Affidavit of
Ralph C. Underwager, Ph. D.


I, having been duly sworn upon oath and under penalty of perjury, depose and state the following as true and accurate.

I have prepared this affidavit at the request of Mr. John Doe, acting pro se in several matters related to charges that he sexually abused his daughter, Jean. Mr. Doe is currently imprisoned, based on those charges, while awaiting trial. Mr. Doe asked me to prepare an affidavit related to the effects on his daughter of the process of investigation and being in the care of the maternal grandmother, whom he regards as the adult whose coercion resulted in the allegations being made. He has also asked that I deal with the question of prosecutorial misconduct as it may apply in his case.

I. (Updated biographical data to provide basis for expertise and opinion is added. Current recent research is also added as it is available and where relevant.)

II. Mr. Doe asked for my professional opinion on the effects of treating a child with therapy for sexual abuse prior to a determination that the child has, in fact, been abused. The actions of the maternal grandmother led to this child being interrogated and required to submit to therapy. My opinion is limited to the general issue of the effects of sexual abuse therapy as treatment for a child before there has been a determination by the justice system of the factual status of the accusation of abuse. Opinions of social workers or child protection workers do not establish the facticity of an allegation.

My opinion is based on my training in psychology, my personal experience in treating children who have been sexually abused and children who have been victimized by false accusations of sexual abuse, and my knowledge of the research literature and professional literature relating to child abuse and within that body of knowledge material relating to the issue of treatment and the effects of treatment for a condition that does not exist. (In our Resource File data base we have read, classified, reviewed, evaluated, and entered 1382 articles relating to treatment for child sexual abuse.)

My personal experience with treating children who have been victims of child sexual abuse includes over 500 cases across twenty-five years. I have also treated hundreds of children for problems unrelated to sexual abuse but rather running the full range of childhood emotional problems and psychological disorders. I have provided treatment for approximately twelve children who have been victimized by being involved in a false accusation of child sexual abuse. My credentials and training correspond to the American Psychological Association, Division 12, Child Psychology Section, Guidelines for the Optimal Training for a Psychologist to Deliver Health Care Services to Children.

III. Whether or not a child should be treated for sexual abuse prior to a determination of abuse by the justice system is affected by several considerations.

1) The system established requires a substantiation or indication by a child protection worker or law enforcement official prior to an accusation entering the justice system for adjudication. It is often mistakenly perceived that such a step establishes the facticity of the accusation and a child is immediately treated by adults and by the system as if the child had truly been abused. However, the information available from research data shows the substantiation of an accusation at this level is, at best, affirmed by the action of the justice system in only 50% of the cases. If plea bargains and dismissals are considered as questionable determinations, the proportion drops even lower than 50%. The decision to substantiate or not is affected by variables other than facticity (Besharov, 1990; Jones,1993; Stevenson, & Grauerholz, 1993, April). Personal biases, personal factors, and significant variables having to do with the workers impact on the decision making process (Jackson, & Nuttall, in press; Mosher, 1991). There is widespread ignorance of research and acceptance of unfounded dogma by workers (Brodie & Rogers, 1993) There is significant overreporting and false positives (Winefield, & Bradley, 1992). Beginning with Starr (1979) and continuing to Lindsay and Read (in press), every scientific analysis of the level and direction of error in the decision making process concludes there is an unconscionable level of false positives (Wakefield & Underwager, in press) The ratios range from 3 - 1 to an astonishing 2000 - 1 (Horner, 1992). This unanimous finding, a rarity in any scientific area, strongly suggests that the system we have established does far more harm to far more children that it helps or benefits. Substantiation or indication of a specific case based upon the decision and judgment of a child protection worker, or even a multidisciplinary team, cannot be permitted to determine facticity nor should it lead to actions based on an assumption of abuse.

2) The nature of the customary sexual abuse treatment given to children when there is an accusation of sexual abuse is insight oriented, dynamic, and feeling expressive psychotherapy (Wakefield & Underwager, 1988). A child is forced to continue talking about feelings, acting out in play, and responding to questions about having been abused. In reviewing records of several hundred cases, we have found at most a half dozen where the therapy provided to a child was anything other than insight oriented, feeling expressive therapy. With younger children, it is exclusively play therapy of this ilk.

