2016). Survivors have either been exposed to violence or are highly likely to encounter violence after the event of abuse (Optimus Study, 2016).
The above findings on CSA survivors show that any child is at risk to be sexually abused, regardless of gender, sexual orientation, exposure to violence or previous abuse (Artz et al., 2018; Clayton et al., 2018). This implies that CSA is and should be an ever-present concern throughout the development of the child (Artz et al., 2018).
2.4. Child Sexual Abuse Disclosure
place in stages, for instance, by mistake, observation, due to change in developmental stages, and having a child merely speak out (Spies, 2006).
There is agreement that children are most likely to disclose abuse to people who will be most supportive of them, especially during an initial disclosure (Anderson, 2016; DeVoe
& Faller, 1999; Reitsena & Geritens, 2016). Children abused by a family member or a person older than them are less likely to disclose abuse (Anderson, 2016). Reports such as these bring to light the need to devise a framework that would allow free disclosure of abuse which can enhance the healing for children, which is critical (Reitsema & Grietens, 2016).
It is almost expected that children will not disclose abuse immediately after the incident, neither does retracting a disclosure signify that abuse did not take place (Spies, 2016). In contrast, Collings et al. (2005), suggested that research on CSA indicates that it is common not to disclose CSA. There are factors which affect disclosure such as the age of the child, support from family, being coerced, the severity of the abuse, and the relationship with the alleged perpetrator (DeVoe & Faller, 1999). When adults who were child survivors of sexual abuse reflected on non-disclosure, they perceived that there would be negative outcomes after disclosure, therefore they did not disclose (Anderson, 2016).
2.4.2. Models of disclosure
Paine and Hansen (2002, as cited in Schönbucher et al., 2012), suggested that there are explanations for why children do not disclose or delay disclosure of CSA. Some children do not disclose due to an unawareness of having experienced abuse (Collings et al, 2005).
Variables that can account for the amount of time it takes to disclose CSA include age,
gender, the identity of the perpetrator, fear, and the number of incidents of abuse (Reitsema &
Grietens, 2016; Ungar et al., 2009).
The extent to which much disclosure is reported on purpose is often argued (Collings et al, 2005; Higson-Smith & Lamprecht, 2004). A considerable number of models of
disclosure use the work of Summit (1983, as cited in Esposito, 2014). The child sexual abuse accommodation syndrome has five phases, maintaining the secret of the abuse, feeling helpless, lacking power to prevent or disclose the abuse, feeling trapped and accommodating the abuse, and being delayed and then recanting disclosure (Esposito, 2014).
Referring to Summit’s (1983) work, Furnis (1991, as cited in Espisito, 2014)
acknowledged the occurrence of both internal and external influences that hinder disclosure.
This challenges the autonomy of children when it comes to disclosure. A popular model of disclosure is that of Sorensen and Snow (1991, as cited in Anderson, 2016), who described three steps in the disclosure process, denial, uncertainty, and active disclosure (Anderson, 2016; Esposito, 2014). The most common disclosures are uncertain or tentative disclosures (Anderson, 2016).
Collings et al (2005) used content analysis to establish two aspects of CSA, whether the abuse was reported or noticed by others, and the duration of the abuse. From this it was suggested that four categories of disclosure exist within these aspects, namely, purposeful disclosure, indirect disclosure, eyewitness detection, and accidental detection (Collings et al., 2005). Purposeful disclosure is the most common (Esposito, 2014; Collings et al., 2005).
Historically, indirect disclosure refers to children giving indirect hints of abuse not
specifically labelled as such but having been indicated to have taken place (Collings et al., 2005). Collings et al. (2005), however suggested that further research in the South African context would be needed regarding eyewitness detection.
2.4.3. People who receive the disclosure
Reporting of CSA to authorities such as police and healthcare workers is not the norm during the disclosure process (Esposito, 2014). Children may first disclose to those with less authority as a means to gauge reactions to trial in-depth disclosure to those in positions of
authority (Ungar et al., 2009). This implies that children are most likely to disclose abuse to those whom they trust, such as family and peers (Anderson, 2016; Esposito, 2014).
Initially, disclosure is shared with an emotionally supportive person. Therefore younger children would tend to tell their parents and adolescents would relate more to their friends (Anderson, 2016; Esposito, 2014). The time it takes for children to disclose abuse is often varied (Esposito, 2014). Older children in forensic interviews are less likely to disclose completely in contrast to younger children who would disclose readily (Anderson, 2016).
Services may often be attained only six months after disclosure (Collings, 2009).
After disclosure, the survivor may experience secondary trauma from maternal figures (Collings, 2007, as cited in Collings, 2009). Often that victimisation can involve being treated in an insensitive manner and blaming the survivor (Collings, 2009). This shows that there is a need to provide psycho-education to people such as family and peers who are likely to
receive disclosures (Esposito, 2014).
