HYPOTHETICAL QUESTIONS FOR CROSS EXAMINING MENTAL HEALTH WITNESSES IN SEX ABUSE CASES

By Michael Brock and Attorney Michael Trager

Recently I was asked by an attorney in another state to provide some potential questions for cross-examining mental health experts in a sex abuse allegation case.  The persons being interviewed were the treating therapist, whose recommendation was based solely on the mother’s allegation of abuse, and someone who had been hired to do an “extended” post-forensic interview.  Both of these tactics are still commonly employed by prosecutors or others involved in the forensic interviewing process when they are not happy with the evidence obtained through legitimate means.  The fact that this process of incorporating sexist and intentionally biased evidence into legitimate legal process is still routine should give anyone genuinely concerned about achieving due process for men accused of these crimes the willies.  It does me.  Of course, these represent possible questions and could be reworded or rephrased to suit the needs of the case.

QUESTIONS FOR TREATING THERAPIST:

1. What is your education and licensure?

2. What specific training have you had in the area of forensic mental health?  Sexual abuse assessment?

3. Do you know the ethics codes applicable to your licensure?

4. Are you aware of professional documents specifically relating to forensic practice (i.e., your state’s Forensic Interviewing Protocol; APA Standards of Forensic Practice; APA Guidelines for Conducting Child Custody Interviews, etc.?)

5. Do you know what a forensic interview of a child suspected of being abused is?  A forensic interviewing protocol? 

6. Did you do a forensic evaluation sufficient to make a parenting time recommendation?

7. Do you think it is ethical to make a parenting time recommendation for someone you have not evaluated?  Someone you never met?

8. What method did you use?

9. Do you know what the American Psychological Association has to say about it?[1]

10. Who was the identified client and what was your treatment diagnosis in this case?  (probably some mention of the as yet unsubstantiated abuse)

11. Prior to your recommendation that the child should have no contact with her father, what did she reveal to you?

12. Who and/or what were your sources of information prior to interviewing the child, that is, persons or documents, or both?

13. Based on what information did you conclude that the child had been abused?

14. Was it based on what the mother told you?

15. By what method did you assess the credibility of the mother?

16. Is that a proper basis to conclude that a child has been abused?

17. Do you know that there are statistically more false allegations of abuse in child custody/visitation cases per the forensic literature?[2]

18. How many cases of sexual abuse have you reported?

19. Have you ever handled a false allegation of abuse?  What you thought was a false allegation?  How would you distinguish between the two?

20. Did it occur to you in this case that the mother could be lying?  Why or why not?

21. If it turned out she was lying, you could have done irreparable harm to the child by severing contact with her father, correct?

22. Did you consider talking to the father before making that recommendation?  Why or why not?

23. Do you know that it is unethical to engage in dual roles with a client?  Perform both treatment and forensic roles with the same client? (Quote ethics codes and protocol that address the issue.)

QUESTIONS FOR THE EXTENDED INTERVIEW “TRAUMA EVALUATOR”:

1. What is your education and licensure?

2. What specific training have you had in the area of forensic mental health?  Sexual abuse assessment?

3. Do you know the ethics codes applicable to your licensure?

4. Are you aware of professional documents specifically relating to forensic practice (i.e., your state’s Forensic Interviewing Protocol; APA Standards of Forensic Practice; APA Guidelines for Conducting Child Custody Interviews, etc.?)

5. Do you know the difference between treatment and forensic functions?

6. What are the differences?

7. Do you know what a forensic interview of a child suspected of being abused is?  A forensic interviewing protocol? 

8. Do you know that it is unethical to engage in dual roles with a client?  Perform both treatment and forensic roles with the same client? (Quote both ethics codes and protocol if they address the issue.)

9. Do you know that accepted protocol based on forensic research involve only one session with the child?[3]

10. Do you know what model you were following in your “Trauma Evaluation?” (Connie Carnes, NCAC model, available on line).

11. Do you know that a forensic examination—one that is intended to produce evidence for the court—should attempt to be objective and neutral?

12. Do you think that the mother’s demonization of the father may have colored your view of him and made you more likely to believe the child had been abused?

13. Did the mother’s report of that the father had been sexually abused make you more likely to believe that he would be a sexual abuser?  Can you cite any studies that say any such connection, were it verified to be true; can ever be considered to be predictive?  (None exists: there is actually a higher correlation for people who have been physically abused.)

14. Did you ever doubt the information that was provided to you by the mother?  Did it ever occur to you that she could be lying?  Did you seek any independent confirmation of the information she reported to you?  Did you observe any of the serious symptoms that she reportedly had observed with the child?

15. Do you know of any studies suggesting that the child’s symptoms, as described by the mother, are predictive of a child who has been sexually abused? (None exist.)

16. Have you ever observed any bizarre behavior by this child?

17. You only have the word of the mother that the child “made herself sick” as a reason for withholding visitation, correct?

