The impact of institutional child abuse: A systematic review using Reflexive Thematic Analysis

Institutional child abuse has several negative impacts, including effects on mental health, well-being and interpersonal relationships. There is a need to understand this complex form of abuse occurring in an out-ofhome setting. The current review aims to understand the literature base regarding the impact of institutional child abuse and to identify areas where further research is needed. Consequently, a systematic review was conducted, which captured quantitative and qualitative methods. This resulted in 58 papers being included. The papers captured the impacts of institutional abuse, covering physical abuse, sexual abuse, emotional abuse and neglect (i.e., a failure to be adequately cared for). These were then analysed using a qualitative methodology, specifically Reflexive Thematic Analysis. Several factors, such as prior abuse, were reported to exacerbate the impact of institutional abuse, whereas secure attachment was noted as a protective feature. Responses to disclosure appear to have an important role in recovery. Areas important for further research included understanding the role of protective factors and how they impact future outcomes, but to do so alongside an acknowledgement and greater exploration of negative impacts.