Assessment of sexual abuse allegations in child custody cases.

Family courts frequently rely on the expertise of mental health professionals to assess allegations of sexual abuse within the context of child custody evaluations. Such evaluations are complex and require knowledge of techniques used in sexual abuse and sexual offender evaluations, as well as knowledge of child custody practices. Preliminary findings from a national survey of 84 psychologists indicated that respondents tend to adhere to the child custody guidelines of the American Psychological Association. However, few practitioners followed formal models, protocols, or guidelines when evaluating alleged victims or alleged perpetrators of sexual abuse in conjunction with child custody disputes. Implications for professional practice are discussed, along with a proposed comprehensive model for assessing sexual abuse allegations in child custody cases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

False allegations and false denials in child sexual abuse.

The amicus brief in the Kelly Michaels case ignores the risks that abused children will fail to reveal abuse unless direct and sometimes leading questions are asked. Although the brief correctly criticizes previous research for understating the risks that aggressive interviewing practices will lead young children to make false allegations of abuse, it overstates the likelihood that false allegations occur by overlooking the aspects of the Kelly Michaels case and the research it inspired that are unlike the typical abuse case. The author discusses factors that lead abused children to falsely deny abuse and that minimize the likelihood that nonabused children will allege abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient values: the guide to medical decision making

Physicians are increasingly challenged by issues surrounding medical decision-making for hospitalized patients. Advance directives express a patient's preferences regarding end-of-life care; when available, they should be used to guide medical treatment. Patients who lack decision-making capacity require special consideration to ensure maximal patient participation with appropriate surrogate involvement. An ethics committee consultation may be especially helpful to resolve conflicts that may arise regarding medical treatments. Physicians play a vital role in promoting earlier patient-physician discussions about end-of-life care preferences, increased completion of advance directives, and ongoing education for physicians to improve communication skills.     

Ethical decision making and mandatory reporting in cases of suspected child abuse

This article presents a unique approach to analyzing the issue of mandatory reporting suspected child abuse from an ethical decision-making perspective with a nursing model. Sometimes nurses confront this problem in their own families or in their neighborhoods or social groups. Clearly, deciding to intervene is a challenging and difficult process. Yet reporting is mandated by law. A model of ethical decision-making may guide the clinician in this process.     

Impact of child sexual abuse: A review of the research.

Reviews studies that have tried to empirically confirm the effects of child sexual abuse cited in the clinical literature. In regard to initial effects, empirical studies have indicated reactions—in at least some portion of the victim population—of fear, anxiety, depression, anger and hostility, aggression, and sexually inappropriate behavior. Frequently reported long-term effects include depression and self-destructive behavior, anxiety, feelings of isolation and stigma, poor self-esteem, difficulty in trusting others, a tendency toward revictimization, substance abuse, and sexual maladjustment. The kinds of abuse that appear to be most damaging are experiences involving father figures, genital contact, and force. The effects of duration and frequency of abuse, age at onset, the child's reporting of the offense, parental reaction, and institutional response are also considered. The controversy over the impact of child sexual abuse is discussed. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's allegations of sexual abuse: Forensic and scientific issues: A reply to commentators.

In this rebuttal, the authors summarize and reply to many of the comments made about the amicus brief. In Section I, they address issues that are commonly raised by "pro-child" advocates in their attacks on the scientific data regarding children's suggestibility. In Section II, they consider issues related to the proper scope of an amicus brief. In the third section, they focus on the concepts of reliability, credibility, and competence and argue that only reliability was an issue in Michaels. In Section IV, they consider some of the procedures involved in taint hearings. The final section, the broadest in scope, covers some legal, forensic, and scientific developments that have occurred since Michaels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to special section on clinical intervention in child sexual abuse.

The purpose of this special section is to further research, clinical practice, and teaching in the area of child sexual abuse. Although most of the articles are written by psychologists and are relevant to research, practice, and teaching by psychologists, the articles have relevance to other professionals as well. The special section is composed of seven articles. The first focuses on the effects of child sexual abuse. The next five articles have relevance for assessment and treatment. The last article focuses on teaching clinical intervention in child sexual abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The challenge of defining child sexual abuse.

Although child sexual abuse has been a concern for many researchers, therapists, and advocates for the past 3 decades, several fundamental issues regarding child sexual abuse remain unresolved. In particular, the term child sexual abuse has never been unequivocally defined. The lack of a commonly accepted definition of child sexual abuse continues to inhibit research, treatment, and advocacy efforts. Early researchers used broad and inclusive definitions of child sexual abuse—definitions that often continue to be used today. The consequences of these definitions are discussed, and strategies for developing other definitions of child sexual abuse are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Court testimony of child sexual abuse victims: Emerging issues in clinical assessments.

Presents a case study of a 15-yr-old female witness in a sexual abuse trial and describes how testimony during cross-examination was improved after S's mental age was assessed using the Wechsler Intelligence Scale for Children—Revised (WISC—R) and after she was coached during a mock trial. Clinical criteria should be developed for assessing children's competency to give testimony, and the needs of child sexual abuse victims should be recognized. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The use of anatomical dolls to assess child sexual abuse: A critical review.

