Assessment of Child Crime Victims

Published in: Mental Health Care for Child Crime Victims: Standards of Care Task Force guidelines / Michele Winterstein, Scott R. Scribner (eds.) (Sacramento, CA: Victim Compensation and Government Claims Board, Victims of Crime Program, 2001), Ch. 4, p. 4-1-4-20

Posted on RAND.org on January 01, 2001

by Michele Winterstein, Bradley D. Stein, Penny Knapp, Barbara Agen Ryan

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Child victims deserve timely and skilled assessment of how the crime has affected their lives and what will help them recover. The initial clinical assessment provides the basis for developing an effective crime-related treatment plan. However, child and adolescent crime victims present distinct challenges to the mental health evaluator. Initial referral is often driven by a traumatic event, rather than by specific symptoms in the child. Clinicians most commonly diagnose posttraumatic stress disorder (PTSD) in these clients; a diagnosis characterized by symptoms of reexperiencing, numbing and avoidance, and hyperarousal (DSM-IV: APA, 1994). However, child and adolescent crime victims frequently develop other disorders instead of (or comorbid with) PTSD (Schwab-Stone et al., 1999) which clinicians might overlook. These include affective disorders such as depression, adjustment and anxiety disorders (Singer, Anglin, Song & Lunghofer, 1995); behavior problems (Martinez & Richters, 1993) and dissociative disorders (Putnam, 1997). Children traumatized by crime can also exhibit avoidant symptoms, cognitive distortions, emotional distress, impaired sense of self, academic problems and interpersonal difficulties (Briere and Elliot, 1994). Developmental factors influence the clinical expression of symptoms. Finally, caregiver capacities must be considered in reaching a comprehensive view of the child's functioning and resources. This chapter focuses on initial mental health assessment of child crime victims, including diagnosis and treatment planning.

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