Containing the Secret of Child Sexual Abuse

Abstract

This study reports a grounded theory study of the process of how children tell of their experiences of child sexual abuse from the perspectives of young people and their parents. Individual interviews were conducted with 22 young people aged 8 to 18, and 14 parents. A theoretical model was developed that conceptualises the process of disclosure as one of containing the secret of child sexual abuse. Three key dynamics were identified: the active withholding of the secret on the part of the child, the experience of a ‘pressure cooker effect’ reflecting a conflict between the wish to tell and the wish to keep the secret, and the confiding itself which often occurs in the context of an intimacy being shared. Children’s experiences of disclosure were multidetermined and suggest the need for multifaceted and multisystemic approaches to prevention and intervention. The need for the secret to be contained, individually and interpersonally in appropriate safeguarding and therapeutic contexts needs to be respected in helping children tell.

Keywords

child sexual abuse disclosure parents’ reactions

Introduction

Child sexual abuse is now recognized as a global issue that despite varying prevalence rates worldwide (see Lalor & McElvaney, 2010 for review) demands further investigation, particularly in relation to how children disclose such experiences. Nondisclosure and delays in disclosure of child sexual abuse are of particular concern in the field of child protection. Research to date, based predominantly on adult surveys and file reviews of children, has revealed two key findings: delays in disclosure in children are common, and a significant proportion of children do not disclose until adulthood (Pipe et al., 2007). In addition, a significant number of children deny that they were abused, even when corroborative evidence is available that abuse occurred and recant allegations of abuse that have been later substantiated (Malloy, Lindsay, Lyon, & Quas, 2007). It is therefore of central importance to the welfare of children that the dynamics involved in the disclosure process are investigated and understood.

Factors Influencing Delays in Disclosure

Empirical research on disclosures of sexual abuse has focused on investigating the extent of delays in disclosure and the factors that inhibit disclosure. Disclosure rates increase with age (Hershkowitz, Horowitz, & Lamb, 2005), and some studies suggest that younger children were more likely to delay disclosing than older children (Kogan, 2004; Smith et al., 2000). However, other studies have found that older children were more likely to delay in disclosing than younger children (Goodman-Brown, Edelstein, Goodman, Jones, & Gordon, 2003; Hershkowitz, Lanes, & Lamb, 2007). Children, in general, and younger children in particular are more likely to make allegations against familiar nonfamily members and strangers than against parents or stepparents (Hershkowitz et al., 2005). Patterns in choice of confidante are evident with younger children confiding in a parent or a trusted adult and older children confiding in a peer (Crisma, Bascelli, Paci, & Romito, 2004; Hershkowitz et al., 2007, Kogan, 2004; London, Bruck, Ceci, & Shuman, 2005; London, Bruck, Ceci, & Shuman, 2007; Roesler & Wind, 1994).

Most studies that examine disclosure in children are conducted in the context of investigative interviews with a particular focus on questioning styles (Hershkowitz, Orbach, Lamb, Sternberg, & Horowitz, 2006; Sternberg, Lamb, Davies, & Westcott, 2001) and developing improved protocols for interviewing children when there are concerns about sexual abuse. Jones (2000) highlights the importance of distinguishing between formal and informal disclosures in such contexts as forensic interviews and informal disclosures to family or friends. Keary and Fitzpatrick (1994) found that most of the children who disclosed in formal interviews had already disclosed their abuse prior to the interview, whereas Coulborn Faller (2007) noted that structured interview protocols, “are best suited to children who are latency-aged, who have already disclosed, and who are willing to disclose” (p. 88). According to London et al. (2007),

It is difficult if not impossible to obtain accurate information if the first disclosure is made outside a formal setting (e.g. to a parent, friend or teacher). We have to rely on studies in which children are questioned in formal investigative interviews. (p. 217)

However, conclusions are drawn in the literature about the way in which children disclose, and the factors that influence such disclosure without drawing the distinction between these formal and informal contexts. There is clearly a need for studies that capture the experience of informal disclosure from the child’s point of view.

Theoretical Models of the Disclosure Process

Few attempts have been made to develop theory to better understand the disclosure process. Summit’s (1983) child sexual abuse accommodation syndrome consisting of successive phases of the disclosure process from the perspective of the child, offered some explanation for why it is that children struggle with being able to tell. According to Summit, the child accommodates to the abuse experience, and nondisclosure is seen as a way of coping with this experience. Furniss (1990), in describing the abuse experience as a syndrome of secrecy, identified those aspects of the abuse experience that contributed to this secrecy: external factors such as the lack of forensic proof for much sexual abuse, and pressure on the child not to tell; aspects of the abusive interaction itself that lend to secrecy leading the child to experience the interaction as uninterpretable; and internal psychological factors within the child such as taking responsibility for the abuse, fear of the perpetrator, and consequences of telling. Conceptualizing the experience of abuse as a syndrome of secrecy highlights the adaptive function for the child of maintaining the secret.

