The Clinical–Forensic Dichotomy in Sexual Abuse Evaluations: Moving Toward an Integrative Model

Abstract

We propose the use of an approach to evaluation that can be undertaken in a clinical setting when concerns regarding child sexual abuse are unclear or ambiguous and other systems are not involved, thus providing an option for the nondisclosing child often discussed in the "delayed disclosure" literature. This approach can also be appropriate for a child with a questionable prior disclosure not being served by other intervention systems. We have labeled this an "integrative" model, incorporating forensically sound practices into evaluations conducted in a clinical setting. The goals of this manuscript are to (a) provide a rationale for conducting child sexual abuse extended evaluations in a clinical setting, (b) delineate the purposes of such evaluations, (c) differentiate this "integrative" model from the forensic-clinical dichotomy framework discussed by Kuehnle (1996), and (d) briefly describe the format, which can be refined by future practice and research.

Views of the Crawford University Work Place Community on Sexual Harassment

“…It may also lead to further victimization, and lodging complaint may further the psychological trauma (Dumond, 2000 and Naik et al, 20100. Hence, many victims of sexual harassment normally delay in telling others about their experiences (Tishelman et al, 2010).…”

Is There a Place for Extended Assessments For Evaluating Concerns About Child Sexual Abuse? Perceptions of 1,294 Child Maltreatment Professionals

“…However, an important next step is to systematically identify models that have been developed and/or are currently in use. A number of models are emerging (Everson & Sandoval, 2011;Faller, 2007;Patterson & Pipe, 2009;NCAC, 2011;Tishelman et al, 2010). There are models that focus primarily on the child and models that include several child sessions but also involve the whole family.…”

“…Nevertheless, there is increasing recognition in the child maltreatment field that there are cases and situations in which a single interview does not adequately address concerns about sexual abuse (Faller, Cordisco-Steele, & Nelson-Gardell, 2010;Tishelman, Meyer, Haney, & McLeod, 2010). A number of studies indicate that approximately a fourth to a half of children identified by professionals as possibly sexually abused do not disclose in a single interview (Carnes, Wilson, & Nelson-Gardell, 1999;Hershkowitz et al, 2005;Hershkowitz et al, 2006;Lawson & Chaffin, 1992;London, Bruck, Ceci, & Shuman, 2005;Lyon, 2007).…”

Child Sexual Abuse: Demography, Impact, and Interventions

“…There is a need for rigorous comparative field and laboratory work about protocols and guidelines such as the Narrative Interview, the Cognitive Interview, anatomical dolls, and anatomical drawings (Brown & Lamb, 2009). For nondisclosing or reluctant children in otherwise corroborated CSA cases, research in Israel and the United States has now demonstrated that more than a single interview may be essential, but protocols for repeated interviews have yet to be fully developed and tested (La Rooy, Lamb, & Pipe, 2009;Tishelman, Meyer, Haney, & McLeod, 2010). The National Child Advocacy Center (NCAC) has developed and field tested a six-session model for such children, and this NCAC model is currently being updated and researched (Carnes, Nelson-Gardell, Wilson, & Orgassa, 2001;Carnes, Wilson, & Nelson-Gardell, 1999;Faller, personal communication, June 24, 2010;Kuehnle & Connell, 2009).…”