Where the streets have no names: factors associated with the provision of counselling and social work services for child rape survivors in KwaZulu-Natal, South Africa

Objective: The aim of this study was to audit the provision of state-assisted counselling and social work services to child rape survivors presenting for medico-legal assessment at a state hospital in KwaZulu- Natal, South Africa. Method: A prospective design was used to collect data from the social and medical case files of 200 consecutive cases of child rape referred for medico-legal assessment to a state hospital located to the north of the City of Durban (South Africa). For each case, information was obtained regarding survivor and offender demographics, the nature and duration of abuse, and the extent and nature of counselling and social work services provided. Results: Only 49% of survivors benefited from state-supported counselling and social work services, with the provision of such services being frequently delayed (by periods of up to six months), and with service provision being restricted to a single intake interview in all but one case. Social work service provision was significantly less likely in cases where the survivor resided in an informal dwelling (OR = 0.507) and where the child presented for medico-legal assessment outside of normal working hours (OR = 0.625). From observations made during the study, it would appear that patterns of professional collaboration in relation to service provision for child rape survivors falls somewhat short of the ideal of effective multi-sectoral engagement. Conclusions: Levels of service provision observed in the study are unacceptably low, with there being a clear need for the development and implementation of carefully considered multi-sectoral protocols which are designed to effectively meet the needs of all child rape survivors.

[1]  Tonya Lippert,et al.  Families who begin versus decline therapy for children who are sexually abused. , 2008, Child abuse & neglect.

[2]  Jacqueline Davies,et al.  Multidisciplinary Teamwork in a UK Regional Secure Mental Health Unit a Matter for Negotiation? , 2007 .

[3]  S. Collings.  Nonsupportive Disclosure in Child Sexual Abuse: Confidants' Characteristics and Reactions , 2007, Psychological reports.

[4]  K. Oates.  The Truth is Longer Than a Lie: Children's Experiences of Abuse and Professional Interventions, Neerosh Mudaly, Chris Goddard. Jessica Kingsley Publishers, London and Philadelphia (2006), 188 pp., £18.99; $34.95 , 2007 .

[5]  Michael E Lamb,et al.  Exploring the disclosure of child sexual abuse with alleged victims and their parents. , 2007, Child abuse & neglect.

[6]  V. Zyl,et al.  Silent victims of rape : police effectiveness in dealing with child rape cases , 2006 .

[7]  H. Conradie,et al.  Adjudication of child victims of rape and indecent assault in Gauteng , 2005 .

[8]  Beryl Satter.  The Sexual Abuse Paradigm in Historical Perspective: Passivity and Emotion in Mid-Twentieth-Century America , 2004 .

[9]  F. Putnam,et al.  Ten-year research update review: child sexual abuse. , 2003, Journal of the American Academy of Child and Adolescent Psychiatry.

[10]  Sarah E Ullman,et al.  Social Reactions to Child Sexual Abuse Disclosures: A Critical Review , 2002, Journal of child sexual abuse.

[11]  R. Bolen.  Guardian Support of Sexually Abused Children , 2002 .

[12]  T. Kilbane,et al.  A Three-Generational Study Comparing the Families of Supportive and Unsupportive Mothers of Sexually Abused Children , 2001, Child maltreatment.

[13]  S. Zuravin,et al.  Intrafamilial Child Sexual Abuse: Predictors of Postdisclosure Maternal Belief and Protective Action , 2001, Child maltreatment.

[14]  A. Elliott,et al.  Reactions of Nonoffending Parents to the Sexual Abuse of their Child: A Review of the Literature , 2001, Child maltreatment.

[15]  Karen Muller.  The effect of the accusatorial system on the child witness , 2000 .

[16]  D. Goh,et al.  Positive Reaction to Disclosure and Recovery from Child Sexual Abuse , 2000 .

[17]  A. Butchart,et al.  Rape Surveillance through District Surgeon Offices in Johannesburg, 1996–1998: Findings, Evaluation and Prevention Implications , 2000 .

[18]  R. Campbell,et al.  Secondary Victimization of Rape Victims: Insights From Mental Health Professionals Who Treat Survivors of Violence , 1999, Violence and Victims.

[19]  C. Hooper,et al.  Women Whose Children have been Sexually Abused: Reflections on a Debate , 1998 .

[20]  S. Collings.  Development, Reliability, and Validity of the Child Sexual Abuse Myth Scale , 1997 .

[21]  R. Steer,et al.  Sexually Abused Children Suffering Posttraumatic Stress Symptoms: Initial Treatment Outcome Findings , 1996 .

[22]  J. Heriot.  Maternal Protectiveness Following the Disclosure of Intrafamilial Child Sexual Abuse , 1996 .

[23]  T. Roesler,et al.  Telling the Secret , 1994 .

[24]  J. Briere,et al.  Forensic sexual abuse evaluations of older children: Disclosures and symptomatology , 1994 .

[25]  M. Chaffin,et al.  False Negatives in Sexual Abuse Disclosure Interviews , 1992 .

[26]  V. Wiehe.  Working With Child Abuse and Neglect , 1992 .

[27]  Cynthia Price Cohen,et al.  United Nations: Convention on the Rights of the Child , 1989, International Legal Materials.

[28]  M. Everson,et al.  Maternal support following disclosure of incest. , 1989, The American journal of orthopsychiatry.

[29]  P. Caplan,et al.  Mother-blaming in major clinical journals. , 1985, The American journal of orthopsychiatry.

[30]  F. Siebrits,et al.  Poverty in South Africa: A profile based on recent household surveys , 2008 .

[31]  C. Goddard,et al.  The Truth is Longer Than a Lie: Children's Experiences of Abuse and Professional Interventions , 2006 .

[32]  Brandon Pleanor.  Stolen childhood : rape and the justice system, D. Ewing : book review , 2004 .

[33]  S. Collings,et al.  Child rape in KwaZulu-Natal, South Africa : an analysis of substantiated cases , 2004 .

[34]  J. Fein,et al.  Interpersonal violence. , 1999, Current opinion in pediatrics.

[35]  J. Briere,et al.  Immediate and long-term impacts of child sexual abuse. , 1994, The Future of children.

[36]  D Finkelhor,et al.  Impact of sexual abuse on children: a review and synthesis of recent empirical studies. , 1993, Psychological bulletin.

[37]  J. Fout.  Forbidden history : the state, society, and the regulation of sexuality in modern Europe : essays from the Journal of the history of sexuality , 1992 .