See also these newsletter issues for coverage of related topics:
Sexual Abuse Treatment
(treatment services to sexual abuse victims and nonoffending parents)
Sexually Abusive Children and Youth.
Guidelines for Interviewing Children top
Bourg, Wendy, Raymond Broderick, Robin Flagor, Donna M. Kelly, Diane L. Ervin, Judy Butler (1999). A Child Interviewer's Guidebook. Thousand Oaks, CA: Sage Publications. 249P.
This guidebook was written at the request of the Oregon Health Advisory Council on Child Abuse to ensure that professionals who interview abused children are well informed and use a consistent approach. The guidelines are not endorsed by any professional group, but they represent ideas about best practice. Each of the topics listed below represents one chapter in the guidebook.
Child Eligibility for a Forensic Interview
Children who make statements about being sexually
abused should be interviewed. Children who are not
making statements can be interviewed or given a
medical examination according to the orientation of
the agency and the judgment of the evaluator.
Interviewer Training
Mental health, child protection and law enforcement
professionals who interview children should have
experience working with children and be:
Establishing a Neutral Environment
Biased adults must not have a chance to influence the
child during the evaluation. The interview room must
be away from the abuse scene, pleasant, non-distracting, and child-friendly, similar to a living room
or play room. The interviewer should wear plain
clothes. The child should be offered a snack/drink
before the interview.
Single Versus Multiple Interviewers
Only one professional should interview the child, to
reduce the child's distress and the possibility of
contaminating her report. However, more than one
interview sessions may be needed to establish rapport
with the child, in complex cases, or if new information
arises. All interviews should be well documented. It
is normal for children's statements to be inconsistent
between interviews. Never use repeated interviews to
rehearse a child's report.
Friendly, Neutral Approach to Children
The interviewer should be warm, calm, and welcoming
to the child and parents, especially in the rapport-building stage.
A nurturant style help children resist
leading questions and reduces their distress. As the
interview progesses, the interviewer should become
more neutral. Supportive words such as you're doing
fine or non-verbal behavior such as head nodding,
should either be used throughout the interview, or not
at all, to avoid giving the impression that the
interviewer approves or disapproves of a particular
answer. Avoid making any emotional reactions,
positive or negative, to the child's statements. Avoid
forming preconceptions about whether or not abuse
took place. Interviewers should watch themselves on
video tape to see if their behavior is neutral.
Gathering and Documenting the Background
Information
Some researchers and professionals believe that the
interviewer who has no advance information about
the case produces a more neutral interview (called a
history-free or allegation-blind interview). However,
research has not yet settled this question, and
history-free interviews are not recommended for
children age 4-6 or special needs children.
For example, the following background information is essential for interpreting the child's statements and may help guide questioning:
Setting the Stage
At the start of the interview orient the child about
what roles she and the interviewer will play and why
the interview is being held. Clarify who you are.
Begin establishing rapport with the child. These rules
for communication may help the child:
For older children, explain about the arrangements for a one-way mirror or video taping if they are used. Briefly assess the child's language abilities.
Posing Appropriate Questions
The interviewer's questions are memory cues for the
child. The stronger the memory cue, the more the
child may talk about her memory, but then she is
more likely to make errors.
Begin with open-ended questions to encourage a free narrative. Always give the child plenty of time after asking a question and making a response, to allow for more elaboration.
After the free narrative, sparingly use specific questions, focused questions, and multiple choice questions. Reduce their suggestibility by using them only to clarify information the child has already offered. Be prepared to defend your use of these questions. Return to open-ended questions to clarify a child's responses to specific questions.
Researchers vary in their definition of question types and what makes a question leading or suggestive. This guidebook recommends using the following question continuum proposed by K. C. Faller, with some additional distinctions:
The Use of Language in Child Interviews
Your use of language in the interview can help or
hinder the child's report. Here are basic suggestions:
The Use of Repeated Questions in Child
Interviews
Do not repeat questions after the child has responded
to them, because repeating questions encourages
children to change their answers. Instead, rephrase
the question to check the child's comprehension.