18. The doctor said there was no sign of abuse when the mother took the father to see him, didn’t he?

19. What was the result of the SANE (Sexual Abuse Nurse Examiner) assessment? (negative)

20. Why was The child taken for therapy? (Abuse investigation in disguise)

21. Do you think she was being questioned about abuse?

22. Had anyone made a finding of abuse prior to visitation being terminated?  So it was terminated on the report of the mother regarding the child’s alleged behavior?

23. How do you think a child would perceive such termination in a case where there was no abuse? (daddy must have done something wrong)

24. Would you, as a mental health professional, expect that as soon as visitation ceased, the child’s behavior would immediately normalize without treatment? (per mom it did)

25. Is it proper forensic procedure to let the mother stay with the child during a forensic interview? (no)

26. Did you allow mother to sit within earshot during the remainder of your ongoing forensic interviews, including bringing her boyfriend to the last session? (yes) what does the protocol say (no)

27. Did you videotape your sessions?  Take verbatim notes?  (no) Would it be in keeping with the highest forensic standards of practice to do so? (yes)

28. What does the forensic literature say about the use of anatomical dolls?[4] (They produce false positives, especially when used before there has been a disclosure.)

29. When you asked the child why she didn’t see her father anymore, she responded, “Because he hurt me.”  You asked the child “How?” and the child said, “I don’t know.”  Did you consider the possibility that the child’s response had been coached and that was why she didn’t have any specifics?

30. Did you ever consider as an alternate hypothesis during the course of your assessment, that mother could have an agenda of making these allegations to terminate the relationship of the father with the daughter?

31. During these interviews with the child you took more evidence from mother of continued decompensation—playing with her feces—when she had previously said the child had made a remarkable recovery when contact with dad was terminated.  Did you ever witnessed any of this regressed behavior?  Any extreme behavior on the child’s part?  Why wasn’t in the notes? (If she says the child running out of her office was extreme, point out that it is no where near what mother says she observed, and it is possible—in my view probable—that the child was reacting to the extreme pressure she was being put under by the trauma evaluator.)

32. Was there any independent verification of this behavior by anyone?

33. When “The child did not want to talk further about good touch, bad touch and “It again seemed that [the child] seemed to understand what was being asked, but refused to cooperate,” how did you interpret these behaviors?  Could it have been that the child felt she was being coerced to say something that she knew hadn’t happened?

34. Do you think that asking a child to “label each body part and state their function and whether anyone has touched them, hurt them, or made them feel uncomfortable on each part” is considered by many researchers to be very leading and inappropriate forensic technique?  (There is almost universal agreement that the best evidence is the child’s narrative.  Note the protocol enclosed based on the NICHD model, Michigan Protocol, and any other Protocol deemed scientifically valid, which probably says the same.)

35. Did The child deny being hurt or touched on most body parts?

36. When she did not want to talk about her “gina” or her “bum” how did you interpret her response? (evidence of guilt of the father)

37. Could she have been showing normal childhood embarrassment?

38. Later in the same paragraph, “The examiner again asked about being hurt and the child got agitated and denied that she had been hurt.”  Did it occur that you were asking very suggestive and leading questions repeatedly and that you were putting the child under a great deal of pressure?  What response were you looking for?  What did you expect the child to say?

39. Doesn’t the forensic research show that the more interviews and the more times you ask the same question, the more likely you are to get a positive response when questioning children?

40. To this point the child has twice denied that anyone has molested her in response to direct and leading questions.  How many times did the child deny being molested before finally giving you an affirmative response?  (Six times the child said no or refused to answer.)

41. What do children do when they are under pressure to supply an answer and they don’t have it? (They fish for it based on what they believe the adult asking the question wants to hear.)[5]

42. In session five, in response to your question, “Did daddy touch you?” she said she played the naked game with her brother and sister.  You asked her to explain.  Would you describe her response as fantasy?

43. You read, Something Happened to Me, and Speak Up, Say No!  to the child.  Was the purpose of reading these books about children who had been sexually abused to elicit a statement from the child that she had been abused by her father?  Does the impact of all this strike you as in anyway leading or coercive?  Can you imagine the pressure you were putting on this child?

44. Was “no” ever an acceptable answer to this interrogation process?

45. After the story was read, the child said she still didn’t know why her daddy hurt her; did she ever say how? (She ran out of the room)

46. At the end of the session The mother told you that The father had threatened the child with alienation from her extended family if she disclosed.  Was there any question in your mind that she might be lying?  How could you have explored that?

47. In the last session, number six, the child said, “I am going to tell you a long story about daddy hurting me.”  Why would she just walk in and offer that information, given that she had been so resistant up to this point?  Could she have been coached?

48. What do you say about the story that followed?  You said, “She went on with a story that didn’t make much sense.”  Would you say that she was in fantasy?  Would you say that was because she knew you expected a story from her and she didn’t have one so she was looking for a story that would satisfy you? 

49. You then said, “The examiner asked about the “gina” and the child said, “I don’t think so.”  What does I don’t think so mean?  Would you say that in normal conversation, even with a three and a half year old it means, “Probably not?”  Is that the ordinary meaning of that phrase?