Bussey and Grimbeek (1995), drawing on the work of Bandura (1986, 1989a, 1989b, cited in Bussey & Grimbeek, 1995), proposed, “a dynamic interactional model in which disclosure is multi-determined” (p. 175). They identified four sociocognitive elements that determine nondisclosure—attention, where children have not paid sufficient attention to the event; retention where children are unable to remember it in sufficient detail; production, where children are unable to communicate adequately about the event; and motivation where children are unwilling to report it. Bussey and Grimbeek noted that the course of disclosure varies according to children’s cognitive capacities, their social experiences, and the particular situation in which they find themselves. From a cognitive perspective, older children are better able to report their abuse due to increased attentional, retentional, and production skills. However, with increased cognitive abilities and social experience, children become more aware of the costs and benefits of disclosure, so it is anticipated that children’s disclosure will be more self-regulated as they mature: “They learn to inhibit their disclosure of events, particularly events that they anticipate others might respond to in an unfavorable manner, even when not explicitly asked not to disclose” (p. 183).

On the basis of previous research, Goodman-Brown and colleagues (2003) proposed a model of delay that suggested that fears of consequences of telling and perceptions of self-blame were key factors inhibiting children from telling about their experiences of abuse. They found that the child’s age at the time of reporting the abuse, the type of abuse (whether intra or extra familial), the child’s perceived responsibility for the abuse, and the child’s fear of negative consequences of disclosure determined the time to disclosure. The authors emphasized the influence of children’s expectations about others’ reactions to and tolerance of disclosure and perceptions of responsibility for the abuse on children’s decisions to disclose.

Staller and Nelson-Gardell (2005) conceptualized the disclosure process as a three stage temporal framework: Self, where preadolescent and adolescent female survivors of sexual abuse (n = 34) came to terms with feelings about the abuse and the abuser and made their decision to tell; Confidant Selection-Reaction where they chose to whom, when, and where to tell and coped with the reaction to their disclosure (supportive and hostile); and Consequences, both positive and negative, that informed their ongoing decision making about telling.

There are two aspects of the models reviewed above that make a significant contribution to the literature on disclosure processes. First, they emphasize the role of children’s expectations of potential reactions to disclosure and the interactive nature of disclosure: “Disclosure is not a one-way process. Children receive, process, evaluate, and react to information based on how adults respond to them” (Staller & Nelson-Gardell, 2005, p. 1423). Thus, the young person’s disclosure is seen in the context of communicating and relating to others. The recipient of the disclosure plays an important role in this dialogue and influences future decisions about telling. This is supported by research highlighting the importance of others’ responses, particularly the mother, to disclosure both in terms of encouraging disclosure (Lawson & Chaffin, 1992) and mediating the psychological impact of the abuse (Lovett, 2004). The second contribution is the assertion that there are life-long implications to disclosure. The child’s world, according to Staller and Nelson-Gardell is divided into those who do know and those who do not know. Young people must continue to make what the authors refer to as “first disclosure decisions” continually evaluating trust, likely response, and consequences of telling in each new relationship. Traditionally, studies have neglected to acknowledge the multiplicity of experiences of disclosure, but more recently studies have identified the first, second, third, fourth person to whom the person disclosed their abuse experience (Hershkowitz et al., 2007). In the words of one of Staller and Nelson-Gardell’s research participants, “It’s never finished, never” (p. 1426). These authors advocate integrating existing theories and research into a model that takes account of both the child’s and the adults’ concerns while taking a broader perspective that includes the predisclosure and postinitial public disclosure experiences.

London et al.’s (2007) review highlights the predominance of quantitative methodologies used in studies investigating disclosure in search for elusive “typical” patterns. However, the assumption that patterns exist and can be generalized to all children may be misleading. Jones (2000) notes that the variability and multiplicity of influences operating on the individual child needs to be better understood to help children disclose their experiences of abuse. According to Jones, there is a need to complement the knowledge gathered from surveys and quantitative studies with more in-depth studies capturing the child’s experience: “Qualitative studies which are able to track the individual experiences of children and their perception of the influences upon them which led to their disclosure of information are needed” (p. 270). A qualitative approach seeks to understand the subjective realm of human experience. It therefore lends itself to a focus on the process of how disclosure unfolds over time in different contexts. In order to understand children’s experiences from their perspective, we need to ask children directly about these experiences, using child-centered methodologies (Greene & Hogan, 2005). Building on Staller and Nelson-Gardell’s work, this study focused on exploring the experiences of young people before, during, and subsequent to making informal disclosures. The central research question is “how do children tell?”

Method

Participants

This study is based on interviews with 22 young people in Ireland, 16 girls and 6 boys, ranging in age from 8 years to 18 years as part of a larger study exploring disclosure experiences. Most of the young people interviewed (n = 21) were aged between 12 years and 18 years. One child was aged 8 years. All but one were Irish born. Eleven had experienced intrafamilial abuse only, nine had experienced extrafamilial abuse only, and two children had experienced both intrafamilial and extrafamilial abuse. Intrafamilial abuse included abuse by the mother’s live-in partner. The type of abuse experienced ranged from sexual fondling to vaginal and anal penetration. The researcher accessed the sample through a child sexual abuse assessment and therapy service, based in a children’s hospital in a large city in Ireland. All participants had given an account of sexual abuse that was deemed credible by the professionals who assessed them. Consent was obtained initially from the assessment team involved with the families, from parents, and, finally, from the young people themselves. Ethical approval was obtained from the hospital’s ethics committee and the University’s School of Psychology ethics committee.

