ACC’s best-practice guidelines for identifying cases of sexual abuse are not credible.
Twenty years ago, New Zealand had a mere handful of people who claimed to be ‘counsellors’. Now they number in their thousands. The phrase, “victims were offered counselling”, has become commonplace, yet the only practical intervention they can make is to talk.
How did we suddenly produce so many wise folk who can provide counselling and therapy to so many? Is counselling science-based or evidence-free ideology? What did we do before we had counsellors?
Despite lofty claims of being trained health professionals, counselling is not registered under the Health Practitioners Competence Assurance Act 2003. Nor is it regulated by Government or any public process. It requires no specific or mandatory training, public examination, knowledge or skills. Selling counselling services to the public can be done by anyone, without control or accountability, much like psychics, spirit guides and mediums.
My particular concern here is sex abuse counselling, the industry it spawned and the part ACC plays. An ACC press release of 16 October 2009 advised that “[b]y law, ACC can only accept sensitive claims from those diagnosed with a mental injury resulting from the sexual abuse they’ve suffered.” There are two parts to this; firstly, sexual abuse must have occurred, and secondly, it caused a mental injury.
A Sexual Abuse Syndrome?
Do sexually assaulted people exhibit predictable behavioural characteristics that can accurately be profiled? The term ‘syndrome’ is defined in the New Shorter Oxford English Dictionary as a “group of symptoms or pathological signs which consistently occur together, especially with an (originally) unknown cause”. There is yet no reliable scientific evidence that sexual abuse is a cause of any specific psychiatric, psychological or behavioural condition. Reactions to sexual abuse are generally idiosyncratic and therefore unpredictable.
The existence of a sexual abuse syndrome would mean the “(originally( unknown cause” could be determined from client behaviour alone. Police would have a field day! No such syndrome has yet been identified, making it impossible to properly conclude from client behaviour alone whether a sexual abuse event was experienced.
Science – and evidence-based diagnosis – should always precede treatment decisions and methods. To ensure correct treatment is given to sexual abuse victims, it is also necessary to define what behaviours are not indicative of sexual abuse, but that has not been achieved. If the possibility of sexual crimes arise, then it is essential to find the facts from other forms of evidence.
A recent president of the NZ Association of Counsellors declared that counsellors are not ideologically driven people – they are trained health professionals with high ethical standards who are not required to investigate crimes. Sexual abuse is a serious crime. But counsellors lack the skills, resources or authority to conduct external investigation of client claims.
To help it survive and grow, the industry created ideological myths and beliefs about abuse, amongst others, the fantasies of recovered memories, multiple personality disorder and satanic ritual abuse, and then invented scores of ‘counselling modalities’ to treat the claimed effects.
Counsellors believe that sexual abuse can be detected, confirmed or diagnosed from client behaviour.They created extensive lists of ‘effects’ and believe that clients presenting with a ‘cluster’of these ‘effects’ must have been sexually abused. In reality, the causes of those ‘effects’ are myriad. Test it for yourself – how many causes of (eg) ‘depression’ can you name?
The three glaring flaws in most sex abuse counselling cases are a lack of credible evidence that the client was in fact sexually abused, inability of counsellors to separate the effects of sexual abuse (if any) from the effects of other trauma in the client’s life, and a penchant to make treatment decisions on the basis that inevitable detrimental consequences arise from sexual abuse.
To them, allegations of abuse are proof of abuse, but absent externally corroborated evidence or other reliable markers of sexual abuse, a counsellor cannot know whether a client was in fact abused.
ACC’s Best-Practice Guidelines
There is much misguided and ill-informed thinking underscoring this vexed topic, as shown by ACC’s document Sexual Abuse and Mental Injury: Practice Guidelines for Aotearoa New Zealand, March 2008 (generally called the Massey Guidelines(.
It was developed for ACC by a research team from Massey University’s School of Psychology (Turitea Campus( and purports to describe best-practice guidelines for professionals from all disciplines providing therapeutic services to people who have experienced sexual abuse.
ACC’s October 2009 press release said, “[t]hese guidelines represent a significant landmark in the treatment of mental injury resulting from sexual abuse, because they’re developed by New Zealanders for New Zealanders; are evidence-based; and the product of four years’ extensive research and consultation.”
The Massey Guidelines declare that over 700 effects of sexual abuse have been identified, which are believed by counsellors to be reliable indicators of sexual abuse. The document states :
“No single effect can be seen as a trustworthy indicator of sexual abuse. Since effects never occur in isolation, it is useful to consider them in terms of what effects are more likely to co-occur.”
‘Effects’ present as ‘clusters’. If ‘pairs of effects’ had been specified, it would mean sets of two. However, the term ‘clusters’ means a group of three or more.
How skilled would counsellors need to be, to be able to determine retrospectively from ‘clusters of effects’ whether the client experienced sexual abuse? A reliable test would be to calculate the permutations to establish how big the task might be.
In the Massey Guidelines, no required order of choice of any single ‘effect’ is evident, and repeatability of any item is allowed (for example,’depression’ could appear in none, any, many or all clusters(. Under these conditions, the permutation formula to calculate the number of clusters is nPr, where n = 700 and r = 3, 4, 5…x, depending on how many effects make up a ‘cluster’.
Suppose any four effects are simultaneously presented as a cluster, then r = 4. The number of different ‘clusters’ able to be presented by a single client, and which the counsellor must be able to recognise, is therefore 7004 raised to the power of 4. That is, 238,047,385,800 possible clusters.
Full knowledge and awareness of that vast number of clusters is beyond ordinary human capacity. Counsellors would also need the ability, resources and authority to externally investigate each cluster and its individual components to ensure – before making treatment decisions – that the sole causewas in fact sexual abuse and not some other event or trauma in the client’s life.
The Guidelines say that for practical purposes in writing the document, the number of effects was conveniently reduced to 200! The number of possible clusters is consequently reduced. With just 200 effects presented in random clusters of four, a mere 1,552,438,800 clusters could exist.
Belief in the utility and reliability of these ‘clusters’ allows counsellors to assert that virtually any human behaviour is caused directly by sexual abuse, and conveniently removes the need for any other form of evidence of abuse.
Debate about the sex abuse industry is one about belief vs evidence. ACC supports the quaint notion of 700 ‘effects’ and believes mental injury is caused by sexual abuse which can be diagnosed from client behaviour alone. But no syndrome yet exists. Besides, counsellors and ACC fail to demand testable evidence of claimed sexual abuse.
I conclude the sex abuse industry is an ideological house of cards, based on myth, assumption and belief, and that ACC and sex abuse counsellors fail to meet legislative obligations. Moreover, every sexual abuse claim submitted to ACC without proper evidence of abuse and mental injury, constitutes a case of improperly using a document to obtain money, services and/or advantage.
Gordon Waugh is a retired Air Force officer with over 30 years of electronics engineering experience. He was a foundation and executive member of Casualties Of Sexual Allegations (COSA), a national organisation dedicated to helping men and their families damaged by false allegations of sexual abuse.