Survivors of Female Perpetrated Sexual Abuse and their Experiences of Disclosure Hannah K ...

219 Pages·2013·3.42 MB·English

Survivors of Female Perpetrated
Sexual Abuse and their Experiences
of Disclosure

Hannah K Clements
Doctorate in Clinical Psychology
2013
Survivors of Female Perpetrated Sexual Abuse and
their Experiences of Disclosure

Hannah Clements BSc (Hons)

A thesis submitted in partial fulfilment of the requirements of the
University of Lincoln for the degree of Doctor of Clinical Psychology

2013
Survivors of Female Perpetrated Sexual Abuse and their experiences of
disclosure
1. Abstract

Overview
Female Perpetrated Sexual Abuse (FPSA) remains a largely under-studied and
poorly understood phenomenon, despite its growing prevalence. Traditional
gender constructions in relation to victimisation and perpetration as ‘gendered’,
may be stifling its recognition, and the recognition of those affected. Survivor’s
perspectives on disclosure are crucial, given its known under-reporting, and
how many people feel silenced. As research on FPSA is in its relative infancy,
understanding the process of disclosing is particularly important in influencing
professional and social change, and progression.
Method
Fourteen participants of equal gender distribution, who self identified as having
been sexually abused in childhood by a female, were recruited online. The
study was advertised via online survivor communities, survivor charities and
forums supporting survivors. Participants were directed to a website designed
by the Researcher outlining the study in its entirety. Participants then offered
their consent to participation and contacted the researcher via the website.
Telephone interviews were arranged and conducted with participants meeting
eligibility, using a qualitative semi-structured interview protocol. Interviews were
transcribed and systematically analysed using a qualitative methodology
applying an Inductive Thematic Analysis approach (Braun & Clarke, 2006).
Results
Four super-ordinate themes relating to participants disclosing sexual abuse by a
female were discussed, with one being a central and over-arching theme
‘Perceptions of Gender and Disclosure’, which influenced the three further
themes;
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 Perceptions of Gender and Disclosure; consisting of ‘social attitudes’,
‘gender roles’, ‘barrier to recognition’ and ‘barrier to disclosure’
o Decisions to Disclose; consisting of ‘relationship with the
perpetrator’, ‘making sense of the experience’, effects of abuse’ and
‘readiness’
o Process of Disclosure; consisting of ‘experiences of services’,
‘contexts of disclosing’ and ‘nature of disclosure’
o Experiences of Disclosure; consisting of ‘perceived professional
responses’ and ‘impact of perceived professional responses’.

Conclusions
Constructions of gender and narrow views of ‘perpetration’ and ‘victimisation’
appear to be stifling personal, professional and social recognition of FPSA. This
lack of awareness and perceived cultural denial may be silencing survivors, and
restricting their ability to disclose and process their experiences. The impact of
gender appears to be two-fold and future research would benefit from exploring
disclosure of FPSA for males and females exclusively, as their experiences and
needs may greatly differ. The value of involving survivors in educating
professionals and in widening awareness is discussed.

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2. Acknowledgements
I would like to thank all of the survivors, who took part in the research, and
acknowledge their willingness to share their experiences and contribute to
understanding FPSA. I would like to acknowledge the considerable leap of faith
this must have taken given the personal nature of the experiences, and to
recognise our conversations as perhaps another important disclosure
experience, I am so very humbled and grateful that you shared with me. I would
like to thank the online organisations, and people who supported the research
by building awareness and advertising on my behalf. Further thanks are
extended to the male survivor organisations for embracing the research and
supporting my recruitment efforts. I would also like to express particular thanks
to Dr Dave Dawson for his supervision and guidance throughout the process.
Finally, I would like to thank my family and friends, for their unshaken support
and patience along the way.

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3. Statement of Contribution
Hannah Clements was the lead researcher for the study and was responsible
for the project design, gaining ethical approval, reviewing the literature,
designing the host website through which participants were recruited, collecting
the data, transcribing the majority of the data, data analysis and writing the
paper.
Dr Dave Dawson and Dr Roshan das Nair supervised the project, and offered
guidance in relation to this process, in particular supporting data analysis,
including the coding process and reviewing theme development.
Sexual abuse charities and survivor groups online assisted the recruitment
process.