Data Collection and Analysis

This study was informed by grounded theory methodology (Charmaz, 2006; Strauss & Corbin, 1998). A semistructured interview schedule was developed based on the literature in the field, consultation with professionals working in child sexual abuse services, and an interview with one young person as a pilot project. Participants were asked a series of open questions to elicit a narrative regarding their experiences of telling: when they first told, to whom they told, what helped them to tell, what prevented them from telling sooner, how people responded to their story, experiences of subsequent telling, and their views on how we can help children tell. The interview schedule was amended through an iterative process, incorporating changes as themes emerged through analysis of earlier interviews in the data-collection process. The interviews were digitally audiotaped and transcribed by the first author. Transcripts were read and re-read, and line-by-line open coding was conducted on all transcripts followed by axial coding (Strauss & Corbin, 1998). NVivo software (QSR International, 2002) was used to facilitate data management and analysis. Categories were developed and compared based on an investigation of the properties and dimensions of each category. Comparative analysis identified similarities and differences that led to the development of more abstract categories.

Analytic memos were written to explicate the conceptual process of developing categories and to provide a paper trail of the analysis process, thus maintaining transparency and reflexivity. All categories and themes were identified from the data, not predetermined. Charmaz (2006) recommended that themes emerging from data should be active if they are to portray an underlying process. One of the coding problems she identified is that of “identifying topics instead of actions and processes” (p. 69). A random sample of transcripts with accompanying coding was read by a colleague, and one young person read the transcript of their interview and discussed the coding with the researcher as a credibility check.

The coding process is illustrated by a triangular model (see Figure 1), whereby the raw data, that is, the transcripts, represent the foundation on which the first level of analysis, a series of open codes identified as key meaning units, was based. The comparative analysis process undertaken resulted in a smaller number of meaning units emerging from these open codes, at a higher more abstract level of meaning representing categories. A further analysis of these categories using comparative analysis led to an even smaller number of key domains, and finally, one core theme was identified that captures the overall process.

Figure 1.

Illustration of data analysis (bottom-up) process

Findings

Containing the Secret of Child Sexual Abuse: A Theoretical Framework

Eleven categories emerged from the axial coding phase of data analysis which in turn led to three key domains being identified: active withholding, pressure cooker effect, and confiding the secret, reflecting an overarching process of containment in the experience of disclosure.

Active Withholding

Young people in this study described not wanting people to know about their experience, denying when asked if anything was wrong, trying to tell someone but having difficulty saying it, and when they did tell, confining the secret to a trusted few. These four categories are captured in the domain “active withholding” and suggest a dynamic process of withholding the secret.

Not wanting people to know

Young people did not wish others to know about what happened, “I didn’t want my mam or anyone to know” (17-year-old girl). A 13-year-old girl wrote a note that she intended giving to her mother when she was older. Some made up stories to deter people from asking questions when they were upset. Others withheld from their friends that they were attending therapy as they could not explain why without divulging the abuse.

Denying when asked

Many young people denied that they were abused at some point. Three young people were asked directly by a counselor or a parent, if they had been abused and denied it. A 16-year-old boy’s sister discovered a cousin behaving inappropriately with her younger brother and asked him if this cousin had ever touched him, “. . . and I kinda started crying, said ‘no no no’ and walked out, ran out of the room and went back onto the road.” Seven or eight years later, having first disclosed to friends, he told his sister that he had been abused. For other young people, denial was an instinctive reaction that was followed immediately by a disclosure: “Like she knew by me face like there was something up. She was saying ‘tell me.’ I was saying ‘God no way no’” (18-year-old girl). A 13-year-old boy told his cousin but when his father asked him about it, “I denied it for a while.” One girl’s friend was suspicious,

She kept on asking me “are you ok?” I said “yes I’m fine” . . . she kind of said something about the way the brother (the abuser) looks at me “what is he doing to you?” I said “nothing.” She’s like “you’re lying.” (18-year-old girl)

Difficulty saying it

For many young people, it appears that it may be easier to keep the secret than to disclose it. Young people described their persistence in trying to tell but not being able to say the words:

I wanted to say something but I just couldn’t . . . It was almost as if I was trying to speak but my voice was just cut off it was like I was just miming it but nothing was coming out. (16-year-old girl)

This difficulty in talking about the abuse is not just experienced the first time the story is divulged but continues in each new telling. One young girl talked about how difficult it was trying to tell two friends, although she had already told her boyfriend and her mother: “I was crying but I couldn’t get it out and they were like ‘what is it? just get it out’ and I couldn’t get it out” (17-year-old girl).

Confining the secret

Withholding information continued even after the first disclosure. This may have been in relationship to disclosing further information, “me Ma was just like trying to get more information out of me but I wouldn’t give it to her” (15-year-old girl) or preventing other people from knowing about it at all: “I didn’t want my Mum or anyone to know” (17-year-old girl). One 14-year-old girl described how she had to self-monitor the extent of information she gave when disclosing, “when I was telling (aunt) I was like ‘oh my god I’m telling somebody’ and I was like ‘right . . . that’s enough’” (16-year-old girl).

