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BELIEFS OF HELPING PROFESSIONALS WITHIN THE CONTEXT OF CHILD
SEXUAL ABUSE ASSESSMENT
Slávka Karkošková1, Gabriela Mikulášková2
1 slavka.karkoskova@gmail.com, The Judicial Academy of the Slovak Republic,
Pezinok, Slovak Republic
2 gabriela.mikulaskova@unipo.sk, Institute of Psychology, Faculty of Arts, University
of Presov, Slovak Republic
Človek a spoločnosť
[Individual and Society]
23(3), 1–17
DOI: 10.31577/cas.2020.03.573
http://www.clovekaspolocnost.sk/
Abstract:
Background: Child sexual abuse (CSA) is one of the most serious socio-pathological phenomena. However, its
identification is challenging and linked to the risk of false positive and false negative conclusions, with far-reaching
consequences for the lives of those affected. Incorrect assessments of suspected CSA cases can be made not only
by lay people, but also by helping professionals who gather and evaluate information, consider further procedures
and make decisions.
Aim: The aim of the presented review study is to summarize current scientific knowledge that answers two key
questions. (1) what contributes to errors in the assessment of relevant cases; and (2) how these errors can be
prevented.
Method: Previous research has shown that personal beliefs significantly influence the processes by which
individuals search for, store, and interpret relevant information (Kahneman et al., 1982). For the purposes of this
study, databases of scientific publications were primarily searched for research papers that mapped the beliefs of
helping professionals in relation to CSA, as well as papers on strategies to reduce errors in the assessment processes
of relevant cases.
Results: We identified three significant groups of beliefs that could lead to misjudgments of suspected CSA cases:
(1) Misconceptions about CSA – especially about: (a) the prevalence and nature of CSA (including the assumption
that CSA usually involves the use of physical force and sexual intercourse); (b) the CSA perpetrators (e.g., that
they are mentally disturbed or sick; that CSA committed by a woman has a less harmful effect on victims than
CSA with a male perpetrator; that the victim's peer cannot be the perpetrator); (c) the victims' responses to sexual
abuse (including the dynamics of disclosure about CSA experiences; the dynamics of behavior in further contact
with the perpetrator); (d) the memory performance of child victims during forensic interview (especially regarding
the expected amount of details and consistency of testimony); (e) the way of conducting interrogations with
suspected CSA victims (including the sensitivity of professionals to suggestive techniques); (f) the CSA diagnosis
method (including the assumption that spontaneous game observation is a good method for assessing suspected
CSA); (g) the frequency of false accusations.
(2) Beliefs related to the implications of the case assessment – especially: (a) excessive trust in the testimony of
children versus skepticism (some professionals may tend to rule out false accusations and thus disregard the rights
of the accused person, while others may approach suspected CSA cases with the a priori belief that a high
percentage of CSA cases are untrue and therefore do not take great account of the rights and interests of the
suspected victim); (b) beliefs about the functioning of the child welfare system (where distrust in this system may
encourage professionals to fail to fulfill mandatory reporting regarding suspected CSA cases); (c) an emphasis on
sensitivity versus specificity (i.e. either focusing on minimizing the occurrence of false negative conclusions to
prevent the actual victim of the CSA from being identified and cared for, or concentrating on minimizing false
positive conclusions to prevent the innocent person from being convicted); (d) beliefs regarding the removal of
the child from the family.
(3) Beliefs about one's own objectivity and expertise – especially the frequent false beliefs of professionals that
with the increasing length of practice and the amount of experience with CSA cases, the level of expertise
Človek a spoločnosť [Individual and Society], 2020, Vol. 23, No. 3, pp. 1-17.
Beliefs of helping professionals within the context of child sexual abuse assessment
2
automatically increases. Experienced professionals can be simultaneously prejudiced and convinced of the
correctness of their own erroneous beliefs. At the same time, more experienced professionals tend to have a more
intuitive approach to assessing CSA cases. In this respect, various cognitive biases (especially patternicity,
confirmatory bias, availability bias, anchoring, representativness heuristic, bias blind spot and the Dunning-
Kruger) effect play a negative role.
In the conclusion, the review study recommends several strategies in order to improve the practice and reduce
errors in the assessment of the cases in question. It emphasizes the important role of the continuing education of
relevant professionals in confronting participants with current scientific knowledge on CSA issues; encourages
helping professionals to reflect on their own beliefs, which may influence the assessment of the cases in question,
and recommends mastering the so-called Bayesian reasoning and effective methods to eliminate cognitive bias. At
the same time, the study considers precise work with hypotheses, weighting evidence, supervision, the submission
of expert opinions to independent review and slowing down of work strategies as an effective strategy of
eliminating various prejudices. In addition, it proposes a multidisciplinary team approach to CSA case assessment
– although the study does note that the impact of the group approach on the final outcomes of the case assessment
process has not been sufficiently scientifically examined yet.