Using Anatomical Dolls and Other Tools
Dolls and drawings can be useful after the child has
made a statement about being abused. They can be
used to test a child's understanding of terms such as
inside/outside or names for body parts. Children can
use them to demonstrate their experiences. However,
using these tools as memory triggers is more
controversial. Explain that the tools have a special
job and are not part of pretend play. Children under
age 4 may not be able to use the props to represent
reality.
Ending the Interview
When the interviewer is finished, or if the child needs
to stop, let the child ask questions, thank her for her
participation and end with some conversation on
positive topics. Remember that the interviewer is
neutral and is not there to provide support or
treatment. If the child needs help, call in an
appropriate colleague.
Verbatim Documentation
Provide a complete record of all questions and the
child's verbal and non-verbal responses. Video- or
audio- taping of the interview has many advantages,
unless the child has difficulty with it. The extra time
required by note-taking during the interview can be
helpful, but the interviewer may miss some
information. Multiple documentation formats can be
used. Always introduce your documentation method
to the child.
Memory and Suggestibilty
Children perceive, remember and report events
differently than adults do. Many of children's
memories are nonverbal. Their memories also have
fewer components than adult memories, and may
include only people and action information and not
components such as emotions, time, and order of
events. Since fewer components are involved, there
are fewer potential cues for triggering the memory.
Also, children do not have adult strategies for
searching their memories. The interviewer's questions
must cue the child's memory without influencing it or
the way it is reported.
Children forget more quickly than adults and are more vulnerable to suggestion because their memories may be weaker. Also, children's ability to report their memories is strongly influenced by their language limitations. They may not be able to determine how they know something, whether by experience, being told, dreaming, or imagining.
Children are influenced by the adults participating in the interview. They assume that adults know more than they do, that they are honest, and that they must avoid offending the adults and try to please them. Interviewers must show interest in all the child's statements. The presence of a possible perpetrator at the interview is clearly detrimental to the child's report.
Children can be led to make false reports when adults communicate a bias by making repeated negative statements about a person or event, or when they repeatedly ask misleading questions. It is important to learn about the previous conversations that adults may have had with the child. However, a child's report should not be discounted just because she has been exposed to one bad interview.
Inaccurate or False Reports
Some research suggests that false reports are rare -
only 1-10% of all reports - although false reports may
be more frequent in custody disputes (14%) or from
teens (8%). Parents may coach a child in a false
report or communicate a bias to a child that creates a
false belief. It is possible for a child to create a false
report to accomplish a goal, but this is more difficult
than lying by answering No.
It is normal for children to be inconsistent about details and this does not necessarily mean a report is false. Inconsistencies can also be explained by misunderstandings in the interview. If a child's report seems inaccurate, the interviewer can ask clarifying questions, as long as they do not unduly stress the child.
The Nondisclosing Child
It is likely and acceptable that the child will not make
a disclosure in the interview. If abuse has actually
ocurred, the child may be afraid, ambivalent or
ashamed. The memory may not be accessible at the
interview, or the child is uncomfortable with the
interview setting or interviewer. It is not the
interviewer's job to get a disclosure but to establish a
setting that helps the child volunteer information.
Saywitz, Karen J. and Gail S. Goodman (1996). "Interviewing Children In and Out of Court: Current Research and Practice Implications." Pages 297-318 in The APSAC Book of Child Maltreatment. Thousand Oaks, CA: Sage Publications.
Eisen, Mitchell and others (1998). "Memory and Suggestibility in Maltreated Children: New Research Relevant to Evaluating Allegations of Abuse." Pages 163-189 in Truth in Memory. New York: The Guilford Press.
The authors review some of the major research studies about child witnesses.
Children's Testimony Can Be Good
Although the ability to report information about past
events increases with age, young children can still do
well at remembering and recounting their experiences,
although not as well as adults. People at any age may
vary in their abilities to remember events and to resist
suggestive or leading questioning, depending on the
situation in which they are interviewed. The reports of
children over 11 can be comparable to those of adults.
