Belated Listening, Delayed Healing – An Exploratory Study of Disclosure and Help-Seeking Practices Among Adult Survivors of Child Sexual Abuse 《「遲來傾聽，療癒來遲」－童年性侵倖存者的事件揭露及求助經驗初探研究》
In March 2019, RainLily has published a report that revealed the severity of child sexual abuse (CSA) problem in the local community. Based on its service records from 2000 to 2018, the Centre finds an average of 13.2 years delay in presentation if the survivor was under the age of 16 years when being assaulted. The average presentation delay of these CSA survivors was ten times longer than their adult counterparts, which overtly points to the greater vulnerability of children and teenage in handling sexual abuse incident. Given these results, our research team has thereby conducted an exploratory study, with the aims to uncover the difficulties of CSA survivors in disclosing their victimisation experience and seeking professional help.
This study adopts a qualitative research approach to elicit and analyse survivors' retrospective narratives of their disclosure and help-seeking experience. With the support from RainLily's counsellors and service users, 16 adult survivors of CSA were recruited from RainLily's service clientele and were invited for a semi-structured interview during the summer of 2019. Our heartfelt gratitude is extended to these 16 informants who bravely shared with us their deeply personal account of the experiences of abuse and coping.
Early Disclosure Experiences in Childhood
In examining survivors' disclosure decision during childhood, this present study found that around one-third of total informants never talked about their abuse to any person until adulthood. A range of inhibitors were identified, such as difficulties in naming the problem and fear of the consequences of disclosure. More importantly, more than two-thirds of total informants did attempt to disclose their CSA incident during childhood, either directly or subtly. Yet, effective follow-ups of their cases were rarely achieved, inflicting further trauma on survivors. Based on informants' narratives, multiple patterns of confidants' response were identified, including neglecting survivors, doubting and blaming survivors, and not knowing how to help the survivors.
In the face of negative and/or unsupportive responses, many of the respondents refrained from revealing further details of the case until adulthood. This present study thereby raises the issue of mishandling of survivor disclosures by recipients. In order to facilitate a survivor's recovery, appropriate measures must be made to improve a potential confidant's handling of disclosure.
Multiple Disclosure Experiences in Adulthood
Apart from their disclosure experiences in childhood, this present study also finds that all 16 informants did disclose their traumatic experiences in adulthood, furthermore, nearly all of them reported multiple experiences of disclosing the abuse. Yet, the incentives of each disclosure actions varied from case to case, ranging from a wish to merely tell a person about the incident to a wish to seek more formal validation and support, from an attempt to share their secret with loved ones to an attempt to confront the abuser face to face, and from an aspiration to speak up for themselves to an aspiration to stand up for other survivors in effecting social change.
With respect to their disclosure experiences, this present study reaffirms the notion that survivors' disclosures must be understood as a complex and life-long process instead of a one-off or single event. Meanwhile, survivors' multiple disclosure experiences also denote a transformation underlying their handling of the trauma over time. Although there is no standard disclosure trajectory for survivors, this present study put forward that each of these disclosure experiences is, nevertheless, crucial to survivors' recovery from their CSA trauma.
Experiences of Seeking Professional Help
Coupled with a survivor’s disclosure action is often their decision to seek professional help. Besides their contacts with RainLily, results from the research interviews found that most informants did ever obtain other support services from various entities per their different needs. Three major professional service providers were identified from their help-seeking experiences: social workers and counsellors, medical professionals and law enforcement agencies. Yet, the findings of this present study indicate that these professional help-seeking experiences are not often helpful or useful in accommodating survivors' needs, whilst the issue of secondary trauma has even come to light in some cases.
Akin to their disclosure experiences, this present study found that survivors' help-seeking experiences are also full of ups and downs. Despite this present study recognises the vital role of professional service providers in facilitating survivors' recovery from trauma, one should not overlook the negative impact of unhelpful experiences to survivors in working with these professionals, and therefore the existing support services should be carefully examined for potential improvement.
Conclusion and Recommendations
In short, this present study puts forward that CSA survivors' decision making in disclosure and help-seeking is never easy. It's a complex lifelong process instead. Regardless of their age at the time of disclosure/seeking help, a wide range of inhibitors to their disclosure and help-seeking decisions often exist, including various personal, interpersonal, institutional and cultural factors. Most importantly, even if survivors dare to disclose their abuse and/or to seek external help, most of these results do not appear promising. With the potential for secondary victimisation, these unpleasant encounters are hardly beneficial to facilitating survivors' recovery from trauma. In order to improve the current situation, this present study puts forward several recommendations for practices and policy measures, which include the promotion of sexuality education for children and adolescents, the provision of CSA prevention trainings to parents and other caregivers, and improvement measures to existing support services.
The full report is available on the bottom of this page.
