Putting words to child physical abuse : Possible consequences, the process of disclosure, and effects of treatment. From children’s perspectives

Abstract: Aim: The overall aim of the thesis is to explore the experiences and possible consequences concerning reported health and relations between a parent perpetrator of physical child abuse and the children who are victims of the parental physical abuse, the children’s thoughts when disclosing the abuse, and the impact of an intervention designed to support these children in a Swedish context – Combined Parent Child Cognitive Behavioral Therapy (CPC-CBT). Methods: This thesis has a mix-method design. Study I and IV used different self-assessment scales, and the outcomes were analysed using descriptive statistics, paired-samples t test, independent t test, ANOVA, Pearson correlations, and hierarchical linear regression. Study II and III consisted of interviews with 15 (Study II) and 20 (Study III) children, respectively. The interviews were transcribed verbatim and analysed using qualitative content analysis. Results: The results suggest that experiencing child physical abuse affects the relationship between a parent and a child as well as the child’s wellbeing in several ways. However, the results also suggest that participating in the CPC-CBT intervention could decrease parents’ use of violence and increase the child’s wellbeing. In addition, the results suggest that trust and participation influence whether a child discloses abuse and contributes to the success of treatment. Conclusion: The CPC-CBT could be seen as a successful turning point for the participating children, shifting from one trajectory (living in fear of violence) to another (living without fear). Furthermore, when children disclose to adults about their physical abuse, it is important that the adults recognise the children’s participatory rights and strive to earn their trust.