By Charles L. Robinson, Ph.D.
Adults do terrible things to children. Although most readers of the Maine Bar Journal know this from their professional experience, issues of child sexual abuse affect members of the Bar outside the court room as well. Some tell me that they don't sleep well when they are involved in cases of child sexual abuse. Others have said that they fear being seen hugging their sons or daughters "too long." Some defense attorneys have stopped accepting cases involving sexual abuse. The situation becomes most stressful when an attorney not only wants a fair hearing for the accused ' 'perpetrator," but actually believes that their client is innocent. A review of recent literature reveals numerous instances of persons presented for trial, hearing, pleading or sentencing who have not, in fact, sexually exploited the alleged victim(s). And yet several people must be reasonably convinced that such conduct has occurred before cases reach this level. How does this happen?
It will be helpful to differentiate between false accusations and false allegations of sexual abuse. tn the former, one person accuses another of an act or acts of sexual exploitation which the accuser knows did not occur. This appears to be an infrequent event. Benedek and Schetky (1984) cautioned that such false accusations are most likely to occur in the context of contested child custody and/or are the product of serious psychiatric disorder. Hodge (1987) also cites a small percentage of cases where adolescents knowingly raise false accusations as a way of "getting out of a situation they perceive to be unaceptable. Several of these adolescents were sexually abused prior to false accusation.' '
False allegations occur with greater frequency than false accusations. They are not the product of volition or psychotic delusions. To understand how false allegations occur requires a conceptual framework which focuses on the activities of social workers, psychologists, physicians, and other members of the so-called "helping professions." Specifically, it requires some understanding of matters of orientation and matters of technique.
MATTERS OF ORIENTATION
Practitioners in the field of mental health are typically disposed to accept their client's/patient's statements as true or accurate. Most clinicians approach their therapeutic task with this orientation. Such was not always the case in regard to child sexual abuse. Freud offered two historically distinct opinions regarding the actuality of sexual abuse as reported by his patients. He initially accepted the reports as valid rediscovered memories on the part of the patient. He subsequently revised his theory to reflect his belief that such reports were fantasized wish fulfillments (Mason, 1984). On a broader level, there is evidence that a cultural trend of initial disbelief, then acceptance, and a subsequent return to disbelief in children's reports of sexual abuse characterized the legal and psychological professions of France between 1850 and 1920 (Cunningham, 1986). Influential thinkers within the profession and cultural acceptance or rejection of ideas or possibilities of sexual abuse do much to color the perceptions of members of specific professions practicing within a specific culture. This selectivity or coloration is termed orientation. Orientation can either limit or expand the accuracy of perception. Unless an adult is oriented in such a fashion as to accept the possibility that adults can and do sexually exploit children, reports by a child that such has occurred will not be accepted as accurate. A skeptical and ultimately censurous orientation regarding child sexual abuse was nearly universal in the U.S. until the mid 1970's. The results of this orientation had tragic consequences for hundreds of thousands of children. Clinicians are now more oriented to assess the accuracy of reports of sexual abuse based on clinical data rather than assuming that sexual exploitation does not occur or occurs only infrequently. An unfounded corollary of this new orientation, however, is: "Children don't lie about sexual abuse."
This corollary orientation is seriously flawed. First, reports of events such as sexual abuse are best evaluated (both clinically and legally) on a continuum of accuracy rather than by a binary paradigm of "true" or "false." An orientation focused on an accuracy continuum allows the clinicjan to both maintain the therapeutic stance necessary for competent clinical work while discharging the necessary obligation to carry out evidence gathering. Secondly, concepts of truth and falsehood are not germaine to children of young ages. It is not possible to state categorically at what age children achieve "competency" in the legal sense. Speaking more generally of children's report accuracy, Segroi (1982) stated: "A skilled interviewer can sometimes elicit helpful information from an unusually articulate young child (age range 3 to 5). However, a child who is that young frequently lacks the verbal and conceptual skills required for investigative interviews to have validity."
A leap is often made from "Children don't lie about sexual abuse" to the assertion that particular persons and/or techniques can determine with accuracy who is capable of sexual abuse, or who did sexually abuse a specific child. These orientations, in concert with technique errors, lead to the assumption that not only does sexual abuse of children occur, but that it did occur in a specific instance and to the assumption that adults not only do sexually exploit children, but that a specific adult did do so. The danger here is that these latter assumptions become orientational prior to satisfactory and valid efforts to assess accuracy and are then vehicles to pursue a "truth" which is in turn selffulfilled as a result of errors of orientation and errors of technique.
MATTERS OF TECHNIQUE
The majority of allegations of child sexual abuse cannot be validated through physical/laboratory findings. In the absence of physical findings, corroborative observations by others, or acknowledgment by the exploiting party, inferences and conclusions based on clinical techniques are used to assess the likelihood of sexual abuse. The past seven years have seen a great increase in the number of books, articles and training programs devoted to techniques which are presented as vehicles to assess ("validate") sexual abuse. This article addresses broader foundation issues rather than focusing upon specific techniques. The reader interested in detailed discussions of specific techniques is referred to Segroi (1982), Finkelhor (1984 and 1985), and MacFarlan et al (1986).
Three foundation principles of clinical technique assume significance when interviewing a child who one believes may have been sexually abused.
These principles are, in turn, significantly influenced by the orientation the interviewer brings to the clinical context.
