Early childhood memories of individuals convicted of sexual offences.

This study used innovative transdisciplinary methods to describe the nature and extent of early childhood memories recalled by 84 adults convicted of sexual offences. The timing of the memories, level of detail recalled and way memories were recollected were largely consistent with extant memory research. One important finding, however, was that more than 30% of our participants recalled particularly traumatic and distressing childhood experiences - a much higher proportion than previously observed in nonoffending samples. The extent to which these memories laid the foundation for subsequent emotional content and feature in the evolution of cognitive schemata is not yet well understood. With that in mind, we consider the implications of our findings for the event centrality in self-narratives. We recommend the inclusion of treatment modalities that maximise as yet unrecognised and undervalued narrative inclinations and story-telling abilities of a complicated population of individuals with rich lived experience that stands to benefit greatly from such approaches.

Eliciting an offence narrative: what types of questions do forensic mental health practitioners ask?

Maximising the accuracy and detail of information elicited through a clinical-forensic interview may increase the reliability and validity of an individual's assessment. Despite this, there is little empirical research on what questions forensic mental health practitioners employ, and whether these correspond with empirically established interviewing strategies. In this study, 22 forensic mental health practitioners participated in a mock interview of a young person referred for a sexual risk assessment. The results highlighted that participants asked very few 'open' questions, over-relied on 'specific' questions and an average of 13% of questions were leading. Finally, practitioners predominantly used 'yes/no' questions when exploring the young person's thoughts, feelings, and physiological responses. Overall, the study demonstrated that empirically supported interviewing techniques were not commonly employed and highlighted the need for further professional development and training around clinical forensic interviewing strategies that best elicit the information needed to inform risk assessment.

"We're All Time Poor": Experienced Clinicians' and Students' Perceptions of Challenges Related to Patient Communication.

PHENOMENON: Communication is a complex and essential element of clinical practice. It is widely accepted that communication skills can be taught and learned, but challenges remain for clinicians in achieving effective communication with patients. This study explored the patient-communication challenges faced by both medical students and experienced clinicians. APPROACH: Semi-structured interviews were conducted with twenty medical students and nineteen experienced clinicians from a range of medical disciplines. Interviews were recorded and transcribed, and transcriptions subjected to thematic analysis and coding to quantify the challenges discussed. FINDINGS: There was remarkable consistency in the challenges described by both groups of participants, with eight predominant challenges identified: time constraints and chaotic environments, rapport building, patient characteristics, reluctance, omissions, assumptions, decision-making, and keeping conversations focused. INSIGHTS: Medical curricula often focus on communication challenges associated with complex or sensitive clinical situations, but many of the challenges identified occur in routine consultations. Both pre-service and post-graduate medical training should adopt strategies to help build students' and clinicians' skills in managing these challenges from the outset of training.

Professionals' perceptions of a multi-agency computerised data sharing system.

We examined the perceptions of multi-agency child abuse investigation professionals following the implementation of an independent computerised data linkage system for case tracking purposes. Semi-structured interviews (N = 30) were conducted with child protection workers and police officers, from both frontline and managerial roles, to explore their experiences in adapting to the new technology. Interview transcripts were coded and analysed using thematic analysis, focusing on the semantic meaning of the data. Four multifaceted themes were generated, of which three (understanding the rationale for change; system implementation and its limitations; and the role of technology within the organisational structure) showed strong divergence between frontline workers and management. While executives highlighted the benefits of the new system, frontline workers (overall) held a negative view about the system's usefulness and impact on workload. The implications of the findings are discussed.

The ability of adults with limited expressive language to engage in open-ended interviews about personal experiences.

This study examines how adults with limited expressive language (with average sentences of five words or less) respond to open-ended questions. Participants (n = 49) completed a baseline measure and were then interviewed about a personal experience using exclusively open-ended questions, followed by open-ended and directive questions about a staged event. Their interviews were coded for mean length of utterance (MLU), number of different words and six dimensions of the Narrative Assessment Profile. Descriptively, the participants were able to give some event-related detail in their narratives, but there was wide variability in narrative quality. Correlational and regression analyses indicate that their MLU was stable across contexts. The findings suggest that adults with limited expressive language can provide informative responses to open-ended questions about their experiences, and that their expressive language is likely to show stability across introductory and substantive interview phases.

Interventions for improving medical students' interpersonal communication in medical consultations.

