(Mis)understanding Cleveland: foundational issues and the sexual abuse of children

The Cleveland case led to the widespread condemnation of a new system for the diagnosis, initial treatment, and management of child sexual abuse. The Butler-Sloss Report identifies what went wrong as resulting from poor organisational links among agencies and poor interpersonal skills among professionals. Without denying that these faults occurred, this paper claims that what happened in Cleveland did so primarily because those making policy ignored two foundational issues inherent in the problem of child abuse: the status of the child in society and hence the State's justification in intervening on her behalf, and the status of abuse and the abuser and the consequences of their medicalisation. Analysis of these foundational issues suggests what additional steps will need to be taken if we are to deal effectively with sexually abused children and their families.