Adolescent disclosure of child sexual abuse in psychiatric care: A French qualitative study of adolescents and their parents

INTRODUCTION: Child sexual abuse (CSA) is a major public health issue which is often characterized by delayed disclosure. While most of the existing research has focused on retrospective accounts from adults, little is known about the experiences of adolescents disclosing CSA to healthcare professionals or about the impact of this disclosure on their families. This qualitative study aims to explore the experiences of adolescents and their parents who have disclosed CSA to a child psychiatrist in a clinical setting. METHOD: Twenty-three participants (ten adolescents aged 12-18 and their thirteen parents) were recruited from a child psychiatry department in France. All the adolescents were receiving psychiatric care and had disclosed CSA. In-depth semi-structured interviews were conducted and analyzed using Interpretative Phenomenological Analysis. RESULTS: Disclosure to a child psychiatrist occurs gradually and involves several stages: recognition by parents of the child's suffering, disclosure to peers, and then professional listening. Fear, particularly of not being believed or of damaging family relationships, emerged as a central theme. Disclosure can have many different effects, sometimes triggering clinical symptoms in the teenager or reactivating old traumas in the parents. Mandatory reporting procedures were perceived ambivalently, generating relief for some families and significant anxiety for others. CONCLUSION: Disclosure in adolescence has complex psychological and relational repercussions for both adolescents and their families. These findings highlight the importance of integrated therapeutic approaches involving adolescents, their parents, and the broader family system, as well as a nuanced approach to mandatory reporting based on current risk levels.