Safeguarding children with strength and hope

Picture (L-R): Peter Saunders, John Slater, Gilli Watson, Zeonbia Nadirshaw, Benna Waites, Khadj Rouf, Peter Kinderman and Danny Taggart.

Survivors, academics, and those working to help unheard generations of abused children, gathered for the launch of new guidelines on what to do when clients disclose historical child sexual abuse. Introduced by the Chair of the British Psychological Society Special Group for Psychology and Social Care, Professor Zenobia Nadirshaw, the day-long event in Oxford saw an atmosphere of strength, bravery and, perhaps most importantly, hope.

In a candid, moving talk, clinical psychologist Dr Danny Taggart (University of Essex) spoke for the first time publicly about his own process as a survivor of sexual abuse as a child, his experience of psychosis and some eclectic sources of comfort. Taggart has also written a paper in response to the guidelines, due to be published in October in Clinical Psychology Forum.

Taggart was sexually abused by the headmaster of his Christian-Brother-run school at the age of eight and has had intermittent mental health problems since then. He has also worked extensively in a clinical capacity with men and women who lived through child abuse and are now trying to cope with the consequences. He asked how this could happen in societies across the globe, describing child sexual abuse (CSA) as a 'public health epidemic'.

He went on to illustrate some of the 'models of madness' society holds; the ways in which we discuss mental health problems and how this may not always translate to a person's experience. Taggart said that as social beings, if the damage is done within relationships this is also where healing must take place – including within therapeutic relationships.

During his period of psychosis Taggart said he took great comfort from music which may have been seen by others as 'mad': John Coltrane and Can's Malcolm Mooney for example. But he said with clients we should understand the meanings people make for themselves, potentially helping them to find something which psychological models alone don't provide – a feeling of being not alone or understood. He said: 'I couldn't understand ordinary life, it was too anaemic. It was only with music like this that there was any peace.'

Taggart touched on the 'memory wars' debate between false memory and recovered memory advocates. He said he was particularly struck by the tone of this conversation, adding: 'The idea of waging a war over the fragmented mind of an abused child seemed so indecent and disturbing I thought academics and practitioners involved had become disconnected from those they were trying to find help for. The idea we can be removed from people with a cold, analytic gaze puts at risk the qualities of relationships we can make with victims of childhood sexual abuse.'

He concluded that many psychologists see ethics as simply a means to an end, but how research and therapy is conducted has enormous implications for clients. He said: 'I experienced a breach of trust, the man who did this to me was in a position of power, was god-like in the context of the Catholic Church. We have a profound responsibility for the people who come to us for help, it's vital that they have a different experience.'

Gilli Watson, a Consultant Clinical Psychologist for Devon Partnership NHS Trust, presented evidence from the extensive research base on the long-term mental health consequences of Childhood Sexual Abuse. She said childhood sexual abuse was a human rights issue and a betrayal of every child's right to safety, nurture and love.

Watson presented research evidence that childhood sexual abuse is a major factor in the development of adult mental health distress across all diagnoses including depression, suicidality, self-harm, eating difficulties, bipolar disorder, hallucinations, and voice-hearing. The strong connection between childhood abuse and adult mental health difficulties, she said, requires adult mental health services to implement the routine enquiry of abuse in childhood and adulthood as part of all adult mental health assessments and a focus in on what has happened to a person rather than what's 'wrong' with them.

The NHS Partnership Trust in Devon has been involved as one of six pilot sites in England with the Department of Health to implement Routine Enquiry of abuse in Adult Mental Health Services. Watson said that once a person's abuse history is known, their psychological distress could be formulated in terms of trauma responses rather than misdiagnosed as mental 'illness'. She pointed to international guidelines for Trauma Informed Practice in mental health services as to the effectiveness of Psychological Trauma Recovery Therapies including Group Therapy in providing a safe environment to break the silence of abuse, share profound distress and be empowered through each person's strength and resilience.

Watson said a shift in focus is needed within adult mental health services towards validating people for their survival of abuse and profound resilience and courage, rather than adding new damage through misdiagnosing people as disordered in terms of personality, eating or thought. The Psychological model currently being developed by the Division of Clinical Psychology for Formulating distress, she added, will provide a strong psychological alternative to psychiatric diagnosis that will enable clinicians to do justice to a person's lived experience.