Conclusion and implications: The study emphasizes that the beliefs of helping professionals and decision-making
skills play an important role in the CSA case assessment process, and that without the targeted application of
effective strategies to eliminate cognitive biases and prejudices, the quality of case assessments is endangered. The
members of various helping professions (especially educators, psychologists, psychiatrists, social workers, police
officers, prosecutors and judges) who come into contact with suspected CSA cases may find the review study
useful. Although the content of the study is based on the results of foreign research, it has application potential in
Slovakia, especially in relation to the preparation of content in the continuous education of professionals, the focus
of supervision in helping professions, or the designing of Slovak research projects focusing on these issues.
Key words: Child sexual abuse (CSA). Personal beliefs. Bias. Heuristics. Decision making.
Introduction
Child sexual abuse (CSA) is one of the serious socio-pathological phenomena, with the
potential of a whole spectrum of long-term negative consequences on the quality of life of its
victims (Karkošková, 2014). According to one of the latest meta-analysis, the global incidence
of CSA ranges from 8 to 31 % in women and from 3 to 17 % in men (Barth et al., 2013). The
results of selected studies from 11 European countries show that 2.9 – 10.5 % of girls and 0.6
– 5.5 % of boys experienced penetrative forms of CSA; when using a broader definition of
contact forms of CSA, their incidence ranged from 10 to 39.8 % for girls and from 6 to 16.2 %
for boys (Lalor & McElvaney, 2011). According to a recent Slovak survey (Karkošková &
Ropovik, 2019), by the age of 18, penetrative forms of CSA occurred in 5.6 % of girls and 1.3
% of boys; up to 30.2 % of girls and 11.6 % of boys experienced tactile forms of CSA and 40.6
% of girls and 17.7 % of boys reported experience with non-tactile forms of CSA. More than
half of the CSA incidents occurred in the postpubescent period.
The identification of CSA cases is limited by several factors; including for instance whether the
child has symptoms that would raise concerns about the child in the social environment and a
consequent interest in finding out if something has happened to him or her; whether the child
victim confides his or her experience; how the person trusted by the child reacts; whether the
case comes to the attention of the competent authorities (child protective agencies and/or law
enforcement authorities); how the case is being investigated; whether sufficient evidence can
be gathered on the case; and whether the evidence gathered is properly assessed (Karkošková
& Mikulášková, 2018).
At various stages of the potential identification of CSA cases, two types of errors may occur
(Bridges et al., 2009; Pelisoli et al., 2015): (1) false negative conclusion: the conclusion that a
child has not been sexually abused but in fact he/she is a victim of CSA; (2) false positive
conclusion: the conclusion that the child has been sexually abused, when in fact this is not the
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Beliefs of helping professionals within the context of child sexual abuse assessment
3
case. Any erroneous conclusion is highly undesirable – both in relation to victims and
perpetrators (Bolen, 2001, p. 229; Staller & Vandervort, 2010). False positive conclusions
about the CSA can lead to the prosecution of innocent people; to their social stigmatization
(expressions of distrust and moral condemnation from the social environment); to disruption of
family and other close relationships; to job loss; to financial losses; and/or to other negative
consequences to the quality of life of the person concerned and his/her relatives. In addition to
the negative consequences for alleged CSA perpetrators, false positive conclusions about CSA
can also lead to disruption of the psychosocial development of the alleged victims and other
negative consequences on the part of the institutions involved. On the other hand, false negative
conclusions can disrupt or block victims' access to adequate care and protection; can expose
the existing and potential victims of the perpetrator to further abuse in the future; can contribute
to the development of the full range of long-term negative consequences to the lives of CSA
victims (Ullman & Filipas, 2005) (including disruption of social relations and social
stigmatization); can be a source of psychological suffering due to the unenforceability of the
law.
An incorrect assessment of suspected CSA cases can be committed not only by lay people, but
also by relevant helping professionals (especially educators, psychologists, psychiatrists, social
workers, police officers, prosecutors and judges) who gather and evaluate information at
various stages, consider further action and make decisions. In this context, the question of what
contributes to errors in the assessment of relevant cases seems to be crucial, and consequently
the question of how these errors can be prevented.
It is clear that decision-making processes are influenced by various factors, including: (1)
factors related to the case under consideration, (2) organizational factors, (3) external
influences, and (4) factors on the part of the evaluator (Baumann et al., 2011). As a detailed
analysis of all of these factor groups is beyond the limits of this study, the focus is put only on
the role of the evaluator's personal beliefs. Indeed, previous research has shown that personal
beliefs significantly influence the processes by which individuals search for, store, and interpret
relevant information (Kahneman et al., 1982).
1 False beliefs about child sexual abuse
In a study of a sample of Australian police officers who were presented with hypothetical CSA
scenarios, Kite & Tyson (2004) found that the participants tended to treat CSA cases differently
depending on whether the perpetrator was male or female. They were convinced that CSA
committed by a woman had a less harmful effect on victims than CSA where the perpetrator
was a man. Such a belief may reduce the recognition of women as CSA perpetrators and lead
to an underestimation of the investigation of relevant CSA cases. The findings of Australian
researchers confirmed the findings from older English research conducted by Hetherton and
Beardsall (1998) on a sample of police officers and social workers in England.
