A CHILD PSYCHIATRIST: EXPERT ROLES IN THE CRIMINAL COURT The Perspective of Child Witnesses in Court by Dr Anthony W Baker (Part 2)
Abstract:
The second article in this series relates to the psychological and social impact on child witnesses because of their exposure to criminal incidents - in whatever capacity, including their experience of giving their testimony. An appendix is attached which refers to a model of emotional responses to trauma and possible remedies, as an aid for experts who are providing evidence on emotional impact in a simplified way for the court to process without the use of psycho-jargon.
Introduction
The author has been invited to comment on the perceived impact of the offences on child-victims in preparing for sentencing once the jury has made a finding of guilt. This may include reference to the impact on the child of being cross-examined while the defendant protests their innocence and the defence counsel insists repeatedly that the child-witness is lying.
In considering aspects of the psychological impact on children and vulnerable witnesses, the assessing psychiatrist will also have to consider the changes and challenges that the witness-victim has had to endure in the protracted time, often two years or more, between allegation and trial.
Impact assessments
The expert child and adolescent psychiatrist or clinical psychologist will be mindful of the child’s age and cognitive and emotional development. In younger children anxiety is likely to be the main emotional driver with associated behavioural symptoms like sleep disturbance, avoidant behaviours and preoccupation with traumatic memories including, for instance, learned compulsive sexual behaviours of children who have been sexually abused.
Older children may also experience guilt, as well as anger based on a sense of injustice. The lack of any redress, in the context of perceived unfairness, may lead children to punish and hurt themselves or others, including the family pets. Where there has been a loss, young teenagers may be affected by the grief and the pain of the sadness that this generates, as well as bitter anger against the perpetrator and the world in general.
Who knows the child well?
An impact assessment should be thorough and the expert would ideally draw on the accounts and observations of carers, social workers, teachers and those who have first-hand knowledge of the child in their ordinary settings. Some children may have had the benefit of a psychological intervention and the therapist may be required to present a report of the child’s progress which the expert may also consider.
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Vignette 3 – A poor prognosis
The author was asked to present an impact assessment for a boy who, with his sister, had been sexually abused by their father from their infancy. The perpetrator was a professional cameraman with a broadcast TV company. His crimes came to light when the thousands of illegal images and video-films that he had recorded were picked up via the internet. The children, then in their teens, had been interviewed during the investigation but they were not called to give live evidence. The images in which their abuse was revealed left the jury in no doubt of the father’s guilt.
A joint professional family assessment revealed the calculated way in which an ordinarily intelligent but devious man had chosen a woman with severe learning difficulties to produce children whom he could abuse with apparent impunity. The two children were of low average intelligence and they were so habituated to sexual interactions with each other that their erstwhile foster carers were unable to keep them safe. The author argued that the children’s mother was also a victim of her husband’s sexual exploitation and that her future would need to be actively safeguarded while keeping her connected to her children whose loss was a major factor for her.
The impact of that man’s abuse of his family would affect them for the foreseeable and distant future because of their extreme vulnerability and susceptibility to sexual exploitation.
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When father kills mother.
An expert who has assessed a child in respect of their competence to be a witness, may also be instructed to present their opinions about the child’s needs to a family court in respect of living arrangements and contact with relatives as well as any future needs.
For instance, a child who has witnessed the killing, by a parent, of a sibling or the children’s other parent will not only have to process psychologically what they have seen and heard but they will have to adjust to new or strange living arrangements either with extended family (who will inevitably be emotionally partisan) or with foster carers.
Everything changes – nothing is normal
In this circumstance, there will be no pre-trial opportunity of any contact with the accused parent until the trial takes place and issues of guilt and responsibility are addressed. Which means in practice that the child’s many questions cannot be answered and no assurances can be given. This is particularly difficult for older children who will have the capacity to experience their emotions based on their wider general knowledge of the possible implications and consequences.
In such complex situations, a careful review of the wider impact on the child by an expert assessor, as opposed to a treating psychiatrist, will assist the judge at sentencing in the crown court, as well as helping those responsible for making future decisions to address the child’s future living arrangements, which would normally fall to a judge in the family court.
The Witness Perspective
Research (Plotnikoff, 2004,2009,2019), (Crawford, 2006), (Hayes 2011) has shown that witness fears include fear of emotional breakdown during cross-examination as well as being in the presence of the accused. Some children fear that it is they who are on trial and they may hold an imaginary fear that if they are not believed they will be sent to prison themselves.
The aftermath
After the child has given evidence, the emotional sequelae may include feelings of guilt and failure, especially if they stumbled or were made to feel disbelieved during cross-examination. Some of the challenging questions and submissions that are presented on behalf of the defendant may leave the witness with a strong feeling of angry resentment which cannot be resolved in the aftermath.
“I want my mum!”
Children of all ages will fare better in the longer term if they have maternal support available to help them cope with the distress after the trial has concluded. Clearly this cannot occur if the mother is a guilty defendant or dead or not emotionally available.
