The Most Important Factor

Note: In this article, “parents” and “parental” includes biological parents, step-parents, foster and adoptive parents, and any partner or family member who lives in the same household and takes a caregiving role toward the child. 

“What is the most important factor in successful outcomes for children who have been sexually abused, and young people who have displayed harmful sexual behavior?”

What do you think: Cognitive behavioral therapy? Successful coordination between safeguarding and justice systems? Quality of training or years of experience for their therapists?

Although all of these are important and helpful, there is another thing that rises even higher: parental involvement and support. 

When I posed this question to a group of safeguarding social workers, I was pleased that most knew the answer right away. One of the attendees asked for the evidence to back up that claim, so I promised to pass it along. 

I appreciated the question, as I am also a person who wants to see the original research and evaluate the evidence for myself. So, for those who appreciate an academic deep dive, I would like to share the existing evidence that demonstrates the vital importance of parental support, for children and young people who have caused sexual harm or have been harmed.

Parental response to a child or adult survivor’s disclosure of sexual abuse is well-documented to have a profound effect on the victim. Responses such as denial, disbelief, minimization, or insufficient response (“shoving it under the rug”, for example) add additional trauma (Shaw 2007, Katz & Hamama 2015, Tener, Katz, Kaufmann 2021, Lewin et al 2023). Many survivors maintain that their parents’ response was at least as traumatic, if not more, than the sexually abusive acts themselves (Rowntree 2007, Lewin et al 2023). On the other hand, parental belief and robust support can have their own healing effects, in addition to enabling access to professional services (Welfare 2008, Lafleur 2009). The long-term effect of continued support has been less extensively examined, but accounts from both survivors and parents have indicated more positive outcomes when there is parental involvement and support (Welfare 2008, Lafleur 2009, VanToledo 2016, Langston 2021). 

Parental involvement has also been documented to improve outcomes for children with problematic sexual behavior (Welfare 2008, Silovsky 2018, Archer 2020). Treatment programs that involve the whole family are becoming preferable to “dishwasher treatment”; i.e. taking the child out of the family, “fixing” them, and then returning them (Harris, Lanni, Svendsen 2023). The difficulty and importance of family engagement in problematic sexual behavior treatment is emphasized in practice guidance for professionals (Sites & Widdifield 2020, Harris, Lanni, Svendsen 2023, Hanson 2024) and for caregivers (Silovsky 2009, Watts 2020, Kahn 2021).

Studies have also demonstrated rather low completion rates for community-based harmful sexual behavior treatment, ranging from 13% to 63% (Carpentier 2006, Barry et al 2017, Jenkins et al 2020, Shields 2020). This provides indirect evidence for the need for parental engagement, given the inherent dependence that children have on their parents and caregivers. Without parental cooperation in the form of consent, scheduling, transportation, and payment, most children cannot access professional services of any type. Parents often control access to supportive peers and adults. They are responsible for day-to-day supervision, enforcement of rules and boundaries, and emotional regulation. Parental attitudes, demeanor, and actions can be either retraumatizing or reassuring. If parents are aware of what the child is working on with a therapist, and especially if they are participating as well, parents can reinforce the lessons at home.  Their encouragement can help children persist through the unpleasant processes that are necessary for healing and progress. For better or for worse, by their presence or their absence, parents have an enduring impact on their children. 

However, as important as parental support is, for both harmed and harming children, sibling sexual trauma brings significant barriers to parents to provide that support. (Welfare 2008, Ward 2023, Westergren et al 2023) Maintaining emotional and physical safety, creating an environment that promotes healing for children who have been harmed, and supporting their other child to overcome problematic sexual behavior is simply not simultaneously possible all the time. The core dilemma presented by at least two children with intense yet conflicting needs is what makes sibling sexual trauma so unique and challenging. Although it can be sidestepped in literature focused on one child or the other, this is an ever-present conundrum for parents, who must face it in the midst of their own trauma and grief (Welfare 2008, Lafleur 2009, Westergren et al 2023, Lewin et al 2024). 

With parental support of children being so important, yet extremely difficult to carry out, it is vital to include parents in their children’s safety and recovery plans (Harris, Lanni, Svendsen 2023), and to find ways to support and guide parents through the traumatic aftermath of sibling sexual harm and abuse. 

Dissociative Identity Disorder and SSA

Dr. Maggie Bell is an Australian composer of music, who experienced sexual, physical and emotional abuse by her brother for 17 years, from the ages of 5 to 22 years. For Maggie, the prolonged severe abuse she endured resulted in Dissociative Identity Disorder (DID), in which different memories, reactions and feelings were isolated into separate parts of her personality. Her doctoral thesis project was a series of musical works, composed by her parts, either separately or in collaboration.

Listen to Maggie's music here: www.maggiesmusic.com.au

Learn more or follow Maggie via her LinkTree: https://linktr.ee/maggiesmusicdid

Hello, I’d like to talk about incest!

Did you notice what just happened? How you may have tensed your back a little, squirmed in your seat.

Very few people want to think about any type of incest, let alone sibling sexual abuse. It’s taboo, something so painful it might make you… crazy…

Well, I’m not so crazy, but I am wounded.

My own wounding resulted in over 60 dissociative identities or multiple personalities, as a result of prolonged severe incest and abuse from the age of 5 to 22.

Being a victim of incest and having a highly misunderstood diagnosis are both deeply steeped in shame and stigma. I want to break the conspiracy of silence that has surrounded my own and other victim-survivors lives.

Dissociative responses to trauma are common, especially in young children and in overwhelming and prolonged traumatic situations. Usually they take the form of “leave-taking”, a way to distance oneself from the reality of what is happening, such as floating above your body; time distortion (slower or faster); feelings of unreality (depersonalisation and derealisation); and amnesia. These are highly protective coping mechanisms to help at the moment of overwhelming trauma.

