What Helps Children Tell? A Qualitative Meta-Analysis of Child Sexual Abuse Disclosure

The increasing use of qualitative methodologies to explore experiences of child sexual abuse (CSA) disclosure has led to the need to synthesise these findings. Recent reviews have tended to focus on the barriers to disclosure more than the facilitators or to conflate findings from studies of adults and studies of children and adolescents. This paper focuses on a qualitative meta-analysis of studies conducted in the past 20 years (1998-2018) that addresses the question of what helps children disclose experiences of CSA. An analysis of 20 studies that met the inclusion criteria suggests that six key themes are important facilitators of disclosure: access to someone you can trust; realising it's not normal; inability to cope with emotional distress; wanting something to be done about it; expecting to be believed; and being asked. These can be conceptualised as representing two key dynamics that help children tell: needing to tell (pressure cooker effect), and opportunity to tell. Professionals and carers can facilitate the process of disclosure through building trusting relationships with children, recognising their distress and initiating conversations with children about their wellbeing. 'A qualitative meta-analysis of studies conducted in the past 20 years (1998-2018) that addresses the question of what helps children disclose experiences of CSA' Key Practitioner Messages There is a need for the focus to be on what helps children tell rather than what hinders children telling. Children need those around them to notice when they need to talk about themselves and what is happening in their lives - when they are unable to cope with their distress, when they want something done about it. Professionals and adults interacting with children need to ask children about their lives and wellbeing, in order to: help create opportunities for children to tell; help them access someone they can trust; let them know they will be taken seriously; and help them to understand that abusive behaviour is not normal.