PSYCHOLOGICAL ASSESSMENT MANUAL
TABLE OF CONTENTS

PSYCHOLOGICAL ASSESSMENT……………………………………………………1

PRE-ASSESSMENT PHASE…………………………………………………………..4

ASSESSMENT PHASE…………………………………………………………...... 5

POST-ASSESSMENT PHASE…………………………………………………………10

THE IMPACT OF TRAUMA EVENTS ON CHILDREN...... 14

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PSYCHOLOGICAL ASSESSMENT

The discipline of psychology is extremely broad in its attempt to understand individual and social functioning from a psychological perspective. The use of expert psychological evidence in court cansignificantly influence the outcome of a case and have a direct or indirect impact on the individuals involved and society in general(Gudjonsson 1998).

DEFINITION

What is a psychological assessment?

A psychological assessment is a general process whereby clinical or any other types of data or observations are used in a hypothetico-deductive process of problem solving(Cohen Malcolm2005:72).

There are many methods of psychological assessment and many approaches to gathering information. The general approach to data gathering includes a combination of clinical interviews, psychometric testing, observational methods, interviews with informants, and background materials which are eventually integrated to form the expert opinion.

In the context of sexual abuse cases, the psychological assessment that has to be conducted depends on the psychological questions posed by the court for purposes of cross-examination; in this instance the psychological assessments are aimed at determining the victims’ mental age as opposed to their chronological age, the capacity to testify with regard to an alleged crime and the impact of the trauma on the victims.

SPECIALIST QUALIFICATIONS

Only a registered psychologist with a master’s degree trained in the field of sexual abuse and, more specifically, having undergone forensic training, not necessarily certification, may conduct such psychological assessment. The above categories of persons should have worked in the field of child abuse for a minimum period of one year.

Where does the assessment process begin?

Psychological assessments form the basis of court proceedings as expert evidence which can be used during trial, before sentencing and at the appeal stage(Allanet al. 2005).

The process begins when a child/victim is referred to a psychologist for psychological assessment by the court, more specifically the prosecutor requesting mental age assessment, criminal capacity, capacity to stand trial or the victim’s capacity to testify and how this has impacted on the victim (for the purposes of sentencing). The information is assimilated into a report which forms the foundation for evidence given in court for court proceedings. The process begins with a referral and ends with expert testimony by the psychologist.

REFERRALS

Victims of sexual assault are often referred by the following sources:

  • The Child Protection Unit or FCS (Family violence, Child protection and Sexual offences) unit
  • The court, more specifically the prosecutor
  • The family advocate’s office (parental rights and responsibilities)
  • Welfare societies and other non-governmental organisations
  • Private mental health practitioners (psychologists, social workers, trauma counsellors, youth and child care workers) not equipped in this field
  • Internal referrals during the course of therapy or other supportive services being rendered
  • Medical practitioners (in private practice)

Please note: From the referral we begin the assessment process.

THE PROCESS OF PSYCHOLOGICAL ASSESSMENT

The process of psychological assessment for the court comprises three levels, namely the pre-assessment phase, the assessment phase and the post-assessment phase. Each phase places a different demand upon the psychologist and raises specific professional, ethical and practical issues.

PRE-ASSESSMENT PHASE

It is important for the psychologist in the pre-assessment phase to be clear about the referral question and the psychological evidence being requested.

QUESTIONS TO BE ASKED

What has happened?

Who is involved?

Who needs to be interviewed?

What is expected of the psychologist?

By when is this needed?

Who is the referee?

Why has an assessment been requested?

GATHERING BACKGROUND INFORMATION

Interviewing the parent,caregiver or guardian

A structured questionnaire is completed with the parent/caregiveror whoever is able to furnish the necessary information. A standard intake process is necessary.

Parents are interviewed separately with the child to establish the child’s background information with regard to birth history and developmental milestones. This information is essential, especially when assessing children with special needs because it can be indicative of the extent of cognitive handicap.In addition,the child’s interests, hobbies and activities are explored to gain a deeper understanding of the child’s functioning and context.

During the interview,situations are explored that could have placed the child at risk of being a victim as well as the possibility of further trauma and secondary victimisation. If the risk factor is identified, it ishighlighted. Intervention aimed at minimising further abuse is provided. Although the focus is on the assessment, the child’s best interests must be considered at all times and, if necessary,the child must be referred immediately for therapeutic intervention.

Behaviouralmanifestations that present after the sexual trauma has been established include those identified at home and at school. During the interview, the evaluator also establishes anyform of regression, whether it beemotional, behavioural and/or scholastic.

ASSESSMENT PHASE

There are many methods of psychological assessment and techniques of gathering psychological information. The assessment process includes the therapist’s clinical observations, qualitative impressions and psychometric tools. The following assessment tools are used:

COGNITIVE ASSESSMENT: RAVEN’S COLOURED MATRICES (STANDARDISED TEST)

This is a cognitive assessment tool comprising diagrammatic puzzles that reflect figures or patterns. Each puzzle has a piece missing which the testee must find among six to eight alternatives presented. Test items require the testee to infer a rule relating to a collection of elements and then to use the rule to generate the next items in a series or to verify that a presented element is legitimate relative to the rule.