These findings support the idea that for the most part, and particularly in older children, nondisclosure is not a passive nondisclosing experience, but rather an active withholding of information: “I . . . held onto it about from the age of 9 until about 15” (16-year-old boy). At a broader family and community systemic level, the secret is still actively withheld. In more than a quarter of families of those young people interviewed (n = 6), only family members knew of the abuse, and in two of these cases siblings had not been told. For 11 young people, their schools had not been told. Thus, an ongoing attempt to restrict those who knew of the abuse was evident.

Pressure Cooker Effect

The second dynamic identified in this study is in the domain “pressure cooker effect,” evident in the categories wanting and not wanting to tell, feeling distressed, opportunity to tell, and unplanned telling.

Wanting and not wanting to tell

Some young people described their ambivalence about telling, representing the conflict between wanting to tell and not wanting to tell:

I did want to tell her I really did. Well, at the same time I didn’t. (17-year-old girl)

I always wanted to tell someone. I remember going into her bedroom and leaving a note I used to wrap it up in her nightie. And then I’d think “No I can’t tell” and I’d run in and get it back. I did that loads of times. (15-year-old girl)

I tried so many times to tell me Mam to tell me dad like to tell me brother. Like I used to just come in and say “Mam I’ve something to tell you” and then she’d say “what?” an I’d say “No it doesn’t matter I’m only messing with you.” (16-year-old girl)

This ambivalence may have been there from the beginning, or it may have emerged as the young person considered the consequences of telling:

And then I’m like maybe I shouldn’t . . . they’re gonna want to say it to someone else . . . but at the same time I’d like to be able to talk to them. And yet at the same you don’t want them to think any less of you either. (15-year-old girl)

Feeling distressed

For many young people, there was an emotional cost in keeping the secret. The psychological distress of actively withholding the secret became too much to cope with: “I didn’t tell anyone for a good few months and it was killing me” (15-year-old girl), “I kinda just tried to bury it and it didn’t work ‘cos it kept coming up to the surface every now and again and I’d get angry and cry and I’d run up to my room” (16-year-old boy). The emotional pressure described by the young people in this study captures the idea of a pressure cooker simmering away and building up to disclosure:

I just felt bad really like holding it in . . . it was just like I had to tell or it was just gonna be there for ever and ever and it’s just gonna annoy me I just had to tell. (13-year-old boy)

I dunno when I would have said it or who I would’ve said it to but there was no way I would have been able to keep that. (15-year-old boy)

Opportunity to tell

Many young people noted that if it wasn’t for the particular set of circumstances at the time they told (an argument, watching a television program about abuse)—they would not have told anyone at all or would not have told for some time: “I often do think to myself God if we actually didn’t have that argument would I have told?” (16-year-old girl). Another 16-year-old girl said she would not have told her mother if the alleged abuser had not telephoned her mother complaining about her: “If I didn’t tell I woulda always kept it in me all the time” (13-year-old girl); “I wouldn’t a told. There’s no way I woulda told” (15-year-old girl).

Unplanned telling

Many of the disclosures described were unplanned, triggered unexpectedly,

It just happened on that day and it was just mad ‘cos like I just came out with it. (16-year-old girl)

We were talking about our problems . . . and em we were trying to help her with that. And then like out of nowhere like I just felt like saying it. ‘Cos it was like built up and all of a sudden I just said it. (16-year-old boy)

Although these disclosures were purposeful in the sense that these young people were not asked directly if they had been abused, it is clear from their narratives that there was no conscious decision made to tell when they did: “Like I never actually planned to turn round and tell somebody. I never said ‘right today’s the day I’m gonna tell somebody’” (16-year-old girl).

Thus, the pressure cooker effect represented a dynamic in the process of disclosure of pressure building up toward the actual telling but also characterized the nature of the telling experience.

Confiding

Finally, having actively withheld the secret, experienced the conflict between the wish to tell and the wish to withhold this information, the secret is confided. The domain “confiding” is reflected in three categories, choice of confidante, context of confiding, and confidentiality.

Choice of confidante

Many young people referred to the issue of trust in talking about to whom they told: “The problem is there’s only a slight few friends you can confide in and I was lucky I found two” (16-year-old boy); “it wasn’t hard telling them cos I knew they wouldn’t say anything” (17-year-old girl). The person to whom the young person first confided was usually someone they felt close to, “and we’re real close we are” (14-year-old girl). Even when young people delayed telling their parents, they referred to the close relationship they had, “my Mum and I have a really close relationship so em . . . I finally told her” (17-year-old girl).

Sharing confidences

The experience of confiding in friends often occurred in the context of a mutual sharing of confidences, “we were talking about our problems” (16-year-old boy), “well a friend of mine actually told me that something had happened her with her next-door neighbour . . . and I wanted to say something” (16-year-old girl).

