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Journal of Child Sexual Abuse
ISSN: 1053-8712 (Print) 1547-0679 (Online) Journal homepage: https://www.tandfonline.com/loi/wcsa20
Maternal Emotional Support following the
Disclosure of Child Sexual Abuse: A Qualitative
Study
Andrea McCarthy, Mireille Cyr, Mylène Fernet & Martine Hébert
To cite this article: Andrea McCarthy, Mireille Cyr, Mylène Fernet & Martine Hébert (2019)
Maternal Emotional Support following the Disclosure of Child Sexual Abuse: A Qualitative Study,
Journal of Child Sexual Abuse, 28:3, 259-279, DOI: 10.1080/10538712.2018.1534919
To link to this article: https://doi.org/10.1080/10538712.2018.1534919
Published online: 02 Nov 2018.
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Maternal Emotional Support following the Disclosure of
Child Sexual Abuse: A Qualitative Study
Andrea McCarthy
a
, Mireille Cyr
a
, Mylène Fernet
b
, and Martine Hébert
b
a
Department of Psychology, Université de Montréal, Montréal, Canada;
b
Department of Sexology,
Université de Québec à Montréal, Montréal, Canada
ABSTRACT
Non-offending maternal (NOM) support is considered one of the
most important protective factors in facilitating better victim
adjustment following the disclosure of child sexual abuse (CSA).
However, recent findings have led authors to conclude that NOM
support has yet to be properly conceptualized and operationalized
within the CSA literature. Emotional support is one dimension that
has consistently emerged in studies attempting to reconceptualize
NOMsupportbutisaconceptwhichalso requires further theore-
tical investigation. Researchers interviewed 22 mothers of children
aged 6–12 years about their experience and provision of emotional
support following their child’sdisclosureofCSA.Datawereana-
lyzedusingamethodinspiredbygroundedtheory.Mothers
reported feeling initially overwhelmed and lost about how to
emotionally support their child but described an improvement in
their support capabilities following conjoint therapy. Furthermore,
three overarching categories emerged outlining maternal emo-
tional support strategies, each serving a specific emotional func-
tion: (a) elaborating, encouraged children to talk about their CSA
experience; (b) soothing, attempted to comfort children’s distress;
and (c) orienting, attempted to guide children’srecoveryprocess.
Authors discuss implications for offering improved and more rapid
clinical services following the disclosure of CSA, and considerations
for the operationalization of NOM emotional support.
ARTICLE HISTORY
Received 6 July 2018
Revised 21 September 2018
Accepted 25 September 2018
KEYWORDS
Child sexual abuse;
disclosure; non-offending
maternal support; emotional
support; qualitative study;
mother
There are many negative short- and long-term consequences that may result
from child sexual abuse (CSA), including depression and anxiety disorders,
post-traumatic stress disorder (PTSD), substance abuse, and sexual and/or
interpersonal difficulties (Hillberg, Hamilton-Giachritsis, & Dixon, 2011).
Over the last two decades, research has focused on developing a better under-
standing of the factors which serve to protect children from the potentially
debilitating effects of CSA. One factor that has frequently emerged as significant
for better child and adult adjustment following disclosure of CSA is the support
a child receives from the significant caregivers in his/her life, particularly their
mothers (Bick, Zajac, Ralston, & Smith, 2014; Elliott & Carnes, 2001; Godbout,
Briere, Sabourin, & Lussier, 2014; Yancey & Hansen, 2010).
CONTACT Mireille Cyr mireille.cyr@umontreal.ca Département de psychologie, Université de Montréal, C.
P. 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada
JOURNAL OF CHILD SEXUAL ABUSE
2019, VOL. 28, NO. 3, 259–279
https://doi.org/10.1080/10538712.2018.1534919
© 2018 Taylor & Francis
However, several issues have been raised with regards to the conceptualiza-
tion and operationalization of non-offending maternal (NOM) support. The
primary concern is that the concept of NOM support lacks a theoretical basis,
and instead was developed based on definitions established by child protective
services and clinical observations (Bolen, 2002; Bolen, Dessel, & Sutter, 2015;
Bolen & Gergely, 2014; Smith et al., 2010). Furthermore, the individual dimen-
sions of NOM support, such as emotional, protective, similarly lack theoretical
investigation and would benefit from conceptual differentiation with the larger
general concept of NOM support (Smith et al., 2017,2010). In fact, each separate
dimension may relate differently to NOM behaviors and child outcomes follow-
ing CSA (Alaggia, 2002; Smith et al., 2010; Zajac, Ralston, & Smith, 2015). In
light of these critiques, this study seeks to better understand mothers’experience
and provision of emotional support to their child following the disclosure of
CSA using a qualitative method inspired by grounded theory.
NOC support and CSA adjustment
In their literature review, Elliott and Carnes (2001) documented research that
indicated non-offending caregiver (NOC) support, including NOM support, as
being one of the most important factors influencing a child’s post-disclosure
adjustment. Indeed, many studies have provided evidence linking NOC support
with child and adult adjustment following CSA disclosure (Bick et al., 2014;
Everson, Hunter, Runyon, Edelsohn, & Coulter, 1989; Godbout et al., 2014;
Yancey & Hansen, 2010). Recently, Bick et al. (2014) found that more positive
and supportive maternal responses helped to normalize children’s reactions and
restore their sense of security following CSA disclosure, while unsupportive
responses were associated with a higher risk of children developing anxiety,
depression, PTSD, and dissociative disorders, as well as suffering from anger and
sexual concerns. Positive NOC support has also been related to fewer internaliz-
ing and externalizing symptoms (Rosenthal, Feiring, & Taska, 2003), lower levels
of PTSD symptoms in both child and adult victims of CSA (Hyman, Gold, &
Cott, 2003) and a secure attachment style later in life, which has known impacts
on a number of psychopathological symptoms and interpersonal outcomes
(Godbout et al., 2014).
