Forensic Interviews Regarding Child Sexual Abuse: A Guide to Evidence-Based Practice

Interviewing a child who reports sexual abuse can be daunting, given the significance of the interview in legal procedures. Also, the pressure to obtain the most accurate information from the child can be enough to overwhelm the most experienced interviewer. There are many nuances in the child's developing brain that make extracting credible information complicated. The intent of Forensic Interviews Regarding Child Sexual Abuse: A Guide to Evidence-Based Practice is to discuss the research supporting the multiple factors that have contributed to child forensic interview protocols and to review the evolution of best practices for conducting child forensic interviews. The book is meant to serve as a guide for the primary interviewer and as a valuable resource for anyone involved in the evaluation or care of a child who has been the victim of sexual abuse.

The book's editors are psychologists whose contributions to the field of mental health are vast and well known. William T. O'Donohue is an expert in human sexuality and advisor to the DSM-V work group on Sexual and Gender Identity Disorders. Matthew Fanetti, former director of the Forensic Child Psychology Certification Program at Missouri State University (Springfield, MO), developed a protocol for assessing child sexual abuse.¹ In this book, each of the 20 chapters is authored by experts in the topic of the chapter.

The book opens with an explanation of the history of multiple prior interview strategies that were used when interviewing children who were the victims of sexual abuse and describes how these strategies generally led to unsatisfactory criminal justice outcomes. Oftentimes these prior strategies led to the punishment of individuals later found to be innocent, with little or no objection (despite the seemingly bizarre allegations against them), or acquittal of predators for lack of evidence after the child's claims were entirely discounted. The remainder of the text can generally be regarded as encompassing five distinct themes: professional roles and responsibilities, factors influencing statement credibility, interview preparation and eliciting information from the child, information about select child forensic interview protocols, and the child interview in the context of the legal process.

The book explores the responsibilities of professionals within the multidisciplinary team who are involved in obtaining safety and justice for children. The roles discussed include those of police officers, Child Protective Services (CPS), psychologists, psychiatrists, medical doctors, prosecutors, and victims' advocates. The book explains the importance of the professionals' collaboration and how various roles overlap, influence, and potentially interfere with one another. For example, Kristen MacLeod explains that the general purpose of CPS is to ensure the child's safety, whereas law enforcement's responsibility is to determine the need for criminal investigation and charges. She describes how the two agencies can interfere with each other, because CPS investigations have stricter timelines than those of law enforcement, and therefore interfere with evidence and tip off prosecutors before law enforcement can adequately investigate for criminality.

The most pronounced theme in the book is a discussion of the factors that most significantly distort the veracity of the child's statement. These factors include the child's knowledge and intention to lie, the abusers' threats and suggestibility, the child's and caregiver's mental fitness, and the child's memory, whether real, false, repressed, or recovered. Of those, most authors highlight the child's memory as the most essential for the forensic interview, as it not only influences the verdict, but the prosecution relies heavily on the child's memory to determine court proceedings such as jurisdiction, charges, and ultimately, sentencing. The book details the effects of maturation and cognition on the child's developing mind. For example, in Chapter 5, Dwight Peterson and his coauthors discuss the emergence of episodic memory (the ability to remember specific events) and the associated neurobiology. Furthermore, they explain the development of the hippocampus as it relates to childhood amnesia and the other cognitive abilities that affect memory, such as language development, self-recognition, metamemory, and executive function.

Several authors also emphasize strategies to collect truthful information from the child efficiently. Principal components involved in eliciting of the truth while interviewing are developing a rapport, assessing the child's developmental level, continually ensuring the child's understanding, and staying neutral. The text also highlights the importance of getting children engaged with professional interviewers early in the postevent process and the need to protect children during the interview process to minimize the risk that other individuals or the public will unduly influence the child's account.

The book suggests using interview protocols created specifically to interview children who are the victims of sexual abuse. The purpose of using these protocols is to incorporate evidence-based techniques and provide a standard model for child forensic interviews in an attempt to limit opportunities for error. Three protocols are discussed: The National Institute of Child Health and Human Development Investigative Interview Protocol; the Rapport, Anatomy ID, Touch inquiry, Abuse scenario, and Closure (RATAC) forensic protocol; and the Step-Wise Interview. Olga Cirlugea and William O'Donohue discuss the heterogeneity of the interview protocols in regard to interrater reliability, component construct validity, predictive validity, incremental validity, sensitivity, specificity, developmental appropriateness, cultural sensitivity, and successful trainability. O'Donohue and Fanetti discuss the protocol they designed to determine reliability and validity of the interview called, “The Protocol for Evaluating Forensic Interviews of Children.” The book also offers suggestions for interview preparation, such as determining who will interview the child when in a multidisciplinary team setting, where and when to administer the interview, and which protocol to use.

