Experience Of Sexual Abuse Research Articles

“Snaps”, “screenshots”, and self-blame: A qualitative study of image-based sexual abuse victimization among adolescent Danish girls

ABSTRACT Image-based sexual abuse (IBSA) refers to the nonconsensual production, dissemination or threat of disseminating private sexual images with the use of digital technologies. This study explores adolescent girls’ experiences of IBSA victimization based on a thematic analysis of 157 posts collected from an anonymous online counselling hotline in Denmark. The analysis shows that 104 of the 157 posts describe experiences of IBSA and that the psychological consequences of IBSA are characterized by negative emotions such as fear, worry, sadness, self-harm and suicidal thoughts. Furthermore, the analysis shows how the technological affordances of social media applications, such as the taking of screenshots on Snapchat, play an important role in facilitating the IBSA. Lastly, the study shows that 52 of the 104 adolescent girls, who had experienced IBSA, blamed themselves for their victimization, explaining this as a result of their own stupidity, naïveté and poor judgement. These findings are discussed in relation to the gendered victim blaming discourses on youth sexting, which have represented sexting teen girls as naïve and foolish and responsibilized them for the misuse of their images. Theoretical and practical implications are discussed, and suggestions for future research are presented. Impact Summary Previous research on image-based sexual abuse victimization has found that the social and psychological consequences of having private sexual images shared nonconsensually are more negative for females than for males. This study shows that adolescent girls’ experiences of image-based sexual abuse are characterized by a range of negative emotions, including fear, sadness, worry and suicidal thoughts. Furthermore, over half of the adolescent girls blame themselves for their victimization. Based on these findings, it is suggested that parents focus on mitigating adolescents’ self-blame in relation to image-based sexual abuse. Interventions aimed at preventing these practices should seek to challenge victim blaming attitudes and focus on issues of privacy and consent.

Incarceration Trajectories of Women Who Are Mothers: A Nationally Representative Study of State and Federal Prisoners

Despite growing research on women’s offending trajectories, knowledge on the imprisonment experiences of women who are mothers is limited. This study used a nationally representative dataset of state and federal prisoners to identify and characterize subgroups of mothers based on incarceration histories. Group-based trajectory modeling identified four groups with distinct incarceration trajectories: stable escalating group, moderate declining group, adolescence-peak group, and young-adulthood-peak group. Bivariate analyses then suggested that different incarceration trajectories were associated with adverse life experiences (i.e., foster care placement, sexual abuse experience) and confinement experiences (i.e., number of episodes of prison confinement). Discussed are the future research directions and implications for criminal justice policies and interventions targeting imprisoned mothers.

“I think about you, X—”: Re-Reading Junot Díaz after “The Silence”

This essay offers an examination of Junot Diaz’s “The Silence”—a nonfiction account of his experience of child sexual abuse and the lingering effects of that trauma—to show how Diaz’s fiction replicates gendered violence even as it claims to write against it. I reveal how his language stages women’s bodies not only as a source of pleasure but as receptacles of pain through which men find their own salvation at a woman’s expense. This essay also highlights the crisis in the Latinx canon that the allegations of sexual misconduct against Diaz revealed and argues that, as the archetype of contemporary Latinx literature, Diaz’s antagonistic position invites us to reconsider how we construct, read, and teach the Latinx canon. His “fall” further reveals the legacies of racial and gendered violence that manifest obsequiously even in “decolonial” literature.

Exploring maternal adversity and childhood outcomes among low-income rural families

BackgroundResearch has linked adversity among mothers to poorer outcomes among their offspring. However, additional inquiry is warranted particularly in rural communities where risk factors for adversity are prevalent. ObjectiveThis study had two objectives: (1) to describe and compare relationships between individual and cumulative maternal adversity with childhood outcomes; and, (2) to determine if mother-child attachment mediated the relationship between maternal adversity and childhood outcomes. Participants and SettingA convenient sample of 140 women with low socio-economic status (SES) were recruited through Head Start programs in the rural Midwest. MethodsData was gathered using a survey comprised of multiple measures to assess maternal adversity and childhood outcomes (i.e. behavior and attachment). Data were analyzed in SPSS using bivariate and multivariate analyses, including stepwise regression. ResultsNearly 80 % of respondents experienced at least one adverse childhood experience (ACE) and 48 % reported having one or more traumatic experiences. Higher levels of adversity were associated with increased attention problems, increased emotional reactivity, and decreased harmonious attachment (p < .05, d = 0.37−0.38). Maternal experiences of childhood physical abuse and sexual abuse, as well as witnessing trauma, significantly predicted childhood outcomes, however, the variance accounted for by each type of adversity was small (4%–6%). Maternal adversity was unrelated to mother-child attachment. ConclusionsLow-SES mothers in rural communities have significant histories of adversity. It is important to consider individual and cumulative adverse experiences, as well as the mother’s perception of events as traumatic. Factors associated with rural communities and Head Start programming, as well as implications for research and practice surrounding maternal adversity and childhood outcomes, are discussed.

