Child sexual abuse: From diagnosis to formulation

Abstract

Aim:To demonstrate the need to replace the diagnosis of child sexual abuse with psycho-social formulations.Method:The literature on the limitations of diagnosis is reviewed and the methodological challenge of assessing child sexual abuse both at the individual and population level examined.Findings:The case for continuing with a diagnostic approach to child sexual abuse cannot be sustained. The complexity of this socio-legal matter requires methodological sophistication in both individual case work and research about the topic.Conclusion:A digital medical logic of present/absent and the search for single diagnostic procedures are ill-suited for a picture of multi-factorial complexity and competing personal accounts. Formulation is better suited for the task of investigating CSA, though the risk of psychological reductionism also attends this improved shift from medical diagnosis.