BACKGROUND: Communication is a common element in all medical consultations, affecting a range of outcomes for doctors and patients. The increasing demand for medical students to be trained to communicate effectively has seen the emergence of interpersonal communication skills as core graduate competencies in medical training around the world. Medical schools have adopted a range of approaches to develop and evaluate these competencies. OBJECTIVES: To assess the effects of interventions for medical students that aim to improve interpersonal communication in medical consultations. SEARCH METHODS: We searched five electronic databases: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, and ERIC (Educational Resource Information Centre) in September 2020, with no language, date, or publication status restrictions. We also screened reference lists of relevant articles and contacted authors of included studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs), cluster-RCTs (C-RCTs), and non-randomised controlled trials (quasi-RCTs) evaluating the effectiveness of interventions delivered to students in undergraduate or graduate-entry medical programmes. We included studies of interventions aiming to improve medical students' interpersonal communication during medical consultations. Included interventions targeted communication skills associated with empathy, relationship building, gathering information, and explanation and planning, as well as specific communication tasks such as listening, appropriate structure, and question style. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. Two review authors independently reviewed all search results, extracted data, assessed the risk of bias of included studies, and rated the quality of evidence using GRADE. MAIN RESULTS: We found 91 publications relating to 76 separate studies (involving 10,124 students): 55 RCTs, 9 quasi-RCTs, 7 C-RCTs, and 5 quasi-C-RCTs. We performed meta-analysis according to comparison and outcome. Among both effectiveness and comparative effectiveness analyses, we separated outcomes reporting on overall communication skills, empathy, rapport or relationship building, patient perceptions/satisfaction, information gathering, and explanation and planning. Overall communication skills and empathy were further divided as examiner- or simulated patient-assessed. The overall quality of evidence ranged from moderate to very low, and there was high, unexplained heterogeneity. Overall, interventions had positive effects on most outcomes, but generally small effect sizes and evidence quality limit the conclusions that can be drawn. Communication skills interventions in comparison to usual curricula or control may improve both overall communication skills (standardised mean difference (SMD) 0.92, 95% confidence interval (CI) 0.53 to 1.31; 18 studies, 1356 participants; I² = 90%; low-quality evidence) and empathy (SMD 0.64, 95% CI 0.23 to 1.05; 6 studies, 831 participants; I² = 86%; low-quality evidence) when assessed by experts, but not by simulated patients. Students' skills in information gathering probably also improve with educational intervention (SMD 1.07, 95% CI 0.61 to 1.54; 5 studies, 405 participants; I² = 78%; moderate-quality evidence), but there may be little to no effect on students' rapport (SMD 0.18, 95% CI -0.15 to 0.51; 9 studies, 834 participants; I² = 81%; low-quality evidence), and effects on information giving skills are uncertain (very low-quality evidence). We are uncertain whether experiential interventions improve overall communication skills in comparison to didactic approaches (SMD 0.08, 95% CI -0.02 to 0.19; 4 studies, 1578 participants; I² = 4%; very low-quality evidence). Electronic learning approaches may have little to no effect on students' empathy scores (SMD -0.13, 95% CI -0.68 to 0.43; 3 studies, 421 participants; I² = 82%; low-quality evidence) or on rapport (SMD 0.02, 95% CI -0.33 to 0.38; 3 studies, 176 participants; I² = 19%; moderate-quality evidence) compared to face-to-face approaches. There may be small negative effects of electronic interventions on information giving skills (low-quality evidence), and effects on information gathering skills are uncertain (very low-quality evidence).  Personalised/specific feedback probably improves overall communication skills to a small degree in comparison to generic or no feedback (SMD 0.58, 95% CI 0.29 to 0.87; 6 studies, 502 participants; I² = 56%; moderate-quality evidence). There may be small positive effects of personalised feedback on empathy and information gathering skills (low quality), but effects on rapport are uncertain (very low quality), and we found no evidence on information giving skills. We are uncertain whether role-play with simulated patients outperforms peer role-play in improving students' overall communication skills (SMD 0.17, 95% CI -0.33 to 0.67; 4 studies, 637 participants; I² = 87%; very low-quality evidence). There may be little to no difference between effects of simulated patient and peer role-play on students' empathy (low-quality evidence) with no evidence on other outcomes for this comparison. Descriptive syntheses of results that could not be included in meta-analyses across outcomes and comparisons were mixed, as were effects of different interventions and comparisons on specific communication skills assessed by the included trials. Quality of evidence was downgraded due to methodological limitations across several risk of bias domains, high unexplained heterogeneity, and imprecision of results. In general, results remain consistent in sensitivity analysis based on risk of bias and adjustment for clustering. No adverse effects were reported.  AUTHORS' CONCLUSIONS: This review represents a substantial body of evidence from which to draw, but further research is needed to strengthen the quality of the evidence base, to consider the long-term effects of interventions on students' behaviour as they progress through training and into practice, and to assess effects of interventions on patient outcomes. Efforts to standardise assessment and evaluation of interpersonal skills will strengthen future research efforts.