Prevalence and Correlates of Intimate Partner Violence Experience Among Partners of Naval Personnel in Lagos, Nigeria.

Military personnel are one of the high risk groups recognized as perpetrators of intimate partner violence (IPV). Little is known about IPV experience of partners of naval personnel. This study determined the prevalence and correlates of IPV experience among partners of naval personnel. A cross-sectional survey of 435 male and female partners of naval personnel selected using the multistage sampling technique from the Navy Barracks in Lagos, Nigeria was conducted. Data were collected using a 40 item interviewer-administered questionnaire between August and September 2017. Univariate, bivariate and multivariate analysis was done to identify the predictors of partners' experience of IPV. Analysis was done at p-value ≤0.05. The mean age of the respondents was 32.7 ± 7.86yrs and 72% were females. The lifetime prevalence of any IPV experience was 40.7% (with 74.4% of this experienced by females, CI: 0.81-1.91). The prevalence of controlling behaviour, psychological, sexual, economic and physical IPV were 31.5%, 16.3% 12.4%, 12.0% and 8.5% respectively. There was a positive association between experience of IPV and respondents' occupational status (p < 0.0001), lifetime experience of physical (p < 0.0001), sexual abuse (<0.0001), and history of childhood abuse (p < 0.0001). After adjustment for confounders, age (AOR = 2.11, CI = 1.07-4.16), occupational status (AOR = 4.56, CI = 2.30-9.02), history of childhood abuse (AOR = 2.10, CI = 1.26-3.49,) and partners' alcohol use (AOR = 3.41, CI = 1.38-8.39) remained significant factors influencing experience of IPV. The prevalence of IPV experience among partners of naval personnel was high. Being unemployed, experience of abuse in childhood and having a partner who consumed alcohol increased partners' vulnerability to IPV. Naval personnel would benefit from marital counseling and training on non-violence conflict resolution strategies.

Disclosure of non-recent (historic) childhood sexual abuse: What should researchers do?

Non-recent (historic) childhood sexual abuse is an important issue to research, though often regarded as taboo and frequently met with caution, avoidance or even opposition from research ethics committees. Sensitive...

Dating Violence Among Rural Adolescents: Perpetration and Victimization by Gender.

Adolescent dating violence (ADV) is a serious concern with various negative impacts on adolescent development. Research on ADV has predominantly been conducted in urban areas and has generally focused on physical and sexual forms of violence. The purpose of this study was to assess prevalence rates of various forms of ADV by gender in the rural context. A convenience sample of rural adolescents responded to an online survey. In total, 131 responses were used for this study. Participants reported perpetration and victimization experiences of physical abuse, sexual abuse, threatening behavior, relational aggression, verbal abuse, and cyber dating abuse. Descriptive statistics and chi-square analyses were used to determine gender differences in proportion and frequency of ADV. Results reveal that various forms of ADV are occurring in the rural context, with many of both males and females reporting perpetration and victimization. Overall, verbal and cyber ADV are the most common. Gender analysis reveals that males were significantly more likely to be victimized by physical abuse victimization, whereas females were significantly more likely to be victimized by sexual abuse. Though the proportion of adolescents reporting ADV were high in this study, most participants reported lower frequencies of ADV. Results support the urgent need in rural areas for education and prevention that target physical, sexual, and psychological components of healthy relationships. Rural dating violence prevention efforts must emphasize the importance of mutual respect across gender, rather than solely presenting this lesson to males in a traditional gendered manner. Results also suggest the need for rural areas to adopt comprehensive sex education that details sexual relationships that are consensual and healthy.

From pain to power: An exploration of activism, the #Metoo movement, and healing from sexual assault trauma.