Problems become progressively more difficult, the easier items serving as learning experiences for later and more difficult items. Thus, the test has been used to assess intellectual efficiency or the ability to become more efficient by learning from immediate experience with the problems.

The purpose of this test is to assess reasoning in the visual modality. It is a popular measure of conceptual ability because responses require noverbalisation, skilled manipulative ability or subtle differentiation of visio-spatial information (Alderton Larson 1990).

The outcome of the testee’s performance is determined by following a grading system in which grade one indicates intellectual superiority and grade five, which is the final grade, indicates intellectual impairment.

PROJECTIVE ASSESSMENT: DRAW-A-PERSON TEST (DAP) (STANDARDISED TEST)

This procedure is based on Karen Machover’s(1994) experience with the Goodenough technique for assessing children’s intellectual capacities. She expanded on the use of the human figure drawings as a technique to explore aspects of personality and self. The child is provided with a sheet of paper and a pencil and is asked to “draw a person”.The DAP test is considered to be a useful and non-threatening way to gain access to information about the child’s conflicts, wishes, fantasies, defences and personal adjustment(Orton1997:264).

This procedure provides a lot of information about how the child sees himself/herself.For example, if a male child is confused about his sexual orientation, this child may project a female in his drawing. However, the information elicited needs to be explored and verified with the use of other techniques as well.

It is important to note that while it is standardised, it is also unstructured and allows the psychologist and the client a lot of leeway to explore and respond.

The Draw-A-Person test (DAP) is used to represent cognitive development, and perceptual and visio-constructive difficulties associated with certain types of brain damage. It is used to estimate a person’s cognitive abilities as reflected in the quality of drawings the individualproduces (Groth-Marnat 1997:500).A scoring sheet is used to establish the mental age.

Questions asked during the DAP test

  • Who is this?
  • Is it a girl or a boy?
  • What is this person doing?
  • What does this person wish for now?
  • What is this person worrying about now?
  • What makes this person happy?
  • Who makes this person happy?
  • Does this person cry?
  • If yes, what does he cry about?
  • Who makes him cry?

This is the line of questioning that could be followed.

PERCEPTUAL ASSESSMENT: BENDERGESTALTVISUAL INTEGRATIVE TEST (STANDARDISED TEST)

This is a standardised test consisting of nine cards with diagrams from which a child is required to copy what s/he sees onto paper. The test is indicative of neurological defects affecting how one perceives the world and the age at which one does so. A scoring sheet is used to determine the age at which an individual perceives the world.

Interviewing the victim

The interview approach followed the guidelines based on the views of Wigmore (para. 506) where Woji vs Santam Insurance Co Ltd 1981 SA 1020 (A) at 1028B-D examined the concept of what constitutes a trustworthy and competent child witness in court. As a consequence the following elements were outlined:

Checking the competency of the child

(i) Capacity of observation. Is the child intelligent enough to observe in any given situation?

In this case, while both the evaluator and client are in the assessment room, the child is requested to bring various play items to the table.

The aim of the task is to establish whether the client/child is able to differentiate one item from another.

(ii)Power of recollection. Does the child have sufficient years of discretion to remember what has occurred and/or is occurring? Assess whether the child is able to present the story in a sequential and logical manner.

(iii)Narrative ability. Does the child have the capacity to understand questions put to him/her and have the ability to frame and express intelligent answers?Responsive and linguistic abilities are assessed.Arethe child’s vocabulary and behavioural responses age-appropriate?

(iv)Sincerity.Does the child have a consciousness to speak the truth?

Does the child/person have the capacity to be devious?(Chiroro Muller2005:227 in Tredoux et al.eds.)Does the child display any evidence of coaching or rote learning?

The evaluator asks the following questions:

Firstly, the evaluator begins with the chain of telling the truth and provides the child with truths and then lies. Thereafter, questions are asked to establish if the child has a clear understanding of the difference between the two.

The interviewer needs to assess if the child is able to distinguish between a truth and a lie, and between fact and fantasy. From the outset, the child should be informed that it is okay to respond with “I don’t know” or “I don’t remember”.

  • What does it mean to tell the truth?
  • What does it mean to tell a lie?
  • If l said thatyou are a boy,wouldthat be the truth(vice versa if the child is a boy)?
  • If l said thatthis is a chair,wouldl be telling a lie(when it is indeed a chair)?
  • If l said thatit is raining, would that be the truth? (The evaluator will point to the window showing the child that it’s not raining outside but still allowing the child to make that judgement call.)
  • What can happen to people who tell lies?
  • What did you have for breakfast today? (This movesfrom the recent to the more distant.)
  • What did you have for supper last night?
  • What did l have for supper last night? (Ask the child what the interviewer had for supper and ensure that the child understands this concept and does not make up when s/he is put on the spot.)

