Trauma-Informed Assessment & Interviewing

Trauma-Informed Care

• Informed consent must be collected from the patient before initiation of any portion of the forensic interview.

• Any clinical exam relating to child maltreatment, abuse, or torture may be extremely distressing and retraumatizing to the patient - inducing suicidal ideation, non-suicidal self-injury, severe panic, avoidance, hostility, sleeping difficulties, etc.

• Building trust and rapport are essential to an accurate recounting of the patient’s abuse history.

• Consider the inclusion of the medical provider to prevent unnecessary re-telling of the trauma and potential retraumatization of the patient.
  Forensic interviews may be recorded by audio and/or video to prevent unnecessary re-telling of the trauma and potential retraumatization of the patient.

Interpreter Use

• An interpreter should be provided for all patients whose preferred language is not English.

• In best cases, the interpreter should be a part of the medical or investigative team and have additional training in pediatrics and maltreatment, abuse, and torture.

Preparing for the Forensic Interview

• Explain to the patient what to expect within the interview.

• Communicate the patient’s right to decline to answer specific questions. Allow the patient to take breaks as necessary.

• Forensic interviews should be conducted by professionals trained in pediatric forensic interviewing.

Interviewing Best Practices

• Utilize open-ended questions wherever possible: “tell me about…” “describe…”

• Utilize closed-ended questions if specific information is needed: “Did parent A or parent B do ?”; minimize excessive use of close-ended questions.

• Avoid leading questions; children are more susceptible to leading questions.

• Avoid asking multiple questions at one time or in quick succession.

• Use developmentally appropriate language when interviewing young children and patients with potential developmental delays.

• It may be helpful to specify information utilizing a timeline: “Did that happen before or after you left school?” “Did that happen before or after sibling X was born?”

• Children who have difficulty verbalizing their history may be more successful if given the supplies and time to draw and describe a picture.

• Limit the use of toys to explain or re-enact torture histories.

Level of Detail

• Attempt to obtain a high level of detail when interviewing, while respecting the retraumatizing nature of forensic interviews.

• Patients may be unable to recall a high level of detail and may forget details of the abuse.

• Inconsistencies in the retelling of torture may be expected due to the nature of torture - extreme stress impairs memory storage and formation, and patients may have been blindfolded or left alone for undetermined periods, or maybe too young to remember the torture.