Watson introduced John Slater who runs, with others, a mutual male survivor peer support group in the Exeter area called Momentum. The group gives men of all ages and backgrounds a safe place to meet talk and feel their emotions. He said: 'Some people still say "men don't want groups" but we have not found this to be so if the groups are backed by individual support and psycho-education understanding and managing trauma. We have regular supervision with a clinical psychologist who is well-experienced in the field and have access to professional psychological support for anyone in the group to consult.' He emphasised the need for more groups, as sexual abuse in childhood was widespread throughout all of society.

Slater added that survivors, and others, wanted to see a truly collaborative, trauma-informed approach taken up by services. He added: 'Services should involve survivors in their approach, to help them recognise the needs of victims of childhood sexual abuse'. He said it was also essential for survivors to meet other survivors, having chances to hear that others share their sense of shame, rage and the self blame that can come with being a survivor. 'To hear and feel from others what they feel and struggle with can be the beginnings of a sense of trust and release from isolation. At Momentum we see the real difference that this makes.'

Peter Saunders, Founder of the National Association for People Abused in Childhood (NAPAC), opened with his view that childhood should be about having 'the confidence to express ourselves and not to be abused in any way.' Also a survivor, Saunders set up the association 20 years ago after his own journey attempting to find help – feeling like 'a piece of dirt' and as if he didn't belong. As well as a support helpline for others needing help and support, the charity has worked with government in recent inquiries into childhood sexual abuse.

The ongoing Independent Inquiry into Sexual Abuse, led by Dame Lowell Goddard, is investigating whether public bodies and other non-state institutions have done enough to protect children from abuse. Saunders praised Home Secretary Theresa May for getting the inquiry off the ground and for listening to survivors' stories at NAPAC. He added: 'The inquiry is not just about history but what's going on now. People have attacked it because of the cost – it's a small price to pay to ensure our own children and grandchildren won't have to suffer in the same way.'

After he had children of his own and a chance encounter with his abuser, Saunders decided to seek help. 'You go from thinking you're one in a million to finding out half the people in the room may have experienced something similar. It's a humanitarian problem that's so big we can't arrest our way out of it, there's something more we can do. We should have a zero-tolerance approach to child abuse.'

Dr Khadj Rouf, Benna Waites and Dr Stephen Weatherhead wrote the new BPS guidance on dealing with disclosures of non-recent abuse. Waites and Rouf's presentation highlighted key aspects of the new document, which is part of the work taking place through the Society's Safeguarding Children and Young People Group. The guidelines draw out the steps that psychologists can take after a disclosure of non-recent sexual abuse. They highlighted that the issues surrounding these disclosures can often be complex and painful for victims. The document emphasises the importance of sharing concerns outside the consultation room, to ensure more children are not at risk. The authors flagged the nuances and dilemmas that can arise during this work, and how to take safeguarding concerns forward in a range of scenarios. They also flagged the importance of a wider role for psychology in shaping the debate around safeguarding and the prevention of abuse. 

The authors sought input for the guidelines from numerous organisations including the police, divisions of the BPS in other areas of psychology, and survivor organisations. Waites emphasised that this first edition of the guidelines and will be reviewed in a year's time. She said, 'This document serves to start a conversation and we hope it will be an iterative process with further input in the future.'

Herself a survivor, Rouf added: 'We have been concerned about the extent of abuse disclosures we've heard from our clients. Recent high-profile cases give us the opportunity to open the debate about how we respond to non-recent disclosures. It's a difficult, uncomfortable conversation, but it's one we should be having.'

The day finished with a panel discussion, hosted by BPS President Peter Kinderman, who emphasised the duty of psychologists to speak up against child abuse. He added: 'This is not just about one-to-one therapy, it's about what we do to protect future generations from abuse.'

Resources

Download the new BPS guidelines  

For more information on Momentum in Exeter call 0777 315 1080

‎For more on NAPAC see www.napac.org.uk or call the free helpline 0808 801 0331