Finnish research (Finnilä-Tuohimaa et al., 2005), involving social workers working with
children, child psychiatrists and child psychologists, showed that these professionals are not
very familiar with the scientific literature focused on investigating the issue. Although they are
involved in the investigation of CSA cases, they show strong beliefs that are inconsistent with
scientific knowledge. This may affect their judgment when assessing CSA cases and,
ultimately, the overall outcome of the investigation.
Australian researcher Shackel (2008) conducted a review study of existing research that looked
at the beliefs of adults about children's responses to sexual victimization. Her study showed that
many people in society, including some professionals, are falsely convinced that delayed
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disclosure, recantation of the original testimony, and discrepancies in the testimony are unusual
and suggest that CSA allegations are fabricated; that CSA victims are usually afraid of the
perpetrators and do not express love for them; and that most victims show overt negative
emotional and behavioral symptoms of CSA. In addition, many people also falsely believe that
most cases of CSA involve the use of physical force and sexual intercourse, and that there are
usually physical findings indicating CSA in CSA cases. Shackel (2008) stated that
misconceptions about CSA are undoubtedly pervasive.
In particular, in a sample of child psychologists, CSA beliefs were examined by the Finnish
team Finnilä-Tuohimaa et al. (2008). Many of the research participants had misconceptions
about the proper way to conduct the interrogation and about the ability of professionals to
diagnose CSA or detect lies. On average, the participants responded incorrectly to 20 % of 19
factual questions (these were presented in the form of statements whose accuracy or inaccuracy
was unambiguous given the current level of scientific knowledge). Only 4.5 % of participants
answered all factual questions correctly. A total of 2 % of participants provided incorrect
answers to more than 50 % of factual questions. Researchers expressed concern that some
misconceptions about CSA investigations are common among psychologists who potentially
deal with suspected cases of CSA, and that there are psychologists who do have a large number
of misconceptions. This can lead to serious errors in CSA investigations, both in relation to the
investigative methods used and in relation to decision-making processes.
Another Finnish research study (Finnilä-Tuohimaa et al., 2009) focused on the level of expertise
of three groups of professionals (social workers, child psychiatrists and non-private
psychologists) involved in team CSA investigations in Finland. These professionals may
participate in all parts of the investigation (including forensic interviewing of children) and
contribute equally to the conclusions drawn from the investigation. In addition to questionnaires
testing their beliefs about CSA, participants were provided with file materials (related to CSA
cases), which to varying degrees included suggestive techniques used in forensic interviews of
children, as well as files in which transcripts of forensic interviews were absent. As it turned
out, research participants were sensitive to the presence of guiding questions but overlooked
other suggestive techniques, while also overlooking the possibility of using suggestive
techniques in cases where the transcript of the forensic interviews was absent from the file.
According to the researchers, this is an alarming finding, because if professionals do not
recognize the suggestive effects as harmful, they cannot take steps to avoid such effects in cases
where they conduct forensic interviews of children. Equally dangerous can be the blind trust in
other professionals, that they have interrogated the child in a non-suggestive manner although
the transcript of the interrogation is not available.
Swedish researchers (Azad & Leander, 2012) conducted research on a sample of prosecutors,
investigators (who investigate a case and usually conduct a child forensic interview) and
lawyers assigned to victims of sexual offenses in the Swedish legal system and whose main role
is to provide assistance to victims and support for their rights and interests in criminal
proceedings. The researchers were interested in the beliefs and research knowledge these
professionals had on the issue of children's testimonies. Participants were asked to comment on
how detailed, consistent and spontaneous children are in CSA testimonies; how repeated abuse
affects their testimony; and what the optimal number of children's interrogations is. All three
groups of research participants mistakenly assumed that the older a child is, the more details
he/she gives in his/her testimony. This assumption can be reflected in the evaluation of the
credibility of older children's testimonies. However, empirical findings show that, regardless of
age, children may have difficulty reporting CSA and their testimonies may be often fragmented
and austere in terms of sexual abuse details (Bidrose & Goodman, 2000; Leander, 2010; Sjöberg
& Lindblad, 2002). Research participants also tended to agree with the statement that sexually
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5
abused children are consistent in their testimonies. However, their beliefs contradict scientific
findings that consistency of the testimony is not an objective indicator of the veracity of the
testimony (Granhag & Strömwall, 1999). Regarding beliefs about the appropriate number of
interrogations with children, researchers noted a wide variation in responses both within the
group of investigators and within the group of lawyers. Different beliefs between members of
the same professional group may lead to the same child being treated differently depending on
the beliefs of the professionals involved in the case.