Despite the evidence documenting the influence of NOC support on child
and adult adjustment following CSA, a recent meta-analysis evaluating the
relation between NOC support and child adjustment following CSA found that
out of 11 variables studied across 29 studies, NOC support was only signifi-
cantly related to three child outcomes, namely lower levels of depression, less
acting out, and improved self-concept (Bolen & Gergely, 2014). Moreover,
NOC support explained only a small amount of the variance in those sig-
nificant child outcomes. As such, some authors (Bolen & Gergely, 2014; Smith
et al., 2010) concluded that researchers must come to a consensus about the
260 A. MCCARTHY ET AL.
conceptualization and operationalization of NOC support and its dimensions
if they wish to gain any real understanding of its link to CSA consequences.
Defining NOC support
Within CSA literature, NOC support has been defined as either general or
abuse-specific. General NOC support refers to NOC’s overall levels of expressed
affection and acceptance of their child, the quality of the NOC–child relationship
(Bolen & Lamb, 2002) and the NOC’s provision of general care, supervision, and
disciplinary style (Cyr et al., 2014). This type of support is influenced by the
previously established interactions and supportive patterns existing in the care-
giver–child relationship. Abuse-specific NOC support has typically been mea-
sured using the Parental Response to Abuse Disclosure Scale (PRADS; Everson
et al., 1989) which evaluates four dimensions of support: whether the parent (a)
believes the child, (b) protects the child from the perpetrator, (c) emotionally
supports the child, and (d) ensures the child receives appropriate access to
health-care services. More recently, Smith et al. (2010) developed the Maternal
Self-Report Support Questionnaire (MSSQ) in response to criticism about the
lack of theoretical conceptualization for NOM support and established that
maternal support comprises two main factors: emotional support and lack of
blame/doubt. Bolen et al. (2015) similarly attempted to address this criticism in
their qualitative study which explores how NOCs support their child after the
disclosure of CSA. Eight key domains of support emerged from their study: basic
needs, safety and protection, decision-making, active parenting, instrumental
support, availability, sensitivity to the child, and affirmation.
Why focus on emotional support?
Interestingly, in both Everson et al.’s(1989) and Smith et al.’s(2010)measures,
emotional support emerged as a significant dimension of NOM support
following disclosure of CSA. Further evidence for the importance of emotional
support in the context of CSA can be found in the stress and coping literature.
Within this literature, Cutrona and Russell (1990) outline a multidimensional
model of social support which promotes the optimal matching of different
types of support with specific stressors. In their article, they describe emotional
support to be an optimal match for supporting those who experience victimi-
zation which is usually perceived as an experience that is completely
uncontrollable and extremely threatening. They define emotional support as
the ability to provide others with comfort and security during times of stress,
leading the person to feel that he or she is cared for by facilitating the
reconstruction of a sense of security and helping cope with the painful emo-
tions of fear, anger, and depression which are essential in the recovery process
following the experience of victimization.
JOURNAL OF CHILD SEXUAL ABUSE 261
In the context of CSA disclosure, the dimension of NOM emotional support
has been defined in many ways, including maternal acceptance, engagement
and attachment toward the child, acknowledgment of the seriousness of the
abuse and of the child’s experience of psychological distress, and meaningful
affective interactions with the child that diffuse self-blame and promote a sense
of security (Alaggia, 2002; Bolen & Lamb, 2004; Smith et al., 2017). In recent
studies assessing this dimension, it was found that higher levels of emotional
support from mothers are related to lower levels of self-blame and doubt
(Smith et al., 2010); fewer internalizing and externalizing problems (Smith
et al., 2017); fewer experiences of anger and depression (Zajac et al., 2015); and
less anxiety, sexual concerns, social problems, and rule-breaking behavior in
CSA victims (Wamser-Nanney, 2017).
Redefining NOM emotional support
As with the overarching concept of NOM support, there is little consensus
regarding the definition and operationalization of NOM emotional support
(Bick et al., 2014). Cutrona and Russell (1990) define emotional support as the
“ability to provide others with comfort and security”without specifying con-
crete behavioral examples. This same criticism can be said of emotional
support definitions across studies in the CSA literature. For example, in the
PRADS/PRIDS (Everson et al., 1989), one of the most commonly used assess-
ment measures of parental support, emotional support provision is evaluated
by “how deeply involved one is with their child”and “whether one gives their
child emotional support (i.e., comfort, reassurance, listening)”, but the tool
does not provide concrete behavioral examples and/or specific measurable
constructs (e.g., what defines being deeply involved with one’schildand
demonstrating good listening?) to evaluate these dimensions. Moreover, sev-
eral studies confound NOM emotional support with its umbrella concept,
abuse-specific NOM support, assuming them to measure the same construct
(e.g., Musliner & Singer, 2014; Rosenthal et al., 2003). In addition, several
studies measure NOM emotional support using only a one-item Likert-scale,
asking for example, “How much do you feel X cares about you?”(Musliner &
Singer; Rosenthal et al.). This practice inadequately captures the concept of
emotional support which is likely a multifaceted notion (Smith et al., 2010).