Professionals' views on how to conduct investigative interviews with adults with limited expressive language.

Adults with communication impairment are vulnerable to abuse and are over-represented as victims in the criminal justice system. Investigative interviewers rely largely on verbal accounts to establish whether a criminal offence occurred, and therefore the way these accounts are elicited is paramount. To date, little research has evaluated whether current interviewing protocols are appropriate for eliciting accurate and detailed information from adults with communication impairment. The present study explored this issue through qualitative interviews with professionals from various disciplines. Specifically, professionals (N = 22) who had extensive experience in interviewing, disability advocacy, and cognitive and communication impairment reflected on current recommended practice and how it could potentially improve. The results indicated widespread support for the current (open questioning) approach, although the professionals perceived that additional verbal and visual scaffolding could potentially enhance the amount of detail obtained without compromising accuracy. Suggestions for interview protocol modifications and future research are discussed.

Assessing the training needs of medical students in patient information gathering.

BACKGROUND: Effective communication is at the heart of good medical practice but rates of error, patient complaints, and poor clinician job satisfaction are suggestive of room for improvement in this component of medical practice and education. METHODS: We conducted semi-structured interviews with experienced clinicians (n = 19) and medical students (n = 20) to explore their experiences associated with teaching and learning clinical communication skills and identify targets for improvements to addressing these skills in medical curricula. RESULTS: Interviews were thematically analysed and four key themes emerged; the importance of experience, the value of role-models, the structure of a consultation, and confidence. CONCLUSIONS: The findings reinforce the need for improvement in teaching and learning communication skills in medicine, with particular opportunity to target approaches to teaching foundational skills which can establish a strong grounding before moving into more complex situations, thus preparing students for the flexibility required in medical interviewing. A second area of opportunity and need is in the engagement and training of clinicians as mentors and teachers, with the findings from both groups indicating that preparation for teaching and feedback is lacking. Medical programs can improve their teaching of communication skills and could learn from other fields s to identify applicable innovative approaches.

Forensic risk assessment interviews with youth: how do we elicit the most reliable and complete information?

When undertaking a forensic risk assessment with a young person, most evaluators complete an assessment interview to elicit autobiographical history as well as perspectives, thoughts and feelings about the individual's offending behaviour. While forensic risk assessment tools provide some suggestions on interview questions and techniques, there is no empirical research that explores the most effective strategies for eliciting detailed and reliable information in this context. This article reviews existing recommendations from the related fields of investigative interviewing and suicide risk assessment and integrates this with guidance from the forensic risk assessment literature to identify best practice recommendations for evaluators. It is hoped that this review will provide a starting point to explore how research from other fields may be integrated into risk assessment interviews to improve the quality and accuracy of forensic assessment.

The effects of episode similarity on children's reports of a repeated event.

Much research has tested techniques to improve children's reporting of episodes from a repeated event by interviewing children after they have experienced multiple episodes of a scripted event. However, these studies have not considered any effects of the similarity shared between event episodes on children's reports. In the current study, 5- to 9-year-olds experienced four episodes of a scripted repeated event that shared a high (n = 76) or low (n = 76) degree of similarity, and were subsequently interviewed about individual episodes. The proportional amount and accuracy of children's reported details were tallied. Children reported proportionally more details and more script deviations after experiencing the high, compared to low, similarity event. Conversely, children were more accurate in their episodic reports when they experienced the low, compared to high, similarity event. The current findings have implications for the generalisability and comparability of past results across laboratory studies.

Effects of interviewer familiarity and supportiveness on children's recall across repeated interviews.

