New report reveals devastating long-term impact of child sexual abuse on individuals and society, and calls for greater awareness by health-related professionals and better access to specialist treatment services for survivors

People who were sexually abused as children by relatives or family friends are breaking their silence in a report launched by charity One in Four describing the long-term pain and trauma they have suffered after being abused by the people they should have been able to trust most.

Despite recent high profile cases involving celebrities and criminal gangs, evidence suggests that around 70% of child sexual abuse (CSA) takes place within the family.

Such is the level of shame and fear that of those who contributed, nearly 90% have never informed the police, preferring to stay silent and mask their internal feelings of chaos, not knowing what help they need.

The report therefore gives a powerful insight into a problem that remains poorly understood.

‘Survivors’ Voices: Breaking the silence on living with the impact of child sexual abuse in the family environment’ has been issued by the charity One in Four, which helps people traumatised by child sexual abuse (CSA). The report contains accounts written by survivors to help them come to terms with their past and show others how CSA shapes lives.

One woman wrote: “I perfected the art of looking happy and internalised the abuse and kept all the difficult feelings inside.” Another wrote: “I never told anyone about the sexual abuse I was subjected to, and that has shaped a lot of my life.”

Linda Dominguez, Director of One in Four said: “By finally speaking out in this way, these survivors have put a personal, human face onto a crime that feeds on secrecy and anonymity. Their accounts expose a problem that has a far-reaching impact not just on individuals, on families, but also on society as a whole.”

Sexual abuse in childhood has been shown to be an underlying factor in a range of health conditions such as eating disorders, self-harm, and addiction to drugs, alcohol or sex. It can result in failed or damaged relationships, and can manifest itself in mental illnesses such as depression, post-traumatic stress disorder and suicidal thoughts or behaviour. Ministry of Justice research shows more than a quarter of women and men in prison report experiencing emotional, physical and/or sexual abuse in childhood.

Yet because it is a largely hidden crime, CSA is all too often missed by health professionals treating mental and physical disorders in their patients. One in Four is calling for greater awareness and better training for those working in healthcare, to help them recognise and manage cases involving past childhood sexual abuse.

A spokesperson said: “Our experience shows when survivors are heard and understood by professionals, they are gradually able to heal and recover from their abuse.

“However, the trauma resulting from CSA is often not recognised or addressed. This means survivors can waste years before finding effective support to help them recover from the sexual abuse they experienced in childhood. Without appropriate care and support survivors’ coping strategies can be negative and destructive to the well-being of themselves and society in general.”

One in Four is urging professionals working in areas such as drug and alcohol dependency, mental health, and eating disorders to ask their clients if they have a history of trauma such as CSA. This means behaviour can be linked to its underlying cause and patients can be offered appropriate treatment, including referral to specialist sexual abuse agencies.

To provide practical support, One in Four is issuing a new guide to help health workers understand the long-term effects of child sexual abuse. The publication, called ‘Responding to Survivors of Child Sexual Abuse’, offers advice, guidance and key practice points including how to manage disclosure, identify vulnerabilities, and direct survivors into specialist care pathways. The booklet also contains guidance for partners, families and friends on how best to support survivors and help them recover from past sexual abuse.

The author, CSA expert Christiane Sanderson, said: “Sexual abuse is not just something that happened in a person’s childhood. It can remain alive inside them and their families, sustained by secrecy and silence to protect the abuser and other relatives. Trust is often distorted and ultimately destroyed, and it is vital that health professionals understand this process so they can treat survivors and help them to ultimately escape from their past.”

Karen Goodman, Professional Officer, British Association of Social Workers (BASW), commented, “The social work profession is all too aware of the appalling impact of sexual abuse on children and the paucity, in particular of therapeutic services, for survivors. BASW supports the work of One in Four and encourages all professionals in the field to read this report. There is under recognition of both the emotional and economic impact of sexual abuse with a high proportion of those in our mental health and criminal justice systems being survivors, trying to cope with the impact of their abusive histories.”