50. You then say, “The examiner asked the child if she were sure or not sure.”  What message were you conveying to the child at that time?  When you ask a child a question repeatedly, aren’t you giving the child the message that her original answer was wrong?  Hasn’t every adult taught children with this kind of questioning?  What color is this Billy? Blue. What color? Red. Come on Billy; try really hard, what color? Yellow.  Yes!  It’s yellow!  Very good, Billy!

51. So the child finally gives you the only answer you were prepared to accept, “Yes, I’m sure he did,” but because she doesn’t recall any such touching, she is not prepared for the next question, “What did he touch you with?”  The child doesn’t want to guess wrong again; she wants the game over, so she asks you for the answer, and you give it to her, “His hand.”  Do you think it is right to provide answers for a child in a forensic interview where the answer will be used to determine the fate of the child’s relationship with her father?

52. Now let’s go back; whose model of investigation are you using here?  The only person that I was able to track down who recommends extended interviewing is Connie Carnes, are you familiar with her protocol? (provide her a copy).  She has a section called “Trauma Assessment.”  That’s what you called your interview, right? 

53. Do you know how many sessions Your state’s Protocol calls for?  (Probably one session, but be sure)

54. Do you know how many sessions Carnes recommends?  “The current NCAC protocol involves one session with the non-offending caregiver and five sessions with the child…”

55. At the beginning of the forensic interview, how do you know who is the non-offending caregiver?  Is it safe to say that the person making the allegation of abuse is assumed to be the non-offending caregiver?  So it’s a good idea to be fast on the draw?

56. So, is it fair to say that this model assumes there has been an offense?

57. Can we assume, since we are talking about forensic interviews of children suspected of being sexually abused, that the offense is sexual abuse?

58. Ms. Carnes also says, “Alleged offending parents are generally not interviewed in this model. Frequently, however, information obtained in the forensic evaluation is used by law enforcement to confront the alleged offender.”  So, then, it can also be assumed that we know who the alleged offender is, right?  Can we assume that would be whomever the non-offending caregiver—or since she is being more precise her—the non-offending parent says it is?

59. Doesn’t your interviewing model assume that there is an offense, a victim, a non-offender, and an alleged offending parent?  Is that proper forensic procedure?

60. And how do we know all this?  From the non-offending parent, who you presume is telling the truth, right?

61. Ms. Carnes also states that, “Forensic evaluation is a process of extended assessment of a child who is too frightened or young to be able to fully disclose his/her experiences in an initial forensic interview.”  So this model assumes that the reason the child did not disclose in the first interview is because the child was too young or too frightened, not because the crime didn’t happen, right?

62. She also says that, “The 8-session condition was significantly more likely to produce successful outcomes than the 4-session condition. Analysis of disclosure patterns in the 8-session condition revealed that 95.3% of new disclosures were obtained by the 5th session with the child. Only 51.2% of the new disclosures had been obtained by the 3rd session with the child.”  So a successful outcome is equated with disclosure, correct?  And therefore non disclosure is failure, right? 

63. Isn’t it true that both science and law have as their underlying goals to remain as objective as possible and ultimately, to arrive at the truth?  Would you say that Ms. Carnes is stating a position that is neutral, or one that assumes one outcome is to be desired and one not?  And that the outcome to be desired is the substantiation of the claim of abuse?

64. Yet even Ms. Carnes, despite her clearly discernable bias, has some misgivings about her method; hence she says, “With five child sessions, the likelihood of obtaining any available credible disclosure information is maximized, and the suggestibility risks of longer evaluations are minimized.”  How many sessions did you have with the child?  Six? When was disclosure made?  That’s right; it was on the 6^th visit. 

65. You stated that the child was “unable or unwilling to talk about any suspected abuse until the last session,” but isn’t it true that you talked about abuse, questioned her about it, read to her about it, throughout the entire course of this extended trauma evaluation, and that the child only agreed that something had happened to her as a result of being asked a direct and leading question and your unwillingness to accept her original response, and then she was unable to give you the simplest detail regarding how it happened; you had to provide that detail—that she had been touched with her father’s hand?

66. Are there any studies or legal decisions cited in the forensic literature that you are aware of that state children’s behavior is diagnostic of sexual abuse?[6]  Are there any that say it is not diagnostic?[7]

67. Have you read any of these studies?

68. Do you think it is right for mental health professionals to draw conclusions of law?

69. What do you think is the central principle of mental health forensic practice?  Would you agree with Mr. Brock (a mental health professional) and Mr. Saks (an attorney) who say that mental health investigations should track law, not vice versa?  Do you think that was done here?

70. Do you know that there are statistically more false allegations of abuse in child custody/visitation cases per the forensic literature?[8]

71. In “Disclosure of Child Sexual Abuse: What Does the Research Tell Us About the Ways that Children Tell?[9]” the authors conclude with regard to Ms. Carnes methods:

Suggestive techniques, especially when used by biased interviewers entail a risk of producing false allegations (e.g. Bruck, Ceci & Hembrooke 2002, Poole and Lamb 1998)…Our analysis clearly shows that when children who have been abused are questioned in a formal setting, they will usually tell, obviating the need for suggestive strategies.”

            Would you agree with this conclusion?