adulthood. The risk involved could differ according to context and the child's stage of development. It therefore needs consideration when intervening (Fouche, 2012).
At times there has been little emphasis placed on allowing children to recover (Bux et al., 2016). Therefore, wanting to seek a conviction is a dynamic to regain power that may be lost. However, as the current research showed, what was important was that a child felt that he or she have been listened too. As the current research pointed out, the child’s definition of justice was then taken into account.
the interaction which would take place as a conversation as opposed to calling it an interview was said to increase trust.
The mesosystem interaction between the perpetrator and the child leads to losing trust in that relationship (Aucamp et al., 2014; Van der Merwe, 2009). When the perpetrator is not known, it is then a traumagenic betrayal by life itself (Van der Merwe, 2009). The extent of the CSA, therefore, adds to the dynamic of powerlessness, implying that the trauma could be more severe (Aucamp et al., 2014).
Bux et al. (2016) suggested that having security, empathy and trust facilitate
disclosure of trauma. Thus, to gain trust empathising with a child is required. By identifying with how a child may be feeling, participants would then ask questions which would create trust, hence, they could disclose. This research indicated that threats that are usually involved in CSA could hinder disclosure. So, by having trust, one can help the child overlook most threats.
Macleod (1999), showed that having a helpline or crisis line assists with
confidentiality of disclosure. Childline uses a crisis line. The current study had the same results. Participants in the current study proposed that knowing that there is no one looking at you when revealing sensitive details or not being able to see the CHWs reaction can
encourage disclosure. Likewise, in the Optimus Study (2016) CSA disclosure was higher in confidential questionnaires (Ward et al., 2018).
5.3.2. A safe environment
An environment can be any context in which the child is embedded. It can be in the home, at the hospital, at school, a police station, in court, or even the therapeutic setting. The incident of CSA may have left the child feeling alone and unable to trust (Ramphabana et al., 2019). Thus, a safe environment, as suggested by the current study, inspires freedom to talk and evokes a feeling of support. Furthermore, during a phone call, a safe environment can
still be established. As a participant indicated, when the CHW is not empathic, the child may resort to abruptly ending the call. Therefore CHWs considered it important to be respectful and probing through well thought out questions.
Further to this, Bux et al. (2016) suggested that a safe environment encourages good coping mechanisms. To create a safe environment, one needs to connect with the child on his or her level. Children interact well through play and can disclose information they are
holding to themselves. As evidenced by Rotter and Bush (2000, as cited in Adlem, 2017), CHWs consider play as a way to get into the hidden feelings of children without causing secondary harm since CSA betrays trust in people that can then affect any relationships the child may form in the future (Adlem, 2017). Therefore the environment should not be perceived as threatening to the child.
From the current study, the use of theory is encouraged when working with a disclosure from children. A participant suggested that instead of asking intrusive questions active listening, including reassurance, is required. Therefore grasping basic therapeutic skills helps one gain the child’s trust.
5.3.3. Supportive family
This study brought home the need for more supportive families. Responses frequently emphasised the need for support. Traditionally adults are uncomfortable discussing topics relating to sex with children (Ramphabana et al., 2019). Non-supportive families make it hard for children to disclose to parents as they need to adhere to rules of respect (Ramphabana et al., 2019). This may then contribute to a cycle of CSA (Ramphabana et al., 2019). Not being supported by trusted loved ones can also contribute to the traumagenic dynamic of betrayal (Van der Merwe, 2009).
Findings from the current study are supported by past studies in that support at the beginning of disclosure, believing the child, and acting after disclosure may help the child to
heal (Bux et al., 2016). The current study showed that support took place at three different stages. There was support before abuse ever happened, support once a child disclosed and support after disclosure. Support before disclosure means setting the standard of what may happen was the child ever to disclose sexual abuse. It is often in a home where the child is encouraged to talk about any topic openly. Parental figures would encourage the child to open up and explain the importance of speaking out. Support once disclosure happens is supposed to build the self-esteem of the child. Knowing that someone believed them is enough for the child to continue. Finally, in the case of support after disclosure has happened, it is apparent that it is not just the child who needs support, but the parents as well, allowing them to convey support and information to the child. Additionally, the role of the supporter is viewed as not reliant on gender or sibling hierarchy. What mattered was that there was
support in the home.