Young children are more influenced by the interview
situation than older people, so the interview must be
thoughtfully arranged.
The reports of 3-5 year-olds are especially dependent on how they are interviewed, and interviewing these children is a challenge. Children's testimonies normally include inaccuracies and inconsistencies and some of these may be due to the interview itself. Children also tend not to remember everything about an event at one interview, but bits and pieces at different times. This inconsistency does not mean their reports are false.
Answers to Open-Ended Questions are Most
Accurate
Research consistently shows that people recall
information most accurately when asked open-ended
questions, because the information must come from
the witness' own mind. This is also true for young
children who generally give accurate answers to open-ended questions.
Some children may respond to an open-ended question by describing a different event than the event the interviewer is asking about. Also children may give inaccurate responses to general questions, because they think in concrete rather than abstract terms. A preschooler may answer No to Did he have a weapon? but Yes to Did he have a gun? Weapon is an abstract category, while gun is a concrete object.
Carefully Supplement With Specific Questions
The major disadvantage to open-ended questions is
that a child may fail to report abuse if asked only
open-ended questions. She may respond to What
happened? with a very minimal response, such as
Nothing, even when asked about a very significant
event that she remembers. This makes it necessary
to ask more specific questions, such as Did you go to
Uncle Bob's house? in order to obtain more
information. Asking questions about specific topics
will elicit more information, but also increases the
possibility that some of the information may be
contaminated.
Answers to Specific Questions Can Be Inaccurate
There is significant controversy in the field about how
often inaccurate information is obtained from children
when asking specific questions, due to children's
suggestibility. Research has not yet given a clear
answer on how to balance the two possibilities:
When closed questions (yes/no) are used, it is important to follow up with questions like Tell me more? or What makes you think so? in order to clarify the child's response.
Children's Suggestibility Varies
Research shows that children can be induced to give
inaccurate information, even when asked open-ended questions, when they have received repeated
false suggestions given in an accusatory style (for
example, that a certain person had done something
wrong). Children could be induced in this way to
deny abuse they had actually experienced.
Some children can also do well at resisting leading questions and this may correlate with higher intelligence and better overall functioning.
Prepare Children for Repeated Questions
Most people believe that repeating questions will
encourage children to change their answers.
However, the latest research shows that when
children are prepared for repeated questions, their
recall may be improved. Explain that I might ask you
the same thing over, but this means I'm confused, not
that your answer was wrong.
Trauma May Influence Memory In Varying Ways
Several studies have shown that people generally
have strong memories for stressful or traumatic
events, although their memories may not be
completely accurate. On the other hand, memories
of traumatic events may be temporarily or
permanently forgotten. In general, research does not
yet tell us how to distinguish true versus false reports
of traumatic events, or true versus false memories of
the events.
Children's Communication Ability is Limited
Even when a child's memory is strong and accurate,
her ability to understand questions and give clear
answers to them in an interview situation may be
limited. A child's answers may be inaccurate
because she does not understand what is happening.
Consider these interview factors:
Courtroom Fears Hamper Memory
Studies show that fear reduces the memory of
children who are interviewed in the courtroom as
opposed to at home or school. Children experience
fears about many aspects of the courtroom, including
public speaking, losing self-control, not being
believed, having to prove they are innocent, being
punished for mistakes, angering family members, and
fear of the defendant being present.
Helping Child Witnesses
Because children are being called on more frequently
to give testimony, there has been some research into
how to support them without influencing their reports.
The following methods of preparation have shown
promise, but the research is still preliminary.
Practice Suggestions
Research has not yet provided a best practice for
interviewing children. But it is clear that when
children are interviewed as if they were adults, their
reports can be contaminated.