「遲來傾聽，療癒來遲」－童年性侵倖存者的事件揭露及求助經驗初探研究
2019年3月，「風雨蘭」發表了一份研究報告，深入分析2000年至2018年間中心接獲的求助個案記錄。在多項研究發現中，兒童性侵害的問題尤為嚴重。該項報告指出，事發時年齡低於16歲的性暴力倖存者平均延遲約13.2年才向「風雨蘭」求助，延遲求助的時間較成年的性暴力倖存者長逾十倍， 情況令人關注。有見及此，「風雨蘭」於是開展一項研究計劃，探討兒少性侵倖存者在揭露事件（Disclosure）及對外求助（Help-Seeking）的整個過程中所經歷的困難及挑戰。
是次調查採用了質性研究方法進行，收集有關資料並進行分析。承蒙「風雨蘭」受助人及輔導員的幫助，研究團隊成功招募16位兒少性侵的成年倖存者進行深入訪談，在此僅對所有參與研究的受訪者表達衷心感激。回顧她們的童年經歷，訪談結果發現，倖存者在兒少時的處境固然艱難，但即使成年以後，處理性侵創傷的過程仍然充滿掙扎，迎來不同程度的挫折與障礙。
兒少時揭露性侵事件的經驗
在整個童年期間，有約三份一的受訪者表示自己從未向任何人提及過自己的性侵經歷，而阻礙她們將事件揭露的原因包括：不懂得界定性暴力、缺乏合適的聆聽者、擔心披露後會帶來負面後果等。更值得注意的是，有超過三份二的受訪者表示曾經向身邊人披露自己的性侵經歷。其中，有些受訪者以較間接的方式向對方提示或暗示，有些則以直接訴說的方式將事件坦述。然而，絕大部份的受訪者都沒有得到正面回覆或適切跟進，更有不少的個案反映，曾因對方的負面反應而感到受傷，這些負面反應包括忽略、質疑、責怪、以及不懂得如何處理等。
面對對方的負面反應，不少人因而不敢再向他人透露自己的性侵經歷，轉而把秘密埋藏心裡，直至長大以後。因此，鼓勵兒童在遭遇性侵後盡快向身邊人求援固然重要，但聆聽者或陪伴者的角色亦十分重要。不恰當的回覆或反應不但會嚴重阻礙兒童得到適切的支援，同時亦會對她們造成更大的傷害。制定適切的策略及措施以提昇聆聽者及陪伴者的應對及跟進技巧，將能更有效地為遭受性侵害的兒童提供適切的支援。
成年後講述性侵創傷的經驗
在成年後，所有受訪者都曾向身邊的人透露自己兒少時的性侵事件。而且，多位受訪者更不只一次向不同人提及自己的經歷和感受。她們每一次將事件揭露或公開講述，都是有不盡相同的動機和意義。例如，部份受訪者在起初僅期望讓伴侶了解自己的過去，發展到後來則希望透過與朋友分享，獲得更多認同與支持；有些受訪者原先只是想向親人揭露心中埋藏已久的秘密，繼而轉化成一種控訴侵犯者的反擊手段，尤其當侵犯者就是自己的親人；有些受訪者在初期旨在為自己發聲，其後決定透過持續發聲去鼓勵其他性暴力倖存者。
訪談的結果反映，倖存者向他人揭露自己的兒少性侵經歷，是一個複雜且漫長的過程。而且，倖存者每一次將事件揭露，同時亦隱含著倖存者在處理性侵創傷的心理變化。隨著相關經驗的累積，倖存者講述事件的表現會漸有不同或漸進佳境，這些微細的差異都反映了她們正在療癒性侵帶來的創傷。縱使每一位倖存者的療癒體驗都是獨一無二，且沒有既定軌跡的，但研究反映，倖存者將事件重複披露，對於走出性侵陰霾有不可取替的重要性。
向專業人士求助的經驗
除了向他人透露自己的性侵經歷，不少受訪者亦曾經向不同背景的專業人士求助。撇開向「風雨蘭」求助的經驗，幾乎所有受訪者都曾向其他專業人士或機構尋求不同形式的支援服務，當中主要求助對象包括社工/輔導員、醫護專業人員和執法人員。然而，並非每一次的求助經驗都能有效地協助她們紓解當刻的困境，更偶有遇上不愉快的經歷。根據受訪者對求助經驗的評比，研究報告分析出多項的影響因素，包括人際關係及制度局限等。在眾多影響因素之中，專業人士的支持與鼓勵對於受訪者的求助經驗起著關鍵作用。
即使面對專業人士，受訪者的求助過程仍然充滿顛簸，相關的受助經驗好壞參半。是次研究報告認同有關專業人士或機構對於促進倖存者跨過性侵經歷尤為重要，不過，服務過程中的不當處理或會令倖存者受到二度創傷，有關問題亦不容忽視。因此，為了更有效地協助倖存者處理創傷，必須持續檢視現行的支援服務，並且就有關的流弊作出適切的改善跟進。
結論與建議
總括是次研究結果與發現，不論是揭露事件或是對外求助，這些決定對於童年性侵的倖存者來說都極困難。倖存者不但在童年時面對種種局限與束縛，即使是成年以後，面對性侵經歷的創傷仍然會充滿掙扎和矛盾。由個人背景至人際關係、由制度框架至文化規範，各種因素皆令倖存者難以作出決定。更值得注意的是，即使倖存者鼓起勇氣將事件向外披露或求助，結果卻往往未如理想。當中的不愉快經歷，反為倖存者帶來更多的傷害，令她們經歷二次創傷。針對倖存者處理性侵創傷時的複雜處境和各種阻礙，是次研究報告提出幾點改善建議予有關的政策及措施，當中包括，加強推廣兒童及青少年的性教育、開拓針對家長及兒童照顧者的預防教育培訓課程、改善現行的倖存者支援服務等等。是次的研究報告將會於稍後上載至協會的網站，公眾如有意參閱研究報告的詳細內文，可持續關注本會網頁的動向。