Helping children to speak out about being abused

The introduction of electronic recording of Garda interviews has helped in the assessment of children who may have been sexually abused because it can reduce the number of interviews a child gives to different agencies about the abuse.

That’s according to Rhonda Turner, principal clinical psychologist and co-coordinator of the assessment service at Our Lady’s Children’s Hospital Crumlin (OLCHC) and Keith O’Reilly, interim director of the assessment unit at Temple Street Children’s Hospital.

The units assess children living in Dublin, Kildare and Wicklow, aged three to 18 years, who are referred by Tusla as they may have been sexually abused.

Stay Safe

Turner and O’Reilly also say the Stay Safe programme in primary schools is encouraging children to come forward and talk about abuse.

O’Reilly says that the Stay Safe programme tries to give children a message about what is right and wrong. “We have had significant numbers of children that it has helped to think about it and talk about it; to say that it is okay to talk about it,” he says.

“A lot of coverage that is out there is around the ‘stranger danger’ aspect of sexual abuse but the vast majority occurs in a context where the child knows the person who sexually abuses them, whether it is family or somebody in a caring role.

“A child might have a good relationship towards a person and might have positive feelings towards a person but obviously not have positive feelings around the abuse. It can be a very complex process.”

Therapy for children

Sixty-five children attended St Clare’s unit in Temple Street for assessment and 106 attended for therapy in 2013. There is some overlap as some children are referred to therapy following assessment.

St Louise’s Unit in OLCHC was attended by 279 children in 2013, of those, 159 were new referrals.

Turner says, “Our first primary role is [one of] assessment; to provide an independent opinion as to whether or not we think sexual abuse has occurred. We are not a court. We are not a judge.

“We don’t view every single case as ‘a child said it; we therefore must believe it.’ We do our homework first, trying to arrive at ‘Does this makes sense?’

According to Turner, there are times when children say things to get attention or for other reasons, but a lot of the cases that she sees are confirmed as involving abuse.

If the concerns are confirmed then the teams make recommendations on how to best to help the child and the family. In cases where it is not confirmed, because the units provide mental health therapeutic services, they will look at why the allegations would have been made.

They consider whether the child is experiencing other difficulties such as family separation, bereavement or bullying at school.

They are also aware that sometimes children may not talk about the abuse even though it has happened.

O’Reilly says, “Some children may still not feel ready to disclose their experiences. [So] there are a range of outcomes to an assessment. It might be that it is a credible account. It might be that it is not credible. It might be that it is inconclusive or the child has not said anything. Or we just don’t know. It is not straightforward sometimes.”

Both are aware that children may not tell them everything. “We are looking for the subtle signs in the interview,” says Turner. “Thankfully, most children are not very good at lying and they give us leaks and other little signs.”

Parental response

When a child does disclose abuse, the response of parents is important. O’Reilly says that parents should take time to listen to the child and to support them. It may be best not to ask too many questions initially so as not to put them under too much pressure.

It’s also important not to be too quick to dismiss stories of abuse as being untrue.

Turner says international research shows clearly that children who have been abused do better afterwards if they are believed and supported by their parents, and if they do not have to keep the secret to themselves for too long.

Speaking out is encouraged by the Stay Safe programme. Turner says, for example, that two girls in a sixth class spoke about abuse that had happened when they were younger. They did not know what had happened was wrong until they had found out at school.

O’Reilly says, “We have had significant numbers of children that it has helped to think about it and to talk about it. To say that it is okay to talk about it.”

Many agencies

Children being interviewed by different agencies about their abuse is of concern to both of them.

Turner says the issue “is trying not to ask unnecessarily repetitive questions of a child without due consideration and bearing in mind the impact on the quality of information when we have to ask repetitive questions”.

She says the system can be made a more seamless process for everyone if the agencies who must interview a child for their roles and functions share that information.

In this way, it would be less likely that the child would be asked the same questions repeatedly by different people.

“With pre-planning it is quite do-able.”

Electronic recording

The introduction of electronic recording of Garda interviews has been a wonderful development in trying to make the services work better for children, she says.

O’Reilly says relevant experience and skill in an interviewer is important because there is a risk that poor interview skills could lead to a false conclusion that the child may or may not have experienced abuse.

Both say that children are resilient and some of their work is with parents and helping them to understand what has happened and how it has affected their child.

Turner says, “It certainly can be very helpful for them to understand the strengths of their child.

“Some parents are very concerned that their child is ‘ruined’ or ‘damaged’ by what happened and we are able to give them other information to help them balance that, [and see] that no, [their life] is not over and [this] isn’t the end.”