The Barriers and Facilitators to Abuse Disclosure and Psychosocial Support Needs in Children and Adolescents around the Time of Disclosure

Background: Children who experience sexual or physical abuse often delay their disclosure. This study aimed to clarify the barriers and facilitators to abuse disclosure in a sample of children and adolescents participating in a police interview regarding alleged abuse. Method: Semi-structured interviews were conducted with 13 children (nine girls) who participated in a police interview regarding alleged abuse. They were asked about their abuse disclosure, their own and others' reactions to it, and the help and support they received from health service providers and other adults. Thematic analysis was used to identify themes, categories, and subthemes in the data. Results: The key theme that emerged was the domino effect of disclosures, which occurred in three ways--unintentionally, delayed, or to professionals. Delays in, and reluctance to, disclose is explained in various ways. Four sub-categories emerged: ambivalence in personal and others' reactions, missed opportunities, reflection depending on age, and varied psychosocial support needs. Notably, disclosure delays did occur because children identified abusive acts as transgressions or did not considered the abuse significant. Discussion: The present study reveals the significance of others' reactions to children's disclosures. The pattern showed supportive responses when children reported transgressions committed by adults, whereas peer abuse was met with mixed responses. Importantly, health care providers such as doctors and psychologists were not preferred confidants. In line with previous research, disclosure to friends or non-abusive family members was more common. The present findings underscore the difficulty with which children disclose abusive experiences, even in instances where it led to a police investigation. Conclusions: Child care practitioners need to be better equipped to meet a basic standard facilitating children to confide in others about abusive experiences. To increase the likelihood of keeping children in therapy after abuse, more active involvement of the child during clinical intervention seems important.