Finnish researchers Korkman et al. (2014) conducted research on a sample of judges. The
questionnaire consisted of questions focused on beliefs about the prevalence of CSA in different
age groups of childhood, beliefs about perpetrators and victims, and beliefs about the
investigation process. About a quarter of judges were mistakenly convinced that the child's
biological parent was a typical CSA perpetrator. Three-quarters of the judges mistakenly
believed that observing free-play was a good method to assess suspicions of the CSA. Many
judges had misconceptions about suggestibility and suggestive techniques; e.g., more than 40
% of judges believed that the use of suggestive techniques in interrogation was useful when the
purpose was to get a child to talk about CSA experiences. Half of the judges believed that no
professionals use suggestive techniques when working with children. The researchers expressed
concern about these results, as they may indicate that judges are unable to identify suggestive
techniques potentially present in forensic interviews of children.
Pelisoli et al. (2015) conducted research on a sample of Brazilian and American professionals
from the ranks of psychologists, social workers and doctors, as well as on a sample of non-
professionals from the ranks of university students. One of the main objectives of the research
was to determine the extent to which participants had knowledge of empirical facts that are
important for the optimal forensic assessment of CSA cases and for drawing correct conclusions
about the validity of CSA allegations. Participants were presented with an 18-item
questionnaire, which included statements about the prevalence of CSA in boys and girls, the
dynamics of victims’ disclosure about their experience, the reliability of clinical judgment, the
memory skills of professionals in relation to forensic interviewing they conducted, the impact
of training on forensic interviewing conduct improvement, the impact of length of practice on
the accuracy of clinical judgment, the ability of professionals to detect lies, and the issue of
children's suggestibility. Professionals answered correctly 55 % of items on average. Only 10
% of professionals achieved 80 % or more of correct answers. The researchers found that many
professionals are poorly informed about the scientific knowledge that is the key to the proper
assessment of CSA cases.
The Spanish research team of Márquez-Flores et al. (2016) focused on examining the
knowledge and beliefs about CSA on a sample of teachers working in preschools, primary and
secondary schools, in both public and private sectors. The researchers identified various
misconceptions among these educators; with a dominant representation of the beliefs
concerning the pathological profile of the perpetrators (that they must be mentally disturbed or
ill, or highly unstable individuals); beliefs that most CSA cases involve some form of violence;
beliefs that the victim's peer cannot be the perpetrator; and that children often fabricate CSA.
Researchers noted that such beliefs undermine the ability to identify cases of CSA and lead to
secondary victimization, which exacerbates CSA latency.
U.S. researchers O'Donohue & Cirlugea (2016) point out that the method and outcome of
investigating cases of suspected CSA may also be influenced by professionals' beliefs about the
false accusations incidence. Based on the analysis of previous research related to the subject
matter, they found that while some research on this issue was based on professional judgment
(of respondents) without clarifying the criteria on the basis of which the judgment was formed,
another part of the research used a variety of criteria, many of which were not empirically
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6
confirmed as valid indicators of false allegations. Although there is no scientific evidence to
suggest that false (malicious) allegations of CSA are a frequent phenomenon, that they
constitute the majority or even a sizable minority of all reported cases (O'Donohue & Cirlugea,
2016), many professionals are convinced about the high incidence of this phenomenon and their
ability to recognize it. In this context, several authors point out that false, intuition-based
assumptions and beliefs about how a real victim should react to a CSA may lead to inadequate
questioning of their credibility (Cossins, 2006; Fanflik, 2007; The Crown Prosecution Service,
2013; National Crime Victim Law Institute, 2014), and to conclusions that the cases are
unfounded and/or that they are false allegations (Goodman-Delahunty et al., 2016).
1
2 Beliefs related to the implications of the case assessment
In the above-mentioned Finnish study, researchers Finnilä-Tuohimaa et al. (2009) also noted
the relationship between the sensitivity of professionals (specifically social workers, child
psychiatrists and psychologists) to suggestive elements in children's interrogations and their
attitudes towards children and the criminal justice system. The Pro-Child Beliefs scale consisted
of items such as "Children don't make up stories about CSA because they don't know anything
about such things." Theoretically, achieving a high score on this scale may indicate a tendency
to trust children unconditionally and rule out the possibility of false accusation, i.e., to ignore
the rights of the accused person. The Anti-Criminal Justice System Scale included beliefs, such
as punishments are not severe enough and perpetrators may be released as a result of dubious
experts, lenient courts and sophisticated lawyers. The results of the research revealed that
individuals who scored high on both scales when assessing suspected cases of CSA more likely
assumed that CSA had occurred and believed that the suspect should be convicted in court. At
the same time, their strong beliefs reduced their sensitivity to the presence of suggestive
elements in children's interrogations. The beliefs and attitudes of professionals involved in
clarifying suspected cases of CSA can influence how the evidence is perceived and what
decisions are eventually reached.
Negative beliefs of professionals about the functionality of the system may also affect whether
helping professionals who come into contact with suspected CSA victims will comply with the
statutory reporting obligation at all. For instance, as shown by Swedish research (Talsma et al.,
2015), doctors did not fulfill the reporting obligation because only 30 % of them believed that
the child welfare office would investigate the case and act properly. Distrust in the child welfare
system was also among the dominant causes of non-compliance with the reporting obligation
in research carried out on a sample of American teachers. However, the main reason was the
fear that they were wrong in their suspicion (Kenny, 2001); from which it can be concluded that
they were more convinced of the importance of the presumption of innocence principle and the
need to protect the reputation of the suspected perpetrator than of the need to protect the rights
and interests of the suspected victim.