OBJECTIVES: Child witnesses often describe their experiences across multiple interviews. It is unknown whether talking with a familiar interviewer increases disclosures, however, or whether any benefits of a familiar interviewer could be achieved by ensuring that interviewers (regardless of familiarity) behave in socially supportive ways. This study tested the effects of interviewer familiarity and social support on children's reports of an adult's transgressions. HYPOTHESES: We predicted that familiarity and supportiveness would increase transgression reports at a second interview and that children who spoke with familiar, supportive interviewers would disclose the most transgressions. METHOD: Children (N = 160, 5 to 9 years) participated in a science event involving 6 transgressions. Across 2 interviews, they spoke with the same trained university student interviewer or different interviewers, and these interviewers engaged in supportive or neutral behaviors. Interviews were coded for overall information reported, number of transgressions, and confabulations. RESULTS: There were no effects of support in the first interview or on total details reported in either interview. Children reported more transgressions to supportive than neutral interviewers in the second interview (IRR = 1.19), even during open-ended prompting (IRR = 1.26), and they omitted fewer transgressions that had been reported in the first interview (IRR = 0.69). Confabulations were infrequent. There were no condition differences in the total number of confabulations reported across interviews, but these errors occurred more often in the second interview in the supportive condition. CONCLUSIONS: Interviewer support may play a greater role than familiarity in facilitating children's testimony. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Australian stakeholders' views on improving investigative interviews with adult sexual assault complainants.

Investigating sexual assault is one of the most challenging tasks in modern-day policing. Because investigators must rely largely on the account provided by the complainant to establish whether or not a criminal offence has occurred, the way in which these accounts are elicited becomes paramount. Although there is a strong empirical consensus on how to maximise the completeness and accuracy of eyewitness accounts, several researchers have suggested modifying adult sexual assault interview protocols to better satisfy investigative and evidential needs and to provide complainants with a greater level of emotional support. This article explores professional stakeholders' views on what form these changes might take, and identifies the broad themes that drive these views.

An Evaluation of the Impact of Australia's First Community Notification Scheme.

In 2012, one Australian state became the first jurisdiction in Australasia to introduce a scheme that allows information about registered sex offenders to be released to the public. This study seeks to better understand the impact of the scheme from the perspective of the police. An analysis of interviews with police officers responsible for the administration of the scheme is supplemented with an analysis of official data relevant to its implementation. The results provide little evidence that the concerns voiced by the police about the introduction of community notification have been realised. There is no consistent view that it has significantly increased the workload of the police responsible for its management, impacted adversely on offenders' psychological well-being, led to vigilantism or resulted in offenders' non-compliance with reporting obligations. The findings of this study may usefully inform the development of policy and practice in places that are considering introducing similar policies.

Evaluation of a Database for Tracking Cases of Child Sexual Abuse.

Administrative databases are used by criminal justice professionals to guide specialist responses to crimes of child sexual abuse. Assumptions might be made that the database will be accurate, contemporaneous, complete, and meaningful; however, this may not be the case. The main aim of the current study was to critically evaluate a database used by practitioners for tracking cases of child sexual abuse, in order to identify evidence that may justify investment in improved data gathering and centralised information management systems. Three data quality dimensions were examined: (1) completeness, measured as data that were not missing and were of adequate breadth and depth, (2) accuracy, namely that the data are correct, and (3) believability, where the data may be regarded as credible or plausible. Results indicated that data quality was of concern for all three dimensions, with missing and inaccurate data found across a range of variables, and issues with believability found on two variables. The implications of these results for development of new data documentation methods are discussed.

Professionals' Perspectives about the Challenges of Using Interpreters in Child Sexual Abuse Interviews.

Interpreters play a crucial role in many investigative interviews with child complainants of sexual abuse; however, little has been written about the interpreting process from the perspective of the interviewers. This study elicited interviewers' perspectives about the challenges of using interpreters, with the aim of understanding how investigative interviews could be improved. The participants consisted of 21 investigative interviewers and prosecutors of child abuse cases (from a range of jurisdictions) who use interpreters on a regular basis. Thematic analysis of semi-structured interviews with the professionals about the interpreting process revealed two main challenges particular to child abuse interviews, namely the interpreters' lack of preparedness to deal with the traumatic and sensitive nature of children's abuse histories, and an insufficient understanding of 'best-practice' child interview process. The recommendations focus on the need for more specialised training for, and screening of, interpreters, and more extensive use of pre-conferencing to familiarise children with the interpreter-mediated interview process.

Prosecutors' Perceptions on Questioning Children about Repeated Abuse.

The purpose of this study is to elicit guidance from prosecutors across Australia on questioning children about repeated events. Two focus groups were conducted. The first sought broad feedback concerning questioning children about repeated events. The second focused more specifically on eliciting feedback about techniques for aiding children in describing specific instances of repeated events. The techniques used are derived from a combination of empirical research and best practice interview guidelines. Data from both focus groups were compiled because themes were highly similar. Thematic analysis of the focus group discussions revealed three broad themes in prosecutors' perceptions about questioning children about repeated abuse: a) permitting children to provide a full generic account before describing individual episodes of abuse, b) using the information obtained during the generic account to create episode labels, and c) probing incidences of abuse chronologically. These themes are discussed within the context of the child development and mnemonic literature, and implications for interviewing protocols are drawn.

