The National Children's Advocacy Center (NCAC)
Extended Forensic Evaluation Model

Continuum of Interventions with Children

The primary interventions with children when sexual abuse is suspected or indicated include the initial investigative interview, forensic evaluation, forensically sensitive therapy and traditional therapy. The interventions vary on a number of dimensions, including:

• Time involvement
• Goals
• Strategies
• Tools
• Consumer

The initial investigative interview is typically the first intervention when a report of suspected sexual abuse is made. It is generally conducted by law enforcement professionals and/or interviewers employed by a child welfare agency. Usually 1 or 2 forensic interviews are conducted with a given child.

Forensic evaluation is a process of extended assessment of a child who is too frightened or young to be able to fully disclose his/her experiences in an initial forensic interview. This model describes the details of a forensic evaluation protocol developed at the National Children's Advocacy Center (NCAC). The current NCAC protocol involves one session with the non-offending caregiver and five sessions with the child, with each session one week apart and one hour in duration. The goals of forensic evaluation are fact-finding and clinical assessment. Investigative techniques are paired with selected therapeutic techniques to allow facts to be discovered in a non-threatening legally defensible manner.

Forensically sensitive therapy is employed at the conclusion of the fact-finding process, when a decision has been made that sexual abuse is likely to have occurred and the child needs assistance in resolving traumagenic states. The approach is used when there are pending criminal or juvenile court matters, and the child needs immediate treatment. The approach is designed to help the child begin the healing process while still preserving the integrity of the case in terms of credibility in court. Cognitive behavioral strategies are the primary methodologies. Traditional child therapy strategies are also used, with the avoidance of both projective techniques and both interpretation of play or art. All therapeutic techniques used are empirically based.

Traditional therapy may or may not be longer in duration than forensically sensitive therapy, but the main difference is that any appropriate child therapy can be used, including interpretation of the child's art and play, and the use of projective techniques.

The table below delineates the differences between therapy and forensic evaluation. The American Professional Society on the Abuse of Children (APSAC) publishes a statement on Therapist Roles and Responsibilities. Therapists working in the field of child maltreatment must recognize that clinical and forensic roles are different, and become informed on the appropriate approaches used in each role.

Therapy Compared with Forensic Evaluation