Need for confidentiality

Young people’s wish and stated need for confidentiality when they did tell was evident and often informed their decisions as to whom to tell: “I suppose I just really needed someone to confide in” (16-year-old girl), “I don’t want to tell my friends . . . some of them are like kind of blabbermouths” (12-year-old girl). The need for confidentiality was also related to the nature of sexual abuse. A 15-year-old girl, having told her mother and professionals, didn’t want her father or her friends to know: “Just ‘cos it’s private stuff.” On occasion, young people asked others not to tell anyone else, “and I asked her not to say anything” (16-year-old girl).

Discussion

The process of disclosure that emerged from this study is conceptualized here as a process involving three key dynamics: active withholding, the pressure cooker effect, and confiding the secret.

Active Withholding

The dynamic of active withholding was evident in not wanting others to know about the abuse, their denial when asked questions, the difficulty experienced when participants attempted to tell someone, and restricting the number of people within their family or social circle that knew of the abuse. Both Summit (1983) and Furniss (1990) emphasized the secrecy surrounding the experience of child sexual abuse, and as noted above, studies of both adults and children record significant delays in disclosure and nondisclosure. This is most notable in studies where respondents reported childhood experiences of abuse for the first time to the researcher in the study—in studies of adults, it was 47% (McGee, Garavan, deBarra, Byrne & Conroy, 2002) and 28% (Smith et al., 2000) and in studies of adolescents, it was 26% (Kogan, 2004). The agency on the part of the child in this process has also been acknowledged. Staller and Nelson-Gardell’s (2005) first phase implies that the decision to disclose is a conscious decision taking account of the costs and benefits, as highlighted by Bussey and Grimbeek (1995), and also acknowledging the role of emotions for the young person. In establishing fear of consequences as a significant inhibitor to telling, Goodman-Brown et al. (2003) also imply an active decision on the part of the young person not to tell. Further evidence of active withholding is evident in those children who denied abuse occurred when asked. This was first highlighted by Summit (1983) and Sorenson and Snow (1991) and has been substantiated more recently (Alaggia, 2004; Malloy et al., 2007).

Active withholding, when it occurs at the intrapersonal level (before the child has confided), may give the child a sense of control and safety in an unsafe world. Keeping the secret may be a way of gaining and maintaining control through managing the flow of information and the accompanying distress associated with sharing this information. McElvaney’s (2002) participants described nondisclosure as a way of forgetting about what happened. It may in effect be the child’s way of regulating the emotional impact of the abuse and providing containment for the child.

Pressure Cooker Effect

The struggle between wanting to tell and not wanting others to know, for the young person who was attempting to self-regulate their emotions, is conceptualized here as the pressure cooker effect. This emotional struggle was evident for many in the context in which they told—an unplanned disclosure, heightened emotional distress and the opportunity being available either in terms of access to trusted others, conversations about intimate experiences, or an inability to withhold the information any longer. Mudaly and Goddard (2006) cited one young 13-year-old boy, “I wanted to (tell) but I didn’t, like, want to” (p. 89). According to Lovett (2004), “most victims of child sexual abuse both long and fear to reveal the secret” (p. 356).

It is central to the idea of the pressure cooker effect that the buildup was emotional. Previous studies have acknowledged the child’s fear of the consequences of disclosing as a significant contributory factor to the disclosure process (Goodman-Brown et al., 2003). Although Finkelhor and Browne (1985) discussed how difficulties with emotion regulation are manifested in behavioral and cognitive difficulties, Bentovim (1995) and Friedrichs (2002) have highlighted how the psychological impact of the abuse experience depends to a large extent on the individual child’s ability to self-regulate emotions. Bentovim (2002) refers to the experience as “overwhelming” and “beyond control,” “the pressure not to see, not to hear, not to speak, means that there is no processing of experiences” (p. 23) whereas Rogers (2006) refers to the trauma as, “the unsayable . . . something that moves toward speech and away from speech at the same time” (p. 57). Alaggia (2005) described adult women in her study, whose disclosures were often precipitated by a psychological breakdown or hospital admission. Thus, overwhelming psychological distress acted as a trigger for disclosure. The pressure cooker effect then represented the buildup of emotions due to increasing psychological distress being asked questions about their well-being or their behaviour, competing with the need to actively withhold the secret. The unplanned nature of many disclosures represents an emotional response to the pressure of having to keep the secret yet needing to tell.

Confiding

The final dynamic in the process of containing the secret was that of confiding. It is suggested that the term confiding more appropriately conveys the meaning associated with the experience of telling as a sharing of intimate information. Young people in this study identified the recipient of their disclosure as someone they trusted, someone close to them be it their parent, friend, or other significant person in their lives. Recent research has highlighted the important role that peers and other nonparental figures play in the disclosure process. Studies relying on clinical samples of children alone tend to reflect a higher proportion of disclosures to parents by virtue of sampling method. Collings, Griffiths, and Kumalo (2005) noted that of their hospital sample of young people in South Africa who had experienced penetrative abuse and had disclosed purposefully, the confidante was a family member in 48% of cases. Sperry and Gilbert (2005), however, found that less than a quarter of their sample of undergraduate students who had disclosed sexual abuse had told a parent. Priebe and Svedin (2008) noted that in their large scale study of adolescents, of those who had disclosed their experience of abuse, 42.6% of the boys and 37.9% of the girls mentioned “friend of my own age” as the only recipient of the disclosure. London et al. (2005) noted that the increase in disclosure rates in adolescence may be associated with the increased availability of same-age peers in whom to confide. The context of confiding for many young people in this study was that of sharing confidences.

