Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals’ assessment practice
Abstract Background Research shows that only around half of all survivors of child sexual abuse (CSA) disclose the abuse during childhood and adolescence. This is worrying, as CSA is related to substantial suffering later in life. The proportion of children and adolescents who have been exposed to C...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | International Journal of Mental Health Systems |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13033-024-00632-y |
| _version_ | 1797199596757188608 |
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| author | Margrethe Seeger Halvorsen Signe Hjelen Stige Jorunn E. Halvorsen Per-Einar Binder Elida Måkestad Ane Ugland Albaek Ann Christin Andersen |
| author_facet | Margrethe Seeger Halvorsen Signe Hjelen Stige Jorunn E. Halvorsen Per-Einar Binder Elida Måkestad Ane Ugland Albaek Ann Christin Andersen |
| author_sort | Margrethe Seeger Halvorsen |
| collection | DOAJ |
| description | Abstract Background Research shows that only around half of all survivors of child sexual abuse (CSA) disclose the abuse during childhood and adolescence. This is worrying, as CSA is related to substantial suffering later in life. The proportion of children and adolescents who have been exposed to CSA is significantly higher in Child and Adolescent Psychiatry (CAP) than in the general population. Healthcare professionals report that uncovering CSA is a complex and challenging task. However, we know little about how they proceed when uncovering CSA. More knowledge of healthcare personnel’s experience is therefore necessary to facilitate and increase CSA disclosure. The study aims to explore how CAP healthcare professionals in Norway proceed when assessing and detecting CSA, how they experience this work, and what hinders or facilitates their efforts. Methods The study employed a mixed method approach. Data was collected through an anonymous online survey, generating both quantitative and qualitative data. The sample consisted of 111 healthcare professionals in CAP, of whom 84% were women, with a mean age of 40.7 years (range 24–72; sd = 10.8). Mean years of CAP clinical experience were 8.3 years (range 0–41; sd = 7.5). The quantitative data was analysed using descriptive statistics, correlations, and independent sample t-tests, while the qualitative data was analysed using a team-based qualitative content analysis. Results The results showed that detection of CSA was viewed as an important, but complex task in CAP, and the existing procedures were deemed to be insufficient. The therapists mostly felt confident about how to proceed when they suspected or detected CSA, yet they seldom detected CSA. In their initial assessment they applied standardised procedures, but if their suspicion of possible CSA persisted, they seemed to rely more on clinical judgement. Specific challenges and facilitators for CSA detection were identified, both in the individual and in the organisation. Conclusions The study highlights the challenges and complexities healthcare professionals and the CAP system face when assessing CSA, which may account for the low detection rate. The results show that healthcare professionals believe room for clinical autonomy and targeted competence development may improve CSA detection. Additionally, the findings suggest a need for CAP to define roles and responsibilities within and between agencies. |
| first_indexed | 2024-04-24T07:18:16Z |
| format | Article |
| id | doaj.art-389721841b2849389523ce3d7e6cfa8e |
| institution | Directory Open Access Journal |
| issn | 1752-4458 |
| language | English |
| last_indexed | 2024-04-24T07:18:16Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Mental Health Systems |
| spelling | doaj.art-389721841b2849389523ce3d7e6cfa8e2024-04-21T11:08:52ZengBMCInternational Journal of Mental Health Systems1752-44582024-04-0118111210.1186/s13033-024-00632-yDetecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals’ assessment practiceMargrethe Seeger Halvorsen0Signe Hjelen Stige1Jorunn E. Halvorsen2Per-Einar Binder3Elida Måkestad4Ane Ugland Albaek5Ann Christin Andersen6Department of Psychology, University of OsloDepartment of Clinical Psychology, University of BergenØyane DPS, Bergen Hospital TrustDepartment of Clinical Psychology, University of BergenBergen Hospital TrustFaculty of Health and Sport Sciences, Department of Psychosocial Health, University of AgderRegional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Abstract Background Research shows that only around half of all survivors of child sexual abuse (CSA) disclose the abuse during childhood and adolescence. This is worrying, as CSA is related to substantial suffering later in life. The proportion of children and adolescents who have been exposed to CSA is significantly higher in Child and Adolescent Psychiatry (CAP) than in the general population. Healthcare professionals report that uncovering CSA is a complex and challenging task. However, we know little about how they proceed when uncovering CSA. More knowledge of healthcare personnel’s experience is therefore necessary to facilitate and increase CSA disclosure. The study aims to explore how CAP healthcare professionals in Norway proceed when assessing and detecting CSA, how they experience this work, and what hinders or facilitates their efforts. Methods The study employed a mixed method approach. Data was collected through an anonymous online survey, generating both quantitative and qualitative data. The sample consisted of 111 healthcare professionals in CAP, of whom 84% were women, with a mean age of 40.7 years (range 24–72; sd = 10.8). Mean years of CAP clinical experience were 8.3 years (range 0–41; sd = 7.5). The quantitative data was analysed using descriptive statistics, correlations, and independent sample t-tests, while the qualitative data was analysed using a team-based qualitative content analysis. Results The results showed that detection of CSA was viewed as an important, but complex task in CAP, and the existing procedures were deemed to be insufficient. The therapists mostly felt confident about how to proceed when they suspected or detected CSA, yet they seldom detected CSA. In their initial assessment they applied standardised procedures, but if their suspicion of possible CSA persisted, they seemed to rely more on clinical judgement. Specific challenges and facilitators for CSA detection were identified, both in the individual and in the organisation. Conclusions The study highlights the challenges and complexities healthcare professionals and the CAP system face when assessing CSA, which may account for the low detection rate. The results show that healthcare professionals believe room for clinical autonomy and targeted competence development may improve CSA detection. Additionally, the findings suggest a need for CAP to define roles and responsibilities within and between agencies.https://doi.org/10.1186/s13033-024-00632-yChild sexual abuse (CSA)Healthcare professionalsChild and adolescent psychiatry (CAP)UncoverDetectFacilitate |
| spellingShingle | Margrethe Seeger Halvorsen Signe Hjelen Stige Jorunn E. Halvorsen Per-Einar Binder Elida Måkestad Ane Ugland Albaek Ann Christin Andersen Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals’ assessment practice International Journal of Mental Health Systems Child sexual abuse (CSA) Healthcare professionals Child and adolescent psychiatry (CAP) Uncover Detect Facilitate |
| title | Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals’ assessment practice |
| title_full | Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals’ assessment practice |
| title_fullStr | Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals’ assessment practice |
| title_full_unstemmed | Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals’ assessment practice |
| title_short | Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals’ assessment practice |
| title_sort | detecting child sexual abuse in child and adolescent psychiatry a survey study of healthcare professionals assessment practice |
| topic | Child sexual abuse (CSA) Healthcare professionals Child and adolescent psychiatry (CAP) Uncover Detect Facilitate |
| url | https://doi.org/10.1186/s13033-024-00632-y |
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