Therapy for children disclosing sexual abuse is important for addressing the effects of trauma and the potentially lifelong impacts of abuse (Blakemore, Herbert, Arney, & Parkinson, 2017; Cashmore & Shakel, 2013; Lewey et al., 2018). However, there are often considerable barriers to children and their families being able to access these services. This paper presents findings from a systematic literature search on the typical rates of referral, engagement and completion of therapy following a disclosure of child sexual abuse to police or child protection authorities.

Understanding the accessibility of therapy across studies and contexts allows services and policy makers across systems (i.e. criminal justice, child protection, community support and mental health systems) to better understand the accessibility and level of demand for local services when designing intake procedures and developing interventions. No Australian jurisdictions have available and current data on rates of referral, engagement and completion of therapy following the disclosure of child sexual abuse. In part, this is because of the range of government and non-government agencies involved in the delivery of this therapy. The lack of published Australian data to include in the review highlights the need for increased local research attention on the barriers to therapy use following disclosure.

Key findings:

• Children who disclose sexual abuse may not be receiving the benefits of therapy due to non-referral, lack of engagement or non-completion of therapy.
• Providing referrals to therapy for all children with suspected or substantiated sexual abuse would likely increase engagement rates.
• Focused research is required to better identify the barriers to engagement and completion and identify approaches to improving accessibility to therapy.
• Additional supports or interventions may be needed to help address barriers to the engagement and completion of therapy for child sexual abuse.
• Engagement and completion of therapy needs to be systematically tracked to more completely track the outcomes and impacts of sexual abuse therapy services.