Notes to Editors

1. Christiane Sanderson, Trustee of One in Four will be launching about Survivors’ Voices: Breaking the silence on living with the impact of child sexual abuse in the family environment on 24.11.15 at a closed conference for survivors, run by the Survivors’ Trust called Surviving Sexual Abuse in London. The Office of the Children’s Commission launches the results of their Inquiry into CSA in the family environment on the same day. There is common ground to the two reports, however the Survivors’ Voices report shows the long-term impacts.
2. Survivors’ Voices: Breaking the silence on living with the impact of child sexual abuse in the family environment, together with the supplementary document with more survivors’ accounts, contains 22 accounts in total. Both will be downloadable from 24.11.15 on
3. One in Four prepared this report to enable survivors to inform professionals how sexual abuse in childhood impacted their adult lives.
4. Twenty-two people (20 women and two men) took part in the project. The majority of this small sample (19 people, or 86%) did not inform the police about their CSA.
5. The report defines sexual abuse in the family environment as being forced or persuaded to take part in sexual activities under the age of 18 by a family member and/or people connected to the family, including parents, step-parents, a parent’s boyfriend or girlfriend, siblings, cousins, uncles, aunts, family friends, babysitters etc.
6. One in Four was established in 1999 and provides long-term counselling, advocacy, prevention work and professional training and development for anyone working with CSA.
7. Over 70% of One in Four clients were abused in the family environment
8. Smith, N, Dogaru, C, Ellis, F (2015) Hear me. Believe me. Respect me. A survey of adult survivors of child sexual abuse and their experience of support services. University Campus Suffolk indicates almost 70% of survivors report they were abused in the family or extended family.,-Business-and-Applied-Social-Science/Department-of-Psychology,Sociology-and-Social-Work/Focus-on-survivors-report.aspx
9. Prisoners’ Childhood and Family Backgrounds (Ministry of Justice, London 2012 Prisoners’ childhood and family backgrounds) shows 29 % of prisoners report having experienced a history of emotional, physical or sexual abuse, of this 67% % of women and 24% of men in prison report suffering sexual abuse in childhood. On these grounds alone, CSA therefore has an enormous cost to society.
10. One in Four is launching its new resource entitled Responding to Survivors of Child Sexual Abuse: A pocket guide for professionals, partners, families and friends, by Christiane Sanderson. Copies can be obtained from

FOR MORE INFORMATION and access to spokespersons, please contact or call 020 8697 2112


Survivors’ Voices – Selected Quotes from the Survivors Voice Report and Supplement

• “What he did to me affected my whole life, every relationship, my personal identity….child sexual abuse manifested in all parts of my life.”

• “For large parts of my life I hated myself, wished I was dead, wished I had never been born.”

• “You stole my childhood, some of my adulthood and my relationship with my family.”

• “He wasn’t a ‘monster’. This is part of the confusion – if he was horrible, it would be so much easier to deal with. I could really hate him then. But I don’t, I just hate what he did.”

• “I am a suffering survivor of childhood sexual abuse and its seems to me that as long as I live I will never be able to fully express the everlasting pain and confusion that being abused in childhood causes.”

• “When I found the right therapist who gave me time, patience, and allowed me to push boundaries without judgement and kept me safe, I slowly began to trust for the first time ever.”

• “I still grieve for the loss of a family I could have had and the absence of a safe and carefree childhood. All the things that I believe are the right of anyone.”

• “I went from being a happy, confident and carefree child, to one that was withdrawn, shy and beset by worries. I had night terrors, was frightened of the dark, plagued by guilt. I was depressed for many years.”

• “The shame doesn’t belong to the victims. It belongs to the abusers.”

• “When I was 13 I became more uneasy about my grandfather’s advances and realized something wasn’t right. I was confused – how could my grandfather who was a respected adult do something harmful?”

• “My abuser walks free without accountability and is loved by many including members of my family.”

• “If you were assaulted by a stranger, not family, people would think it outrageous to ask you to keep a relationship going with the person who assaulted you.”

• “After years of anguish, my family are breaking the silence.”