An Exploration of the Barriers and Facilitators to Clinical Psychologists Routinely Asking about Histories Of Childhood Abuse and Neglect

Aims: The primary aims of this study were to explore the extent to which UK clinical psychologists enquire about experiences of historical child abuse and child neglect, to explore clinical psychologists’ beliefs about the practice of routine enquiry and to understand the barriers and facilitators to clinical psychologists engaging in routine enquiry. The secondary aims were to understand how clinical psychologists respond to disclosures and to gather some preliminary data on clinical psychologists’ likelihood of enquiring about three other adverse childhood experiences (discrimination, bullying and poverty).
Method: This study used a mixed method (qualitative and quantitative) methodology, gathering initial data using an online survey and following this with qualitative interviews with some of the survey respondents, conducted and analysed using a thematic analysis approach.
Results: Clinical psychologists reported asking more frequently than previous research on mental health professionals’ enquiry would predict. However, they also reported varying views on how to ask, ranging from direct questions about child abuse and neglect to broader questions about early life experiences. They reported a number of barriers and facilitators to asking about child abuse and child neglect. They reported that they respond to disclosures of child abuse and neglect using core therapeutic skills such as listening, validating, and formulating. They reported varied practices regarding the extent to which they record enquiry into child abuse and neglect in their clinical notes.
Conclusion: This study provided a useful insight into a previously under researched topic. These results combined with the results from previous research point to the need for greater access to trauma informed training across mental health professional disciplines and to the need for a paradigm shift at the systemic level towards more trauma informed services. The specific implications and directions for future research are discussed.