National conference highlights that repetitive interviewing of children by various agencies where sexual abuse is a concern can contaminate the child’s story

At a joint Temple Street Children’s University Hospital and Our Lady’s Children’s Hospital Crumlin (OLCHC) conference today, it was confirmed that potentially repetitive interviews of children where sexual abuse is a concern by various agencies have to be avoided. Delegates were advised that this can result in potential contamination of the primary account of the story, inconsistencies that could be a function of interviewing style and questions posed, that can further undermine the credibility of a child’s account and frustrations and added trauma on children who do not understand why they need to talk about the same things over again. The annual conference organised by St Clare’s Unit, Temple Street and St Louise’s Unit, OLCHC was attended by 125 professionals working in the area of child and adolescent mental health, social work, child protection, criminal justice, specialist services, foster care and residential care. The Units at Temple Street and OLCHC offered 5,200 appointments (for assessment and therapy) to families and children where child sexual was a concern in 2013.

Today’s conference titled ‘What Do I Need to Know? Navigating intimate boundaries & privacy in children’s lives’ focused on how professionals working in the area of child sexual abuse can improve processes for children caught up in the various professional systems designed to respond to child sexual abuse (CSA) concerns. The conference also explored how professionals can address the complexities involved in meeting divergent professional obligations in order to provide a sensitively attuned response to children and families.

Conference delegates also heard that when interviewing a child where child sexual abuse is a concern;

• It is vital to obtain the child’s own narrative account with as little direct questioning as possible during the first phases of an interview.
• Direct questioning can be used at a later stage of an interview process – if information has arisen that warrants further clarification
• Best practice indicates that a child should be interviewed by one interviewer who is trained in the area, and that the content of the interview can be used for multiple purposes (i.e. Child Protection, Investigative and Mental Health).
• If further interviews are required by another agency, that agency should incorporate what content has already been generated and define the other areas of inquiry they need to explore with the child.
• Supervision, evaluation and ongoing training of professionals conducting these interviews are a requirement for best practice.

Speaking in advance of the conference, Keith O’Reilly, Interim Director, St Clare’s Unit, Temple Street said “Before interviewing a child where child sexual abuse is a concern, it is important to consider what supports the child requires and that their own wishes and concerns in relation to the process are taken into account.  During the interview it is vital to assess the impact that the abuse / process has had on the child and family and to conduct an interview in a manner that meets the presenting needs of the child. It is also of vital importance that there are sufficiently robust and clear structures in relation to inter-agency working and oversight from the time of disclosure through to the completion of the process to ensure that the child’s needs are kept to the forefront.”

Also speaking in advance of the conference, Rhonda Turner, Principal Clinical Psychologist, St Louise’s Unit, Our Lady’s Children’s Hospital Crumlin (OLCHC) said “The two units at OLCHC and Temple Street are particularly concerned about finding a balance that shares children’s information appropriately between the agencies involved; but is also respectful to the need to protect their privacy. An example of an area that is still under review and would benefit from legislation is the legal system’s interest in child therapy notes where there are named criminal proceedings. If release of therapy notes must occur, for the sake of a fair trial, legislation could allow that a Judge decide whether the material in question should be disclosed to the Defence and Prosecution.  The Units, along with other agencies such as CARI and the RCC, will continue to advocate on this and related issues.”

For further information and/or to organize an interview please contact Jane Curtin, Temple Street Children’s University Hospital. Tel.: 087 938 0779

Editor’s note

St. Clare’s Unit, Temple Street Children’s University Hospital and St. Louise’s Unit, Our Lady’s Children’s Hospital Crumlin (OLCHC)

The units at Temple Street and OLCHC were established in 1988 to provide an assessment service for children and families where child sexual abuse was a concern and the therapy services followed in 1996 with St Louise’s Unit and with St Clare’s unit in 1998.  The units provide both Assessment and Therapy services to children and families who live in Dublin City and County, Co. Kildare and Co. Wicklow.

The units were established in paediatric hospitals as it was felt that this would provide for a child sensitive environment with appropriately trained personnel available to conduct such assessments.  From the outset, the units determined that the assessments carried out would be therapeutic in nature and forensically valid.  Since 1988 other such units have been established throughout the country, primarily based in community care settings under the auspices of TUSLA, also known as The Child and Family Agency, which is the statutory agency for Child Protection in Ireland.

When a child makes a disclosure of child sexual abuse, an initial referral is made to the local TUSLA Social Work Department.  The Social Work Department subsequently conducts an initial assessment and makes a determination as to whether or not to refer this child to a specialist child sexual abuse service such as St. Louise’s Unit or St. Clare’s Unit.

Assessment Service

The Units accept referrals pertaining to children when there are grounded reasons to be concerned that the child may have been sexually abused; which have been notified to statutory services and who reside in the catchment area.  The primary objective of these assessments is to provide an opinion on the probability of the occurrence of child sexual abuse. A secondary objective is to facilitate onward referral to an appropriate service where necessary. This involves forming a preliminary opinion in relation to therapeutic need.

Assessments include interviews with all relevant adults who are in or have been in a caring role, the child themselves, and feedback to the significant adults involved as to the outcome of the assessment and recommendations. The assessments are considered therapeutic in orientation and forensically defensible; but we do not consider our work to be primarily forensic in nature.

In cases where children have been found to have provided a credible account of sexual abuse, the case may be referred to the therapeutic service within St. Louise’s Unit/St. Clare’s Unit or the case may be closed to the unit but may be referred on for further intervention elsewhere.  In other cases, they may be closed to the units, however onward referral to other agencies may be identified if there are ongoing needs for the children and/or family.

Therapy Service

The units offer a range of therapeutic interventions to both children and families deemed in need of this service where sexual abuse has occurred.  This range includes individual therapy, group therapy and family therapy.  Supportive work with parents, caregivers, foster parents, siblings and other family members is also provided as appropriate.  The therapeutic service is needs driven and as such the range of interventions and approaches taken may vary from time to time. These include humanistic and integrative approaches, play therapy, art therapy, psychoanalytic psychotherapy, family therapy, child-parent work and filial Therapy.

The work of the two units often involves ongoing interaction with the criminal justice system, family law and child protection services.  It is within these three areas that the units feel further cooperation and interagency working should be improved.  Over the last number of years, the Gardaí have had the facility to access specialist child interviewers to take the child’s statement (TUSLA refer all cases of suspected child abuse to An Garda Siochana and they carry out their own investigations).  Unfortunately to date there is no co-ordination in these interviews meaning that a child often has to tell their story to a number of different professionals.  This is a matter that we are interested in and the units continue to strive for integrated work practices for the benefit of children and families affected by CSA.