U.S. researchers Everson and Sandoval (2011) addressed the oft-observed phenomenon that
evaluators examining the same evidence often come to significantly different conclusions in
forensic assessment of suspected CSA cases. The aim of their research was to try to identify
and quantify the subjective factors that contribute to such discrepancies. The research sample
consisted of 1,106 professionals working in various positions, in which they participated in the
forensic assessment of suspected cases of CSA (they were experts in the field of child welfare,
1
Explanation of the so-called counterintuitive reactions of CSA victims is available in Slovak in the study of
Karkošková (2015).
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7
mental health experts, police investigators and prosecutors). The researchers found that the
evaluators' discrepancies about suspected CSA could be partly explained by individual
differences in score levels on scales measuring three attitudes related to forensic decision-
making:
1. emphasis on sensitivity – i.e., focusing on minimizing the occurrence of false negative errors
to prevent the actual victim of CSA from not being identified and cared for;
2. emphasis on specificity – focusing on minimizing false positive errors so that an innocent
person is not convicted;
3. skepticism about children's testimony – individuals with a high degree of skepticism,
approach suspected cases of CSA with the a priori belief that a high percentage of CSA cases
are false.
Researchers note that skepticism and the emphasis on specificity are interrelated but are not
synonymous. Individuals who score high on the scale of skepticism are more likely to
emphasize specificity when making decisions. However, the opposite is not always true. One
can place considerable emphasis on specificity without being prejudiced against children's
testimonies about CSA. Similarly, emphasizing sensitivity over specificity does not require the
belief that all (or most) cases of CSA are true (Everson & Sandoval, 2011). In any case, the
three attitudes mentioned above act as prejudices or predispositions to perceive suspected cases
of CSA as rather true or rather false (Everson & Sandoval, 2011).
When comparing different professions, the researchers found that workers from child protection
services achieved significantly higher scores on the scale of specificity and skepticism than
other professions, but they scored well below the average on the scale of sensitivity. Based on
such results, they can be more likely expected to not believe in CSA suspicions. The attitude
profile of workers from child protection services does not correspond with traditional views on
their role. Suspected cases of CSA, which often enter the system through the child protection
service, should be sensitively captured. A more in-depth investigation into whether the
suspicions are substantiated should ideally be carried out in cooperation with other players in
the system (including the police, the prosecutor's office, the courts, forensic experts). However,
in most cases this will not happen. Thus, if child protection service workers set standards for
substantiating allegations that are too high, there is a risk of many true cases of CSA being
assessed as unsubstantiated, and victims will not receive assistance (Everson & Sandoval,
2011).
Dutch researchers Bartelink et al. (2018) carried out research on a sample of social workers
from child protection services. The participants in the research were presented with a
hypothetical case in which a primary school teacher filed an incentive with the child protection
service to investigate a suspicion that a child was being abused at home. Participants were to
determine if they considered the suspicion to be well-founded, to assess the risk to the child and
to recommend interventions, including answering the question of whether the child should be
removed from the family. It turned out that the decisive influence on their assessment was not
the case characteristics or expectations regarding possible interventions (advantages and
limitations of different interventions), but above all, subjective beliefs in relation to the removal
of the child from the family in general. Professionals who inclined towards the removal of a
child from the family, assessed the risk for the child as increased and were more prone to place
the child in foster care. Professionals who decided that the child should stay at home
emphasized the importance of the biological family. Similarly, earlier Irish research (Spratt et
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8
al., 2015) revealed that professionals tend to subordinate their child welfare decisions to the
values they prefer: either child protection or family preservation.
3 Beliefs about one's own objectivity and expertise
Probably the most sophisticated theory of human reasoning, known as dual process theory
(Kahneman, 2012), points out that two different systems play a role in our decision-making
processes. In the first system, the way of decision-making and finding solutions is based on
intuition and association and is therefore very adaptable and fast, because it requires less
involvement of cognitive functions. The second system, on the other hand, is more analytical,
relies on facts and normative rules, and therefore requires more cognitive resources, which may
not be available (Kahneman, 2012). System 1 acts unconsciously in decision-making and
automatically processes and interprets the information obtained; it is therefore referred to as an
intuitive model. System 2, on the other hand, works with abstract concepts and hypotheses, and
its involvement requires concentration, time, and energy; it is often referred to as an analytical
model.