The first principle is that of rapport. Rapport is achieved only in a context of regard for the total integrity of the child. If the child is seen as a repository from which evidence is to be removed, rapport will not be possible. In valid cases of abuse, inaccuracy will then be the result. Rapport is likewise diminished or distorted if the clinicjan brings to the interview context unacknowledged expectations which he/she "demands" be fulfilled by the child. This result is a direct consequence of orientation ("This kid was abused." "He never would do this to this child.' '). Rapport is also compromised by such factors as lengthy interviews, too intense a focus on "evidence" issues, serial interviews (first the guidance counselor, then the parents, police officer, social worker, psychologist, victim advocate, prosecutor, defense attorney, etc.), hostile settings ( a dark basement of a courthouse is a good example) and a host of other factors both obvious and more subtle. A lack of rapport (and a chitd's attendant fear of the strange and powerful interviewing adult) can readily lend itself either to a false negative outcome (a finding of no abuse when the abuse did, indeed, occur) or a false positive outcome (a finding of abuse when it did not occur).
A second clinical principle that is particularly relevant to cases of alleged sexual abuse is that of children's developmental levels. Validating child sexual abuse via clinical techniques alone with children five and younger is often difficult. The developmental patterns of memory, suggestability, vocabulary, syntax, and cognitive operations of children are as yet incompletely understood. Insufficient appreciation of developmental levels or norms (especially in concert with a "truth" orientation and poor rapport) Jeads some clinicians to develop inappropriate expectations of a child. When these expectations are not fulfilled, the clinicjan "helps" the child to communicate and this "help" leads to the creation of the technical errors discussed next.
Interviews with children suspected of being sexually abused should emphasize the use of open-ended interview techniques. A review of written case summaries, court testimony, case notes, verbatim transcripts, and reviews of video-taped "validation" interviews all too often yield examples of improper techniques such as: leading questions, the establishment of "yes sets," behavioral and verbal interviewer behaviors which shape verbal reports and behaviors through successive approximation, the use or withholding of nonverbal rewards (smiles, head nods, stroking, etc.), and the use of forced choice questions. These techniques as well as the use of methaphors are said to be necessary to "help" the child express that which cannot be clearly communicated because of the child's developmental level or the child's fear. These technique errors are especially prevalent when the interviewer holds a "truth" and/or "evidence gathering" orientation. It is through the confiuence of these errors of technique and errors of orientation that remarkably persuasive "cases" of sexual abuse are created out of the personal (divorce, custody litigation, fear. etc.) and cultural (inadequate day care, the equation of male sexuality with power and consumption, etc.) chaos of our times. In some instances, young children come to experience these events in such a manner as to "believe" in the "truth" of the abuse. The well-intentioned but ultimately destructive publication of long lists of "indicators" of child sexual abuse are often the cloth from which these allegations are cut--"... symptoms such as social withdrawal or not wanting to go home from school could as easily be found in a child whose parents are going through a divorce as in a child who is being sexually abused." (DeYoung, 1986)
Young children communicate in a fashion similar to, but different from that of adults. All people (regardless of age) who have undergone significant trauma such as sexual abuse evolve still
more unique ways of commuhicating (including not communicating) the pain, anger, guilt and fear engendered by trauma. These factors have prompted some clinicians to extend the utilization of metaphoric techniques such as puppets, drawings, and "anatomically correct" dolls for the treatment of child trauma to the use of such techniques to establish: (1) that trauma has occurred; (2) what the nature of the trauma was; and (3) what (who) caused the trauma. This is a highly questionable practice. There is no persuasive empirical support for the independent accuracy of these techniques. Indeed, there appears to be evidence to the contrary (Jensen et al, 1986).
A second category of psychological evidence used in making a determination of child sexual abuse concerns the result of psychological examinations of alleged "perpetrators." Research efforts directed towards the development of a psychological test profile of persons who do or do not sexually molest children have not (and probably will not) achieve any significant degree of proficiency. The success of these efforts is so limited that there is good cause to sU:ictty limit the introduction of "evidence" derived from such tests.
The past decade has seen the development of new psychological techniques and a significant body of research data regarding child sexual abuse. Parallel with these developments, there has been a broad cultural and professional re-orientation regarding the accuracy of self-reports of sexual abuse made by children. These factors have significantly elevated the importance of psychological evidence in most civil and criminal proceedings related to child sexual abuse. Like most scientific advances, these new techniques and research findings have brought risks as well as benefits in their applications. A related variable which plays an important role in the development of psychological evidence regarding child sexual abuse is the use of video-tape technology. Video-tape technology offers a methodology to observe the applications of new techniques and to examine orientations regarding sexual abuse. The technique of video-taped interviews holds important promise in safeguarding all parties involved in matters regarding sexual abuse. Video-taped interviews facilitate both appropriate treatment of child victims and explicit and confident presentation of psychological evidence. The process also serves a vital training purpose for clinicians in that the use of video-taped interviews is the only method known to analyze both orientation and technique. Only a small proportion of interviews with children suspected of being sexually abused are now video-taped. A mandate to employ this technology in all interviews with suspected child abuse victims will be a most significant advance in safeguarding children and in protecting the rights of persons accused of abusing children.
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Cunningham, J. French Psychiatry and Sexual Abuse in HISTORY OF PSYCHOLOGY NEWSLETTER, Vol. XVIII, No. 3, pp 82-91. 1986.
DeYoung, Mary A. A Conceptual Model For Judging the Truthfulness of a Young Child's Allegation of Sexual Abuse. AMERICAN JOURNAL OF ORTHOPSYCHIATRIC ASSN., 55(4), Oct., 1906 pp 550-559, p. 556.
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Hodge, Sandra. False Allegations of Child Sexual Abuse in CHILD ABUSE AND NEGLECT: THE MAINE HEALTH PERSPECTIVE, Vol.2 , No. 1, p. 5.
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