In the videotapes of therapy we have reviewed, we have seen children being given a toy gun and taught to shoot a Bobo doll identified as Bad Daddy, children encouraged to throw darts at pictures of the person accused, make clay figures of the person accused and then pound them with mallets and hammers, and throw dolls identified as the person accused in boxes labeled jail. Children are reinforced for yelling screaming, saying angry and hostile things about the person accused. Children are taught to be fearful, to believe they have been victimized, and to believe people they love are wicked and evil. Play therapy of this nature cannot be anything other than destructive and harmful to the child (Campbell, 1992a; 1992b; Russ, 1987; Trad, 1992; Casey, & Berman, 1985)

This approach to therapy for young children is based upon the model of therapy developed for adult victims of rape. That approach has simply been imposed upon children with no effort to find out if it works. There is no evidence that this treatment has any utility, efficacy, or benefit to children who have been sexually abused. The research reviews of therapy with children consistently demonstrate that the most effective therapeutic modality for children is a behavioral, learning theory based therapy, not insight oriented, feeling expressive therapy (Weisz, Weiss, Alicke, & Klotz,1987; Weisz, Weiss, 1989; Weisz & Weiss, 1993; Fantuzzo & Twentyman, 1986). This finding strongly suggests that there is little or no benefit from this therapy approach to children who have been abused.

In fact, the most recent meta analysis of the research literature on child therapy reaches the distressing conclusion that when the research conducted in a real world clinical setting is evaluated separately, the results show that child therapy as it is actually dispensed is harmful to children and not beneficial (Weisz & Weiss, 1993). The conclusion is that the most likely cause for child therapy harming children is that it is dynamic, insight oriented, and feeling expressive therapy that is actually given to children in the real world rather than the learning theory based techniques that are positive.

3) A consideration often overlooked by prosecutors, law enforcement, child protection, and judges is the effect on a child if adults make a false positive mistake. When adults treat a child who has not been abused as if the child had been abused, it is not an innocuous or benign experience for the child. It is devastating and runs a high risk of causing a child to be psychotic. It is an assault upon a young child's ability to develop the capacity to tell what is real from what is not real. There is a little discussion of this type of error but a growing body of research on the issue. A false negative error, missing real abuse, may also be harmful to a child. In either direction, adult errors may have tragic consequences for a child.

Most recently, a study by Westminster College, part of Oxford University, examined the effect of a false accusation on the children and concluded the impact was like that of growing up in a war zone. It was as if the children had been raised in Beirut (Prosser & Lewis, 1992; Prosser, 1995 a, 1995b) Davis & Reppucci (1992) also report on the harm done to children, including siblings, by a false accusation. Specific damage done to children by a false accusation include precipitating suicide (Smith, 1991), school failure and delinquency (Richardson, 1990), and destruction of the family (Schultz, 1989).

4) Another possible consequence to a child treated for sexual abuse prior to the adjudication is described in the following material taken from an Amicus Curiae Brief we submitted to the U. S. Supreme Court in Maryland v. Craig.

Point IV. In the interim between accusation and a trial, therapy for a child thought to be a victim is feeling-expressive, insight oriented therapy which may well have the effect of teaching a child to be afraid of a defendant.

Especially in criminal trials there is often a long time between an accusation and a child testifying. During this interim, many children are placed in therapy for having been sexually abused, a decision made before the factual issue is determined in the courtroom. Analysis of records of therapy given to 405 children and study of 617 articles and books dealing with treatment show the therapy given to children focuses on getting their feelings about being abused out and acting out those feelings in a variety of techniques. However, all in one way or another encourage and reinforce the expressing of anger and hatred toward the alleged perpetrator. If a child, once a week for a year, has spent an hour hitting a bobo doll named as the defendant, making clay figures of the defendant and throwing them in jail, using a toy pistol to shoot a representation of the defendant, throwing darts at a picture of the defendant, drawing pictures of the defendant and burning them, and talking about how bad and terrible the defendant is, it is hardly surprising if that child may talk about fearing the accused and even show fear if seeing him or her in the courtroom. But the fear may well be caused by the treatment rather than by the alleged abuse.

If it can be demonstrated that a given child has been subjected to this therapeutic technique, there is no way a court can hope or attempt to determine the cause of the fear, if it is present, other than by confrontation. While there is no scientific data to support this specific proposition, it may occur as it did in the trial of Robert and Lois Bentz, when their five year old son, Billy, who had been in foster care and therapy for months, was led into the courtroom by the prosecutor, he spied his parents, waved, smiled, and in a cheery voice called out, "Hi Mom! Hi Dad!."

