Child Sexual Abuse: Knowing and Not Knowing in Social Work Practice and Education

Abstract

Child sexual abuse (CSA) is a pervasive yet elusive social problem, arguably crossing all domains of social work practice. Within the practice sphere of mental health and addiction CSA is particularly prevalent, however, research indicates that inquiry is not routinely undertaken. Dominated by a medical paradigm and impeded by barriers at individual and organisational levels, mental health services often fail to truly implement a bio-psychosocial model and provide trauma-informed services. Within undergraduate social work programmes, the topic of CSA and the wider field of trauma have garnered minimal attention. Consequently, national and international studies have identified the need for specific training in CSA for social workers and mental health professionals. However, it is unclear to what degree social work educators are engaging in the “painful pedagogy” of teaching about CSA, and what their views are regarding the issue. Similarly, there is a paucity of research which has sought to qualitatively explore social workers’ perceptions of CSA, the sources for their understanding, and the degree to which they encounter and work with clients who have been sexually abused. This qualitative, interpretivist study draws on hermeneutic phenomenological methodology and attempts to fill some of these research gaps. Taking a dialectical perspective, I utilise a theoretical framework drawn from attachment, psychodynamic, neurobiological, and trauma literature, while also turning to Goffman’s (1959, 1963) work on stigma and impression management.

Eleven social workers within youth and adult mental health or addiction services explored their cognitive and affective perceptions regarding CSA, across two semi-structured individual interviews. A second sample of eight social work educators discussed pedagogical and pastoral implications of teaching about CSA, and expressed opinions about the sufficiency, efficacy, and relevance of CSA training within their social work programmes. Finally, a focus group comprising a sub-sample of social workers and educators provided an opportunity for both professional groups to dialogue about the education and practice implications, and to consider future directions. While both sets of participants offered a range of opinions and strategies to address CSA academically and professionally, they also cited barriers. Social workers clearly recognised that CSA disclosure was a difficult and often delayed process, and perceived an association between addiction or mental health problems and a CSA history. Yet sexual abuse inquiry was not routine, nor was it always considered necessary or appropriate. Social work educators considered the topic of CSA to be relevant to social work, yet participants revealed significant professional, student-related, and organisational obstacles to a greater academic focus on CSA. Among both samples, participants understandably expressed or exhibited emotional or bodily discomfort when discussing CSA, particularly in relation to perpetrators. This thesis argues that the significant emotional costs in addressing CSA may lead to individual and organisational responses which marginalise CSA as a practice or educational concern. Participants’ suggestions regarding working with clients or teaching students about the issue of CSA revealed a number of parallel processes, and pointed to the merits of a trauma-informed framework for practice and education. Drawing on the findings, extant literature, and policy, the study makes recommendations for mental health and addiction services and social work education.