Lastly, researchers have failed to evaluate certain key factors that might be
associated with NOM emotional support, such as mothers’emotion regulation
capacities (Langevin, Hébert, & Cossette, 2015) as well as skills such empathy,
acceptance, and goal-oriented behavior usually associated with the develop-
ment of a good therapeutic alliance (Middle & Kennerley, 2001).
262 A. MCCARTHY ET AL.
Mothers’experience of emotionally supporting their child
Hooper (1992) found that mothers are usually the ones who receive the first
disclosure of CSA and that it’s particularly important that they recognize the
severity of the situation and validate the distress of their child at this moment.
There is a paucity of research evaluating mothers’subjective experience while
supporting their child, either emotionally or otherwise, and how this contributes
to the provision of support. Cyr et al. (2014) assessed mothers’provision of abuse-
specific support following CSA disclosure and found that only 50% provided
emotional support to their child during the sensitive period following the dis-
closure of CSA. While these results suggest that providing emotional support is
something that mothers struggle with, to our knowledge, no studies have exam-
ined how and why mothers find providing this type of support particularly
difficult. Some speculation can be made in association with the results found in
a qualitative study conducted by Plummer and Eastin (2007), in which mothers
reported that the mother–child relationship is strained following disclosure due to
factors such as parenting insecurity, parental exhaustion from increased demands,
internal turmoil surrounding feelings of guilt and self-blame, interference by
investigators, and behavior problems and emotional mood swings in the child.
Furthermore, it has been documented that mothers may experience ambivalence
toward supporting their child, especially when they have financial or emotional
ties to the abuser (Bolen, 2002;Bolen&Lamb,2004). Other important factors that
may affect NOM support include cultural expectations of emotional expressive-
ness, mental illness, and triggers related to the mother’s past traumatic experi-
ences, all which may make the mother less emotionally available to cope with the
child’s reactions to the abuse (Alaggia, 2002).
Objectives and research questions
The primary objective of the current study is to better understand how mothers
experience and provide emotional support to their children following the dis-
closure of CSA. The first question asks: How do mothers subjectively experience
providing emotional support to their child following the disclosure of CSA? This is
notanevaluationofthemother’s experience of the disclosure itself, but of
providing emotional support to their child. The second question explores what
mothers do in attempts to provide emotional support following the disclosure of
CSA. That is, do they change their supportive patterns or not? Do they employ any
specific types of strategies to provide emotional support? A qualitative approach
inspired by grounded theory was chosen to interpret the results of this study. This
methodology is an inductive approach which moves from empirical data (mothers
verbatim) toward the development of a theoretical model. It allows for the in-
depth exploration of a phenomenon of interest by both incorporating existing
JOURNAL OF CHILD SEXUAL ABUSE 263
knowledge on the topic while also gaining an understanding of the topic from the
experience of the participants (Hennick, Hutter, & Bailey, 2011).
Method
Participants and recruitment
Participants were 22 mothers recruited in a child advocacy center (CAC)
[Centre d’expertise Marie-Vincent]. Mothers’ages ranged from 29 to 57
years, with a mean age of 39.8 years (SD = 7.5) and 91% identified themselves
as being of Canadian origin. Fifty percent of the participants indicated that
they were full-time homemakers, while the other 50% reported working at a
variety of different paid jobs. Family structure was defined as either an intact
mother–father biological or adoptive family (36.4%), a stepfamily (27.3%) or
single-parent family (27.3%). For two mothers (9%), their child was living in
a foster care facility. Approximately half of the mothers (54.4%) reported
having experienced CSA. Mothers declared a total of 30 sexually abused
children. Children’s ages ranged between 4 and 14 years, with an average
of 7.6 years (SD = 2.5), during the period when the CSA occurred, and were
aged between 7 and 15 years at the time of the interview, with an average age
of 10.5 years (SD = 2.1). The majority (85%) of the children were abused by
someone in their family (father, brother, sister, grandparent, stepfather),
while the others (15%) were abused by friends of the family or people in
the child’s close environment. A third of the children experienced anal,
vaginal, and/or oral penetration, while the remainder experienced various
types of sexual voyeurism, exhibitionism, and sexual touching.
Participants were recruited using the theoretical sampling method which
seeks out people with a depth of information on and a variety of experiences
related to the topic of interest (Hennick et al., 2011). Inclusion criteria were
(a) to have a child who experienced CSA; (b) be over 18 years of age; (c) not
to suffer from any major mental health disorder, thus providing more
normative rather than clinical experiences; (d) the mothers’children were
required to be between the ages of 4–12 at the time of abuse; and (e) the
disclosure of CSA must have occurred at least 1 year before the interview to
allow time for participants to gain some distance and perspective with
regards to their experience. Recruitment took place during the last session
of the child’s therapy at the CAC or during a follow-up with the family 1 year
after completing treatment.
Data collection and procedures
Therapists or research assistants first presented mothers with the details of
the research project following their final therapy session or during a follow-
264 A. MCCARTHY ET AL.
up session at home. Mothers who consented were contacted over the tele-
phone by the first author to set up an interview date. Before beginning the
interview, mothers provided their formal consent by signing a consent form
which was approved by the Université de Montréal Ethics Committee and
filled out a sociodemographic questionnaire. Mothers and their children were
given fictional names and all compromising details were changed to ensure
their anonymity. Data were collected using a semi-structured interview style
which provides the interviewer with the structure of several predetermined
questions but also provides interviewers with flexibility to develop their own
questions aimed at gaining a deeper understanding of mothers’responses.
