Children’s Disclosure of Sexual Abuse: A Systematic Review of Qualitative Research Exploring Barriers and Facilitators

Abstract

This study evaluates and synthesizes qualitative evidence addressing factors affecting a child's decision to disclose an experience of sexual abuse. Childhood sexual abuse is a devastating crime, with long-term negative impacts. Understanding the factors that affect a child's decision to disclose is vital. Disclosure enables access to support and protection, both therapeutically and legally. A systematic review was conducted focusing on factors affecting a child's decision to disclose an experience of sexual abuse. Seven studies were identified, quality appraisal undertaken, and meta-ethnography used to synthesize the studies. Six new super-ordinate themes were developed: Fear of what will happen; Others' reactions: fear of disbelief; Emotions and impact of the abuse; An opportunity to tell; Concern for self and others; and Feelings toward the abuser. Themes indicated the importance of support, structure, and opportunity to facilitate disclosure and should be utilized by agencies to develop practices that facilitate disclosures.

Helping Children to Tell about their Experiences of Sexual Abuse

“…Over the past 20 years, there has been a plethora of research studies, particularly drawing on qualitative methodologies, that have tried to capture the child's experience of disclosure following sexual abuse (Morrison et al ., ). Prior to this, most of what we knew about disclosure was from large‐scale studies that elicited information about the context of disclosure, to whom a child disclosed and the time frame from abuse to disclosure (McElvaney, ).…”

“…However, what these studies did not offer was an in‐depth account of the experience of the children as they struggled with their decision to tell, their fears of what would happen if they told, feelings of shame and perceived responsibility for the abuse. With the publication of studies that directly asked children and young people about their experiences of disclosure (Morrison et al ., ), we now have a much richer tapestry of children's narratives from which to learn about how we as professionals can help children to tell. While these studies have predominantly focused on barriers to disclosure, more recent studies have attempted to highlight what helps children to tell (McElvaney, ).…”

“…Despite the increased awareness of sexual abuse in our society, studies of both adults and adolescents continue to record significant proportions of respondents who have never told anyone about their experiences prior to the study (McElvaney, ). Qualitative studies conducted over the past 15 years highlight the need for children to be presented with an opportunity to tell about their experiences (Morrison et al ., ). This may result from intrapersonal pressure (feeling distressed) or interpersonal pressure (being asked) as illustrated in McElvaney et al .…”

“…Morrison et al . () in a review of qualitative studies with children and adolescents identified six key themes that influence the children's decision to disclose: fear of what will happen; others' reactions, such as fear or disbelief; emotions and impact of the abuse; opportunity to tell; concern for self and others; and conflicted feelings about the abuser.…”

“…Nevertheless, a lack of recognition of children's strengths and over attention to their victimisation can further disempower children. Including children in conversations about what will happen next, particularly given their fear of the unknown (Morrison et al ., ), listening to their concerns and inviting their views during the process of investigation and intervention may mitigate the likelihood of further traumatisation and promote their resilience. ‘Having a say’ is a recurrent theme in the literature on young people's need for participation in processes that impact on their lives (Ungar et al ., ).…”