Interviewing Victims Of Abuse Flashcards
Role of the physician
● Taking a history
● Perform a complete physical or full examination
● Take valid specimens if needed
● Writing a detailed report
● Giving medical opinion
● Giving evidence in court.
General medical history
● Past & present health, current medications, previous accidents, previous surgery,
● Family, social, environmental, occupational histories
● Prenatal, natal, immunization, developmental, nutritional
histories
Specific history
● Details related to the situation for which the examination is being conducted (e.g., use of force, drugs, damage to clothing, relative position of victim and assailant, circumstances surrounding the abuse, etc.)
● Opinion will be based on the specific history with the physical findings
● Before you begin your interview, you must establish rapport with your patients.
Interviewer
● Sensitive and responsive
● Competent
● Skillful
Environment
● Safe, private
● Comfortable, quiet, free from distractions
Listen to the woman closely, with empathy, and without judging
Listen
Assess and respond to her various needs and concerns - emotional, physical, social and practical (e.g. childcare)
Inquire about needs and concerns
Show her that you understand and believe her. Assure her that she is not to blame
Validate
Discuss a plan to protect herself from further harm if violence occurs again.
Enhance safety
Support her by helping her connect to information, services and social support.
Support
Child sensitive interview
○ Introductions (developmental screen)
○ Instructions (include promise to tell the truth)
○ Narrative event practice
○ Transition
○ Substantive space
○ Closure
There are a lot of strategies that you may use because the narrative ability of a child is influenced by
○ Age
○ Developmental level
○ Family style
○ Level of trauma and neglect
○ Health problems
Interviewing
- Victim is asked to explain the assault in her own words
- Use open-ended, non-leading questions
- Avoid “why” questions
- Allow her to complete her account with no interpretations and to clarify later and to be thorough in eliciting embarrassing details
- Address the patient’s questions and concerns in a non judgemental and empathetic manner.
- Use a very calm tone of voice
- Maintain eye-contact
- Do not express shock or disbelief
- Avoid using victim blaming statements.
Details you want to ask:
○ How the assault happened
○ Date, time, location of the assault including a
description of the type of surface on which the assault occurred
○ The name and identity and number of assailants.
○ The nature of physical contacts, detailed account of violence inflicted
○ Use of weapons, restraints
○ Use of medications/drugs/alcohol/inhaled substances
Investigators and court want to know about the following:
- age of an injury
- how the injury was produced (mechanism)
- amount of force required to produce the injury
- circumstances in w/c the injury was sustained
- consequences of the injury
Classification of injuries
● Use standard, universally accepted descriptive terms
○ E.g. laceration, abrasion, bruises, stab wounds, size
wounds (gun shot wounds)
● Assists in identifying the mechanism by which the injury was sustained
● Contributes to a better understanding of the circumstances
in which the injuries may have been sustained
● May allow deductions about the weapon or the object that caused the injury
● Examination of the pattern of injuries may assist in answering questions about whether the injuries were sustained in an accidental, assaultive or self-inflicted manner
Examination notes
● Normal and abnormal findings
● Detailed
● The use of abbreviations is NOT recommended ● Legible
Documentation (Photographic evidence)
● Make use of the body Diagram and the L- shaped ruler to measure
○ Describe and give detail of the injury
■ “Medial aspect of the thigh, 23 cm above the knee, red-blue bruise measuring 4 x 2 cm”
○ On the body map draw the injury
■ Circle for Hematoma/Bruise
■ Line for Laceration
■ Put an arrow on the injury with a description
○ Take note of the lateralities (left, right, anterolateral, distal, medial, or proximal, etc)
Ano-genital examination
Tanner staging
Taking valid specimens: “Silent Witnesses”
- traces of contact, scientific evidence
- lab exam
Taking valid specimen: chain of custody
- labeling of each specimen, proper recording
- ID of all who handled the specimen
- prevent contamination of specimens
If there is a need to take valid specimens, please do so. This is to:
○ Confirm the history
○ Attempt established contact between the individuals
○ Establish contact of the victim and the alleged scene of the incident.
○ Assist the identification of the assailant.
Examples of Valid specimens in the identification of the sexually abused:
○ Cultures
○ Gram staining
○ STDs, etc.