If therapy has the potential for teaching a child to be fearful of the person accused, as it does, to put a child in therapy before the day in court may well destroy any ability to obtain a reliable statement from the child, or to effectively cross examine a child, and seriously negatively affect the ability of the finder of fact to weigh accurately the demeanor of the witness.

5) All therapy is essentially a learning process. It does not matter what the theoretical approach is or the technique employed. Any impact any form of therapy has derives from its ability to teach a disturbed person something that makes a difference. Therapy with a child is a learning experience. When the usual insight-oriented, feeling-expressive therapy is given to a child when there is an accusation of child sexual abuse, it may teach a child inaccurate and unreliable memories for events that did not occur (Ceci & Bruck, 1993; Goleman, 1993). The research evidence on the impact of misleading information on the memories of adults and children is strong and clear. The effect is to generate inaccurate and unreliable accounts (Loftus, 1993). If this occurs with a child in such therapy, there is likely a marked contaminating impact upon the ability of the child to personally recall actual events.

6) If a child is truly demonstrating problematical behaviors, the most successful therapy is going to be a behavioral, learning theory based therapy that targets specific troublesome behaviors and changes them. In the interim period between an accusation and an adjudication, the welfare of the child does not require treatment for sexual abuse. Instead, any difficulties a child may be showing can best be treated by a behavioral therapy that does not need nor require a child to muck about in feelings about being abused or act out aggression and hatred.

7) When a child who has not been abused is treated by adults who have concluded the child has been abused. it is tragically the case that the adults teach the child to be a victim. If a child continuously denies the abuse the adult believes in, the adult does not accept that no abuse occurred. Instead, the adult concludes the child is dissociating, repressing the memory, and may give a diagnosis of Multiple Personality Disorder. The child is then coerced and forced to develop this most serious iatrogenic malady. The end result may well be the destruction of the child for any normal adult life.

III. Putting together the above considerations, the risk of a child who has not been abused being treated with sexual abuse therapy can be avoided and the serious negative consequences of being forced to undergo wrong headed or inappropriate therapy, whether abused or not, can be averted by ordering no sexual abuse therapy. In the specific case involving Jean Doe, placing her in an environment other than that of the maternal grandmother is absolutely required. The maternal grandmother is heavily invested in supporting the charges of abuse and leaving the child in that environment would be harmful to the child. If the child has behavior problems, they can be treated successfully by behavioral methods without anything approaching the usual harmful sexual abuse therapy. If the adjudicatory process determines the child was abused, there is then ample time and opportunity to find and use an effective sexual abuse therapy if it is needed.

IV. On the issue of the conduct of the prosecutor, unfortunately the pressure for misconduct is at its most intense when a prosecutor believes firmly in the guilt of the person being tried. It is also then the case that conduct that otherwise might be avoided may be seen as necessary in order to obtain a conviction. Since it is the prosecutor's job to see that justice for all citizens is done, misconduct is any prosecutorial behavior that tends to impede the objective search for truth (Jonakait, 1987). This may include improper and unfair vilification of the defendant or the defendant's attorneys or expert witnesses. Such behavior may occur either inside or outside the courtroom. It appears that the prosecutor in the case of Mr. Doe has acted outside the courtroom in ways that are highly prejudicial to his ability to receive a fair trial. This involves principally appearances and statements made on local television programs. Also motions she has filed support a view of strong prejudice against Mr. Doe and those assisting him in his defense. The emotional tenor and attacking rhetoric appear to fall within the range of behaviors which the Minnesota Supreme Court recently found to be reversible error (Cutler, 1989). She has already engaged in efforts to impeach Mr. Doe's witnesses, prior to their appearance in the witness box, that have been ruled in a number of courts to be inflammatory, prejudicial, and to lack probative value ( Goldstein, 1988).

I declare the foregoing is true and correct.

Further your affiant saith not.


______________________________
Ralph C. Underwager, Ph.D.
Licensed Psychologist

Date: __________________________





Subscribed and sworn to before me by Ralph C. Underwager on this ___ day of _______, 19__, to certify which witness my hand and seal of office.



_________________________________
NOTARY PUBLIC


References


Besharov, D. J. (1990). Gaining control over child abuse reports. Public Welfare, Spring 1990, 34-41.

Brodie, L., & Rogers, M. L. (1993) What do we know about how we make judgments about child sexual abuse? Unpublished manuscript.

Campbell, T. W. (1992a). Promoting play therapy: Marketing dream or empirical nightmare? Issues in Child Abuse Accusations, 4(3), 111-117.

