Understanding the role of GPs in responding to adult survivors of child abuse

Tim Senior

30/05/2018 2:40:23 PM

In the context of the Royal Commission into Institutional Responses to Child Sexual Abuse – and with governments and other institutions delivering or still crafting their own response – it is important to remember GPs’ vital role in responding to adult survivors of abuse, Tim Senior writes.

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The Royal Commission into Institutional Responses to Child Sexual Abuse saw more than 8000 people share their stories in private sessions. (Image: Jeremy Piper/AP)

The Royal Commission into Institutional Responses to Child Sexual Abuse Final Report was released at the end of 2017.

GPs play a key role in responding to adult survivors.
For GPs, it is important to remember that many adults who have experienced childhood abuse may appear unaffected. However, childhood abuse can adversely impact an adult’s functioning and affect their interpersonal relationships, parenting capacity, family functioning and mental health, which are often the cause of presentations to general practice.
For this reason, GPs should be alert to the possibility that adults with whom they speak may have experienced abuse or other adverse childhood events. Clues to a history of past trauma are often missed.
The Royal Commission into Institutional Responses to Child Sexual Abuse (the Commission) has found that survivors of abuse may not disclose their experiences, sometimes for years or decades. The Commission also found that when survivors have disclosed in the past, they have commonly received inappropriate responses from professionals.
GPs are often highly trusted professionals, seeing people at vulnerable times in their life. It is not unusual that a person’s first disclosure of abuse – to anyone – is to their GP.
A disclosure of childhood abuse by an adult survivor is a very significant event and GPs should acknowledge this, believe what they are told, and assist the patient to access appropriate support.
GPs’ responses to intervention can be guided by the ‘Nine steps to intervention – the 9 Rs’ in the RACGP’s Abuse and violence: Working with our patients in general practice (White Book).
When responding to a disclosure, GPs are advised to:

  • use a trauma-informed approach, informed by an understanding of the impacts of child sexual abuse in institutional or non-institutional contexts (as relevant)
  • show care and compassion
  • provide culturally appropriate responses
  • acknowledge the patient’s disclosure and reassure them that they are believed
  • offer support, including linking the person to appropriate health and other services (where available in your local area, it is preferable to refer to a coordinated case management service that can help address survivors’ needs)
  • consider whether other children may still currently be at risk from the alleged perpetrator and, if so, call the Child Protection Helpline (132 111) to address the risk. 
Survivors commonly experience a range of mental health issues, and mental health services are a key form of support they access. In responding to these issues, the focus should be not only on alleviation of symptoms and making a mental health diagnosis, but also supporting survivors’ broader health and wellbeing and helping them to address their underlying trauma.
Further resources
RACGP: The Royal Commission into Institutional Responses to Child Sexual Abuse: 1800RESPECT:
  • Daisy App – designed to support patients and includes tips on the safe use of phones in an abusive situation

abuse-and-violence Royal-Commission-into-Institutional-Responses-to-Child-Sexual-Abuse white-book


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