Assessing Sexual Abuse of Preverbal Children top
Seman, Clare Haynes, Jon Korfmacher, Michael R. Freedman, Jane Hoffman, Susan Van Scoyk and Diane Baird (1998). "Evaluation of Allegations of Sexual Abuse of Young Children: A Multimodal Assessment Approach." Clinical Child Psychology and Psychiatry v3 n4 p561-582.
The authors have developed a way to investigate allegations of sexual abuse when children are preverbal or minimally verbal.
Use This Method for Young Children or if
Allegations Are Unproven
The child interview is usually the most important part
of an investigation of sexual abuse allegations.
However, this multimodal assessment is used when
the child is not developmentally ready to be
interviewed, or when the interview has failed to prove
the allegations.
The method has been used in hundreds of cases involving young children whose parents were contesting custody. However, it has not yet been formally evaluated.
Grounded in Attachment and Family Systems
The method is based on techniques used by
experienced clinicians as well as attachment theory
and family systems work. Both attachment theory and
family systems theory support using observation as a
way to determine underlying family dynamics.
Multimodal Assessment Protocol
This assessment protocol includes four components -
the child play interviews, family observation, parent
interviews, and parental testing - that are described
below.
How to Interpret the Interviews/Observations?
The authors have prepared a list of "Decision
Characteristics" which were developed by a
multidisciplinary group of professionals on the basis
of their training and experience in hundreds of cases,
as well as on the literature of child sexual abuse. The
decision characteristics have not yet been formally
tested, but they are available from Clare Haynes
Seaman, 2121 South Oneida Street #195, Denver CO
80224.
Look for Consistent Patterns
There should be a consistent pattern of results across
the four components of the evaluation - child
assessment, interactions, parental interviews and
supplemental information. Below are factors from
each of the first three components that are important
to consider.
Case Study: The Smiths
The Smiths had three children and were married for
11 years. They were divorcing when Mrs. Smith
learned her husband was having an affair. Shortly
after separating, the 4-year-old daughter, Linda, said
her father had touched her in a private area. At the
child psychologist, Linda showed sexualized behavior
with dolls. Mrs. Smith alleged abuse by Mr. Smith,
but it could not be proven.
The multimodal assessment, however, indicated that it was unlikely that Mr. Smith abused Linda, although he had narcissistic and sociopathic personality features that could be abuse risk factors. Mrs. Smith showed paranoid thinking, dependency, and was not very able to see Linda as a separate individual. Linda showed positive interactions with her father, but little enjoyment with her mother. Linda's sexualized behaviors at the psychologist were likely the result of her seeing nudity at her father's house, as well as walking in on her father and his new partner in bed. Linda's sexualized behaviors disappeared during the course of the evaluation.
Case Study: The Trents
The Trents daughter, Sara, was 1 year old when they
divorced. Sara returned from a visit to her father's
complaining of pain with urination. She said her
daddy had hurt her. The initial evaluations of this
situation saw Mr. Trent as being the better parent, with
Mrs. Trent having an ambivalent relationship with her
daughter, and having contrived the allegations of
abuse.
The multimodal assessment, however, found support for Mr. Trent having abused Sara. Mr. Trent was attentive to Sara except when she expressed distress, when he would be indifferent or dismissive. He seemed to expect his relationship with Sara to have adult-quality intimacy, and to be more focused on his needs than on hers. Mr. Trent's background had several abuse risk factors, including incest between his father and a cousin, an allegation that Mr. Trent had also abused the cousin, parental alcoholism and harsh punishment from his father. He showed little indication of having dealt with these childhood issues. Also, he did not fully cooperate with the child protection investigation.
Most Abused Children Do Not Testify top
Martone, Mary, Paula K. Jaudes, Mary K. Cavins (1996). "Criminal Prosecution of Child Sexual Abuse." Child Abuse and Neglect v20 n5 p457-464.
The authors reviewed records for 451 child sexual abuse cases handled by the La Rabida Children's Hospital in Chicago during 1986-1987.
