topics may lead children to believe that these adults are not to be trusted with such difficult and sensitive information’ (Brennan and McElvaney, 2020, p. 110). Contexts in which children trust others are the ones in which disclosures, and therefore protection, become possible.…”

“…Whether it is the relationship between schools and refuges, sports clubs, associations and parents, the police and community groups, or carers and therapists, they all have the potential to interact in ways that foster contexts in which children are seen or silenced. As Brennan and McElvaney (2020, p. 111) note in their concluding remarks, children are ‘entitled to have adults who respond to them in noticing when they are distressed, asking them about their wellbeing, taking them seriously, and taking action to protect them from further harm’; it is relationships and cultures, rather than individualised datasets and depersonalised guidance documents, which will create the contexts where this is possible.…”