Professionals dealing with difficult cases need to extract from the large amount of information
those pieces that are needed for the case, having only limited time and cognitive capacity at
their disposal. Therefore, many decisions are made through some kind of mental abbreviations
(heuristics), leading to the achievement of answers that are fast, but may not always be correct
(Martino Baráková, 2020). It is clear that cognitive bias is often behind professionals' decisions
(Finnilä-Tuohimaa et al., 2005, 2009; Gambrill, 2008; MacLean et al., 2019; Petherick, 2020),
with the following being particularly relevant in the context of CSA suspicions:
• Patternicity (apophenia) – the tendency to perceive patterns in the data even when there
is no pattern in them (Petherick, 2020); originally defined as the tendency to find
meaningful patterns in meaningless noise (Shermer, 2008). It may be the result of an
adaptive tendency to reduce complex patterns of information to simplified forms or
explanations (Petherick, 2020). This cognitive error becomes particularly problematic when
the discovery of a non-existent semantic pattern is combined with confirmatory bias
(Petherick, 2020).
• Confirmatory bias – the tendency to seek, interpret, prioritize, and recall information in a
way that confirms our existing beliefs or hypotheses, with disproportionately less attention
being paid to alternatives (Nickerson, 1998).
• Availability bias – the occurrence of a certain phenomenon is assessed on the basis of how
easily the examples of the given phenomenon come to mind and not on the basis of how
frequent the given phenomenon actually is. If some phenomena are often mentioned in
private, in the workplace or in the media, they appear to be more widespread than they really
are (Tversky & Kahneman, 1973). Professionals may exaggerate the likelihood of certain
phenomena, e.g. those they often encounter. This means that those who come across many
cases of suspected CSA in their work may tend to overestimate the likelihood of CSA
(Finnilä-Tuohimaa et al., 2005).
• Anchoring – the tendency to give more weight to the information we encountered initially
than to the subsequent information (Kahneman et al., 1982). However, the initial
information may not be relevant, complete or true at all and may adversely affect judgment.
Professionals are often exposed to conflicting information and may have difficulty
reformulating the original hypothesis in the light of information subsequently obtained.
• Representativness heuristic (representative thinking) (Tversky & Kahneman, 1974) –
this means that professionals with clinical practice combine a certain problem with a certain
characteristic, forgetting that it is possible to have this characteristic without the problem.
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Because clinicians may be in a constant contact with people who have a given problem and
have a given characteristic, they conclude that each new client with both criteria provides
feedback confirming that people with the problem also have that characteristic. For instance,
sexualized behavior in children is often considered the evidence of CSA, although
according to research, no specific behavioral symptom can be considered definitive
evidence of CSA (Friedrich, 1995). This error can only be corrected by clinical practice
based on research findings, not on impressions (Finnilä-Tuohimaa et al., 2005).
• Bias blind spot – is a cognitive bias in which a person can recognize the effect of cognitive
bias in other people, but not in himself/herself. As a result of this bias, the person is
subconsciously convinced that his/her views are correct and objective compared to the
views of others (Pronin et al., 2002).
• Dunning-Kruger effect (Kruger & Dunning, 1999; Krueger & Mueller, 2002) – it states
that the relationship between competence and self-confidence may not be directly
proportional. When knowledge is low, self-confidence tends to be high because the
individual lacks an understanding of exactly how much he/she does not know. With
increasing knowledge, self-confidence tends to decrease as the individual begins to
comprehend the scope of the problem and admits how little he/she knows about the domain
of inquiry. As the level of knowledge increases even more, self-confidence also increases
slightly, as the person begins to develop a sense of mastery. Ideally, self-confidence should
never exceed knowledge (Petherick, 2020).
Cognitive bias may come from three different categories of sources: (1) a specific case –
something about that case causes bias in how the data is perceived, analyzed and interpreted;
(2) a specific evaluator – something about a specific person assessing a case (e.g. experience,
personality, motivation, personal ideology and beliefs, coping with stress and fatigue, the need
to close a case) can cause bias; (3) the natural cognitive architecture of the human brain which
we all share regardless of the specific case or the specific person of the evaluator (Dror, 2020).
Uncertainty is an essential element in the investigation of CSA cases. Research on judgment
and decision making identified several problems of human judgment in situations of
uncertainty, including a wide range of cognitive biases (Finnilä-Tuohimaa et al., 2005, 2009),
which can lead to selective information handling, lack of critical thinking, and failure to
consider alternative hypotheses, which can reduce the quality of decisions (Gambrill, 2008;
Munro, 1999; Saltiel, 2015). When evaluating complex and uncertain information (evidence),
professionals should properly start with a judgment based on the base-rate probabilities of a
given event or phenomenon and then adjust these probabilities based on new information (the
so-called Bayesian approach).
2
However, this is often not the case (Finnilä-Tuohimaa et al.,
2005, 2009). One of the reasons is that professionals do not know the relevant research data on
the incidence of certain phenomena, e.g. relevant data on the prevalence of CSA or on the
prevalence of false accusations of CSA.
