I Know Something Happened: Physician Management of Parental Disclosure of Suspected Child Sexual Abuse

Abstract

Abstract Introduction This is a case scenario simulating a physician encounter with a parent who has concerns about the sexual abuse of her child. The case scenario was developed to enhance competencies around the initial steps in management of child sexual abuse. Methods In the initials stages of a case like this, the establishment of rapport despite the emotionally charged nature of the issue is paramount. This resource is most applicable for addressing communication skills of trainees interacting with the caregiver of a possible child victim. In addition, the scenario impresses the need for trainees to acknowledge their role as a mandated reporter of all forms of family violence. Other competencies relevant to this case include being familiar with sexual behaviors that are considered developmentally appropriate in a prepubertal child while acknowledging the implications when there are variations from the norm. Results Prior to this experience, many trainees assumed that they knew how to manage a case of child abuse. After the training, trainees appeared less confident about the initial stages of managing a case of sexual abuse. On the other hand, they could easily identify the competencies they found the most challenging after the experience. The identification of these management challenges will inform curricular efforts on this topic at individual institutions based on available resources. Discussion Lessons learned from implementing this case in a resource-deficient environment can highlight the need for existing resources and bolster the argument for additional ones. This exercise can also serve as a needs assessment tool to inform the processes required for addressing the identified management challenges for similar cases.

Keywords

• Child Abuse
• Sex Offenses
• Disclosure of Sexual Abuse
• Child Maltreatment
• Parental Disclosure