Interviews were conducted by three researchers previously trained to use this
interview style. Interviews were held at the CAC or at the primary research-
er’s university in secured interview rooms and lasted approximately 2 hr.
Predetermined questions covered three content categories: maternal affective
reactions and experiences following the disclosure of CSA, maternal
responses and actions to assist their child following disclosure, and mothers’
perception of her maternal role and relationship with her child. Questions
were presented in the form of a reverse funnel, starting with precise questions
(e.g., “Did your child’s disclosure of CSA change the way you got involved
with him or her?”and ending with more open-ended questions aimed at
detailing the experience being shared (e.g., “Tell me more about. . .”or
“How?”). After the interview, a debriefing was conducted with participants
to provide them with resources and the possibility to obtain psychological
support if needed. The majority of mothers who participated were already
receiving psychological services from the CAC at the time of the interviews.
Data analysis
A method inspired by grounded theory procedures was used to analyze the
data. First, a very thorough verbatim was completed for each interview.
Coding began with the analysis of these verbatim interview transcriptions
using open coding (Bryant & Charmaz, 2007), which consisted of gathering
together basic elements or units of information such as actions, events,
interactions, or emotions, into groups. The second stage, axial coding, com-
pared these different grouped units of information for any similarities or
differences and categorized them into various larger conceptual themes. In
the third stage, selective coding, these larger conceptual categories were
linked together into networks in an attempt to create an overarching theore-
tical framework. This coding process constantly evolved, moving between the
three stages of coding at various points throughout the analysis as new data
were acquired and concepts emerged. The coding was conducted using the
software program ATLAS-ti V5 (Bandeira-De-Mello & Garrelau, 2011).
JOURNAL OF CHILD SEXUAL ABUSE 265
Results
Mother’s experience of providing emotional support
Mothers experienced a period of uncertainty about and adaptation to emo-
tionally supporting their child following the disclosure of CSA. This experi-
ence can be described as a process moving through three phases: (a) Mothers
perceived their child as developing new needs following CSA, (b) mothers
felt overwhelmed and uncertain about how to respond to their child’s new
needs, and (c) mothers felt better equipped to respond to their child’s needs
following therapy with their child.
1. Mothers perceive their children as having new needs following CSA
disclosure. Mothers experienced a change in how they perceived their child
and their child’s needs, which they attributed to their child’s experience of
having been sexually abused (n= 12).
[My child] experienced things that, normally, she shouldn’t have experienced at
her age. [. . .] It’s certain that it made me change as well, in my way of perceiving
her and in the help that I provide her with. –Doris
Participants reported, for example, that their children became more inse-
cure, started having difficulty in school, and developed various mental
health (e.g., attention deficit/hyperactive disorder, anxiety) and behavior
problems (e.g., aggression, withdrawal, and sexually inappropriate beha-
vior). Consequently, mothers felt they had to adjust the way they responded
to their child’s needs due to these perceived changes in their child’s
behavior. Some mothers (n= 9) reported that their child’smentaland
behavioral problems created a barrier when trying to emotionally support
their child. Mothers found it difficult to adequately respond to their child’s
newfound anxiety and anger, and felt distanced by their child’s aggressive-
ness or sexually inappropriate behavior.
He didn’t want to be touched anymore. I can’t approach him for affection; I need
to wait for him to come to me. But going to him, forget about it. –Monique
Many mothers described how their own mental health issues impacted their
experience of supporting their child (n= 8). Some reported symptoms of
depression, anxiety, substance abuse, and even PTSD:
It’s after [the event] that I started keeping everything inside [. ..] Since then, I
would say, I started having panic attacks, anxiety, trouble sleeping. [. ..] Since the
disclosure, I have had nightmares [. ..] Let’s say I am a lot more vigilant with the
children, also. It was a difficult period to just listen and be with them. –Cassiopeia
2. Mothers experience insecurity and uncertainty in responding to their
child’s new emotional needs. Several mothers recounted how adapting their
supportive behaviors following their child’s disclosure of CSA was quite a
266 A. MCCARTHY ET AL.
difficult experience (n= 10), describing it as a tough learning process.
Mothers said they felt lost and uncertain about what to do or say.
A child of 4-5 years old, you don’t know what to tell him. You don’t know what to
say, you know nothing. You [need] someone there to help you, you know, to tell
you what to say and what to do with that. –Genevieve
With the apparition of these new needs, mothers felt anxious and insecure
not only about supporting their child but, even more globally, about their
role as a mother.
I felt incompetent in my role as a mother because I had no idea what to do. –Kitty
Mothers reported that they needed assistance moving forward because they
were at a loss with regards to how to respond to their child. Many mothers
(n= 9), especially those who were also victims of CSA themselves (n= 6), felt
overwhelmed and shocked by their child’s disclosure of CSA and the accom-
panying changes. These mothers were both emotionally surpassed by and
confused about how to deal with their own emotions. They felt it impacted
their emotional availability in responding to their child’s needs:
You are less capable of helping your child because you are stuck with your [own]
emotions. You haven’t found resources yourself, how can you give your children
resources? If you don’t know how to help yourself, how do you help your child. –
Chantale
3. Mothers learned how to better respond to their child’s emotional needs
following personal experiences in their own or their child’s therapy.
Despite initially feeling overwhelmed and helpless in emotionally supporting
their child, many mothers reported an improvement in their confidence
about and abilities to support their child after engaging in therapy with
them at the CAC (n= 13). Mothers felt that they had better tools for
managing their own and their child’s emotions which allowed them to better
deal with their child’s emotional outbreaks and behavioral problems, discuss-
ing sexuality, and setting boundaries and implementing routines.