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4. Table of Contents
Page Number
1. Abstract 1
2. Acknowledgements 3
3. Statement of Contribution 4
4. Table of Contents 5

5. Systematic Literature Review 11
5.1. Abstract 11
5.2. Introduction 12
5.3. Method 13
5.3.1. Information Sources and Search Criteria 13
5.3.2. Inclusion and Exclusion Criteria 16
5.3.3. Study Selection 16
5.3.4. Data Abstraction 17
5.3.5. Methodological Quality 31
5.4. Results 31
5.4.1. Methodological Characteristics
(Quantitative Studies) 31
5.4.2. Methodological Characteristics
(Qualitative Studies) 34
5.4.3. Key Findings: Professional Perspectives 38
5.4.4. Key Findings: Victim Perspectives 39
5.5. Discussion 41
5.6. References 45

6. Journal Paper 51
6.1. Abstract 51
6.2. Introduction 52
6.2.1. Summary 58
6.2.2. Research Aims 58
6.3. Method 59
6.3.1. Research Design 59
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6.3.2. Epistemology 60
6.3.3. Participants 60
6.3.4. Procedure 63
6.3.5. Interviews 63
6.3.6. Ethical Issues 63
6.3.7. Analysis 64
6.4. Results 64
6.4.1. The Sample 64
6.4.2. Participant Disclosure Information 66
6.4.3. Theme Overview 69
6.4.4. Theme Identification 69
6.4.5. Perceptions of Gender and Disclosure 71
6.4.6. Decision to Disclose 74
6.4.7. Process of Disclosure 75
6.4.8. Experience of Disclosure 76
6.4.9. Summary of Findings 77
6.5. Discussion 78
6.5.1. Survivor Reflections 85
6.5.2. Strengths and Limitations 86
6.5.3. Conclusions 86
6.6. References 88

7. Extended Paper 100
7.1. Extended Background 100
7.1.1. Prevalence of FPSA 100
7.1.2. Prevalence and Gender 101
7.1.3. Child Sexual Abuse: A Gender Perspective 102
7.1.4. Gender Perspectives and FPSA: Gender Roles
And Constructions of Women 103
7.1.5. Gender and Perceptions of Impact 104
7.1.6. Professional Perspectives of FPSA 104
7.1.7. Professional Responses to FPSA 106
7.1.8. Disclosure 107
7.1.9. Theories of Female Sexual Offending 108
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7.1.10. FPSA and Impact on Offending 109
7.1.11. Characteristics: Perpetrator and Victim Targeting 110
7.1.12. Female Sex Offenders: ‘Typologies’ 110
7.1.13. Women who Sexually Abuse Adults 113
7.1.14. Juvenile Female Perpetrators 113
7.1.15. Sampling and Recruitment in FPSA Literature 114
7.2. Extended Methodology 116
7.2.1. Qualitative Approaches in Psychology 116
7.2.2. Thematic Analysis 116
7.2.3. Epistemology: Considerations of Critical Realism 117
7.2.4. Epistemology: Considerations of Social Constructionism 118
7.2.5. Procedure: Recruitment Information 120
7.2.6. Semi-Structured Interview 122
7.2.7. Analysis in Thematic Analysis 123
7.2.8. Evaluation and Quality of Qualitative Enquiry 126
7.2.9. Ethical Considerations 127
7.2.10. Ethical Considerations of Interviewing 127
7.2.11. Managing Data 128
7.3. Extended Results 130
7.3.1. Long Term Effects of FPSA 130
7.3.2. Sample Overview: Relationship with Perpetrator 132
7.3.3. Characteristics of Abuse 132
7.3.4. Nature of the Sexual Act 133
7.3.5. Overview of Participant Disclosure Information:
Level of Disclosure 134
7.3.6. Nature of Disclosure 134
7.3.7. Type of Professional 135
7.3.8. Professional Responses 135
7.3.9. Theme 1: Perceptions of Gender and Disclosure 135
7.3.10. Theme 2: Decision to Disclose 139
7.3.11. Theme 3: Process of Disclosure 143
7.3.12. Theme 4: Experience of Disclosure 148
7.4. Extended Discussion 151
7.4.1. Disclosure 151
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7.4.2. Professional Responses 153
7.4.3. Relationship with Perpetrator 154
7.4.4. Memory: FPSA and Disclosure 154
7.4.5. Services and Support in FPSA 156
7.4.6. Strengths and Limitations: The Sample 156
7.4.7. Recruitment 157
7.4.8. Position of The Researcher 159
7.4.9. Conclusions and Clinical Implications 159
7.4.10. Current Context and Service Implications 160
7.4.11. Relevance to Clinical Psychology 162
7.4.12. Future Research 163
7.5. Critical Reflection 164
7.5.1. Reflections on Thematic Analysis 164
7.5.2. Researcher’s Reflections 165
7.6. References 170

8. Appendices 189
A. Example Research Appeal 190
B. Research Website details and Screen-view 191
C. Participant Information 192
D. Image of website ‘Contact Page’ and Consent 195
E. Telephone Semi-Structured Interview Schedule 196
F. Confidential Transcription Agreement 200
G. Ethical Approval (final) 201
H. Reflective Diary Excerpt 202
I. Example transcript Excerpt with Codes 203
J. Example of Collating Codes and Developing Themes 204
K. Images of Researchers ‘mind-map’, showing Thematic 205
Networks
L. Thematic Diagram (1) ‘Perceptions of Gender and 208
Disclosure’ with sub-themes
M. Thematic Diagram (2) ‘Decision to Disclose’ 209
with sub-themes
N. Thematic Diagram (3) ‘Process of Disclosure’ 210
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