Clinical observations

During the assessment, behavioural observations are made. These include emotional presentation/effect, work pace on assessment tests, ability to follow instructions, concentration, physical appearance, i.e.self-grooming, among other things. Observations are madeduring the assessment but also in the waiting room when the child is still in the care of the caregiver. Cognisance should be taken of all interactions.These are both verbal and nonverbal behaviour displayed by the family system.

The length ofthe evaluation

Evaluators do well to ensure that they will have the opportunity to conduct as many interviews as they consider warranted. It is a serious mistake to confirm the number of interviews beforehand.Many evaluators confine themselves to one or two interviews; sometimes they are dictated by the pressures of the court and the large number of cases that need to be evaluated. Such evaluators should appreciate that they are working under significantly compromised circumstances and the likelihood of their coming up with valid conclusions may be small. The acquisition of psychological information requires adequate time to curb for external factors that would result in biased results. A good rapport needs to be established. The more sessions held, the greater the likelihood that such a relationship will develop. It is considered that three to five interviews may be appropriate for the development of the relationship and for gathering information. This is especially the case with children who have been genuinely abused because of their fears of the consequences of the disclosure. Even in cases in which the abuse has indeed been fabricated, one wishes to ascertain whether changes take place over a series of interviews in order to confirm one’s initial conclusion. Thus it is important to conduct more than one interview to gather sufficient information and allow for the child to develop confidence in the evaluator and make the disclosure. However, it needs to be noted that this may not work in all cases.

POST-ASSESSMENT PHASE

REPORT WRITING

A report which summarises the information gathered during the assessment is made and the psychologist outlines his/her opinion. The report then forms the foundation for the expert evidence given in court, including cross-examination. The psychologist then prepares to justify every line in the report and prepare thoroughly for any challenges that may arise during cross-examination.

GIVING EVIDENCE IN COURT

The psychologist makes an appointment to meet with the prosecutor before appearing in court. The reality is that there are time and money constraints and therefore the evaluator should arrange to meet before testifying, perhaps allocating 20 to 30minutes before testifying in court. The psychologist attends court to give evidence as an expert witness. If assessment has been done with expertise, giving evidence in court will not be a problem. Brodsky et al. (2002) recommend that honesty, consistency and professional competency are the best policies when serving as an expert witness. Regardless of expertise and experience, the psychologist should prepare thoroughly and comprehensively before giving evidence in court(Brodsky et al.1999).Psychologists should also familiarise themselves with the layout of the courtroom, court procedures and court etiquette.Refer to details provided in the forensic assessment.

RISK ASSESSMENT

The concept of harm to others plays an important part in both criminal and civil proceedings (Monahan Steadman 1994).Factors that may subject an individual to further abuse are established and indicated. Clinical practice and research have repeatedly found that the most vulnerable group are individuals who are mentally and physically challenged and are at a greater risk of being abused when there are no protective measures implemented to ensure their safety. This creates a social control function whereby the professional contributes to decision making that has implications for both public safety and the individual’s right to freedom.

ASSESSING SPECIAL NEEDS CHILDREN

Assessing a special needs child
  1. Establishing an effective rapport
  2. Explaining the purpose of the interview
  3. Reassuring the child that s/he has done nothing wrong
  4. Explaining to the child the need to tell the truth
  5. Explaining the process step by step, what is expected and how the sessions will run
  6. Reassuring the child that it is acceptable torespondwith, “I don’tknow” or “I don’t understand” or “I’m not sure” or “I cannot remember.”
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  • Try to meet the needs of the child and proceed at his/her pace.
  • Use age-appropriate language.
  • Repeat instructions if there is a need to do so.
  • Give the child enough time to complete the assessment andtask and allow for breaks to permit a positive level of concentration.
  • Check whether the child has understood what has been posed to him/her.
  • Allow the child a longer time to respond.
  • Repeatedly clarify messages relayed to the child.

CASE IN POINT

A 29-year-old woman was alleged to have been sexually assaulted and the matter was reported at the police station. The alleged perpetrator was arrested and the merits of the case wereassessedby the magistrate. A referral for psychological evaluation to determine the victim’s mental age and her capacity to testify in court was made by the prosecutor.

The risk factors were identified as follows:

  • The woman attended treatment alone and the accused was male.
  • She was vulnerable as she complied with the instruction that the act was part of the treatment process.

Background information with regard to the incident was gathered through interviews with the guardian. As the interviews proceeded, the risk factorsof the victim being abused were considered. The victim was also interviewed and provided an account of what occurred on that fateful day.

Psychological assessments were done using tests such as the Draw-A-Person test, Bender Gestalt Visual Integrative test andthe Raven coloured matrices, among other tests. The tests were designedto determine the victim’s capacity to observe and her cognitive capacity. These would determine if she had the capacity to observe, as well as the power to recall what occurred. Her linguistic abilities were also considered.As a result, it was found that although cognitive functioning was far below that appropriate for her chronological age, she was able to testify in court.