True and False Allegations of Child Sexual Abuse: Assessment and Case Management

True and False Allegations of Child Sexual Abuse: Assessment and Case Management. Edited by Tara Ney. New York: Brunner/Mazel, 1995. 396 pp. $45.95.

Tara Ney has compiled a collection of careful research, sober thinking, and straight talk about the limitations and realities of searching for the truth of child-sexual-abuse allegations. Each contributor to this volume speaks compassionately yet matter of factly about the subtle traps and false assumptions that can endanger a child or falsely label an alleged offender. The authors, all of whom are members of the mental health or legal profession, present research findings to the practice community, translating their findings into specific practice recommendations.

The book is intended for professionals already familiar with basic interviewing techniques with alleged sex-abuse victims. The authors advocate a conservative approach to drawing conclusions and are cautious about generalizing from much of the research. For this reason, the book may be frustrating for child advocates who are looking for undeniable validation of their beliefs. While reminding us that this field has no room for absolutes, the authors increase our confidence in our skills by encouraging assessments that evaluate all possible explanations for statements and behaviors. Tools and steps for discerning the validity of allegations are discussed. When the truth cannot be found and evidence indicates that the child is still at risk, the authors advocate case management techniques for providing services and ensuring child safety.

The first two chapters attempt to capture the essence of the issues brought out in the rest of the book, but the book's real value is evident in the four sections that follow: Child Development Issues, The Interview, Assessment Issues, and Legal and Ethical Issues.

In the section on child-development issues, the authors carefully dismantle the misconceptions and assumptions surrounding each issue, then piece together research-based practice recommendations and questions that need to be answered in the assessment process. Readers are led first through an exploration of the meaning of children's behaviors during an evaluation then through a description of the research on the capacity of children at different ages to distinguish truth from lies and on the forces that influence that distinction. Research clarifying the memory process at different developmental stages is reviewed, and how very young victims communicate their abuse and how adolescent development shapes allegations are discussed. Considerable overlap across the chapter discussions and recommendations confirms the soundness of the authors' recommendations.

The section on interviewing begins with a discussion on how language development of children can lead to misrepresentations and misunderstandings by both children and adult interviewers. The message sent does not always coincide with the message received. Two chapters in this section describe content analysis and an interview protocol, both of which are more suited for adult interviews and have cautionary value when used with children. A fascinating discussion of the influence of therapists in uncovering repressed memories of abuse in adults and older children is presented.

The last two sections present assessment issues while offering recommendations for case management. The authors speak to the difficult assessment and practice issues that arise in the professional evaluation. One chapter sorts through allegations that occur in the midst of child-custody disputes, discussing the potential dynamics of adults making allegations on behalf of a child. Another chapter clarifies the minimal importance of medical examinations in child sexual abuse, arguing that decisions be based on the social information gathered apart from a search for physical evidence. Two chapters similarly argue that physical examinations be considered as part of the evaluation but not as the defining test of the truth of an allegation. Authors describe the strengths and limitations of the phallometric assessment and categorize family dynamics in child-molestation situations. The section concludes with chapters on the special issues that arise when a victim has disabilities and when the abuse is part of a ritual. One argues for the need for further research to help practitioners assess difficult cases.

The final section on legal and ethical issues makes recommendations regarding legal and safety issues for child witnesses and points out the tendency of therapists to underreport sex-abuse allegations to child protective services while serving as professionals most likely to testify the most in court.

This volume is rich in practice wisdom and should be on the shelf of every sex-abuse evaluator.

Copyright Family Service America Apr 1996
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