When ongoing, severe, repetitive trauma occurs during childhood development at the time a cohesive sense of self is usually forming (before the age of nine), these repetitive dissociative experiences can become states-of-being that fail to integrate. Instead, they become isolated self-states with their own sense of identity, memory, feelings and behaviours. Although these dissociative identities help a person cope, if they cause impairment or distress in at least one area of functioning (school, work, relationships, self care etc), the condition of Dissociative Identity Disorder can be diagnosed.

Prior to my doctoral thesis, I had not publicly disclosed my diagnosis and its cause. I have now been able to do that through composing music. This artistic research involved 14 new musical compositions, with a written explanation to go with each. To my knowledge, this is the first time a dissociative identity system has published an investigation into how different parts feel and relate to each other, communicated through musical composition.

Some pieces were composed by small groups of the previously scattered voices, or parts, who held different aspects of certain themes, such as suppressed rage, while other pieces reflected the struggles of daily life and were created by nearly all parts, each composing the

sections relevant to them.

Through that process I came to identify, know and accept my dissociative identities better than I ever had before, and my parts came to know and accept each other and work together collaboratively. That has been a game-changer for me. And breaking my silence about what happened to me and how it has affected my life has also been a game-changer. I realised how soul-destroying being silent about your own truth can be. And I stopped being ashamed. 

Your takeaway from this might be about this weird multiple personality music composer. Having multiple personalities brings to mind TV series and movies of dramatic switches and serial killers. Actually, most of us are just people you would never notice, carrying our wounds in hidden silence. 

I hope that by hearing a bit of my experience of living with DID, you will have more understanding and be able to talk about it in open conversations, which in turn helps to reduce stigma and shame. Maybe you can personally relate to this description of DID, within yourself or in someone close to you.

I hope you will also remember that there are many victims of incest and many sufferers of Dissociative Identities, who have not yet found a voice and can be hidden in plain sight. Learning more about DID might help you understand yourself or those around you. https://www.aninfinitemind.org/ would be a great place to start.

Crisis Centers in Crisis

No More's global directory of local centers servicing survivors of sexual violence is a key resource for those affected by sibling sexual abuse.

At 5WAVES, our all-volunteer team keeps abreast of current research and resources related to sibling sexual trauma and abuse, creates content for education, awareness, and prevention, provides peer support, and collaborates on research. Through our websites, social media presence, and responses to those who contact us by email, we direct thousands of people each year to local services for crisis support, healing services, and legal advocacy. But what happens if those services are not available? What if the helpline is closed, no advocate to help survivors through the court system, no counseling available to those who lack insurance coverage? If the helpline is only open two days a week or if emergency counselors have a 6-month waiting list, can that even be called crisis support?

The No More Global Directory is a worldwide listing of sexual and domestic violence service providers.  5WAVES features it at the top of each page on siblingsexualtrauma.com, and it is linked in the auto-reply that goes to all who fill out our contact form. We know how crucial it is to have human interaction and individual support, from people who are familiar with local resources, cultural practices, and legal landscapes, when facing the wide-ranging trauma that follows sibling sexual harm and abuse. We also realize that many individuals and families who contact us are also facing other types of domestic and sexual violence, both within and outside the family. 

As an organization in daily contact with service providers in the US and worldwide, the No More Foundation conducted an emergency survey in April 2025 to call attention to a funding crisis facing virtually all of the organizations in their network. The full report from this survey was just released. 

Although the needs of those facing domestic and sexual violence have always surpassed available services, actions taken by the US federal government in 2025 have precipitated a near-universal crisis for organizations addressing sexual and domestic violence. These will have an alarming impact on many survivors and family members in the sibling sexual trauma and abuse community. 

Here are a few examples from the No More report:

• 80% of providers in the No More network have already had their services disrupted.

• 65% of organizations have or will be cutting staff positions.

• In 2025 alone, an estimated 45,000 years of work experience in the domestic and sexual violence sector will be lost due to staff reductions (based on extrapolations of survey data). Staff who remain are at extreme risk for burnout and secondary trauma. 

• 61% of those providing direct services to children have had to reduce their hours or services.

• With less than 10% of all nonprofit revenue coming from individual and foundation donations, the capacity simply does not exist for the private sector to make up for loss of government funding. 

5WAVES, Inc. is not a political or partisan institution. We know that people of every political persuasion live in the shadow of sibling sexual abuse, trauma, and harm, and we are committed to keeping our services welcoming for all. We share this report, not to cast blame for what has been done in the past, but to raise awareness of an emerging crisis that will affect many within our community. This includes children who are currently facing sibling sexual harm and abuse. We respect our readers’ ability to choose their own response to this information, based on their own ability, beliefs, and conscience. 

What impact might this funding crisis have on 5WAVES as an organization? We have neither received nor sought any governmental funding thus far. Our services have all been provided by volunteers with a deep commitment borne of lived experience of sibling sexual trauma, and this is not in jeopardy. However, competition for the limited grant money available is increasing steeply, leaving emerging organizations like 5WAVES with very few options to expand our services. With professional support and counseling services likely to be cut, those facing sibling sexual trauma will be leaning even more heavily on the peer support and reliable online information that 5WAVES provides, free of charge. 

Although 5WAVES has not received any government funding that will be cut, we rely almost exclusively on the donations of those who value the information and support we provide to cover our expenses. We welcome one-time or recurring donations, in any amount, via PayPal. We also encourage readers to check in with their local domestic and/or sexual assault crisis center. We suggest asking how they are faring, learning how you might help. Then let them know that 5WAVES exists and we can help their clients facing sibling sexual trauma and abuse.