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IICSA Independent Inquiry into Child Sexual Abuse

Support services for victims and survivors of child sexual abuse

Research findings

The key research findings from both the quantitative and qualitative aspects of this work are presented below. Victims and survivors who took part in the quantitative survey are referred to as ‘respondents’, while those who took part in qualitative interviews are referred to as ‘participants’.

1. Most victims and survivors have not accessed support services.

Nearly three-quarters of survey respondents reported not having accessed any support services, with only just over a quarter having received some form of support, advice or treatment due to their experience of child sexual abuse.

2. Victims and survivors who access support services take a long time to do so and rate them as mediocre.

The average time between first child sexual abuse victimisation and contact with a support service was 19 years and there was a substantial variation in time between sexual abuse and access to support services (0–58 years). The average ‘helpfulness’ rating across all support services was 5.3 (on a scale of 0–10 with 0 being ‘Not helpful at all’ and 10 being ‘Extremely helpful’).

3. The most highly rated forms of support across all services were those provided by voluntary sector specialist services.

Across all support services, the most highly rated by survey respondents were counselling provided by a charity/voluntary organisation specialising in child sexual abuse and sexual abuse and/or rape support services provided by a specialist charity/voluntary organisation. One participant said of such a service: ”They were really, really good. I felt very, very comfortable talking to them. I just needed to try and get closure to the way I was feeling.

Interview participants also stressed the importance of such specialist support being from counsellors/therapists with training in, and particular knowledge of, trauma generally, and child sexual abuse specifically. One participant said that there should be more “people that are trained in child sexual abuse. Not a generalised counsellor.

4. Counselling provided through health services was considered the least helpful service overall by some respondents, and the most helpful service overall by some other respondents.

Survey respondents were asked what one service was the most helpful overall. The service selected by the highest number of respondents was counselling provided through health services like a GP or hospital.

However, it is notable that when survey respondents were asked which one service was the least helpful overall, counselling provided through health services was again selected by the highest number of respondents.

While the finding that counselling provided through health services was named as both the most and least helpful form of support may seem counterintuitive or contradictory, there are a number of potential explanations. First, it is important to note that this form of support is the most commonly accessed. Therefore, more respondents had experience of the service on which to judge it. Second, there are many different factors that might impact on how different individuals perceive the helpfulness of services and these can vary between services of the same ‘type’. These include the individual needs and preferences of the respondent, where and when they accessed the service, and the reason for accessing the support service. In addition, respondents’ relationships with individual counsellors may have differed, as might the type of counselling (eg trauma-informed versus generic mental health), and the number of sessions offered and attended.

For example, one participant who had a positive experience of counselling through health services said: “I felt the person [counsellor] that I was talking to really cared about what happened and was giving me the courage to open up about it”.  While a participant who had a negative experience of counselling said: “I had the feeling she just wanted to do the prescribed six sessions with me and just get me out of the surgery to move on.

5. Victims and survivors stressed the importance of being heard, listened to, understood, believed, and not judged, by caring and empathetic professionals.

Interview participants appreciated professionals who were caring and empathetic; heard, listened to and believed them; did not judge or blame them; and gave them enough time to talk. One participant said: “She [the counsellor] was empathetic. She’d studied it. She’d looked at it. She understood it.”

Participants also talked of the importance of welcoming, warm, private and comfortable physical environments, as opposed to clinical ones: “It was a very friendly, very calm place. Each of the rooms was very private, very kind of neutral, like comfy chairs, quite dim lighting.

6. The vast majority of victims and survivors reported at least one barrier to support.

More than four in five (84%) survey respondents identified at least one form of barrier to support, such as personal (67%), service-specific (53%), family or community (48%), practical (33%) or financial (29%) issues.

One personal barrier participants spoke of was feeling that you should ‘just get on with it’: “These two things happened and you get over it. You don’t make a big fuss or a dance about it. Get on with life.”  Service-specific barriers included long waiting times: “The NHS wait was too long ... I was desperate. I was in a really bad way.” While family or community barriers included protecting the family: “One abiding thought I’ve always had is: I was aware of protecting my parents ... so I didn’t say everything ... I’ve always kept some of it back.”

7. A key personal issue or reason for not accessing support was victims and survivors not feeling they needed it.

One particularly interesting finding was that some participants reported not feeling that they needed support and had not been adversely affected by their experiences. It is notable that these participants tended to be older. One said: “It didn’t do me any lasting harm ... I suppose, deep down, I don’t feel that I’ve got a problem.

There are different ways to interpret this finding. It could be argued that victims may benefit from support even if they do not think that they need it. However, such arguments can be seen as paternalistic and it may be that some victims and survivors have higher levels of resilience than is commonly supposed.

8. A substantial minority of victims and survivors reported having unmet needs.

Two in five (43%) respondents reported currently having unmet needs linked to their experiences of child sexual abuse. The most commonly mentioned type of support desired (but not available or offered) was counselling provided by a specialist organisation. One participant said: “I’ve looked in my area for services specific for child sexual abuse and it’s very thin on the ground.

Participants also talked of how support services could be improved by: help being available as soon as it is needed; better training; less reliance on medication; services for females only and services for males only; specialist support groups; multi-agency working; ongoing support; free services; and up-to-date treatments. One participant said: “I think there should be almost immediate help.

9. Significant relationships were found between the views and experiences of victims and survivors of child sexual abuse and their demographic characteristics and the type of child sexual abuse experienced.

Female respondents were significantly more likely than males to report having experienced child sexual abuse in a family setting, but were less likely to have done so in an institutional setting. Those respondents who tried to get support but were unable to, and those who had unmet needs, were significantly younger in age.

Those respondents experiencing child sexual abuse within family and/or institutional contexts were significantly more likely to report experiencing barriers to accessing support services than those who experienced child sexual abuse in other settings. Those who experienced child sexual abuse within the family were, however, significantly more likely than others to have accessed support.

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