Rosaleen McElvaney

To Tell or Not to Tell? Factors Influencing Young People’s Informal Disclosures of Child Sexual Abuse

The aim was to understand the factors influencing informal disclosure of child sexual abuse experiences, taking account of dynamics operating prior to, during, and following disclosure. In-depth semi-structured interviews were conducted with 22 young people who experienced child sexual abuse and 14 parents. Grounded theory methodology informed the study. The key factors identified as influencing the disclosure process included being believed, being asked, shame/self-blame, concern for self and others, and peer influence. Many young people both wanted to tell and did not want to tell. Fear of not being believed; being asked questions about their well-being; feeling ashamed of what happened and blaming themselves for the abuse, for not telling, and for the consequences of disclosure; concern for how both disclosure and nondisclosure would impact on themselves and others; and being supported by and yet pressurized by peers to tell an adult, all illustrate the complex intrapersonal and interpersonal dynamics reflecting the conflict inherent in the disclosure process. These findings build on previous studies that emphasize the dialogic and interpersonal dynamics in the disclosure process. Both intrapersonal and interpersonal influencing factors need to be taken account of in designing interventions aimed at helping children tell. The importance of asking young people about their psychological well-being and the role of peer relationships are highlighted as key to how we can help young people tell.

A call for dialogue: psychotherapists and psychologists specialising in psychotherapy

Abstract The development of psychotherapy as an independent discipline in many countries in Europe has stimulated debate within the field of psychology as to what constitutes psychotherapy as a specialism of psychology. The authors, both clinical psychologists who pursued further training in psychotherapy, offer a reflection in this paper on the historical battle between psychiatry and psychology for ‘ownership’ of psychotherapy, describe recent developments in Europe to clarify this specialism within psychology and discuss the distinctive contributions that psychologists offer in developing psychotherapy as a specialism within the discipline. The aim of the paper is to begin a dialogue both within the profession of psychology and outside the profession, with our psychotherapy colleagues, that can develop into an interdisciplinary discourse and a more mutually respectful professional environment.

Associations Between Forced and “Persuaded” First Intercourse and Later Health Outcomes in Women:

The effects of nonconsensual first experiences of sexual intercourse in women are understudied. This was investigated in 3,875 adult women of whom 6.7% reported “persuaded” first-sex and 0.8% reported forced first-sex. Compared with willing first-sex, both forced and “persuaded” first-sex occurred earlier, involved a greater age difference between partners, and were associated with more lifetime sexual partners and some measures of worse psychological well-being. In addition, “persuaded” first-sex was associated with worse general physical health. “Persuaded” first-sex and its relation to health need to be better understood, along with how culture influences women’s experiences of first-sex.

Childhood Sexual Abuse: Sibling Perspectives:

Despite a recent focus highlighting the systemic impact of childhood sexual abuse (CSA), the needs of nonabused siblings have been largely overlooked. This interpretative phenomenological analysis study explored the lived experience of nonabused adult siblings of survivors of CSA. Semistructured interviews were undertaken with five adult siblings who were, or had been attending a support service. Emergent themes demonstrated the personal and relational impact of CSA on siblings which were captured across five domains: trying to make sense of it all, struggling to provide support, managing the impact on the wider family, feeling silenced and finding a voice, and rescripting the future. Participants struggled to make sense of their siblings experience, questioning their own memories of happy childhoods, often in the face of limited information about what happened. The impact of the sexual abuse not only affected the sibling relationship but was compounded by the distress of other family members, particularly parents. Participants reported feeling a lack of reciprocity in terms of their own support needs and described ongoing issues arising from the sexual abuse that they believed would likely continue for the rest of their lives. How siblings can be supported through psychoeducation and family therapy is discussed, both for their own needs and those of the entire family.

“Why would you want to do that work?” The positive impact on therapists of working with child victims of sexual abuse in Ireland: a thematic analysis

Abstract Research on the impact on psychotherapists of working with trauma has typically focused on negative impact and protective strategies and supports for therapists working in this field, such as self-care strategies and supervision. Yet many clinicians speak of the rewarding and fulfilling experiences of working with those who have been sexually abused. This study explored the positive impact of working with children who have been sexually abused in a sample of psychotherapists in Ireland. Unstructured interviews were conducted with nine female therapists who work in a specialist sexual abuse service with child victims of sexual abuse. An inductive thematic analysis identified four key themes: “the struggle to talk about the positive impact”, “professional satisfaction from helping children”, “learning life lessons from children” and “the magical connection that happens in therapy”. The findings show that, despite therapists’ tendency to think about negative impact, when encouraged to do so they described finding the work professionally rewarding, experiencing an enhancement of their own attitudes and lives through learning from the children they worked with and feeling uplifted within the therapeutic relationship with the child. Suggestions are offered for future research that may provide a broader understanding of the positive impact of this work.