The wish for confidentiality to be maintained was clearly articulated by young people in this study and reflected young people’s fears of consequences of telling and their need for this information to be contained. Young people spoke of fears of friends or even family members talking to others about the disclosure. The need for confidentiality both influenced young people’s decisions to tell and continued to be felt after confiding in another.

Containing the Secret

Containment, as it is suggested, is a psychological response to the experience of abuse and represents the need of the child to cope with the unmanageable anxiety associated with the experience of abuse. The child is involved in the overall process as an active agent, attempting to regulate the emotional impact of the experience of abuse. Lovett (2004) suggested that intentional disclosures reflect that the victim is better able to contain her anxiety in that she has actively made the decision to disclose the abuse and seek help. Reconceptualizing “disclosure” and “nondisclosure” as aspects of a process of containing the secret is consistent with viewing these processes as adaptive for the child. Summit suggested in 1983, that for many children, silence is an adaptive-coping strategy for children. Although the disclosure process has not been conceptualized in the literature as one of containing the secret, research findings are consistent with such a conceptualization.

Conclusion and Implications of Findings

The process of confiding experiences of child sexual abuse is not linear and sequential as suggested in the early literature on child sexual abuse, but is, as Staller and Nelson-Gardell (2005) suggested, a dialogical process that is renegotiated and influenced by each experience of disclosure. The findings of this study suggest that this process is best conceptualized as one of containment, involving the dynamics of actively withholding information, a pressure cooker effect and confiding. The process may continue in a “stop-start” fashion throughout the life span, whereby each successive experience of telling involves these dynamics as young people disclose in new trusted relationships, thus renegotiating the process (Staller & Nelson-Gardell, 2005). Thus, the task of facilitating young people in telling their experiences continues.

The sample in this study was limited in terms of age, gender, and cultural context. This theoretical model may not reflect the disclosure process of younger children or adults, and further research with boys and men may reveal gender specific dynamics. Most of the young people in this study were above 12 years of age. Although prevalence rates for disclosure are higher in adolescence (DiPietro, Runyan & Fredrickson, 1997; Hershkowitz et al., 2005, 2007; Keary & Fitzpatrick, 1994), there is insufficient data to support the thesis that this is regardless of age at the time of the abuse, though Farrell (1988) did find that older girls who were abused by their fathers were more likely to disclose in adolescence.

The factors that influenced these dynamics in this study are the subject of a paper in preparation. However, it is relevant to note here that this study was undertaken in a particular cultural context that may limit its applicability to other contexts. Ireland is a small country with a strong Catholic ethos that permeates familial, educational, and societal institutions. The superior rights of parents in relation to their children as enshrined in the Irish constitution are a concern where children are the victims of intrafamilial abuse. A recent evaluation of the implementation of a relationships and sexuality education program in second level schools noted the discomfort on the part of teachers in discussing sexuality in the classroom (Mayock, Kitching, & Morgan, 2007). Ireland has no legislation mandating professionals to report child abuse to child protection or law enforcement agencies, and prosecution rates for sexual offences are low. Goode, McGee, and O’Boyle, (2003) noted that Irish legislation and governmental policies in Ireland contributed to the suppression of public awareness of child sexual abuse, and a low prosecution rate of sexual crimes (15%), “because of the desire of parents to keep the abuse secret and their reluctance to have their child appear in court” (p. 281). Variations in belief systems and value orientations related to one’s cultural background have been identified as factors influencing an individual’s willingness to disclose sexual abuse (Toukmanian & Brouwers, 1998). The findings of this study, therefore, need to be situated in this particular cultural context.

The framework proposed here builds on previous work in several respects. First, it elaborates on Staller and Nelson-Gardell’s (2005) first phase of the disclosure process, that of “self” whereby the young person comes to terms with their feelings about the abuse and makes the decision to tell. The active-withholding dynamic describes the active nature of nondisclosure and conceptualizes this as adaptive for the young person, meeting their need for containment. Second, building on the interpersonal dimension of the disclosure experience, this framework illustrates how young people are strongly influenced by others in this process—through their difficulty in speaking of the abuse to others, their fear of others knowing, denying when asked, and when they do confide, confining the secret to a trusted few. The telling itself, as it is suggested, is preceded by a dynamic of pressure cooker effect representing the conflict between the need to tell and the need to withhold the secret. Finally, telling is conceptualized as confiding, representing the confidential nature of the experience, the trust placed in the confidante and the context of the telling.