Mark Kruger, a former assistant district attorney in Carson City District Attorney's Office and Lyon County District Attorney's Office in Carson City, NV, explains the variables prosecutors should consider to achieve justice in the case. He discusses the operative standards of a prosecutor set by the American Bar Association, their role in providing legal guidance to the multidisciplinary team, and the impact of the process on the victim. He details factors that influence the decision of whether to prosecute the crime, such as pressure on the prosecutor to charge, the time it takes to charge and make an arrest, the availability of collateral evidence, and the use of an expert witness. He further explains the way courts shifted away from using the forensic interview during the trial, because it was considered hearsay. Now, more children must testify and bear the risk of retraumatization.

Many authors stress the difficulty in obtaining justice in child sexual abuse cases. Especially considering that the child's recollection of facts is often the most critical piece of evidence in most instances, given that only approximately four percent of all child sexual abuse cases have physical proof. The difficulty lies in the prosecution's ability to prove beyond a reasonable doubt that the crime occurred with scant physical evidence and only the child's testimony. Various authors mentioned that although children rarely lie about being sexually abused, acquittals not uncommonly occur because the prosecution cannot meet its burden of proof.

The material in this book is robust, with a credible research backing. Experts in the field may find themselves gaining a wealth of knowledge regarding interview techniques and other contributing factors that may have seemed less significant in the interview process in years past. For example, many skilled interviewers consider the ways external elements such as suggestibility affect the child's statement. The book goes beyond merely explaining suggestibility as an influence, instead describing several ways that suggestibility is linked to the child's age, direct and indirect communication with the child, the timing of the interview, and interview methods, including the type of questioning and props used. Authors include very specific details to create the most cutting-edge body of work regarding forensic interviews of sexually abused children.

Each chapter is presented as an independent manuscript that may not be particularly related to other chapters of the book, and the book's organization can be viewed a couple of ways. The format is desirable for those who need ease in locating supporting information for a particular topic, because each chapter can stand alone. However, when reading cover to cover, the reader may notice that the book is redundant at times, and some chapter content can appear misplaced. No clear overarching organizational structure ties one chapter to the next, and each of the book's 20 chapters seems to stand alone, as the previous section is often unrelated. At times, a topic covered in one chapter would be detailed again in another, sometimes with contradictory interpretations of the same content. For example, suggestions for interview preparation are described in Chapters 4, 7, 10, 11, and 12.

A notable omission was a more detailed discussion of the actual interview process itself. It might have been helpful to introduce the protocols, then explain the interview tactics in conjunction with the protocols to help build the foundation for conducting an interview. Instead, a description of the protocols and discussion about the characteristics that make for high-quality protocols did not occur until Chapter 13, although one author referenced one of the protocols in an earlier chapter without significant detail. By discussing the research supporting particular interview techniques, independent of the protocols themselves, the book did not avail itself of a stylistic opportunity that could have attracted more readers.

The structure of information varies within each chapter, which is expected to some degree, given that each chapter was written by a different contributing author. The more constructive chapters allowed for a natural flow of information by separating the text-appropriate sections and using more basic language for ease of understanding. Also, the subject matter of the chapter was relevant and interconnected with the book's purpose. Less constructive chapters abandoned the topic of the chapter to supply detailed information about other elements of the forensic interview that were covered in another chapter. Overall, the content could have been more optimally organized.

The book is suitable for all psychiatrists involved in interviewing child victims of sexual abuse, but particularly for child and adolescent and forensic psychiatrists. It is a sufficient resource to enhance professional education and to reference for further research. However, these basic details are not covered and someone with minimal expertise in this arena may need additional background information for developing rudimentary child forensic interview skills before picking up this book.

Overall, the content of the book provides a significant body of research and historical data that could be of value for everyone in the field. The text was not focused primarily on the forensic interview administration, but it is more concentrated on the importance of a credible interview, the effects of the environment and the child's development on the report, and the weight of the interview on judicial outcomes. By providing a broad base of material, the authors portray the bigger picture, outlining the importance of every interaction and every professional involved.

• © 2018 American Academy of Psychiatry and the Law