In this qualitative study, we explored the role that social activism and #MeToo and other large scale antiviolence activist movements may play in sexual assault survivors' healing process and how they navigate and make sense of their sexual assault experience. We interviewed 16 adult sexual assault survivors (13 women, 2 genderqueer/nonconforming individuals, and 1 identifying as a man and genderqueer) who were engaged in anti-sexual assault activism and analyzed their data using thematic analysis. Participants were predominately White and highly educated. We found that activism helped participants find their voice and regain their power. They described a process of moving from silence and shame around their sexual assault to freedom and empowerment. Their involvement in activism and/or connection to larger scale antiviolence activist movements (a) helped increase their understanding of themselves and their sexual assault experience, (b) served as a useful coping mechanism, (c) improved their self-confidence and relationships, (d) allowed them to stand up and speak out against attitudes and behaviors that foster rape culture, (e) provided support, validation, and connection to others, and (f) provided a source of meaning and fulfillment in their lives. Helping other survivors through their activist work also contributed to participants' healing process. Participants also described challenges associated with anti-sexual assault activism and #MeToo and related movements. These included being triggered, being inundated with media coverage and public narratives about sexual assault, burning out, and feeling disillusioned and frustrated. Finally, participants noted the importance of mainstream movements in increasing awareness. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Health care consumption and psychiatric diagnoses among adolescent girls 1 and 2\xa0years after a first-time registered child sexual abuse experience: a cohort study in the Stockholm Region

Child sexual abuse (CSA) is a crime against human rights with severe health consequences, and suicidal actions, stress, eating disorders, and borderline disorder are common among survivors of CSA. The objective of this study was to analyze how health care consumption patterns developed among adolescent girls in the Stockholm Region, Sweden, 1 and 2 years after the first registration of CSA experience appeared in their medical record, as compared to age-matched controls without such registration. In this cohort study, number of healthcare visits, comorbidities, and prescribed drugs were collected through the Stockholm Region administrative database (VAL), for girls age 12–17 with registration of CSA experience in their medical record (n = 519) and age-matched controls (n = 4920) between 2011 and 2018. Healthcare consumption patterns remained higher among the girls with a registered CSA experience compared to the controls, both 1 and 2 years after the first CSA experience registration. Highest odds ratios (ORs) were found for suicide attempts [OR 26.38 (12.65–55.02) and 6.93 (3.48–13.49)]; stress disorders [25.97 (17.42–38.69) and 15.63 (9.82–24.88)]; psychosis [OR 19.39 (1.75–214.13) and 9.70 (1.36–68.95)], and alcohol abuse [OR 10.32 (6.48–16.44) and 6.09 (1.98–18.67)], 1 and 2 years, respectively, after the first CSA experience registration. The drug prescriptions were also significantly higher among the girls with a CSA experience registration than for the controls. The results highlight the need to systematically evaluate and develop assessment, treatment planning, and interventions offered to adolescent girls after their first CSA experience registration.

Comparing outcomes of children and youth with fetal alcohol spectrum disorder (FASD) in the child welfare system to those in other living situations in Canada: Results from the Canadian National FASD Database.

The current study aimed to explore differences in adverse outcomes between youth and adolescents with fetal alcohol spectrum disorder (FASD) living in child welfare care (i.e., foster care or group home) with those living with their biological parent(s) or with adoptive or other family member(s) in Canada. Data gathered from the Canadian National FASD Database were used for analysis. A total of 665 youth and adolescents with a clinical diagnosis of FASD under the age of 18 living in child welfare care, with biological, adoptive or other family members, were included in the sample. Key areas examined included living situation, legal problems, experience of sexual or physical abuse, mental health (anxiety, conduct disorder, mood disorder and post-traumatic stress disorder) and suicidal ideation. Descriptive statistics and chi-square comparisons were utilized to explore these differences. Results revealed a significantly higher rate of reported sexual and physical abuse among individuals in child welfare care compared with those living with biological parents or with adoptive or other family member(s). Rates of difficulty with the law were also higher among those in child welfare care compared with adoptive/other family members. Conversely, the rate of mood disorders was significantly higher among those living with adoptive/other family members compared with child welfare care. Results highlight similar rates of reported suicidal ideation/attempts across all living situations, as well as mental health concerns. Results offer rare insight into the lives of youth and adolescents under age 18 with diagnosed FASD who reside in child welfare care in contrast to those living with biological parent(s) or with adoptive or other family members. These findings increase our awareness of the complexity of mental health concerns and suicide risk across all living environments. Results have further implications for policy, practice and clinical intervention.