Of the 451 cases:
This study found that few children in cases of alleged child sexual abuse will have to testify. Many cases are not recommended to the prosecutor by DCFS because the victims are not expected to pass a witness competency test. As is true for all criminal cases, many are eliminated during hearings and arraignments, and others do not go to trial because defendants plead guilty and engage in plea bargaining.
This study also found that a trial often takes 12-16 months to complete.
Repeated Testimony and Interviews Distress Children top
Henry, Jim (1997). "System Intervention Trauma to Child Sexual Abuse Victims Following Disclosure." Journal of Interpersonal Violence v12 n4 p499-512.
Sexually abused children must negotiate the systems intended to protect and assist them - child protection, law enforcement, and the courts - and these systems may cause them additional distress. Past studies have found that:
A Study of 90 Children
The author studied 90 children who had been abused
by an adult household member and were involved in
the courts as a result. His results confirm those of
previous researchers and also include the following:
Repeated interviewing may be harmful to children because it confirms their belief that they are responsible for the abuse and it reinforces their feeling of stigmatization. 84% of the children studied felt that describing the abuse was the most difficult part of the interview.
Able to trust a professional - Most of the children in the study were willing to trust a system professional, in spite of being betrayed at home, and this relationship was important in reducing their distress. Professionals must avoid acting in ways that children might see as betrayal, such as getting a disclosure from them without explaining what will happen afterward.
Testifying in court was frightening - Testifying was easier for the children when they were prepared, when a trusted person was available, and when people in the courtroom responded positively to them. Children were fearful while testifying, and having the perpetrator present was the most fearful aspect of the experience. They felt that not having the perpetrator in the courtroom was the most important change that could be made.
Placement was positive or neutral - 65% of the children who were removed from home said it was a helpful or neutral experience, perhaps because the children who were removed had unsupportive mothers. It was important to children to be safe from the perpetrator as well as from 'verbal attacks' from their mothers. However, children said that professionals should have listened more and given them better preparation and explanation about the removal.
They would tell again - 71% of the children thought their experience with the system was positive and almost all the children said they would tell again, or encourage their friends to tell about sexual abuse.
Medical Exams are Little Studied top
Hibbard, Roberta A. (1998). "Triage and Referrals for Child Sexual Abuse Medical Examinations from the Sociolegal System." Child Abuse and Neglect, v22 n6 p502-513.
There are Not Enough Examiners for All Children
There are few physicians who are expert at examining
sexually abused children, and certainly not enough to
provide exams for all children when abuse is
suspected. Exams can be costly and may not be
covered by insurance.
Guidelines are Needed
Although most literature recommends that all children
be examined, we need guidelines about:
The Existing Literature is Limited
There are few studies about medical exams for sexual
abuse victims. However, the literature indicates these
trends:
The most recent trend is for exams to be requested of experts rather than general practitioners, because they are thought to provide more valuable information and to be more willing to cooperate with sociolegal professionals. However, there is not enough research information to indicate whether general practitioners or experts should perform the exams.
Advice for Dealing With Incest: Plan for Victory, Prepare for Defeat top
Myers, John E. B. (1997). A Mother's Nightmare - Incest: A Practical Legal Guide for Parents and Professionals. Thousand Oaks, CA: Sage Publications. 246P.
This book was written in a personal style for protective parents and professionals to help them through the legal aspects of a child sexual abuse case. The "Action Plan" from chapters 15 and 16 are summarized below.
Act Cautiously - Do not overreact or act too quickly. If you bring forward a charge of sexual abuse and it turns out you are wrong or if you cannot prove it in court, you may be labeled hysterical, vengeful, or other negatives and will be discredited.
Lawyer - It is essential to get a good lawyer.
Get an Assessment - Get a thorough psychosocial assessment of the child by a mental health professional with expertise in child sexual abuse.
Collect Evidence - Document the evidence for sexual abuse and build the case, but don't overvalue the evidence. The unfortunate truth is that sexual abuse is difficult to prove in court. Keep a written record of the child's behavior and statements that may be relevant. Your attorney may recommend waiting for more evidence to strengthen the case.