Really?
The author recalls meeting with a mother of a 16-year-old girl whose stepfather had molested her in her sleep when she was 12 years old and again when she was 14. She had feigned sleep on both occasions but she became alarmed when he was expressing excitement at her forthcoming 16th birthday. Her rising fear led to her disclosure to her teacher and a criminal investigation was put in train. Her mother said to the author, ‘I don’t know why she is so upset – it only happened twice!’
Family intervention called for!
Clearly there was a task to do to open the mother’s eyes to the enormity of her daughter’s experiences and the emotions that she had kept hidden for four years. It was put to the mother that from the age of twelve years her daughter never knew when her stepfather would come to her bed again. During the day she had to pretend that everything was normal because she did not know how to tell her mum.
Is effective help at hand?
The message is clear that witnesses do need post-trial support and this may include recommendations by an appointed child psychiatrist to address the child’s needs of this – through family support and possibly more formal therapeutic interventions. The implications for the future of the child witness may be dealt with in the Family Court and the expert child psychiatrist, with ready knowledge of the matters and issues, may be called to assist with recommendations. In the author’s experience this secondary piece of work may include assessing the issues of potential contact with an imprisoned relative or one who is detained in a secure psychiatric unit.
Delay Harms.
Children do not cope well if there are cancellations and postponements that delay the trial leading to anticipatory fatigue. They may become even more distressed if unexpected things occur which they perceive as a threat. Anger at specific elements of the experience may be more likely to find expression after the anxiety has passed and the individual continues to process their experiences cognitively within their familiar cultural framework of understanding the way things are.
Identifying emotions
Every child victim/witness endures a wide range of abnormal experiences in the normal run of events before and after disclosure. It is impossible to protect them from all of the emotional fall-out from the criminal actions of adults. They will need the adults who are supporting them to be aware of the turmoil that has become a daily (and nightly!) source of symptoms of stress.
Those symptoms may be the expression of anxiety, guilt, anger (at injustice) and/or grief which together can be seen as the inevitable emotional sequelae of such types of trauma.
See Appendix for model of emotional responses to trauma.
The final part of this series will be published on the 01/09/2021.
Useful References
- Baker, A (2021) A Child Psychiatrist’s Expert Roles in the Criminal Court. BJPsychAdvances, Cambridge University Press.
- Crawford E, Bull R. (2006) Child witness support and preparation: are parents/caregivers ignored? Child abuse review vol 15 issue 4. Chichester: Wiley.
- Hayes D, Bunting L, Lazenbatt A, Carr N, & Duffy J. (2011) The Experiences of Young Witnesses in Criminal Proceedings in Northern Ireland. Department of Justice (NI).
- Plotnikoff J and Woolfson R. (2004). In their own words: The experiences of 50 young witnesses in criminal proceedings. London, NSPCC
- Plotnikoff J and Woolfson R. (2009). Measuring Up? Evaluating implementation of Government commitments to young witnesses in criminal proceedings. London: NSPCC.
- Plotnikoff J and Woolfson R, (2019). Falling Short? A snapshot of young witness policy and practice. London: NSPCC.
The Author
Dr Tony Baker qualified in 1974 at Westminster Hospital Medical School. He joined the British Army during his period of clinical studies and on successful completion of his pre-registration probationary years in medicine and surgery, he took up his post as a general duties medical officer in Dusseldorf, W.Germany – where he remained for two-and-a-half years before embarking on a training course in psychiatry. After a year in a British Military Hospital in Germany, he returned to the UK to complete his professional training in psychiatry leading to Membership of the Royal College of Psychiatrists (1980).
He then embarked on a course of higher professional training at Great Ormond Street Children’s Hospital and St George’s Hospital in Tooting. During the early 1980’s he became concerned with the fate of children who are abused, including sexual abuse and exploitation and he developed training for professionals in psychology, psychiatry, social work, police and education. To this end he co-founded a charitable organisation to facilitate interprofessional training and increase awareness in all levels of those with responsibility for children. Dr Baker has conducted research into the prevalence of sexual abuse in the 80’s in the UK and he also worked to develop therapeutic methods in respect of children and their families in the aftermath of disclosure.
The lack of therapeutic availability in the NHS prompted the setting up of a new charity to raise funds to enable post-abuse survivors to access independent therapy, The Emily Appeal Fund, which also offered free training to social workers and children’s care home workers.
In a rich and varied career in NHS practice and in the independent sector, Dr Baker has run a residential addiction detox and group rehab service in parallel with his work with children and families.
He has also developed a practice to provide expert assessment and reports to the Family Courts and to present evidence to a variety of court settings and tribunals including Criminal Courts.
Dr Baker has developed specialist consultancy services for children in care, both with residential homes and with fostering. He has also developed assessment and therapeutic support initiatives for children and young adults with complex developmental issues like ADHD and Autism.
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