To have therapy with [my daughter], and to participate with her, it really did me
some good, it gave me a lot of good tricks, it gave me ways to get my emotions out,
and also, to talk about sexuality normally. –Suzie
Mothers’emotional support strategies
Mothers also discussed what they did in an attempt to respond to their child’s
needs following the disclosure. Through the analysis of mothers’interviews,
three overarching emotional support strategies (elaborating, soothing and
orienting) emerged which group together those verbal, attitudinal, and beha-
vioral methods adopted by mothers in their reported attempt to facilitate their
JOURNAL OF CHILD SEXUAL ABUSE 267
child’s post-disclosure recovery process (see Table 1): A) Verbal methods
involve mothers talking with their child about certain topics and providing
support through words, B) Attitudinal methods describe how mothers adopt a
new mental approach toward their child and C) Behavioral methods involve
mothers taking supportive actions toward their child. The majority of the
mothers (n= 14) used at least one emotional support strategy from all three
functional groups and most mothers (n= 18) used all three methods.
Strategy 1. Mothers adopted emotional support strategies to help their
child elaborate on and process his or her experience. Many mothers
(n= 19) underlined the importance of encouraging their child to elaborate
on their abusive experience; either by helping their child discuss the details of
the abuse, describe their reactions to the abuse, or talk about their daily
experiences following the disclosure. This group of strategies is subdivided
according to the three methods: verbal, attitudinal, and behavioral.
A. Verbal method: Mothers talked with their child more frequently about
their emotions. Mothers’reported increasing their verbal inquiries into their
child’s emotional state; inviting their child more frequently to verbalize their
reactions to and their feelings associated with the CSA events (n= 9).
Mothers asked about their child’s moods, feelings, and perceptions. They
also encouraged their child to name what emotion they were experiencing
and assisted them in processing their affective state.
I really talked a lot with her so that she could get it out of her [system]. She told me
a lot, she really told me a lot about how she was feeling and all that. –Julie
B. Attitudinal method: Mothers became increasingly sensitive to and per-
ceptive of their child’s emotional states. Mothers also adopted a new attitude
of sensitivity toward their child’s emotional states (n= 6). Some mothers
expressed how they became more aware of the verbal and nonverbal signals
exhibited by their child in their emotional highs and lows, as well as their
child’s emotional triggers.
Table 1. Strategies of emotional support.
Function Method Strategy
Elaborating Verbal Discussing Emotional Reactions
Attitude Sensitivity/Perceptiveness
Behaviour Availability
Soothing Verbal Reassurance
Encouragement
Attitude Empathy/Acceptance
Behaviour Involvement/Implication
Affection
Orienting Verbal Education
Attitude Openness
Behaviour Discipline/Structure
Autonomy Support
268 A. MCCARTHY ET AL.
It’s like I developed better antennas, and I see more quickly when there is some-
thing that is tiring her or bothering her [. ..] I see it more easily [. . .] it’s come to
the point that I can tell [how she is feeling] just by the way she will look at me. –
Nadia
C. Behavioral method: Mothers increased their availability to create a com-
municative space for their child. Finally, mothers attempted to create a com-
municative space for their child by simply making themselves more available
and present for emotional discussions with their child (n=7).Inordertobe
more accessible to their child at home, some mothers reduced their hours at
work, started eating dinner at the table, or implemented bath time.
I think it’s doing them some good the fact that I no longer work at night, that I am
there more often. [. ..] I am there in a better way, to play with them, talk with them
and even for homework too. –Roxanne
Strategy 2. Mothers adopted emotional support strategies to soothe their
child’s emotional distress. Mothers tried to emotionally support their child
by soothing their emotional distress using comfort and encouragement
following the disclosure (n= 16). They wanted their child to feel loved and
to restore their sense of safety and well-being within a secure and caring
relationship. In order to do this, mothers used the following methods: (a)
verbal reassurance and encouragement, (b) empathetic attitude toward their
child’s experience, and (c) engagement and affection toward their child.
A. Verbal method: Mothers attempted to soothe their child using words of
reassurance and encouragement. Many mothers (n= 13) described using
words of love, comfort, and consolation with their child in an attempt to
reassure them following the CSA disclosure. Mothers wanted to ensure that
their child felt safe by reminding them that they would always be there to
support them during difficult times:
I told her that it would be OK and that I was there to help and accompany her in
[the disclosure] and that we would do everything possible to make sure she would
be OK and that our family would get through this. –Cassiopeia
Through their reassurance, mothers wanted to quell their child’s self-doubts
and restore their self-esteem by telling their child that they are courageous,
beautiful, and smart. Mothers’appeasement attempts also took the form of
encouragement (n= 9). Mothers told their children that they believed in
them and that they knew they would be able to push forward and get through
their difficulties.
I encouraged her, to prove to her that she was capable of continuing to live and to
live happily and that she should love herself and that others loved her. –Julie
B. Attitudinal method: Mothers adopted a more empathetic attitude toward their
child. Mothers’new empathetic attitude involved being more compassionate,
JOURNAL OF CHILD SEXUAL ABUSE 269
accepting, and understanding of their child. Mothers wanted to demonstrate to
their child that they felt compassion for their situation, that what their child was
saying was being respected and taken seriously, and that they recognized the
impact of the CSA on their lives. Many mothers (n= 10) indicated that they
now felt they better understood their child’sbehaviorsandwereabletobemore
accepting and tolerant than before the disclosure:
I understood her mood swings better [. ..] So, I started reacting in a different way
by sitting down with her and discussing so I could understand why she got to that
point [. ..] It helped me understand her better. –Helen
C. Behavioral method: Mothers also became more engaged in their child’s
life and provided them with more affection. Mothers increasingly involved
themselves in their child’s lives as a way to reassure them (n= 13). Mothers
wanted to appease their child’s insecurities by showing them that their
relationship was important. This was done by increasing their play time
and daily interactions with their child, or by involving themselves more in
their child’s school work and extracurricular activities. Some mothers also
soothed their child by expressing affection (n= 6), through hugs, kisses,
caresses, and various acts of tenderness.