Limit Child Questioning - Unfortunately, your motives for talking with the child are automatically suspect and may hurt your case. It is better to let professionals interview the child than to ask questions yourself.
Restrain Emotions - Emotions are used against women, so guard your emotions. Unfortunately, there is a long tradition of discrediting women who allege sexual abuse with charges of being hysterical or unstable.
Focus on the Child - Be sure that the message you project to all the professionals you work with is that you are only interested in the truth and protecting the child. If you seem to be interested in hurting the child's father, you will be discredited.
Prove Other Faults Instead - Your attorney may recommend trying to prove that the father has other faults, such as substance abuse, rather than proving sexual abuse. Other faults may be easier to prove.
Stay Open-Minded - It is possible to misinterpret innocent behavior as evidence of abuse. Keep an open mind and consider other explanations.
Find Personal Supports - Dealing with sexual abuse may be a long and arduous process. Find enough personal support that you can provide all that your child needs and never give up.
Be Prepared for Defeat - In some cases, judges disbelieve charges of sexual abuse and award custody to the alleged abuser. Your child will need you more than ever, so you must remain strong and available. Doubly guard your emotions or you may be considered unstable and your visiting rights curtailed.
Consider Legal Options - You may be able to request a new trial within a limited time period, or appeal to a higher court. If circumstances change in the future, such as the abuse reoccurs and you have better evidence, you may be able to modify the custody decision.
Kidnapping Will Backfire - Although you may be tempted to kidnap your child, this will probably reduce your ability to protect her. If you are caught (and if you take the child across state lines you will be pursued by the FBI) you will be charged with a crime, can be sent to prison, and most certainly will never get custody in the future.
Be Available For Your Child - Even if you lose custody, you are still your child's lifeline. Find ways to make your love always available to her.
Offender Characteristics and Treatment top
Brown, Joanne L. and George S. Brown (1997). "Characteristics and Treatment of Incest Offenders: A Review." Pages 335-354 in Violence and Sexual Abuse at Home: Current Issues in Spousal Battering and Child Maltreatment. New York: Haworth Press, 1997.
Marshall, William L. (1996). "Assessment, Treatment, and Theorizing About Sex Offenders: Developments During the Past Twenty Years and Future Directions." Criminal Justice & Behavior v23 n4 p162-199.
Marshall, W. L. (1999) "Current Status of North American Assessment and Treatment Programs for Sexual Offenders." Journal of Interpersonal Violence v14 n3 p221-239.
Murphy, William D. and Timothy A. Smith (1996). "Sex Offenders Against Children; Empirical and Clinical Issues." Pages 175-191 in The APSAC Handbook on Child Maltreatment. Thousand Oaks, Sage Publications: 1996. 449P.
These authors evaluate research on the characteristics and treatment of sexual offenders, including child molesters and incest offenders.
Research About the Offender Personality is
Unclear
The literature includes many descriptions of and
theories about sex offenders. Offenders are
described as having repressed anger, being
addictive, unassertive, self-centered, lying and
manipulative, lacking empathy and self-control,
projecting blame, having poor communication skills,
believing in male sexual entitlement, and lacking
good relationships with adults.
However, researchers have not yet been able to define a personality profile for incest offenders or other sexual offenders that explains their offending, or is reliable in distinguishing offenders from non-offenders. Various ways of categorizing sexual offenders - such as by gender and number of victims - have been suggested, but none have been validated. Results of other research into sexual offenders are summarized below:
Sources of Assessment Information
Sexual offenders are assessed to help determine
their treatment needs. Because a valid offender
profile does not exist, assessment does not help
determine guilt.
Offenders usually deny and minimize responsibility for their offenses, so assessment must be based on more than their own reports. It is essential to gather information from external of sources as well. These include:
Areas of Assessment
The areas discussed below are often assessed,
although treatment programs generally do not have
funds for thorough assessment in all areas.
