SINGAPORE - Throughout most of her childhood, Fiona (not her real name) dreaded going home because she knew her stepfather would be there.

He began sexually abusing her when she was nine years old, when they were alone.

It took Fiona, now in her early 30s, five years before she confided in her best friend.

"It was a huge relief. I wasn't keeping this big secret to myself any more," said Fiona, a housewife.

She was in secondary school when, accompanied by her friend, she told her teacher about the abuse and a police report was made.

Fiona was helped by her school counsellor and Child Protective Service (CPS), which arranged for her to get therapy and helped her move in with her aunt.

"At that point, I didn't even know what recovery was. It always felt like one step forward and two steps back; I would feel a bit better because the counsellors always believed me, but whenever I saw him I still felt fear.

"He still had a hold over me," said Fiona, who suffered from depression as a teen and would harm herself.

The case against her stepfather never reached the courts, and Fiona eventually forgave him and moved back to live with him and her mother when she was in her early 20s.

"I spent most of my childhood and teenage years getting professional help and trying to recover. I know that it's because of him I wasn't able to enjoy those years, which were supposed to be the best or most formative years of my life. That's what he stole from me.

"But I realised that forgiving him was the best thing I could do for myself. I didn't want him to have power over me any more," said Fiona.

Unlike Fiona's stepdad, whose case was dropped because of a lack of evidence, abusers often end up serving long prison sentences.

On Nov 8, a 46-year-old man who molested his stepdaughter was sentenced to 37 months' jail and three strokes of the cane. The abuse started when she was in Primary 3 and continued till she was in Secondary 1.

Even after his wife confronted him about the abuse, the man assaulted the victim again, escalating the abuse by placing his private parts on her lips.

In another case, a man, 50, raped his 11-year-old daughter after a fengshui master said he would face a life-threatening accident that could be averted only if he had sex with a virgin. He was sentenced to 23 years' jail on Oct 18.

The victims also end up imprisoned - by the trauma caused by the experience.

Association of Women for Action and Research (Aware) president Margaret Thomas said child sexual abuse can have a long-term impact on the psychosocial development of children, as the abuse changes the way they view themselves, others and the world.

She said: "Children typically experience a lot of guilt and self-blame. They may view themselves as shameful, unworthy and dirty and the world as an unsafe and volatile place."

Responding to queries from ST, the Ministry of Social and Family Development (MSF) said CPS mainly handles cases involving children who have been abused by their family members.

The service does not handle cases where the alleged perpetrator is not a family member, and the parents are protective of their children.

Close to 90 per cent of perpetrators in child abuse cases investigated by CPS are family members involving a parent or step-parent, said the ministry. The service works with caregivers to keep the child safe if the alleged perpetrator is a family member.

Depending on the severity of the alleged abuse and following consultation with the police, the child might be allowed to continue living in the same household.

But CPS must be convinced that there are safe adults to protect the child. The child and alleged perpetrator must also not be left alone at any time, said an MSF spokesman.

If it is unsafe for the child to stay at home, the child will be placed in alternative care with relatives, foster carers or in a children's home.

The MSF spokesman said victims are given therapy and may be referred to MSF psychologists at the Clinical and Forensic Psychology Service.

The psychologists assess how the child and family have been impacted by the sexual abuse and determine if the child needs specialised help. These victims could also be referred to community agencies such as Family Service Centres and Child Protection Specialist Centres for support after CPS closes the case.

Parents will have to foot the bill for services not provided by MSF or referred by CPS, such as counselling with a private agency.

Fiona said there are still triggers that set off her anxiety. She urged survivors to get help from any of the established networks, or simply speak to a trusted friend.

"It's important to know that life gets better. I was devastated at first when it happened, but I realised the abuse cannot be all there is to my life.

"The best justice you can get is to achieve everything you want and show him (the perpetrator) that even after all he did to you, you still made a better life for yourself."

Abusers may have been victims of abuse in the past, says expert

A father who molested and raped his biological daughter was himself sexually assaulted by his cousin when he was eight.

The 45-year-old man was sentenced to 21 years' jail and 24 strokes of the cane on Oct 14. He had tried to feed his daughter contraceptive pills disguised as cough medication.

In his mitigation plea, his lawyers Jonathan Wong and Riko Isaac revealed that the man had been sexually assaulted by a male cousin who was 10 years older than him.

"At the time, he did not realise that such an action was wrong and merely followed what his cousin wanted him to do," wrote the lawyers.

They added that the man realised what he had experienced was sexual assault only when he was about 14 years old, and had "unresolved feelings" about the abuse.

While the man in this case said he was not sexually interested in pre-pubertal girls, addiction therapist Andrew da Roza told The Straits Times that being a victim of sexual abuse is a typical trait among clients who have sexual desires for children.

Some develop an addiction to child pornography. Often, pornography becomes their sex education as sex was a taboo subject at home, said Mr da Roza, who specialises in sex addiction.

He has had clients employed in positions where they were responsible for children, and went on to develop emotionally intimate relationships that led to sexual abuse of children.

"It can be a lifetime of recovery and vigilance, awareness, distraction, and avoidance of triggers, urges and cravings. Attendance at and involvement in 12-step recovery groups, such as Sex and Love Addicts Anonymous and Sexaholics Anonymous, for many years is common," said Mr da Roza.

Many of the clients who sought treatment were pressured to do so by their partners, family members, friends or the authorities after their behaviour was discovered.

In order for clients to be diagnosed with a disorder, they must exhibit clinically significant distress, said Mr da Roza.

Some of his clients have not acted out their urges with children but instead turned to pornography involving underage females.

These people tend to suffer serious relationship issues with their partners and families.

Many also suffer sexual dysfunction from obsessive and compulsive pornography use, and are anxious and depressed because they have tried many times to stop, he said.

Their families suffer, too.

"I have had partners of clients who have been treated with the same - or even more - disdain, disgust and anger by others.

"They are often asked, 'How could you not have known about the behaviour and why could you not have stopped it?'," said Mr da Roza, urging not only victims, but also partners and family members of offenders to seek help.

Multiple factors behind rise in investigated cases

The number of child sexual abuse cases investigated by the CPS has more than tripled in the last five years.

The MSF told The Straits Times that the figures are consistent with its efforts to expand screening, to better identify cases.

In 2015, CPS investigated 82 cases. This figure climbed to 261 last year.

"The increase in cases corresponds with MSF introducing, over the years, more rigorous screening tools and training for professionals such as social workers, educators and health professionals, which helped to sharpen their ability to pick up safety concerns for a child and seek appropriate intervention," said an MSF spokesman.

He added that more cases were also uncovered with greater public awareness as a result of stepped-up public education efforts.

The increase could also be a result of more ground-up movements.

Dr Cherie Chan, president of the Singapore Psychological Society, said: "Recent movements and campaigns like #metoo help to normalise and encourage the action of speaking out.

"As more and more adults or celebrities point out what it means to say no and what is not okay, these then flow down to encouraging younger people to speak up too."

Despite more cases being investigated, Aware president Margaret Thomas pointed out that many survivors come forward only when they are adults.

This could be because they did not know at the time what constitutes abuse, or some victims may have also felt protective towards both the abuser and other family members, she said.

"Parents and other guardians, teachers, counsellors and other school personnel should all be trained to detect physical and behavioural indicators of abuse," she added.