Campbell, T. W. (1992b). False allegations of sexual abuse and the persuasiveness of play therapy. Issues in Child Abuse Accusations, 4(3), 118-124.

Casey, R. J., & Berman, J. S. (1985). The outcome of psychotherapy with children. Psychological Bulletin, 98(2). 388-400.

Ceci, S. J., & Bruck, M. (1993). The suggestibility of the child witness: A historical review and synthesis. Psychological Bulletin, 113(3), 403-439.

Cutler, B. L. (1989). Cross-examination of expert witnesses State v. Blasus, Minn Sup Ct., No. CX-87-2006, 9/15/89. APA Monitor, 20(12), 37.

Davis, S. M., & Reppucci, N. D. (1992). Accusations of child sexual abuse: A study of process and consequences. Revision of a paper presented at the American Psychology-Law Society 1992 Biennial meeting. San Diego, CA.

Fantuzzo, J. & Twentyman, C. (1986). Child abuse and psychotherapy research: Merging social concerns and empirical investigation. Professional Psychology and Practice, 17(5), 375-380.

Goldstein, R. L. (1988). Psychiatrists in the hot seat: Discrediting doctors by impeachment of their credibility. The Bulletin of the American Academy of Psychiatry and the Law, 16(3), 225-234.

Goleman, D. (1993, June 11). Studies reveal suggestibility of very young as witnesses. New York Times, p. A1, A23.

Horner, T. M. (1992). Expertise in regard to determinations of child sexual abuse. Unpublished manuscript.

Jackson, H., & Nuttall, R. L. (in press). Clinician responses to sexual abuse allegations. Child Abuse & Neglect.

Jonakait, R. N. (1987). The ethical prosecutor's misconduct. Criminal Law Bulletin, 23(6), 1987).

Jones, L. (1993). Decision making in child welfare: A critical review of the literature. Child and Adolescent Social Work Journal, 10(3), 241-262.

Lindsay, D. S., & Read, J. D. (in press). Psychotherapy and memories of childhood sexual abuse: A cognitive perspective. In M. Zaragoza, J. R. Graham, G. C. N. Hall, R. Hirschman, & Y. S. Ben-Porath (Eds.), Memory and testimony in the child witness. Newbury Park, CA: Sage

Loftus, E. F. (1993). The reality of repressed memories. American Psychologist, 48, 518-535.

Marvasti, J.A. (1989). Play therapy with sexually abused children. In S. M. Sgroi (Ed.), Vulnerable populations: Sexual abuse treatment for children, adult survivors, offenders, and persons with mental retardation (Vol. 2, 1-41). Lexington, MA: Lexington Books.

Mosher, D. L. (1991). Ideological presuppositions: Rhetoric in sexual science, sexual politics, and sexual morality. Journal of Psychology & Human Sexuality, 4(4), 7-29.

Prosser, J., & Lewis, I. (1992). Child abuse investigations the families' perspective. Parents Against INjustice.

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Russ, S. W. (1987). Assessment of cognitive affective interaction in children: Creativity, fantasy, and play research. In J. N. Butcher and C. D. Spielberger (Eds.), Advances in Personality Assessment (Vol. 6) (pp. 141-155). Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.

Schultz, L. (1989). One hundred cases of unfounded child sexual abuse: A survey and recommendations. Issues in Child Abuse Accusations, 1(1), 29-38.

Smith, J. (1991). Aftermath of a false allegation. Issues in Child Abuse Accusations, 3(4), 203.

Starr, R. H. (1979). Child abuse. American Psychologist, 34(10), 872-878.

Stevenson, D. G., & Grauerholz, E. (1993, April). The role of crisis centers in defining and reporting child abuse. Families in Society: The Journal of Contemporary Human Services, pp. 221-225.

Trad, P.V. (1990). Conversation with preschool children: Uncovering developmental patterns. New York: Norton & Company.

Weisz, J. R., Weiss, B., Alicke, M. D., & Klotz, M. L. (1987). Effectiveness of psychotherapy with children and adolescents: A meta-analysis for clinicians. Journal of Consulting and Clinical Psychology, 55(4), 542-549.

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Weisz, J. R., & Weiss, B. (1993). Effects of psychotherapy with children and adolescents. Newbury Park: Sage.

Winefield, H. R., & Bradley, P. W. (1992). Substantiation of reported child abuse neglect: Predictors and implications. Child Abuse & Neglect, 16(5), 661-671.


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