The child’s need for containment then needs to be appreciated in devising interventions that aim to help children tell. Balancing children’s need to tell with their tendency to withhold raises the question of children’s need to be asked. Recent qualitative studies that take account of disclosures in informal contexts suggest that prompted disclosure may be much more common than had been previously represented in the research, even for older children. Hershkowitz et al. (2007) note that 43% of their sample of 30 children only disclosed abuse after they were directly asked. This phenomenon has not been recognized by studies examining this process solely in the context of investigative interviews. Collings et al. (2005) highlight the role played by both children and significant others in the process of child sexual abuse recognition and reporting. Detection by another was found to be more likely as the stimulus for disclosure than purposeful disclosure by the child, as noted in less than 30% of their sample of young people. Jensen, Gulbrandsen, Mossige, Reichelt, and Tjersland (2005) note that in their study, the context for disclosure resulted in someone recognizing the child’s cues and probing further. They suggest that a certain “preparedness” and “sensitivity” is required from the caregiver to initiate conversations or follow-up on the cues the child has offered to facilitate disclosure, and a certain “readiness” on the part of the child is needed to tell about the abuse experience.

The diversity of children’s experiences of confiding sexual abuse in this study and elsewhere, supports the position that children’s experiences of disclosure are multidetermined (Jones, 2000), and a multifaceted and multisystemic approach to prevention and intervention is needed that takes account of the potentially conflicting needs of child protection, therapeutic and legal systems, and the needs of children and their families to contain the secret of sexual abuse. In helping children tell, it is necessary to respect their need to contain this secret.

Footnotes

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Health Research Board in Ireland through a Health Services Research Fellowship grant awarded to R. McElvaney.

References

Alaggia

(2004). Many ways of telling: expanding conceptualizations of child sexual abuse disclosure. Child Abuse & Neglect, 28, 1213-1227.

Alaggia

(2005). Disclosing the trauma of child sexual abuse: A gender analysis. Journal of Loss & Trauma, 10, 453-470.

Bentovim

(1995). Trauma organised systems. London, UK: Karnac.

Bentovim

(2002). Developmental identity disorder: A developmental perspective. In Sinason

(Ed.), Attachment, trauma and multiplicity. New York: Brunner-Routledge.

Bussey

Grimbeek

E. J.

(1995). Disclosure processes: Issues for child sexual abuse victims. In Rotenberg

K. T.

(Ed.), Disclosure processes in children and adolescents (pp. 166-203). Cambridge, UK: Cambridge University Press.

Charmaz

(2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: SAGE.

Collings

S. J.

Griffiths

Kumalo

(2005). Patterns of disclosure in child sexual abuse. South African Journal of Psychology, 35, 270-285.

Coulborn Faller

(2007). Interviewing children about sexual abuse: Controversies and best practice. New York, NY: Oxford University Press.

Crisma

Bascelli

Paci

Romito

(2004). Adolescents who experienced sexual abuse: Fears, needs and impediments to disclosure. Child Abuse & Neglect, 28, 1035-1048.

10.

DiPietro

E. K.

Runyan

D. K.

Fredrickson

D. D.

(1997). Predictors of disclosure during medical evaluation for suspected sexual abuse. Journal of Child Sexual Abuse, 1(6), 133-142.

11.

Farrell

L. G.

(1988). Factors that affect a victim’s self-disclosure in father–daughter incest. Child Welfare, 67, 462–468.

12.

Finkelhor

Browne

(1985). The traumatic impact of child sexual abuse: A conceptualisation. American Journal of Orthopsychiatry, 55, 530-541.

13.

Friedrichs

W. N.

(2002). Psychological assessment of sexually abused children and their families. Thousand Oaks, CA: SAGE.

14.

Furniss

(1990). The multiprofessional handbook of child sexual abuse. London, UK: Routledge.

15.

Goode

McGee

O’Boyle

(2003). Time to listen: Confronting child sexual abuse by catholic clergy in Ireland. Dublin, Ireland: Liffey Press.

16.

Goodman-Brown

T. B.

Edelstein

R. S.

Goodman

G. S.

Jones

D. P. H.

Gordon

D. S.

(2003). Why children tell: A model of children’s disclosure of sexual abuse. Child Abuse & Neglect, 27, 525-540.

17.

Greene

Hogan

(Eds.). (2005). Researching children’s experiences: Approaches and methods. London, UK: SAGE.

18.

Hershkowitz

Horowitz

Lamb

M. E.

(2005). Trends in children’s disclosure of abuse in Israel: A national study. Child Abuse & Neglect, 29, 1203-1214.

19.

Hershkowitz

Lanes

Lamb

M. E.

(2007). Exploring the disclosure of child sexual abuse with alleged victims and their parents. Child Abuse & Neglect, 31, 111-123.

20.

Hershkowitz

Orbach

Lamb

M. E.

Sternberg

K. J.

Horowitz

(2006). Dynamics of forensic interviews with suspected abuse victims who do not disclose. Child Abuse & Neglect, 30, 753-769.

21.

Jensen

T. K.

Gulbrandsen

Mossige

Reichelt

Tjersland

O. A.

(2005). Reporting possible sexual abuse: A qualitative study on children’s perspectives and the context for disclosure. Child Abuse & Neglect, 29, 1395-1413.

22.

Jones

(2000). Editorial: Disclosure of child sexual abuse. Child Abuse & Neglect, 24, 269-271.

23.

