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.