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G71(P) Beyond risk management in child sexual abuse: Understanding a resilience-based approach
  1. KB Borg1,
  2. DH Hodes2,3
  1. 1Department of Paediatrics and Adolescent Health, Mater Dei Hospital, Msida, Malta
  2. 2Department of Paediatrics, University College London Hospital, London, UK
  3. 3Department of Paediatrics, Royal Free London Hospital, London, UK

Abstract

Introduction The multiagency response to allegations or suspicions of child sexual abuse (CSA) often lacks coordination between and within agencies. Current management tends to focus predominantly on risk management with limited attention given to how resilience can be promoted as a means of overcoming adversity. We looked for the evidence around resilience in CSA in order to give support to a framework that may improve current practices.

Methods A search strategy was devised and a systematic literature search of the major databases followed. Both qualitative and quantitative peer-reviewed studies that included resilience and its promotion in victims of CSA were included. The evidence found was critically appraised using standardised checklists. Furthermore, case studies of CSA from the UK and Malta were used to highlight limitations in the current response and follow up to CSA.

Results Resilience post-CSA can be achieved through managing both risk factors and promoting protective factors, since these are cumulative. Risk management includes targeted intervention by professionals, noting that unnecessary interventions may dampen resilience. Risk management, including preventative strategies, aim at rendering the child safe from further harm and thus a means of promoting protective factors. Non-professional contribution in the form of support and stability, offer the major source of protective influences, thus the most powerful resilient promoting factor in CSA. Engaging in positive experiences at school and within communities also enhances resilience. Internal resilient promoting factors include positive self-esteem and better adaptive coping skills. The victimised child should not be over-sheltered by carers or services involved.

Conclusions A resilience-based model to CSA is child-centred and advocates for services to work together in a timely fashion, aiming towards providing a holistic and ecological response to better meet the child’s needs. This model can be promoted through joint multiagency training by providing professionals with a better understanding of their role in CSA. It can serve to advocate for policy changes that provide services that better fit the needs of the child, prevent re-victimisation and which offer targeted interventions focussing on both inner and external resources that enhance resilience, including support of the carers. This response may be more cost-effective and improve outcomes.

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