Health care utilization by women sexual assault survivors after emergency care: Results of a multisite prospective study.

Approximately, 100,000 US women receive emergency care after sexual assault each year, but no large-scale study has examined the incidence of posttraumatic sequelae, receipt of health care, and frequency of assault disclosure to providers. The current study evaluated health outcomes and service utilization among women in the 6 weeks after sexual assault. Women ≥18 years of age presenting for emergency care after sexual assault to twelve sites were approached. Among those willing to be contacted for the study (n = 1080), 706 were enrolled. Health outcomes, health care utilization, and assault disclosure were assessed via 6 week survey. Three quarters (76%) of women had posttraumatic stress, depression, or anxiety, and 65% had pain. Less than two in five reported seeing health care provider; receipt of care was not related to substantive differences in symptoms and was less likely among Hispanic women and women with a high school education or less. Nearly one in four who saw a primary care provider did not disclose their assault, often due to shame, embarrassment, or fear of being judged. Most women receiving emergency care after sexual assault experience substantial posttraumatic sequelae, but health care in the 6 weeks after assault is uncommon, unrelated to substantive differences in need, and limited in socially disadvantaged groups. Lack of disclosure to primary care providers was common among women who did receive care.

Study on the relationships between precollege sexual abuse experiences at different stages and adult attachment in college students

Objective: To explore the association between precollege sexual abuse experiences at different periods and adult attachment in college students. Methods: In October 2018,a total of 4 034 college students were selected from 4 colleges in Hefei City by using the stratified cluster sampling method. A self-designed questionnaire was used to investigate the demographic characteristics, sexual abuse experience, and attachment style of participants. Multivariate linear regression analysis was performed to analyze the association between different periods, types of precollege sexual abuse experiences and attachment style in college students. Results: The rate of total precollege sexual abuse, noncontact sexual abuse, and contact sexual abuse was 14.1% (569), 12.7% (512) and 5.4% (219), respectively. Multivariate linear regression analysis showed that secure attachment [β(95%CI)=-0.205 (-0.292, -0.117)] was negatively correlated with total precollege sexual abuse experiences, whereas anxiety attachment [β(95%CI)=0.211 (0.110, 0.310)], avoidant attachment [β(95%CI)=0.117 (0.020, 0.216)] were positively correlated with total precollege sexual abuse experiences. The number of periods of precollege noncontact sexual abuse was negatively correlated with secure attachment [β(95%CI)=-0.106(-0.171, -0.041)]and positively correlated with anxiety attachment [β(95%CI)=0.158 (0.084, 0.231)]and avoidant attachment [β(95%CI)=0.080 (0.008, 0.152)]. The noncontact [β(95%CI)=0.427 (0.018, 0.775)] and contact sexual abuse [β(95%CI)=0.468 (0.251, 0.687)] in high school were positively correlated with anxiety attachment (P<0.05). Conclusion: Different periods, types of precollege sexual abuse experiences were all associated with adult attachment in college students.

Racializing Emasculation: An Intersectional Analysis of Queer Men’s Evaluations of Sexual Assault

Abstract This article focuses on how 60 queer men perceived emasculation in relation to their experiences of sexual assault, drawing particular attention to racial and ethnic differences. While previous scholarship has focused primarily on gender, the author of this article uses an intersectional approach to explore queer men’s narratives. Results demonstrate that queer men of color with intra-racial experiences of assault typically denied feelings of emasculation, emphasizing instead other emotions that were intimately related to challenges they faced due to their social position. Most White participants with intra-racial experiences felt emasculated after the assault. Racial and ethnic differences appeared even more pronounced with interracial forms of violence, as Black queer men drew attention to racialized concerns, such as fear over being perceived as a “troublemaker” for reporting a White assailant, while White and Latino participants described feeling emasculated, in large part due to masculinizing stereotypes of Black men. The implications of this research suggest that emasculation is a racialized, as well as a gendered, process for queer men – one that does not arise automatically from simply being a man who has been sexually violated but one that springs disproportionately from whiteness and that generally involves particular racialized gender dynamics.

