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The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 1
Liar, Liar, Pants on Fire:
Understanding Expert & Victim
Testimony from a Mental Health Perspective
Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S
Learning Objectives
Identify 2 dynamics that occur during sexual abuse which make the behavior of child witnesses counterintuitive
Identify 2 short- or long-term psychological consequences for victims who testify in legal proceedings
Identify 3 areas to explore when questioning qualifications of a therapist
who is serving as an expert witness
Sexually Traumatized
Children
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 2
Sexually Traumatized Children
Highly diverse population with varying risks for mental health problems
Victim characteristics & abuse characteristics influence risk factors
Sexual abuse is usually not the only trauma sustained
Psychiatric comorbidity is common
(Saunders, 2012)
Sexually Traumatized Children
The nature & dynamics of sexual abuse & sexually abusive relationships are often traumatic (Hall & Hall, 2011)
Avoidant coping is problematic because it
masks symptoms (Saunders, 2012)
PTSD symptoms, internalizing problems, & externalizing problems,
are the most common effects (Trask, Walsh, & DiLillo, 2011)
Interventions & supports are needed before, during, & after testimony (Quas & Goodman, 2012)
Understanding the Impact of
Trauma
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 3
Impact of Trauma
Adverse Childhood Experiences (Anda, 2013)
Neurobiological impact (Perry, 2013)
Evidence-based treatment
Trauma-informed practice (Steele & Malchiodi, 2012)
How ACEs Play Out
Compared to someone with an ACE score of 0, those with an ACE score
of 4 or more are: Twice as likely to be smokers
7 times more likely to be an alcoholic
10 times more likely to have injected street drugs
12 times more likely to have attempted suicide
Dynamics of Child Sexual
Abuse
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 4
Child Sexual Abuse Accommodation Syndrome
Secrecy
Helplessness
Entrapment & accommodation
Delayed disclosure
Retraction
(Summit, 1983)
Traumagenic Dynamics Model
Traumatic sexualization
Betrayal
Stigmatization
Powerlessness
(Finkelhor & Browne, 1985)
Severe Trauma Factors
Disastrous response to disclosure
Distorted offender identification
Distorted victim identification
Sexual responsiveness
Terror (anticipation)
Footprints (coping skills)
Withheld report
Under age 12
Trauma bond
(Hindman, 1999)
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 5
Impact of Testifying
Impact of Testifying
Findings on the impact of testifying are mixed & complex
Empirical research largely supports that testifying is harmful
However, under certain circumstances, testifying may also be beneficial
Reactions to testifying are shaped by a complex interplay of multiple variables
(Quas & Goodman, 2012)
Predictors of Mental Health
How many times the child testifies
Corroborative evidence
Maternal support
Severity of the abuse
(Quas & Goodman, 2012)
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 6
Predictors of Mental Health
Delays & continuances
Repeated interviews
Verdict/outcome of case
Age
(Quas & Goodman, 2012)
Predictors of Attitudes
Case outcome
Testifying
Abuse severity
Number of interviews
Child’s age
(Quas & Goodman, 2012)
Caveats to Findings
Findings are based on research to-date
Research remains limited with unintegrated findings
Generalizability is questionable
Supports, safeguards, accommodations & interventions are essential
Need more systematic studies
(Quas & Goodman, 2012)
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 7
Findings
Children should be involved in criminal proceedings
Uniform bans on children testifying are unrealistic & overly simplistic
No study has demonstrated legal involvement causes trauma which warrants full exclusion of children
Negative consequences related to testifying can be avoided or reduced
(Quas & Goodman, 2012)
Findings
Children can provide testimony without significant long-term harm
Some involvement may be beneficial
Children should be informed of the case outcome
Legal accommodations should be case-by-case
Professional collaboration may reduce trauma
(Quas & Goodman, 2012)
Testimony from Mental Health Professionals
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 8
Mental Health Testimony
Broad category of professionals
Scope of practice
Continuum of care/services
General questions
Specific information pertaining to expertise
Scope of Practice
Masters degree
License to practice
Continuing education
General practice vs. specialzing
Scope of Practice
A license to practice therapy does not qualify a professional to work with cases of sexual abuse
An “expert” in one area of mental health does not make someone an “expert” in other areas
Once an expert, not always an “expert”
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 9
Forensic vs. Therapeutic
Forensic Therapeutic
Purpose to discover truth
Procedures governed by laws & courts
Supportive but neutral
Alternative explanations explored
Details crucial
Purpose to promote well-being
Procedures governed by research & standards of practice
Advocates for child
Subjective reality accepted
General idea of abuse is enough
(Wolf, 2006; Based on conceptualization by Melissa Steinmetz)
Forensic Therapeutic
Verbal disclosure required
Techniques in which information is obtained are
critical to outcome
Generally, only 1 or 2 interviews are considered forensically acceptable
Nonverbal is enough
Techniques may or may not influence outcome
Process unfolds over longer period of time in successive sessions
(Wolf, 2006; Based on conceptualization by Melissa Steinmetz)
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 10
Important Questions
Fullest extent?