I take more time to play with her [. ..] I learned to play board games with her, to
watch movies with her, to share similar interests and to have fun with her [. ..] it
brought us a lot closer together. –Nadia
Strategy 3. Mothers adopted emotional support strategies to guide and
orient their child in the post-disclosure recovery process. Finally, many
mothers described how they wanted to orient their child toward emotional
growth following the disclosure (n= 17). Mothers oriented their child’s
recovery using the following methods: (a) verbally sharing educational
knowledge regarding the disclosure process and consequences of abuse (b)
attitudinally by becoming more open-minded about their child’s needs, and
(c) behaviorally by adapting their child’s environment in a seemingly more
appropriate way.
A. Verbal method: Mothers educated their child about their post-disclo-
sure experiences. Many mothers wanted to educate their child regarding
CSA; by normalizing their potential emotional reactions and discussing
steps involved in the disclosure procedure (n= 9). Mothers helped them
understand the experience of going through therapy or police proceedings.
I told her, “We’re gonna go to [the] hospital”, I explained everything to her, what is
a psychologist, how they can help her, etc. –Diane
They also wanted to ensure that their child understood that romance and sex
can be healthy and adaptive in intimate relationships and that what hap-
pened to them was not normal.
270 A. MCCARTHY ET AL.
I try to tell [my child] that [sexuality] can be very beautiful, very pleasant with
someone whom we love. –Helen
B. Attitudinal method: Mothers were more open-minded in addressing
certain topics, such as sexuality. Mothers also described how they tried to
keep an open mind toward their child’s struggles, questions, and emotional
reactions following the disclosure, ensuring their child felt comfortable
addressing any topic with them (n= 9). With a more open mind, they felt
better able to respond to their child’s needs. For example, mothers were more
receptive to discussing difficult topics, such as sexuality, which they initially
found intimidating or taboo, and thus reported being better able to respond
to their child’s questions.
If they ask me a question, I will maybe answer more honestly than I would have
before. [. ..] If they ask me a question about sexuality or drugs or whatever, I
respond honestly without making detours. –Helen
C. Behavioral method: Mothers adapted their child’s environment provid-
ing the opportunity for healing and growth. While some mothers initially
reacted with hypervigilance and excessive monitoring in an attempt to
protect their child’s emotional well-being (n= 12), others reacted by becom-
ing more permissive toward their child (n= 7). After going through therapy
at the CAC, many mothers found themselves readjusting their approach to
more effectively respond to their child’s specific needs. This reorientation
was done either by attempting to restore the child’s confidence through
autonomy development or by attempting to restore a sense of security
through the creation of a more structured and stable environment.
At the beginning, I was very protective towards my daughter. I learned to let go a
little. You know, as a parent, with the restrictiveness towards my daughter, the
protectiveness, well she is getting older, you have to let go. I learned to let go. –
Christine
We put together a plan with a routine, defining the house rules, how to implement
them, a calendar of the rules, as well. It was a way to facilitate communication. [. ..]
It really helped improve our relationship and restore confidence. –Monique
Discussion
The purpose of this study was to explore how mothers experienced emo-
tionally supporting their child following the disclosure of CSA and how they
attempted to do so. Mothers who participated in the study were interviewed
at least 1 year after their child’s disclosure, which allowed them to gain some
distance from and perspective on their experience. Additionally, all mothers
were interviewed after having participated in conjoint therapy with their
child addressing the impact of CSA on their lives. This context provided
JOURNAL OF CHILD SEXUAL ABUSE 271
researchers with access to a new perspective on NOM emotional support
than has previously been explored in the literature. First, mothers reported
going through a learning process when attempting to respond to their child’s
new emotional needs. Second, mothers described their emotional support as
comprising of three main functional strategies which aimed to assist children
in their post-disclosure recovery process: (a) elaborating on emotional reac-
tions to CSA, (b) soothing child’s distress in relation to the disclosure, and
(c) orienting the child’s healing process by finding a balance in structure and
autonomy in the child’s environment. Each of these functional groups is
made up of three different types of strategic methods: (a) verbal, (b) attitu-
dinal, and (c) behavioral.
Mother’s experience of emotionally supporting their child
The majority of mothers perceived their child’s emotional needs to be
different following the disclosure of CSA and attempted to respond to
those new needs using various emotional support strategies. Similar to find-
ings in previous studies, mothers reported difficulty learning to deal with
their child’s emotional distress, structuring their child’s environment, work-
ing on restoring their child’s confidence and managing their child’s displays
of externalized behaviors (aggression, sexual inappropriateness) during an
emotionally charged period of their lives (Cyr et al., 2014; Plummer & Eastin,
2007). In their qualitative study, Plummer and Eastin (2007) found that
mothers often described feeling incompetent and anxious in their maternal
role during the period following their child’s disclosure of CSA. Mothers in
the current study described the experience of emotionally supporting their
child as being overwhelming and certain mothers even felt helpless and lost
in their maternal supportive role. These results coincide with the experiences
reported by mothers in previous studies which demonstrate that, out of the
four types of abuse-specific NOM support, mothers have the most difficulty
providing emotional support to their child directly following disclosure (Cyr
et al., 2014; Everson et al., 1989). Cyr et al. (2002) suggested that mothers
who have difficulty providing emotional support to and managing the emo-
tional reactions of their child following disclosure were the same mothers
who had difficulty dealing with their child’s reactions in everyday life. Bolen
and Lamb (2004) discussed NOM support as being influenced by mothers’
own reactions to the disclosure, previous traumatic experiences, and relation-
ship with the abuser who could lead to ambivalent supportive actions.