Treatment of Posttraumatic Stress Disorder Related to Military Sexual Trauma

The experience of military sexual trauma (MST), including harassment and assault, is a reality for hundreds of thousands of active duty service members and veterans. Those who have experienced MST are at risk for the development of posttraumatic stress disorder (PTSD) and often require comprehensive care to facilitate recovery. This article describes evidence-based approaches for the treatment of PTSD related to MST, the settings in which such care is most effective, and the supplementation of evidence-based treatment for PTSD with skills-based approaches for managing emotional distress and improving relationships (eg, dialectical-behavior therapy, skills training for affect and interpersonal regulation). Pharmacologic treatment and holistic modalities (eg, mindfulness, yoga, art therapy) are also discussed. [ Psychiatr Ann . 2020;50(10):432–436.]

Disruption and Design: Crowdmapping Young Women’s Experience in Cities

The history of women’s exclusion and invisibility in cities is well charted, yet young women’s experience of sexual harassment and assault has been difficult to quantify. This article discusses the Free to Be project initiated by Plan International in 2018. In partnership with Monash University’s XYX Lab and CrowdSpot, the crowdmapping web app enabled young women in Delhi, Kampala, Lima, Madrid, and Sydney to identify and share their experiences of public spaces. It is believed to be the most ambitious global crowdsourced data collection project on street harassment ever undertaken. By using coding and visual data techniques, the data demonstrated the scale of the problem and the urgent need for city-level decision makers, as well as other members of society, to take action. This article outlines the findings from Free to Be, and explores the ways data and activism led by girls and young women are a powerful method for creating change.

Substance Use, Risky Sex, and Peer Interactions Predict Sexual Assault Among College Women: An Ecological Momentary Assessment (EMA) Study

Sexual assault is an unfortunately common experience among women in college campuses. This study used ecological momentary assessment (EMA) to gain a better understanding of the contextual determinants of sexual assault among college women. EMA reports inquired about sexual assault experiences, risky sex (sex without a condom and regretted hookups), and substance use (alcohol and cannabis use), as well as what activities participants were engaged in (e.g., pregaming, drinking with peers, and drinking with a casual sexual partner), and whether they experienced peer pressure to engage in casual sex. Participants were 103 freshman undergraduate women (18-24 years old) at a Southwestern university in the United States, who were unmarried, interested in dating opposite-sex partners, engaged in binge drinking (defined as having 3 or more drinks on one occasion) in the past month, and reported at least one experience of sexual intercourse in their lifetime. Participants completed reports (one random and two time-contingent) via EMA three times a day over a 42-day period. Compliance in completing EMA reports was good (84.2% of prompted reports were completed), and time-to-completion of reports once signaled was acceptable (mean = 26 minutes, median = 5.75 minutes). During the 42 days, 40 women (38.8%) reported 75 occasions of sexual assault. The odds of experiencing sexual assault were significantly greater during occasions of regretted hookups and unprotected sex. Additionally, drinking with peers and peer pressure to engage in casual sex were each associated significantly with occasions of sexual assault. Reducing risk for sexual assault among undergraduate women may be possible by targeting these behaviors and contextual features in near real-time via momentary intervention.

Sexual Assault Victimization and Eating Disorders Among College-enrolled Men.

Sexual assault victimization and eating disorder rates are high among college populations and have significant psychological, physiological, and social outcomes. Previous research has found a positive relationship between experiences of sexual assault and eating disorder symptoms; however, these analyses have primarily focused on female students. Using data from the 2017-2018 Healthy Minds Study, the aim of this study was to investigate the relationship between experiencing a sexual assault within the previous 12 months and screening positive for an eating disorder among cisgender college-enrolled men. It was hypothesized that college-enrolled men who report experiencing a sexual assault within the previous 12 months would be more likely to screen positive for an eating disorder. Analyses were conducted using a sample of 14,964 cisgender college-enrolled men. Among the sample, nearly 4% reported a sexual assault within the previous 12 months and nearly 16% screened positive for an eating disorder. Results from logistic regression analyses indicated that college-enrolled men who reported experiencing a sexual assault in the previous 12 months, compared to those who did not, had significantly greater odds of screening positive for an eating disorder (OR = 1.40, p < .01). Analyses also indicated that college-enrolled men who identified as gay, queer, questioning, or other sexual orientation and reported experiencing a sexual assault in the previous 12 months had greater odds of screening positive for an eating disorder (OR = 2.50, p < .001) compared to their heterosexual peers who did not experience a sexual assault in the previous 12 months. These results indicate that eating disorders may be a negative outcome among college-enrolled men who have experienced a sexual assault, particularly among sexual minority men. Thus, mental health professionals need to be adequately prepared to treat the underserved population of men who experience an eating disorder and who have experienced sexual assault.

