I’ll be a survivor for the rest of my life

Adult survivors of child sexual abuse and their experience of support services

Authors: Emma Bond, Fiona Ellis and Jenny McCusker
This report is based on a collaborative qualitative research study conducted in partnership between the University of Suffolk and Survivors in Transition (SiT) between January and May 2018.
The focus of this study was initially broadly based on the main findings from the Focus on Survivors national online survey (see Smith et al., 2015) which identified that the satisfaction with services for adult survivors of childhood sexual abuse (referred to as ‘survivors’ throughout this report) was closely related to basic qualities in the way services treated survivors, namely, feeling listened to, believed and respected. The study based on the online survey concluded that ‘poor service can have a long-term impact and represent a barrier to support for survivors. In contrast, a good service response can result in survivors coming to a point of recovery or resolution sooner in their lives’ (Smith et al., 2015: p. 4).
Following on from these findings in this under-researched area, this study was qualitative in nature, based on in-depth life biography style interviews with 28 adult survivors of child sexual abuse who volunteered to share their experiences of support services. This approach facilitated a deeper understanding of survivors’ experiences on the path to effective support:
1. To gain deeper understanding of survivors’ experiences of disclosure
2. To gain deeper understanding of pathways and support services survivors accessed
3. To provide the opportunity for adult survivors of CSA to consider what support had been effective for them and recommend how support services can be improved.
The methodology for this study was purposefully designed from the outset to be as collaborative as possible and to embed the involvement of service users throughout the research process. To this end, a Q-sort of the main findings from the 2015 Smith et al. study gave valuable insight as to what survivors identified as the main priorities for this more in-depth qualitative study. The results and priorities from the Q-sort were then used to inform the focus and basis for the interview questions. The open-ended interview questions were further developed with the guidance of the Service User Group at SiT and formulated to allow the participants to discuss their experiences within their own terms of reference at their own pace and to talk about what was important to them.
The questions were piloted in January 2018 as one-to-one interviews conducted with seven survivors at SiT. The purpose of the pilot study enabled the research team to verify the suitability and sustainability of the questions for a larger qualitative study and for participants to provide additional feedback on the questions and process.
The wider study was undertaken between February and May 2018 with 28 survivors. The interviews, some of the interviews lasted over three hours, yielded rich, detailed descriptions of survivors trying to access help and support and their experiences of services. The study aimed to develop a deeper understanding of each survivor’s experiences of:

  • disclosure
  • accessing services
  • the support they had received
  • what they felt ‘worked’ in terms of effective support and good practice
  • and how survivors consider support services can be improved.

The findings are presented in such a way as to follow the dominant trajectory of the 28 survivors’ narratives who volunteered to share their experiences with us. It starts with their disclosure journeys and considers the barriers to disclosure and impact of delayed disclosure, before documenting the responses they received to their disclosure(s) and the consequences of poorly supported disclosures, which often resulted in barriers to seeking and accessing effective help. The over reliance on medication and the limitations of time-limited interventions are highlighted, as well as the dearth of available specialist support services. The findings suggest that specialist support which is available is often poorly signposted by professionals and, as a result, survivors battle for years, even decades with mental health issues as a direct consequence of delayed disclosure and inappropriate service provision.
This report finally documents ‘what works’ in effective help and support for survivors of CSA; their reasons for seeking help, and the importance of being listened to, believed and respected throughout their journey towards recovery.
The survivors’ accounts reveal the importance of allowing survivors to engage with support services on their own terms, without a predetermined time period and within a safe, non-judgemental and inclusive therapeutic context. Their narratives evidence the positive and lasting impact of safe opportunities for survivors to engage with past trauma, to build trusting relationships with services, staff and therapists, to equip them with the necessary skills that can empower them take to control of their lives.