Keary

Fitzpatrick

(1994). Children’s disclosure of sexual abuse during formal investigation. Child Abuse & Neglect, 18, 543-548.

24.

Kogan

S. M.

(2004). Disclosing unwanted sexual experiences: Results from a national sample of adolescent women. Child Abuse & Neglect, 28, 147-165.

25.

Lalor

McElvaney

(2010). Child sexual abuse, links to later sexual exploitation/high risk sexual behavior and prevention/treatment programmes. Trauma, Violence and Abuse, 11, 159-177.

26.

Lawson

Chaffin

(1992). False negatives in sexual abuse disclosure interviews: Incidence and influence of caretaker’s belief in abuse in cases of accidental abuse discovery by diagnosis of STD. Journal of Interpersonal Violence, 7, 532-542.

27.

London

Bruck

Ceci

S. J.

Shuman

D. W.

(2005). Disclosure of child sexual abuse: What does the research tell us about the ways that children tell? Psychology, Public Policy, and Law, 11, 194-226.

28.

London

Bruck

Ceci

S. J.

Shuman

D. W.

(2007). Disclosures of child sexual abuse: A review of the contemporary empirical literature. In Pipe

M. E.

Lamb

Orbach

Cederborg

A. C.

(Eds.), Child sexual abuse: Disclosure, delay and denial (pp. 11-40). London, UK: Lawrence Erlbaum.

29.

Lovett

(2004). Child sexual abuse disclosure: Maternal response and other factors impacting the victim. Child and Adolescent Social Work Journal, 21, 355-371.

30.

Malloy

L. C.

Lindsay

Lyon

T. D.

Quas

J. A.

(2007). Filial dependency and recantation of child sexual abuse. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 162-170.

31.

Mayock

Kitching

Morgan

(2007). RSE in the context of SPHE: An assessment of the challenges to full implementation of the programme in post-primary schools. Dublin, Ireland: Crisis Pregnancy Agency/Department of Education and Science.

32.

McElvaney

(2002). Delays in reporting childhood sexual abuse and implications for legal proceedings. In Farrington

D. P.

Hollin

C. R.

McMurran

(Eds.), Sex and violence: The psychology of crime and risk assessment (pp. 138-153). London, UK: Routledge.

33.

McGee

Garavan

deBarra

Byrne

Conroy

(2002). The SAVI report: Sexual abuse and violence in Ireland. Dublin: The Liffey Press.

34.

Mudaly

Goddard

(2006). The truth is longer than a lie: Children’s experiences of abuse and professional interventions. London, UK: Jessica Kingsley.

35.

Pipe

M. E.

Lamb

M. E.

Orbach

Stewart

Sternberg

K. J.

Esplin

(2007). Factors associated with nondisclosure of suspected abuse during forensic interviews. In Pipe

M. E.

Lamb

M. E.

Orbach

Cederborg

A. C.

(Eds.), Child sexual abuse: Disclosure, delay and denial (pp. 77-96). Mahwah, NJ: Lawrence Erlbaum.

36.

Priebe

Svedin

C. G.

(2008). Child sexual abuse is largely hidden from the adult society: An epidemiological study of adolescents’ disclosures. Child Abuse & Neglect, 32, 1095-1108.

37.

QSR International. (2002). NVivo [Computer software]. Doncaster, Australia: Author.

38.

Roesler

T. A.

Wind

T. W.

(1994). Telling the secret: Adult women describe their experiences of incest. Journal of Interpersonal Violence, 9, 327-338.

39.

Rogers

A. G.

(2006). The unsayable: The hidden language of trauma. New York, NY: Random House.

40.

Smith

D. W.

Letourneau

E. J.

Saunders

B. E.

Kilpatrick

D. G.

Resnick

H. S.

Best

C. L.

(2000). Delay in disclosure of childhood rape: Results from a national survey. Child Abuse & Neglect, 24, 273-287.

41.

Sorenson

Snow

(1991). How children tell: The process of disclosure of child sexual abuse. Child Welfare, 70, 3-15.

42.

Sperry

D. M.

Gilbert

B. O.

(2005). Child peer sexual abuse: Preliminary data on outcomes and disclosure experiences. Child Abuse & Neglect, 29, 889-904.

43.

Staller

K. M.

Nelson-Gardell

(2005). “A burden in your heart”: Lessons of disclosure from female preadolescent and adolescent survivors of sexual abuse. Child Abuse & Neglect, 29, 1415-1432.

44.

Sternberg

K. J.

Lamb

M. E.

Davies

G. M.

Westcott

H. L.

(2001). The Memorandum of good practice: Theory versus application. Child Abuse & Neglect, 25(5), 669-681.

45.

Strauss

A. L.

Corbin

(1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: SAGE.

46.

Summit

(1983). The child sexual abuse accommodation syndrome. Child Abuse & Neglect, 7, 177-193.

47.

Toukmanian

S. G.

Brouwers

M. C.

(1998). Cultural aspects of self-disclosure and psychotherapy. In Kazarian

S. S.

Evans

D. R.

(Eds.), Cultural clinical psychology: Theory, research and practice (pp. 106-126). New York, NY: Oxford University Press.