Although observing the impact of therapy on NOM emotional support
was not an objective of this study, several mothers consistently described how
they felt much more capable of emotionally supporting their child after
having participated in conjoint therapy sessions with their child at the
CAC and other related centers. After the initial shock and uncertainty wore
272 A. MCCARTHY ET AL.
off, and following therapy, a number of mothers reported that they better
understood their child’s needs and how to respond to them more appro-
priately. For example, many mothers reported initially experiencing difficulty
discussing emotions and sexuality with their child following the disclosure
but felt much more equipped to do so after learning how to identify emo-
tions, recognize signs of their child’s affective states and monitor their own
emotional reactions. In their study on caregivers’needs following their
child’s disclosure of CSA, Van Toledo and Seymour (2016) found that
caregivers reported a need for assistance with learning to manage their child’s
behavior and coping with their own reactions. These authors recommended
that caregiver therapy should be provided alongside the child’s therapy.
These results combined indicate the need to implement a psychoeducational
component into therapy for parents following CSA disclosure, to normalize
their own and their child’s reactions, while also providing tools to deal with
CSA consequences. Questionnaires assessing NOM support following dis-
closure should consider investigating areas in which mothers feel they have
the most difficulty approaching their child, such as topics of sexuality and
affect. A temporal element could also be added to evaluate changes in
mothers’experience and perception of difficulty over time.
Emotional support strategies
Mothers adopted several different strategies in an attempt to emotionally
support their child, which were assembled into three overarching strategy
groups (elaborating, soothing, and orienting), each representing a specific
function used to facilitate the child’s recovery process. These three over-
arching strategy groups were further subdivided into three types of approach:
(a) verbal methods which involved mothers using their words to provide
support in what they would say and how they would say it, (b) attitudinal
methods in which mothers adopted a different attitude, mentality or posture
toward their child and finally, (c) behavioral methods which involved
mothers’different actions toward and interactions with their child. By adopt-
ing strategies from the elaborating functional group, mothers aimed to help
their child open up, discuss, and elaborate on their experience of CSA in an
attempt to make sense of it; whether that was by making themselves more
available for emotional discussions, being more sensitive, attentive and per-
ceptive to their child’s moods, or talking about the child’s emotional reac-
tions or needs. By using strategies in the soothing functional group, mothers
attempted to appease the child’s emotional distress in response to the CSA,
through the use of reassurance and encouragement, an attitude of empathy
and acceptance, and by becoming more involved and affectionate with their
child. With the orienting functional group, mothers used strategies in an
attempt to guide their child’s recovery process toward emotional growth in a
JOURNAL OF CHILD SEXUAL ABUSE 273
secure but flexible environment by educating them, adopting an open-
minded attitude, boosting their confidence through autonomy development
and by structuring their environment.
These functional groups seem to correspond well with Cutrona and
Russell’s(1990) definition of emotional support; that is, the ability to provide
others with comfort and security during times of stress, which leads the
person to feel that he or she is cared for, facilitates the reconstruction of a
sense of security and assists the person in coping with painful emotions. The
three functional strategy groups found in this study enhance Cutrona and
Russell’s(1990) definition by providing concrete behavioral examples of how
one provides their child with comfort and security. Moreover, these concrete
observable behaviors of emotional support could be used to further oper-
ationalize NOM emotional support and help develop and refine NOM emo-
tional support assessment measures. Several of the reported strategies were
comparable to those identified in previous studies. The domains of avail-
ability, sensitivity, and affirmation described in Bolen et al.’s(2015) qualita-
tive study appear to coincide with some of the strategies found in the current
study, namely maternal availability, sensitivity/perceptiveness, and encour-
agement or reassurance. Furthermore, Smith et al. (2010,2017) recently
developed the MSSQ which identified emotional support as one of the key
factors involved in maternal support. In their study, emotional support is
described as having the child feel safe, telling the child that they are loved and
cared for, listening, demonstrating an interest in the child’s feelings and
soothing the child’s distress. These authors define emotional support in
ways that correspond with our elaborating and soothing functional strategy
groups, suggesting some potential corroboration for the strategies of emo-
tional support reported in the current study.
Some of the strategies that were identified in this study can also be
compared to elements that create a good therapeutic alliance when treating
clients who have experienced CSA. In a qualitative study conducted by
Middle and Kennerley (2001), clients with a history of CSA emphasized
the need for a therapist that was genuine, encouraging, reassuring, who
provided active listening, sensitivity, and responsiveness and did not dis-
play alarm or negative reactions in response to the client’s feelings and
thoughts. Participants in this study also valued an environment that had
boundaries, commitment, structure and focus. These results provide
further support for the importance of strategies that fall under the func-
tions of elaborating and soothing but also highlight the importance of
orienting strategies which create structure and boundaries, allowing for an
environment that facilitates emotional expression and potential growth.
