Inceste au sein d’une fratrie : spécificités cliniques, modèles explicatifs, qualification juridique et principes de la prise en charge

Abstract

Sibling sexual abuse is the most widespread form of incest and is often perceived as being normal, consensual sexual exploration. As little is revealed by the victims and little is reported by healthcare professionals, this can have serious physical and psychological consequences for the victims. This article develops, in the field of child and adolescent psychiatry, the perspectives opened by the law of 21 April 2021 aimed at protecting minors from sexual offences and incest and by the report of the “Commission indépendante sur l’inceste et les violences sexuelles faites aux enfants” (CIIVISE ; Independent Commission on Incest and Sexual Violence against Children) published in November 2023. The aim of this study is to help healthcare professionals gain a better knowledge and understanding of this complex phenomenon, to appreciate its scale, to have access to theoretical models to guide their understanding, to be aware of recent legal developments and their resulting medico-legal obligations, and to provide them with practical guidelines for caring for patients and their families. Disclosure of incest usually leads to a major family crisis requiring multidisciplinary care for the victim, the perpetrator and the family as a whole, through individual and group interventions. Professional secrecy can be broken when it comes to reporting abuse of minors, and prevention is crucial. Thus the question of incest should be raised more systematically during interviews. Finally, this article highlights the need for future work aimed at establishing precise protocols and recommendations for professionals.