The Cognitive Behavioral Treatment Model
Despite the lack of clear research evidence about
sexual offenders and the reasons they offend,
treatment of offenders is usually based on the
cognitive behavioral model. Most programs use group
therapy, which is relatively inexpensive and has the
advantage that group members can help confront
each other's denial and distorted thinking. The
following treatment components are commonly
included:
Cognitive Behavioral Treatment May Reduce Recidivism top
Grossman, Linda S., Brian Martis and Christopher G. Fichtner (1999). "Are Sex Offenders Treatable? A Research Overview." Psychiatric Services v50 n3 p349-361.
Professionals and the public alike often assume that sexual offending is not treatable. The authors reviewed studies published 1970-1998 that give outcome data for treatment programs to see if there is enough evidence to determine if treatment is effective.
How to Measure Improvement?
All outcome studies face the problem of how to
measure improvement in offenders. The number of
known re-offenses is the only measure available, but
it is not a reliable number. Both offenders and police
records under-report these crimes.
Studies are Usually Not Comparable
The various studies on treatment outcomes are very
difficult to compare one to another. Most studies do
not use matched groups of treated and untreated
offenders, because this is not ethical. The individuals
chosen for a particular study may not be similar in
important characteristics, such as the number and
type of victims, intelligence and socio-economic
status. Some programs only accept offenders meeting
certain critera, such as being 'low risk' or are limited
only to those who complete treatment, which are
biased samples. Studies also vary in their length of
follow-up period (longer periods increase the
recidivism rate) and in how they define re-offenses (if
they include only sexual re-offenses or all types of
criminal re-offenses).
Recidivism Rates of 3%-39% for Treated Offenders
Treatment Reduces Re-offending
This review of outcome studies suggests that
cognitive behavioral treatment reduces sexual re-offending.
If treatment is responsible for reducing the
recidivism rate from 27% to 19%, then this is a 30%
remission rate, which is substantial. The review also
suggests that offenders who need to be
institutionalized are less likely to benefit from
treatment.
It is not true to say that sex offenders are untreatable, but we should be cautiously optismistic about the outcome studies which are complex and hard to interpret. More research in this area is certainly needed.
Deviant Interests Predict Relapse top
Hanson, R. Karl and Monique T. Bussiere (1998) "Predicting Relapse: A Meta-Analysis of Sexual Offender Recidivism Studies." Journal of Consulting and Clinical Psychology v66 n2 p348-362.
A Meta-Analysis of 23,393 Offenders
The authors did an extensive meta-analysis of 61
studies on sexual offender recidivism, totalling 23,393
offenders. Their analysis shows that overall, the
recidivism rate for sexual offending is low, 13.4% for
all types of offenses within a 5-year follow-up period.
The rates for some types of offenses is higher, but
none are higher than 40%.
Deviant Results on Phallometry Predict Relapse
The strongest variable predicting recidivism was
sexual interest in children as measured by
phallometry. Related predictors were interest in boys
and any deviant preference other than rape, again
according to phallometric tests.
Not Completing Treatment Predicts Relapse
Failure to complete treatment was a moderate
predictor of recidivism. This may mean that
treatment is effective, or simply indicate that the
higher risk offenders are more likely to quit
treatmemt or be terminated. Those who did not
complete treatment were likely to be younger,
uneducated, and have antisocial personality
characteristics. Whether treatment is effective is still
debated, but this study suggests that it does help to
reduce recidivism.
Interestingly, low motivation for treatment or denial of offending were not predictors of sexual re-offending, although they did predict non-sexual re-offending.
Assess General and Sexual Re-offense Risk
Separately
There has been extensive research on predicting
recidivism for non-sexual offenders. Studies show
that re-offenders are young, lack stable employment,
abuse alcohol/drugs, have pro-criminal attitudes, and
associate with other criminals. On the other hand,
sexual offending appears to have different
contributing factors. Risk assessments should
consider sexual re-offense and non-sexual re-offense
risks separately.
Unfortunately, research does not yet support a validated actuarial risk scale for predicting recidivism of sexual offending. However, actuarial methods are still better than clinical risk assessments, which have a very low accuracy rate.
