Judging the Veracity of CSA Memories 1.
In October of 1996 a group of Psychologist at Stanford University began conducting a study funded by an award from the Institute on Women and Gender located also at Stanford University. This study centered on examining factors associated with therapist’s judgements and treatment decisions regarding patients with memories of childhood sexual abuse (CSA) and how these personal judgements affected treatment strategies. The researchers implemented a detailed questionnaire and surveyed five hundred four male and five hundred four female therapists and then compiled the results obtaining some very contradictory results when compared with previously held beliefs.
The study identified three primary goals: to examine the relationship between characteristics of sexual abuse memories and the therapists’ ability to judge the credibility of the allegations, to review the link between the therapists’ determination of truthfulness of the sexual abuse memory and the treatment decisions made, and to examine the effect of the therapists’ beliefs on clinical judgement and treatment decisions. The researchers noted that there is a growing body of empirical evidence that shows a large number of adults reporting sexual abuse also report forgetting some or all of their abuse. Problems have been feared though if a therapist does not believe their client and navigates a course of treatment that will not benefit the patient’s actual needs. They also mention a growing fear among therapists of being accused in criminal court of planting false memories of CSA. The fourth goal of this study, not outlined by the researchers, was interpreted as finding and establishing a strong guideline to assist therapist when reviewing patients reporting memories of CSA or presenting symptoms relating to those memories.
Judging the Veracity of CSA Memories 2.
The research group implemented a detailed and original National Psychologist Survey that included a varying case vignette and a questionnaire. The case vignette consisted of two paragraphs with the first paragraph describing a 32-year-old male or female patient with seven psychological symptoms that have been associated with CSA including specific instances of acting out for men and women. The second paragraph then contained specific information of five different characteristics of abuse. These varied in a ratio to conceive 48 different vignettes and each participant was randomly given one of the 48 vignettes. Also included were four separate sections to the questionnaire, the Abuse Credibility Rating, Abuse-Focused Treatment Scale (AFTS), Prevalence of Sexual Abuse Scale (PSABS), and demographics. The research group utilized five focus groups and one panel of experts to develop the questionnaire and vignettes.
The participants were 1008 randomly chosen members of the APA. Sixty eight percent of the participants responded with one percent refusing to participate. Five percent of the questionnaires had too much missing data to be useful. This created a pool of 64% of 984 usable questionnaires. The participants represented an ethnic breakdown that was consistent with the APA as a whole with the majority being doctoral level therapist. Twelve percent of the respondents reported a history of sexual abuse with two percent refusing to answer the question and three percent not being sure
These efforts revealed some expected and some surprising results concerning how therapist interpret the type of recollection a patient presents. The article cited a study by Ofshe and Watters (1994) which stated that therapists rely on vague memories as evidence of sexual abuse. Whereas the results of this study showed therapists tend to
Judging the Veracity of CSA Memories 3.
hold vivid memories as proof of CSA. The study also showed therapists tend to disbelieve the truthfulness of previously forgotten memories as portraying actual events. However, there is a large volume of studies present, employing varying methodologies, which show a portion of CSA survivors experience periods of forgetting all or part of their ordeal such as those suffering from post traumatic stress disorder. Despite strong evidence proving a CSA survivor may well forget portions of their trauma, this study showed therapists tend to believe vivid and complete memories as opposed to vague, partial, or previously forgotten memories.
Therapists also take into account the age of the patient at the time they experienced the abuse. They are prone to believe the patients who remember the abuse occurring after age 4. The therapists were not affected by the type memory, vivid or vague, at these early ages. This finding is conclusive with a study conducted by Pillemer and White in 1989 stating a person’s earliest memories do not occur before the age of 3.
Therapists, according to this survey, hesitate to believe memories of sexual abuse perpetrated by women. They reported to have these hesitations regardless of the gender of the patient. This was bothersome to the researchers due to the fact that boys are presumably more apt to be abused by female perpetrators.
The study was able to disprove the allegation that therapists implant false memories of past abuse by showing that therapists do not hold extreme views on the prevalence of CSA therefore are hesitant to believe memories that are not vivid, occurring before the age of 3, and perpetrated by female assailants.
Judging the Veracity of CSA Memories 4.
The article concludes with five suggestions to therapists dealing with forgotten memories of CSA. It states that therapists should only provide therapy in their area of competence, seek as much corroboration of the abuse as is appropriate, and to be aware that personal beliefs can effect clinical judgement in the absence of evidence. The study also advises therapists not to be too critical or too open and to carefully maintain complete documentation of diagnoses, prognoses, progress, and treatment plans.
The review process is complete and effective due to the variety of reviewers and the test/re-test method employed by the researchers. I found the sampling of therapists to be a wide overview that seemed to adequately cover a general sampling of all working therapists. The use of the vignettes and questionnaires assured that each instance of an actual case was presented to varying therapists to provide a complete outlook of common practices.
The article is informative and interesting. I was surprised to learn that such a significant proportion of therapists let their personal feelings affect their judgement and treatment strategies. This article suggest that therapists allow their convictions on the subject of CSA to affect their clinical diagnosis and at times the wrong treatment may be charted, doing more harm than benefit to the patient. It helped lend to the validity of therapists accused of instilling false memories of CSA by showing that therapists are hesitant to believe memories with those characteristics.
Judging the Veracity of CSA Memories 5.
Gore-Felton, C., Koopman, C., Thoresen, C., Arnow, B., Bridges, E., & Spiegel, D. (1998). Psychologists’ Beliefs and Clinical Characteristics: Judging the Veracity of Childhood Sexual Abuse Memories. Professional Psychology: Research and Practice, 31, 372-377.