University of Bristol: Child sex abuse victims reveal barriers faced in new ‘Keeping Secrets’ report

In the report, Bristol Medical School researchers sought to understand the factors preventing children from receiving specialist pre-trial therapy. Historically legal processes have restricted access to these services, based on the view that therapists discussing case details may damage the quality of evidence.

It is estimated that as many as 15% of girls and 5% of boys will experience child sex abuse (CSA) before the age of 16. Many of these cases will never make it into the criminal justice system. The majority of which do not tell anyone about the abuse at the time, and even fewer see their case reach court – in the year ending March 2020, only 12% of CSA offence investigations resulted in a decision to charge the offender.

Researchers surveyed over 100 specialist CSA therapists, alongside one-to-one interviews with them and wider professionals, including the police, children’s social services, specialist advocacy services, and the children, young people and affected families.

In their report, the team reveal how services for those experiencing child sexual abuse are stretched and inconsistent. In particular, there is a lack of services for younger children, with only 31% of those that surveyed providing support for those aged three-to-five years, and only 11% providing therapy for those aged under three.

They show there is a mistaken belief that children and young people who have experienced sexual abuse should not access therapy until the criminal justice process has ended. When pre-trial therapy does happen, the choice to talk about the abuse is often taken away from the child or young person. They reveal that professionals delivering pre-trial therapy are working within a culture of fear. The therapists that were interviewed expressed a real fear that their involvement could damage the criminal case for their clients. Often, this was a fear that their therapeutic notes could be used against their client or that they may be called as a witness against their client in court, with some worried about being accused of coaching the victim.

Dr Gemma Halliwell, a Research Fellow at the Centre for Academic Primary Care, Bristol Medical School, University of Bristol, said: “Our report is timely as new guidelines around pre-trial therapy have just been published by the Crown Prosecution Service (CPS). Children and young people who have experienced sexual abuse can face a difficult and traumatic experience of the criminal justice system, often without seeing their perpetrator prosecuted at the end of this process. Currently, these children, young people and their families are placed in an even more painful situation due to unnecessary barriers that prevent them from accessing pre-trial therapy and other forms of emotional support.

“Timely therapeutic support is crucial to tackling the emotional and psychological impact of CSA, which can include post-traumatic stress disorder (PTSD), depression, anxiety and a range of behavioural problems. Without the right support at the right time, this trauma can have a detrimental impact throughout the child’s or young person’s life.”

Among the team’s conclusions are recommendations for better training, particularly for the police, children’s social services and schools to develop awareness of sexual violence, its impacts and how to make referrals to pre-trial therapy services that will help support families.

They also highlight that all services (therapy and non-therapeutic) need to ensure that they permit children and young people to talk about abuse within their services if that is what they need to do. Professionals should be equipped to inform children and young people of the duty of disclosure in a positive way and share any relevant information with the police after obtaining the consent of the survivor. Therapy services should also follow a standardised protocol or policy on how to deliver pre-trial therapy according to the CPS guidelines to ensure consistency of care for children and young people.

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