Reunifying Incest Families top
Hewitt, Sandra K. (1998). "When Abuse is Not Proven: Managing High-Risk Cases." Pages 245-273 in Assessing Allegations of Sexual Abuse in Preschool Children: Understanding Small Voices. Thousand Oaks, CA: Sage Publications.
Many cases of alleged sexual abuse of preschool children are not proven. This leaves professionals with three concerns that must be balanced in dealing with reunification and visitation:
Nonoffending Parents May Resist Contact
If the child's parents are divorcing, the nonoffending or
custodial parent may oppose contact between the
alleged offender and the child. Also, the nonoffending
parent may intentionally or unintentionally negatively
affect the child's relationship with the alleged offender.
Children's Characteristics That Are Risk Factors
Little research has been done about the risk factors for
re-abuse when families are reunified. But the author's
clinical experience suggests that children at lower risk
of re-abuse:
Therapeutic Management of Reunification in
Preschool Cases
The author published the following protocol in 1991,
based on her clinical experience, and offers it again
here with revisions. The protocol cannot guarantee
safety to the child, and research to validate it is still
needed.
Reunify When Good Progress is Made
If the relationship between the visiting parent and the
child develops well, reunification could be scheduled
within 1.5 to 3 months. The parent must display safe
behavior, respond to the child's limits, encourage the
child's autonomy, and support the child's
preferences.
Use a Supervised Visitation Center
If the child responds well to the contact but the
parent's behavior poses some problems, a
supervised visitation center can be used for
continued visits. These centers are staffed by
trained personnel who observe and document the
visits.
Use Chaperoned Visits
If the relationship is progressing, the parent and child
may visit accompanied by a chaperone. The
chaperone must be informed about the details of the
case and guidelines for the visits. The therapist will
also meet with the chaperone and child to learn how
the visits have gone.
Suspend Visitation if Needed
If the visiting parent cannot comply with the
therapeutic management contract, the therapist can
inform the court and request that the parent be
referred for evaluation or therapy. The court should
determine the specific changes that the parent must
make before visits can continue. However, a parent
who has not been convicted has a right to refuse
treatment. Treatment programs now often offer
services without requiring an admission of guilt.
If the child develops problems, she should receive individual therapy. Also, the custodial parent may be so anxious about the visits or so negative about the visiting parent that she affects the child's experience of the visits. In this case, a psychological evaluation of both parents should be court-ordered, so that the dynamics between them can be understood.
Characteristics of High-Risk Children and Parents
In the author's clinical experience, children who are
passive, withdrawn and anxious, unable to express
their emotions, or unable to recognize problem
behaviors are unlikely to be reunified.
Parents at higher risk of failed reunification have these characteristics:
American Bar Association Center on Children and
the Law
http://www.abanet.org/child/catalog/books.html
Scroll down the page to read about and order a new
book - Handbook on Questioning Children: A Linguistic
Perspective.
Association For the Treatment of Sexual Abusers
http://www.atsa.com
Look here for upcoming training and conferences
related to treatment of sexual abusers.
National Clearinghouse on Child Abuse and Neglect Information
http://www.calib.com/nccanch/pubs/index.htm
Scroll down the list of publications from the
clearinghouse to find:
National Child Advocacy Center
http://www.ncac-hsv.org/pubs.html
The center offers a Forensic Evaluation Manual written for practitioners about how to evaluate
possible sexual abuse. It which can be ordered from
their web site.
Office of Juvenile Justice and Delinquency
Prevention
This Federal agency offers several publications
related to sexual abuse. Three are available on their
web site:
The following guidebooks can be ordered by sending email to puborder@ncjrs.org
Safer Society Foundation
http://www.safersociety.org
This organization offers many books and tapes on
assessing and treating sexual offenders, such as the
Adult Sexual Offender Assessment Packet. To see
the list of publications, select Safer Press.
You can also get a referral to an offender treatment program by using their online referral service under the Services section.