Professional license history & status?
Pending action?
Disciplinary review?
Denied professional or hospital privileges?
Important Questions
Denied or canceled professional liability insurance?
Renewal been refused or surcharged because of claims?
Malpractice claim, investigation, or lawsuit?
Resigned or been asked or resign?
Important Questions
Sanctioned by Medicare or Medicaid?
Convicted of any crime?
Chemical dependency and/or substance abuse problem?
Under the influence during working hours?
Additional information?
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 11
Important Questions
Recent & specific continuing education?
Professional organizations?
Journals?
Supervision, consultation?
Published?
Instructing, teaching, lecturing, etc.?
Questions & Answers
Summary & Closing Remarks
The 21st Annual Children’s Law Institute/Liar, Liar, Pants on Fire
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S 12
noziska@iinet.com
Thank-You
Copyright 2014, Sueann Kenney-Noziska, MSW, LISW, LCSW, RPT-S Page 13
References
Anda, R. (2013, April). Adverse childhood experiences and their relationship to social function & disease. Session presented at the Child Abuse & Family Violence Summit, Portland, OR.
Finkelhor, D., & Browne, A. (1985). The traumatic impact of child sexual abuse: A conceptualization. American Journal of Orthopsychiatry, 55, 530-541.
Hindman, J. (1989). Just before dawn: From the shadows of tradition to new reflections in trauma assessment and treatment of sexual victimization. Ontario, OR: AlexAndria Associates.
Kenney-Noziska, S. (2008a). Techniques-techniques-techniques: Play-based activities for children, adolescents, and families. West Conshohocken, PA: Infinity Publishing.
Kenney-Noziska, S. (2008b). The sexual abuse literature & considerations for play therapists. Association for Play Therapy Mining Report, October 2008, 1-3. Clovis, CA: Author.
Kenney-Noziska, S. (2010). A strengths-based approach to working with abused & traumatized children. In D.A. Crenshaw (Ed.), Reverence in healing: Honoring strengths without trivializing suffering (pp. 123-135). Lanham, MD: Jason Aronson.
Kenney-Noziska, S., & Lowenstein, L. (in press). Play therapy with children of divorce. In D.A, Crenshaw, & A. Stewart (Eds.), Play Therapy: A comprehensive guide to theory and practice. New York, NY: Guilford Press.
Perry, B. (2013). Helping children recover from trauma. Washington, DC: National Council on Behavioral Health.
Quas, J.A., & Goodman, G.S. (2012). Consequences of criminal court involvement for child victims. Psychology, Public Policy, & Law, 18, 392-414.
Saunders, B.E. (2012). Determining best practice for treating sexually victimized children. In P. Goodyear-Brown (Ed.), Handbook of childhood sexual abuse: Identification, assessment, and treatment (pp.173-197). Hoboken, NJ: John Wiley & Sons, Inc.
Steele. W., & Malchiodi, C.A. (2012). Trauma-informed practices with children and adolescents. New York, NY: Routledge
Summit, R.C. (1983). The child sexual abuse accommodation syndrome. Child Abuse & Neglect, 7(2), 177–193.
Trask, E.V., Walsh, K., & DiLillo, D. (2011). Treatment effects for common outcomes of child sexual abuse: A current meta-analysis. Aggression and Violent Behavior, 16(1), 6-19.
Wolf, M. (2006). How it happens: Understanding dynamics of sexual abuse. Unpublished presentation. Corona, CA.
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