Reviews the empirical literature to investigate the following 2 aspects of the controversial use of anatomical dolls to assess for child sexual abuse: (1) Are anatomical dolls valid tools to assess child sexual abuse? (2) What progress has been made toward the development of an anatomical doll interview that is objective and standardized? 16 empirical studies were located which have assessed children's reactions to anatomical dolls. Criteria used to evaluate the studies are listed. In regard to validity, the empirical data suggest that children who have been referred for sexual abuse respond differently to anatomical dolls than nonabused children. Furthermore, considerable progress has been made toward the development of an objective assessment protocol and reliable scoring criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Institutional management of child sexual abuse]

In the years 1992-94 the Child Protection Centre Kiel carried out the first investigation of how various institutions (nursery schools, schools, advisory offices, children's specialists, youth welfare departments, police, judicial authorities etc.) in the German-speaking area deal with suspected cases of sexual child abuse. A special comprehensive questionnaire and a personal interview were drawn up to find out details concerning knowledge, experiences, attitudes and concrete measures of the employees. The particulars were evaluated of about 900 persons from three differently structured districts in Schleswig-Holstein. The institutions (with the exception of the police and judicial authorities) do not have any clear concepts regarding the handling of suspected cases of sexual child abuse. The reactions of the institutions usually depend on the level of knowledge, experience and subjective assessment of individual employees. Roles are not clearly defined and there is not enough cooperation between the institutions. The employees require more practice-orientated training and case-specific supervision. There are not enough coordination bodies for those concerned, therapeutic places and accommodation possibilities for children and youths as well as effective offers of assistance for adults and youths who have abused children.     

Simplifying child sexual abuse data management: from medical record to computer

This article presents a model approach for child sexual abuse data management for centers that provide medical evaluations of suspected sexual abuse victims. The uses and advantages of this system are summarized and an example data entry form is provided. Information and guidelines for developing a computer database and for efficient entry of the data by clinical personnel are outlined.     

Judicial decision making in timely and delayed prosecutions of child sexual abuse in Canada: A study of honesty and cognitive ability in assessments of credibility.

Child sexual abuse is an alarmingly common criminal offense. Whether prosecutions occur shortly after the alleged offense or after a lengthy delay, complainant credibility is often the central issue at trial. In both law and in psychology, credibility is said to be a function of two relatively distinct factors: honesty and cognitive ability. Complainant age informs evaluations of both such that younger children are seen as more honest but less cognitively competent than older children and adults. When a complainant describes a recent event, current age may be used to assess honesty and cognitive ability. However, when a complainant describes an event that occurred in the distant past, we argue that current age is most informative in evaluations of honesty, whereas age at the time of the alleged offense should inform evaluations of cognitive ability. In this research, we analyzed judicial assessments of complainants' credibility in 52 timely (child complainant) and 49 delayed (adult complainant) criminal prosecutions of child sexual abuse. Judicial comments concerning cognitive ability suggest that adults were viewed more positively than children, despite the fact that all complainants were children when the alleged offense occurred. As expected, comments related to honesty suggested that children were seen to be more honest than adults unless they had been exposed to suggestive influences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Support Network: Crisis intervention for extrafamilial child sexual abuse.

Describes the establishment of the Support Network, a community-based treatment program for children and families facing crises due to extrafamilial child sexual abuse. The components necessary to establish a Support Network are discussed. A crisis intervention model of treatment is proposed that provides these children and families with immediate contact with a therapist, emotional support, education, and problem-solving strategies, thus enabling some resolution of the crisis and a return to precrisis routines and adaptation. Termination and follow-up issues are also addressed, and a case example of 4-yr-old sexually abused girl is presented to illustrate the usefulness of the Support Network. It is contended that, by providing services to these children and their families, Support Network therapists also help to sensitize and educate other community professionals to the needs of the sexually abused child and his/her family. A list of selected references for use with children and families is appended. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relating body image to psychological and sexual functioning in child sexual abuse survivors

Cognitive-affective body image variables and their relation to long-term psychological and sexual functioning were investigated in a community sample of 57 female adult child sexual abuse (CSA) survivors and 47 comparison subjects. The Body-Self Relations Questionnaire and the Body Esteem Scale were administered to assess cognitive-affective body image. Group comparisons indicated that, after controlling for actual weight status, survivors evaluated their health more negatively and reported less body esteem regarding their sexual attractiveness than comparison subjects. Body image variables related to health and sexual attractiveness significantly explained variance on symptom measures that reflect the diverse CSA long-term sequelae. Results suggest the need for careful assessment of body image disturbances and the development of effective interventions targeting body image in the treatment of CSA survivors.     

Prevention of child sexual abuse: Myth or reality.

Programs to prevent child sexual abuse have proliferated as a result of increased public awareness and professional documentation of its incidence. We describe the content and format of these prevention programs in general and examine selected programs for effectiveness. Although there is limited evidence for an increase in knowledge for program participants, most evaluations suffer from basic design problems and present few results indicative of either primary prevention or detection. Overall, we argue that self-protection against sexual abuse is a very complex process for any child and that few, if any, prevention programs are comprehensive enough to have a meaningful impact on this process. Finally, we discuss several untested assumptions that guide these programs. We conclude that it is unclear whether prevention programs are working or even that they are more beneficial than harmful. (PsycINFO Database Record (c) 2010 APA, all rights reserved)