Research studies that also analyzed the relationship between the length of practice, beliefs,
scientific knowledge and assessment of one's own expertise on a sample of professionals
involved in investigating CSA cases (Finnilä-Tuohimaa et al., 2005) and judicial decisions in
relation to CSA cases (Korkman et al., 2014) showed that professionals relied more on their
professional experience than on scientific knowledge to assess the level of their own expertise
in relation to the assessment of CSA cases. However, relying on professional experience is
highly risky. Meta-analyses of studies examining the relationship between experience and the
2
For more information on the importance of Bayesian reasoning in the forensic sciences, see e.g. Vrtiška, (2018).
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10
accuracy of clinical judgment concluded that experience alone has a negligible impact on
judgment accuracy (Spengler et al., 2009; Faust & Faust, 2012). At the same time, researchers
noticed one unfortunate consequence of extensive practice (experience) - namely, that over
time, experienced professionals gain an increasing sense of certainty about the correctness of
their judgments - and this is happening without a real improvement in judgment (Faust & Faust,
2012; Korkman et al., 2014; Pelisoli et al., 2015).
The length of practice and the associated professional experience with CSA cases is not a
guarantee of expertise, as professionals may be prejudicial and may lack objective feedback
(Dawes et al., 1989; Garb, 2005; Finnilä-Tuohimaa et al., 2008, 2009; Spengler et al., 2009;
Bridges et al., 2009; Korkman et al., 2014; Pelisoli et al., 2015). The individual can only learn
from experience correctly if he/she receives unbiased and accurate feedback on the conclusions
he/she has reached (Dawes et al., 1989). In this regard, Bridges et al. (2009) note that whenever
experts make a mistake in assessing suspected CSA cases, they are unlikely to be aware of it;
and without clear feedback on the correctness of their conclusions, how can they use their
experience to improve their decisions and methods? An expert who claims that via practical
experience, he/she can distinguish between sexually abused and non-abused children, almost
certainly bases his/her claim on evidence with serious deficiencies and may suffer from false
self-confidence (Bridges et al., 2009). Research shows that professional experience alone does
not correct misconceptions and does not increase expertise in relation to CSA issues (Finnilä-
Tuohimaa et al., 2008, 2009; Korkman et al. 2014). On the contrary, with the length of
professional practice, persuasion in bias can also increase (or in the correctness of one's own
misconception) (Pelisoli et al., 2015). More experienced professionals tend to have a more
intuitive approach to assessing CSA cases (Finnilä-Tuohimaa et al., 2008). Many professionals
may not be aware of the problems associated with learning from experience, as they have been
socialised in their profession to believe that their practice is objective, and that prejudice rather
concerns others (Finnilä-Tuohimaa et al. 2005; Neal & Brodsky 2014).
Although, in general, professionals by virtue of their profession are not automatically immune
to the various cognitive biases in the assessment of the cases they deal with, particular concerns
about their objectivity arise in situations where they assess the case on the basis of private
requests from those affected. Research looking at the ability of experts to maintain objectivity
and accuracy when hired to carry out a private expert opinion has reached alarming conclusions.
In such situations, experts tend to "abandon objectivity" and become "advocates" for the party
that hired them. Research has shown that different experts can reach conflicting conclusions in
relation to the same person under investigation, even if they use procedures designed to increase
objectivity and reliability. Although the subject examined achieved the same score in the same
test, the results were interpreted differently by different experts (Murrie et al. 2013; Murrie &
Boccaccini 2015; Guarnera et al. 2017). This phenomenon also applies to the interpretation of
scores in tests designed to assess the risk of sex offenders (Chevalier et al. 2015). The
mechanism behind this phenomenon is probably similar to subconscious heuristics and
cognitive biases, which disrupt judgment in many other situations as well.
4 How can the assessment of child sexual abuse cases be improved?
In order to improve practice and reduce errors in the assessment of the cases in question, several
strategies need to be applied. The starting strategy should be the continuous training of relevant
professionals. In order to eliminate widespread misconceptions about CSA, participants should
be confronted with current scientific knowledge on CSA issues, encouraged to reflect on their
own beliefs that may influence the assessment of cases, get acquainted with the difficulties of
human judgment in situations of uncertainty, and be led to the acquisition of the so-called
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Beliefs of helping professionals within the context of child sexual abuse assessment
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Bayesian reasoning and effective methods to eliminate cognitive bias (Bartelink et al., 2018;
Finnilä-Tuohimaa et al., 2005, 2008, 2009; Korkman et al., 2014; Pelisoli et al., 2015;
Petherick, 2020).
The first step in dealing with cognitive biases is to recognize their existence and the impact they
can have on hard-working, determined and skilled professionals. In this context, Dror (2020)
speaks of the need to get rid of the six misconceptions about cognitive biases that professionals
often have: (1) that it is only a matter of personality, integrity and morality (i.e., that bias applies
only to corrupt and ruthless individuals); (2) that it is a question of competence; i.e., it only
happens to professionals who do not know how to do their job properly; (3) that experts are
impartial and immune to cognitive bias; (4) that the use of modern technology or artificial
intelligence guarantees protection against human prejudice; (5) that other experts, but not me,
are affected by the bias; (6) that if I realize that biases can affect me
3
, I can control them by
force of will.