Childhood trauma and amygdala nuclei volumes in youth at risk for mental illness.

Adults with significant childhood trauma and/or serious mental illness may exhibit persistent structural brain changes within limbic structures, including the amygdala. Little is known about the structure of the amygdala prior to the onset of SMI, despite the relatively high prevalence of trauma in at-risk youth. Data were gathered from the Canadian Psychiatric Risk and Outcome study. A total of 182 youth with a mean age of 18.3 years completed T1-weighted MRI scans along with clinical assessments that included questionnaires on symptoms of depression and anxiety. Participants also completed the Childhood Trauma and Abuse Scale. We used a novel subfield-specific amygdala segmentation workflow as a part of FreeSurfer 6.0 to examine amygdala structure. Participants with higher trauma scores were more likely to have smaller amygdala volumes, particularly within the basal regions. Among various types of childhood trauma, sexual and physical abuse had the largest effects on amygdala subregions. Abuse-related differences in the right basal region mediated the severity of depression and anxiety symptoms, even though no participants met criteria for clinical diagnosis at the time of assessment. The experience of physical or sexual abuse may leave detectable structural alterations in key regions of the amygdala, potentially mediating the risk of psychopathology in trauma-exposed youth.

Sexual violence victimisation among university students in Italy: a gendered intersectional quantitative approach

There is rising attention in Italy and Europe to the occurrence, consequences, and factors related to sexual violence. The focus on women as the primary victims of sexual violence has, however, left data collection and research on young men and sexual minorities in the background. Moreover, young people’s experiences of sexual abuse in the context of their relationships with peers are hardly recognised as a policy concern. The ultimate aim of this paper is to disentangle intersectionalities between gender, migration background, sexual orientation, and sexual experience in shaping the risk of experiencing sexual violence among university students in Italy.We use data from the Sexual and Emotional LiFe of Youths (SELFY) survey carried out in Italy in 2017. Our data confirm that women and foreign-born students are at higher risk of sexual violence. Our data also support previous evidence that bisexual women are at a higher risk of sexual violence victimisation compared with peer students with other sexual orientations. Previous same-sex sexual experience is more relevant than sexual orientation in shaping the risk. The effect is gendered: the risk of sexual violence is lower for women with previous same-sex sexual experience compared with their male peers. The intersection between gender, sexual orientation, and same-sex sexual experience generate specific high-risk profiles whose needs should be targeted by support services.

Using biographical narrative interviewing methodology to research adults’ experiences of disclosing childhood sexual abuse

Disclosure of sexual abuse can be a process rife with barriers, setbacks and trauma. Those who have experienced sexual abuse in childhood tend to delay disclosure, possibly until adulthood, and can be silenced by structural, societal and personal barriers. Those who do disclose are often referred to as the ‘tip of the iceberg’, highlighting the potentially large hidden population who never come forward. This paper is drawn from a wider study which presented narratives of adults who have disclosed their experiences of childhood sexual abuse to social work services in the Republic of Ireland. In Irish child protection policy such disclosures are called ‘retrospective disclosures’. Recent reports by Irish State bodies have shown that those who have reported their childhood experiences to child protection authorities have not always received the response they would have hoped for (Office of the Ombudsman, 2017; Health Information and Quality Authority, 2016). Since the ‘narrative turn’ in social work research a rich body of work has been produced which explores the use of narrative approaches to address pertinent issues affecting social work practice. Biographical Narrative Interviewing Methodology (BNIM) is one such approach to narrative research and focuses on the presentation of voice and life experience. This paper presents the BNIM data collection process as it was used in the wider study and justifies the rationale for using such a methodology as a means of conducting research on a sensitive topic with a population that are too often silenced. This paper presents how an awareness of the socially constructed environment, the dynamics of abuse and the use of appropriate methodologies can bring such silenced and marginalised voices to the fore.