How Psychological First Aid is useful when Children are testifying in Court

“Why do I have to go through this, didi….even when I did not make any mistake”.

During one of my counseling sessions, a girl victim of sexual offence, 16 years old, told me that she did not want to repeat her statement in the courts. It wasn’t that she was scared. But just the act of repeating her statement all over again threatened to return her to memories she was trying to hide and move away from.

I remembered her words when I read the news about Bombay High Court asking the Maharashtra government to set up child-friendly courts as priority. This was to ensure that children deposing in courtroom do not feel fear and apprehension. The news report stated how the special courtrooms would have child friendly infrastructure and safety requirements that would serve to dispel the distress experienced by children. However, is child friendly infrastructure the solution to the fear and re-traumatization experienced by children when they journey through the courts?

But when I think back to the 16 year old victim and many others who have confided the deep fear of deposing in courts, I cannot help but feel that child friendly infrastructure is only part of a larger solution. More urgent is that the existing infrastructure and the systems be peopled by professionals who are sensitive to children and have awareness around trauma and its symptoms.

So, what does being sensitive to the child actually mean? Is it limited to offering chocolates or ice-cream to the child? Or are there other ways?

Before looking at solutions, there is a need to understand why child victims find it distressing to recall the abuse.

The Distress of Remembering Abuse in Courts:

In cases of sexual abuse, children may tend to forget the details of the incident as part of coping with the situation or dissociation which is a mental process of disconnecting from one’s thoughts, feelings, memories or sense of identity. Remembering these details may evoke several emotions which could have positive as well as negative implications. The positive aspect is that the child is able to remember each and every detail, however the negative consequence are loop of intrusive thoughts. While attempting to narrate the incident, there is a good chance that children feel that they are undergoing and experiencing the incident all over again. This may ultimately lead to re-traumatization (Pantell, 2017).

Thus, the evidence recording process in Indian courts which demands that the child narrate the incident in minutiae may potentially lead to creating an emotional disturbance in the mind of child.

The Anxiety of Going to Court:

Studies have established clearly that children experience anxiety and stress surrounding court appearance (Pantell, 2017). Children walking into the court premise go through feelings of fear, anticipation, confusion, anxiety etc.The major fears associated with evidence recording include; facing the alleged accused, embarrassment about crying and not being able to answer questions (Pantell, 2017). Some of the physical manifestations include sweating, shivering hands, keeping silence, looking down, being numb and not responding.

To ensure that the child is resilient and recovers from the stressors associated with court appearances, psychological first aid is an effective strategy.

What is Psychological First Aid (PFA):

Psychological First Aid (PFA) is the primary support which can be provided to a child going through a distressing event. It is a sensitive manner of responding to children that can reduce the initial stress and avoid the re-traumatization which may happen when child sexual abuse victim testifies in the court. It can help prevent short term and long term mental health issues.

PFA enables the practitioner to establish contact with the child, assess whether child is feeling safe and comfortable, and if not, to stabilize the child, understand their needs as well as provide practical assistance.

The Basics of Administering PFA:

Unlike counseling, PFA need not be carried out only by professionals. Anyone who has been trained and is capable can administer it.

Establishing Contact: Right at the start, PFA emphasizes the need for letting the child know the name of the practitioner along with the role that the person is going to play in relation to the child. (For eg: I am X working with YZ organization). This is established even before eliciting the details of the child. It is also important to note that the permission of the child needs to be taken before asking questions. This evokes the agency of the child and ensures that the child feels that their participation is being considered rather than coerced.

Stabilizing the child: More the child is frightened; less would be the child’s ability to answer the questions. Therefore before eliciting information about the incident, it is important to stabilize the child and make him/her comfortable in the environment. ( Pantell, 2017)

The first step in stabilization is explaining the procedures and court set-up to the child. This includes an overall idea about how many people may be present in the court, who would be asking questions to the child etc. This can be followed by providing items that give physical comfort to the childlike soft toys, smiley-faced stress balls etc. This must be based on the age and preferences of the child. One must actively and at regular intervals inquire if the child is hungry or thirsty.

Psycho-educating about flashbacks or intrusive thoughts: The child needs to be made aware that the flashbacks or intrusive thoughts are not real. That these thoughts exist only in the brain. It is important to convey to the child that such heightened emotions are normal and commonplace, especially when one speaks about such incidents. Keep emphasizing to the child that they are safe.

Grounding techniques: Grounding is a technique that helps keep the child rooted in the present. They help reorient a person who is being overwhelmed back to the here-and-now and in reality. Grounding skills can be useful in managing overwhelming feelings or intense anxiety. They help people to regain their mental focus from an often intensely emotional state or memory. Some of the grounding techniques useful for children during intense trauma memories are:

  • Providing an object to touch or feel: This would include soft toys or stress balls which they can be squeezed to relieve the tension in the body.
  • Finger acupressure exercise: Gently pressing each segment of the finger for 3 or more than three times. Completing this exercise one round on each finger.
  • Breathing exercise: If the child is crying or blank while narrating the incident, telling him /her to take deep breath five times before any further questions are asked.
  • Sensory awareness grounding exercise: Asking the child to name five things they can see in the room, four things that they can feel (chair on back or feet on floor), three things can hear (sound of vehicle horn), two things that they can smell or their favorite smell and one good thing about themselves (Coping Skills for Trauma).
  • After the evidence recording, providing Mandala sheets and coloring books which could take child’s mind off from the traumatic memories.

The art of sensitively dealing with children also demands that the professional need to reframe questions and ask in an age-appropriate way. Providing a safe space to narrate the incident would help in reducing short term or long term mental health issues. An enabling and supportive environment with professionals with positive attitude is the way forward.

Reference:

  • Peirsac. (2019). Retrieved February 7, 2019, from https://www.peirsac.org/peirsacui/er/educational_resources10.pdf
  • Pantell, R. H. (2017). Robert H. Pantell. American Academy of pediatrics.
ARTICLE WRITTEN BY: SHARON ANN SABU, Counsellor, Strengthening Child Protection Systems in Maharashtra.

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