A qualitative evaluation of the challenges faced by dieticians when interviewing children.

BACKGROUND: Investigative interviewing is a critical and challenging skill involved in the assessment and design of appropriate interventions for children's dietary problems. The current study provided an evaluation of the challenges faced by professional dieticians when conducting child investigative interviews, in the hope that this would provide a framework for the development of further guidance and resources in this important area. METHODS: Fourteen professional dieticians were interviewed; they were asked about the information that they needed to elicit from children in particular situations and the questions that they would ask to do so. They were also asked to describe the strengths and limitations of the techniques that they used. RESULTS: The results revealed that professionals faced three main challenges. The first challenge was eliciting information from children who did not want to answer questions. The second challenge was determining the level of accuracy in children's (and caregivers') responses. The third challenge was eliciting very specific information in particular situations, such as determining the cause of an allergic reaction. CONCLUSIONS: Overall, professionals had difficulty articulating the questions that they would use to elicit the information that they required; indeed, their responses focused more on the content that they wanted to elicit (such as specific details) rather than the overall process that they would use to do so. Professionals may benefit from the development of guidelines to assist them in their interviews with children, based on what is currently known about interviewing children generally.

Investigative Interviewing of Aboriginal Children in Cases of Suspected Sexual Abuse.

This study examined the investigative interviewing of Australian Aboriginal children in cases of alleged sexual abuse, with a focus on three commonly included components of interview protocols: ground rules, practice narrative, and substantive phase. Analysis of 70 field transcripts revealed that the overall delivery and practice of ground rules at the beginning of the interview was positively associated with the spontaneous usage of rules in children's narratives of abuse. When specifically examining the "don't know" rule, however, only practice had an effect of children's usage of the rule (as opposed to simple delivery or no delivery at all). Children spoke more words overall, and interviewers used more open-ended prompts during the substantive phase when the interviews contained a practice narrative. Children most often disclosed sexual abuse in response to an open-ended prompt; however, they produced the most words in response to suggestive prompts. This article concludes with a discussion of the effectiveness of ground rules, practice narratives, and questioning with Aboriginal children.

The Effects of Practice on Children's Ability to Apply Ground Rules in a Narrative Interview.

Despite the widespread use of ground rules in forensic interview guidelines, it is unknown whether children retain and apply these rules throughout narrative interviews. We evaluated the capacity of 260 five- to nine-year-olds to utilize three ground rules. At the beginning of the interview all children heard the rules; half also practiced them. Children then responded to open-ended prompts about a repeated laboratory event and were assessed for their application of the rules. Logistic regressions revealed that practice only benefitted the use of the "don't know" rule. Although the children accurately answered "don't understand" and "correct me" practice questions, practice appeared to give no greater benefit than just hearing the rules. Results suggest that the current format of ground rule practice in interview guidelines is appropriate for the "don't know" rule, but the other rules may require more extensive practice with this age group.

Detecting orphanage trafficking and exploitation.

BACKGROUND: There is growing awareness that a proportion of children in orphanages have been recruited or transferred into the facility for a purpose of exploitation and/or profit. These children are often falsely presented as orphans to evoke sympathy and solicit funding. This process is known as orphanage trafficking. Although orphanage trafficking can be prosecuted under legal frameworks in some jurisdictions, including Cambodia, there have been limited prosecutions to date. One factor that likely contributes to a lack of prosecution is poor detection, yet the indicators of orphanage trafficking have not been considered by extant research. OBJECTIVE: The current study was conducted as a first step towards providing evidence-based indicators of orphanage trafficking. PARTICIPANTS AND SETTING: Professionals who had identified or responded to cases of orphanage-based exploitation in Cambodia were interviewed. Participants included criminal justice professionals, investigators from civil society organisations, and child protection social workers. METHODS: Professionals' perspectives on how to identify orphanage trafficking were explored via in-depth interviews, and the data were analysed via thematic analysis. RESULTS: The analysis revealed a distinct set of indicators that may be used to detect orphanage trafficking, including the operation of an unauthorised facility, orphanage tourism and volunteering, and an overt focus on fundraising. CONCLUSION: The indicators revealed in this study point to the need for an effective and thorough monitoring system for orphanages, as well as adequate education and training of relevant personnel to aid in the detection of orphanage trafficking.