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CODE OF PRACTICE TO FACILITATE THE PROVISION OF THERAPEUTIC SUPPORT TO CHILD WITNESSES IN COURT PROCEEDINGS
THERAPEUTIC SUPPORT
What is Therapeutic Support?
25 The term "therapeutic support", in the context of this guidance, refers to formal psychotherapy and counselling. It also includes other therapeutic activities that do not constitute formal psychotherapy or counselling but which may draw on the principles and skills of psychotherapy and counselling. A broad range of services, which include psychological, psychiatric, local authority social work and voluntary sector projects
provide therapeutic support.
26 Therapeutic support may address a variety of issues that can arise from being a witness in civil, criminal or children's hearing court proceedings or from being a victim of crime. These issues can include increasing self-esteem and confidence, reducing anxiety, depression, suicidal or self-injurious behaviour and improving peer and family relationships. Therapeutic support may also address any trauma associated with court proceedings, such as trauma as a result of witnessing a crime, being a victim of crime, or from being involved in a child custody dispute or any other civil proceeding.
27 There are a vast number of different approaches to the provision of therapeutic support, which are underpinned by different theoretical models and utilise different therapeutic intervention methods. It is out with the scope of this document to describe all the different approaches, however, Appendix 2 provides a summary of three core approaches (Cognitive-Behavioural, Psychodynamic and Person-Centred).
28 The type of intervention methods used can vary according to the theoretical approach. However, different approaches often use the same methods of intervention. For example, the use of play as a therapeutic technique can be used in a variety of approaches to facilitate engagement. In addition, some therapeutic support providers take an eclectic/integrated approach and use intervention methods derived from a variety of theoretical approaches.
29 The nature of the problem therapeutic support providers are addressing will also influence the type of intervention methods they use. For example, if the therapeutic support provider is working with problems the child is experiencing in the here-and-now such as low self-esteem or anxiety, the methods they use will be different than if they are working directly with the trauma a child has suffered. Some of the intervention methods that are utilised are detailed in Appendix 3.
30 In addition to the various intervention methods, the context in which therapeutic support takes place also varies. Therapeutic support can be provided on an individual basis or in a group. For example, the group can consist of individuals who are experiencing similar difficulties, or, in the case of family therapy, the group can consist of other family members (see below for some of the concerns about group work).
31 Well-controlled studies on the effectiveness of therapeutic support provided to children have been relatively sparse. This is due to the ethical and practical difficulties of conducting randomised controlled clinical trials with this population. However, a number of studies have recently demonstrated the effectiveness and benefits of various therapeutic interventions with children (for reviews see Ross & O'Carroll, 2004; Saywitz, Mannarino, Berliner & Cohen, 2000; Kazdin & Weisz, 1998).
32 Concerns about contamination of evidence, if therapeutic support is provided prior to court proceedings, have in some cases resulted in therapeutic support being delayed. This is of particular concern when the delay in court processes can exceed two years. If the intervention is delayed for too long, a child's symptoms can exacerbate or become chronic and resistant to treatment (Saywitz, Mannarino, Berliner & Cohen, 2000).
33 The child's well-being is of paramount consideration and, as such, the provision of therapeutic support should not be delayed until after the court proceedings. However, the nature of the therapeutic support to be provided should be considered carefully in order to avoid the risk of contaminating the evidence or the allegation that the witness has been coached (see below for further information).
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