These components related to the therapeutic alliance have yet to be
explored in the literature related to CSA with regards to NOM emotional
support and merit further investigation.
274 A. MCCARTHY ET AL.
The three functional strategy groups outline what could be considered
normal healthy parenting behaviors and describe elements related not only to
abuse-specific support but also to general NOM support (e.g., disciplinary
style, influence of existing parent–child relationship, preestablished patterns
of interactions). This suggests that a mother’s response to and emotional
support following CSA disclosure may be linked to their previously existing
parenting skills and emotional support capacities. Researchers could further
investigate how NOM general vs. abuse-specific emotional support is similar
or different. While many of the emotional support strategies found in the
current study correspond with those existing in the literature, those strategies
related to positive changes in mothers’attitude (i.e., sensitivity/perceptive-
ness, empathy/acceptance, and openness) merit further investigation. The
impact of mothers’attitudes of ambivalence has been studied in regards to
the provision of support following disclosure (Bolen, 2002; Bolen & Lamb,
2004), but positive attitudes that might affect the provision of emotional
support could provide a different perspective on CSA child outcomes.
Furthermore, what is the relation between a mother’s attitude and her
supportive actions and verbalizations toward her child? NOM support ques-
tionnaires should consider assessing parental attitudes not only related to
believing the child, but also their sensitivity, empathy, and openness toward
their child following disclosure.
Limitations and future research
While it is very interesting to look at different strategies of maternal emo-
tional support from a mother’s experiential perspective, we cannot determine
from this study whether and how these strategies are actually applied in
reality as we relied solely on mothers’self-report. This study focused on
North American mothers’experiences, limiting the generalizability of the
results to this population. Future studies could explore similar questions in
different cultures or with perspectives from other types of NOCs, such as
fathers. Mothers that participated in the study were also mothers who sought
out professional services to help their child, and thus are mothers who likely
already have some abilities for supporting their child.
Future studies should explore children’s experience of being emotionally
supported by their mothers, the impact of such emotional strategies on
children’s post-disclosure functioning and should attempt to validate those
potential constructs of emotional support discovered in this study, perhaps
using a mixed method approach. Other studies could also explore whether
maternal emotional support strategies evolve over time, moving from time
periods directly after the disclosure to six months and 1 year later. Finally,
how do various elements in a mother’s life, such as her relationship with the
perpetrator, her financial situation or the presence of mental or physical
JOURNAL OF CHILD SEXUAL ABUSE 275
disorders, influence her choice of adopting different strategies? These ques-
tions await further investigation.
Conclusion
This study provides a detailed portrayal of mothers’experience emotionally
supporting their child following the disclosure of CSA and what strategies they
putintoplaceinanattempttodoso.These results are encouraging for future
research as they may facilitate the development of more accurate and concise
conceptualizations of both abuse-specific and general NOM support. Mothers
reported feeling better equipped to emotionally support their child following
therapy at the CAC and emphasized their own need to be coached and supported
in facing this difficult life crisis. This underlines the importance of quickly
implementing a psychoeducational forum for mothers after their child’sdisclo-
sure when they seem to experience a sense of helplessness and confusion about
how to emotionally support their child. Thus, the strategies adopted by mothers at
this time could be either further reinforced or adapted depending on the areas in
which they are struggling to provide for their child. Not only would these services
be essential for educational purposes, but they would also have a direct impact on
the mothers themselves, who would be better able to emotionally support their
child during this difficult process by learning various emotion regulation
strategies.
Disclosure of interest
All authors declare that they have no conflicts to report.
Ethical standards and informed consent
All procedures followed were in accordance with the ethical standards of the Ethics Board of
Université de Montréal and with the Helsinki Declaration of 1975, as revised in 2000.
Funding
This research benefited from the financial support of the Canadian Institutes of Health
Research (grant #172315), the Chaire de recherche interuniversitaire Marie-Vincent sur les
agressions sexuelles (2015-RG-178804) envers les enfants [Marie-Vincent Inter-University
Research Chair on Sexual Abuse Against Children], and the Centre de recherche sur les
problèmes conjugaux et les agressions sexuelles [CRIPCAS: Research Centre on Intimate
Relationship Problems and Sexual Abuse] as scholarship to the first author.
276 A. MCCARTHY ET AL.
Notes on contributors
Andrea McCarthy, Psy.D., is Clinical Psychologist in Québec who recently graduated from
Université de Montréal.
Mireille Cyr, Ph.D., is Clinical Psychology Professor at Université de Montréal, in Québec and
Director of the Centre de recherche sur les problèmes conjugaux et les agressions sexuelles
(CRIPCAS: Research Centre on Intimate Relationship Problems and Sexual Abuse) and Co-
Chair with Martien Hébert of the Chaire de recherche interuniversitaire Marie-Vincent sur les
agressions sexuelles envers les enfants [Marie-Vincent Inter-University Research Chair on
Sexual Abuse Against Children].
Mylène Fernet, Ph.D., is Full Professor of Sexology at Université du Québec à Montréal and
Director of Laboratoire d’études sur la violence et la sexualité [Laboratory of studies on
violence and sexuality].
Martine Hébert, Ph.D., is Psychologist and Full Professor of Sexology at Université du
Québec à Montréal and Director of the Research Team Équipe violence et santé (ÉVISSA:
Research team on Sexual Violence and Health) in Montréal.
ORCID
Mireille Cyr http://orcid.org/0000-0003-1778-7818
Martine Hébert http://orcid.org/0000-0002-4531-5124
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