5.3.4. Stakeholders
The operation of a multidisciplinary team (MDT) helps alleviate workloads and expand on the holistic treatment of children. Currently, the role-players in CSA cases are doctors, nurses, counsellors, designated social workers, victim assistance officers (VAO), site-coordinators, IOs, forensic social workers, psychologists, and other personnel.
Participants suggested that having multiple role-players would help CSA disclosure.
It was not just their visibility, but also their efforts in maintaining CSA awareness campaigns and keeping to events such as Children’s Day, which would help to spread the message about CSA.
Learners and teachers are also facilitators of CSA disclosure (Brattfjell & Flam, 2019;
Ramphabana et al., 2019). This means that the school setting is an environment where CSA can be disclosed. Therefore, having educational programmes rolled out in schools on CSA
would be beneficial for survivors and also peers as they can learn how to respond when a friend confides in them about sexual abuse.
Networking between role-players was reported as a method of ensuring a smooth path towards disclosure. When possible, the IOs or designated social workers often assisted by transporting survivors to therapy at Childline. Consequently, this overcame the challenge of children who discontinued treatment due to financial constraints. However, with high
numbers of abuse, not every child has been able to receive this service (National Prosecuting Authority, 2019; South African Police Service, 2019).
5.3.5. Community awareness
The structure of many South African households has been affected by urban migration of parents or the death of parents due to illness (Jewkes et al., 2005). Parents often have to go out and provide financially for children. As a consequence, they are not always at home to observe the behavioural shifts in their children. Hence children are left to head families or are left in the care of the extended family, usually ageing grandmothers.
It is no surprise then that the community in which the child is embedded may be aware of behavioural changes or even witness the sexual abuse. Communities were described in the study as now being educated on CSA. This implies that a shift has taken place from a passive role to an active role. The role they have played may be of reporting suspected abuse and even offering their support to children. Childline has outreach workers who go out into the different communities and provide awareness on GBV, particularly CSA. Through these campaigns, people are reached, and they can then disseminate the information to others.
The mesosystem role-players are often family, school, community, and religious groups (Aucamp et al., 2014). Results of this study supported previous findings that children were likely first to report abuse to their peers (Brattfjell & Flam, 2019; Ramphabana et al.,
2019). The CHW’s might then find out from a survivor’s friend or through the friend’s parent. Hence the vigilance of teachers and community members often led to disclosure.
5.3.6. Cultural practices
Culture is multi-layered, and CSA exists in diverse cultures (Ramphabana et al., 2019). Hence the results of the current study showed the strength and areas for improvement within a culture. As a facilitator of disclosure, culture came marginally recommended by the present study. It is noteworthy that there was no literature found on the facilitating factors of culture regarding disclosure of CSA. Thus, this has implications for the current research and is a need for future research.
The sense from the study was that leading up to practices such as virginity testing and lobola negotiations some people were encouraged to disclose any sexual activity. Such a practice could then be a mechanism to disclose CSA. Further to this, a participant reflected that regardless of the context, people from different African cultures have similar reactions to CSA. Consequently, the endpoint, when relating to abuse, was that there is no variation in culture.
Traditionally the macrosystem consists of the predominant culture and its resources (Aucamp et al., 2014). However, for this study, the child was seen as embedded within a culture. Therefore culture is always present in the child’s life, so is part of the macrosystem.
5.3.7. Media
Similar to community awareness, yet a sub-theme on its own was the impact of media. Mass media or social media reaches millions in the country in various ways.
Furthermore, the standard response in the research was its ability to encourage disclosure.
The exosystem encompasses the interactions and the impacts between systems in the microsystem as well as broader organisations (Aucamp et al., 2014). Seeing other survivors
and campaigns in the media has a way of normalising the experience of disclosing, taking away feelings of self-blame.