CHWs who work with sexual abuse play an important role before and after disclosure (Esposito, 2014). This justifies why this study chose CHWs from Childline KZN. They are often expected to manage a therapeutic and forensic role in disclosure (Esposito, 2014). As the disclosure continues over time, additional details that the CHWs may have to face may surface (Spies, 2006). There is a paucity of research involving their perceptions of CSA (Esposito, 2014). Collings (2009), indicated that only 49 percent of survivors benefited from the services of CHWs. South African CHWs have been advised to be aware of compassion- and system-fatigue as a result of ineffectual legislative systems (Capri, 2013).
2.4.4. Barriers to child sexual abuse disclosure
The Optimus Study (2016), suggested documenting the reporting of cases to show the methods that exist which impede or enrich how abuse is dealt with to intensify service
delivery and reduce harm to child survivors. Hence, the current research aimed to provide a
broad perspective on the current practices of CSA disclosures. This was done by exploring the perceptions of the CHWs of how they facilitated disclosure. The intention was to work towards developing a framework for disclosure within the African context.
According to Koss (1993, as cited Jewkes and Abrahams, 2002), in the United States of America (USA), of all the different types of victimisation, an incident of rape is more likely to be kept secret. Several women have a fear of not being believed and would even go as far as choosing the form of rape they would report (Jewkes & Abrahams, 2002). This adds to the existing narrative of being afraid of the repercussions and not trusting in caregivers and local authorities (Fouché, 2012). Some repercussions could include revenge from the
perpetrator and fear of prosecution (Jewkes & Abrahams, 2002).
Naidoo (2013) delivered a call to action in addressing rape in South Africa. There appeared to be insufficient facilities which had designated crisis centres, hence a perceived barrier to reporting abuse due to fear of being turned away or referred to other crisis centres (Naidoo, 2013). Naidoo also found that medical staff were not well informed on legislation regarding the process that needs to be followed when disclosing abuse (Naidoo, 2013). Hence there is a need for knowledge concerning the barriers to and facilitators of disclosure
(Collings et al., 2005).
2.4.5. Facilitators of child sexual abuse disclosure
Despite the barriers to CSA disclosure, there are still cases which are reported (South African Police Service, 2019). This means that there are factors which facilitate or promote the disclosure of sexual abuse. Legislation demands that all cases of CSA be reported. This encourages disclosure and prevents keeping CSA a secret (Fouché, 2012). Furthermore, over the years with amendments to legislation and its implementation, specialised units to protect children have been developed and specific specially designated sexual offences courts are operating (Fouché, 2012; National Prosecuting Authority, 2019).
The Optimus Study (2016), through their data collection, found that disclosure of sexual violence happens more often when self-administered questions are used as opposed to having a face-to-face interview. Hence it seems that it is easier to disclose CSA without a person who can listen and see the participant. Parents and caregivers need to be encouraged to foster relationships with their children which are warm and caring, making them more approachable so that children more likely to disclose CSA (Optimus, 2016).
2.4.6. Effects of child sexual abuse disclosure
When considering the impact of abuse, it should be noted that abuse harms the child’s immediate physical and emotional wellbeing and continues over his or her development (Clayton et al, 2018; Paolucci et al., 2001). Interestingly, contrasting views exist on the effects of not disclosing abuse. For example, there is a school of thought which argues that reporting child abuse has no viable effect on the child. Those in favour of this method argue that there is no difference between children who have experienced abuse and those that have not experienced abuse (Hartman & Burgess, 1989; Woodward & Fortune, 1999).
In contrast, adults who were abused at a young age have in past studies shown to have post-traumatic stress disorder (PTSD), depression, social withdrawal, anxiety, obsessive compulsive disorder (OCD), and sexualised behaviour (Erickson et al., 1989; Jones &
Ramchandani, 1999; Woodward & Fortune, 1999). Furthermore, other scholars have argued that the degree of the abuse, the type of abuse, the extent of the abuse, and the amount of resilience and support are what warrant how children will be affected by abuse in the long- term (Spies, 2006; Wickhen & West, 2002).
Interestingly, disclosing abuse early on reduces the risk of long-term consequences of psychological disturbances (Arata, 1998; Fontes, 1993, as cited in Schönbucher, et al., 2012).
The Optimus study (2016), also showed that children who had been abused showed double
the vulnerabilities to develop anxiety and depression and were three times more likely to experience PTSD compared to children who had not been sexually abused.
Immediate reactions after the abuse and disclosure bring on the probabilities of being pregnant and contracting sexually transmitted diseases while simultaneously undergoing intense feelings of loss and grief over the abuse (Adlem, 2017; Capri, 2013). Survivors often
“…experience shock, disbelief, numbness, fear, anger, self-blame, sadness and sometimes elation, and behavioural changes such as withdrawal, sleep disturbances, hypervigilance, mood swings and poor concentration; lifestyle changes and avoidance are common” (Naidoo, 2013, p. 210). Additionally, Naidoo (2013) suggested that these scars can heal over a short time or drag on long-term.