Precise work with hypotheses is considered to be an effective strategy for eliminating various
biases. After a thorough collection and acquaintance with the information on the case, it is
necessary to develop a range of alternative hypotheses that take into account each possibility or
probability. Subsequently, each hypothesis should be tested on the basis of the available facts,
and efforts should be made to refute it rather than confirm it. If, however, there are still several
hypotheses that cannot be definitively ruled out, it is necessary to proceed with an exploration
of competing hypotheses, in which a summary of the evidence supporting (+) or refuting (-)
each hypothesis is made and the hypothesis with the highest support (the most +) is finally used
as a working hypothesis for a given case (Petherick, 2020; Berman & Killeen, 2019).
Furthermore, it is necessary to build a culture of evidence, not belief (Petherick, 2020). An
effective way of protection against errors and failures is to follow the evidence - to take into
account the data available and the data that are missing and to reflect how it limits our analysis
and what follows from this in relation to the conclusions drawn in a particular case (Petherick,
2020). Ideally, the evaluator (e.g. the forensic expert) will have information that is highly valid,
highly reliable and sufficient. The further the situation moves from the ideal, the more room
there is for speculation. In any case, the weight of evidence should be clearly communicated
and the evaluator 's conclusions should be formulated in probability categories (Petherick,
2020). Undoubtedly, the subject of the supervision of suspected CSA cases should also be the
examination of the potential presence and impact of personal beliefs of helping professionals
in decision-making processes.
In the case of expert opinions, in order to increase their objectivity, it is recommended to submit
a draft to an independent review (Otgaar et al., 2017; Petherick, 2020). The reviewer should not
know whose work he/she is evaluating and at the same time the evaluated person should not
know who the reviewer is. The reviewer's role is to examine the draft, to determine whether the
expert has carefully used the scientific literature and information in the file to support his/her
hypotheses and conclusions, and to make critical comments if necessary.
4
Everson and Sandoval (2011) state that a multidisciplinary approach to case assessment may
be particularly useful in order to provide alternative perspectives and reduce individual
3
Many professionals mistakenly believe that introspection is the most useful strategy to prevent cognitive bias
and prejudice. In fact, this strategy is ineffective and may even exacerbate prejudice; when looking inward, the
professional does not notice any bias and succumbs to a false sense of reassurance (Neal & Brodsky 2016;
MacLean et al. 2019).
4
Such an approach (independent review of the draft) is a common practice among Dutch forensic psychologists
(Otgaar et al., 2017).
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Beliefs of helping professionals within the context of child sexual abuse assessment
12
prejudices. However, the impact of such a group approach on the final outcomes of the case
assessment process has not yet been sufficiently scientifically examined (Capacity Building
Center for States, 2017). In this context, it should be noted that the bias does not affect only the
individual in isolation or only one aspect of the work; often the bias cascades from one person
to another, from one aspect of work to another and affects various elements of the investigation
and assessment of a case (Dror, 2020).
In addition to the above-mentioned strategies, one should bear in mind that activating the
analytical model of reasoning (as opposed to intuitive) requires not only an awareness of the
risks of various biases, but also sufficient time and energy. In order for evaluators to focus fully
on the specific task, “slowing down” workplace strategies are recommended (Neal & Brodsky,
2016, p. 60). An excessive number of assigned cases and time pressure push the evaluator's
thinking more into the sphere of intuition and cognitive abbreviations, which can negatively
affect the quality of decisions (Martino Baráková, 2020).
Conclusion
CSA cases are often a confusing mosaic of complex data. The present study has shown that the
ability to identify, integrate and draw reasonably correct conclusions from multidimensional
and complex data without being influenced by cognitive biases and prejudices requires not only
expertise but also good decision-making skills reflecting the difficulties of human judgment in
situations of uncertainty. Affiliation to a certain helping profession and the length of practice
do not in themselves guarantee that the helping professional has knowledge that is in line with
the current state of scientific knowledge in relation to CSA. Previous research has shown that
members of various helping professions have many misconceptions that can lead to errors in
identifying, investigating and assessing suspected CSA cases. If for instance judges are carriers
of prejudices or if they do not notice the bias of other professionals who are involved in
clarifying CSA cases, judgments may be prone to error (Korkman et al., 2014). Errors in
assessing CSA cases cannot be completely eliminated, but to understand how they arise and
what far-reaching consequences for the lives of the persons concerned they may have can
motivate the introduction of measures to achieve improvements in the processes of assessing
these difficult cases. This represents a special challenge for the Slovak context, in which the
issue in question has not yet been properly reflected either in application practice or in
professional and scientific publications. We consider the main benefit of this study to be the
filling of the mentioned gap in the literature.
Given that no research has yet been carried out in Slovakia to map the nature and occurrence
of various beliefs of professionals coming into contact with CSA cases, along with the impact
on decision-making processes, the present study may be an inspiration for preparing research
projects with this focus.
Acknowledgements:
This work was supported by the Slovak Research and Development Agency under the
contract No. APVV-16-0471.
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