Twice wounded: retraumatisation of child sexual abuse survivors in legal proceedings – a practice-focused review

Purpose This paper aims to review evidence that legal proceedings can further harm child sexual abuse (CSA) survivors, and set out the practice, training and policy response. Design/methodology/approach Narrative review of three bodies of evidence: longitudinal studies of child witnesses; research on trauma and memory; and studies of how protective legal practices are used. Adult trauma research supplements thin child-specific evidence. Findings Children who testify repeatedly, often facing the defendant unsupported, show long-lasting distress, behavioural problems and changes in brain regions controlling memory, fear and language. Protective measures – pre-trial preparation, multidisciplinary centres, pre-recorded cross-examination, CCTV, intermediaries and support workers – reduce harm but are unevenly applied. Research limitations/implications Narrative rather than systematic review; search was not pre-registered and included only English-language sources. Long-term outcome evidence relies heavily on two related US cohorts, and some trauma andmemory evidence draws on single-event accidental trauma, not CSA. Research priorities: CSA-specific replication and the institutional factors behind persistent under-use of existing protections. Practical implications Five priorities: use a structured forensic interview protocol; apply special measures without gatekeeping; guarantee courtroom support; mandate trauma-informed training for judges, prosecutors and defence lawyers; and use forensic mental health expertise explicitly. Social implications Legal protections exist on paper but are applied inconsistently. Child survivors face a “postcode lottery” in which access to justice depends on local discretion rather than enforceable rights. Originality/value Integrates long-term outcome data, trauma neurobiology and implementation research in a practice-focused account for forensic work.