Psychologist attitudes towards disclosure and believability of childhood sexual abuse: Can biases affect perception, judgement, and action?

BACKGROUND: The perception of CSA disclosure belief is critical to long-term outcomes for CSA survivors. Despite disclosures often occurring in clinical settings CSA survivors do not always report a sense of clinician belief in response to their disclosure. Ascertaining the factors that influence clinician belief is essential to improving outcomes. OBJECTIVE: This study examined whether language (i.e., word choice to describe abuse) and ongoing relationship status with a perpetrator impact perceptions of CSA belief amongst psychologists. METHODS: This 2 × 2 within subject's study examined relationship effects (ongoing verses estranged) and language effects (consensual verses abusive), embedded in fictitious vignettes, on believability. Seventy-five participants completed demographic surveys, rated and discussed belief in four vignettes, and completed validated scales capturing clinician trauma history and CSA myth endorsement. RESULTS: A significant main effect for relationship was found with ongoing victim-perpetrator relationships being less believed than depictions of estranged relationships (F(1,3) = 15.57, p = .001, h2 = 0.174). While no main effect for language was found (F(1,3) = 0.06, p = .801, h2 = 0.001) content analysis of the open-ended items revealed 80 % of psychologists reported being influenced by the language manipulations. Correlations revealed male psychologists were less likely to believe disclosures and more likely to endorse CSA myths than females, and psychologists who had engaged in trauma training appeared to have heightened disclosure belief and lower myth endorsement. CONCLUSIONS: While psychologists generally report belief in CSA disclosures they appear to evaluate specific disclosure aspects to inform this level of belief. Issues around social desirability, measure sensitivity, and learning effects are discussed alongside the importance of trauma training for psychologists.

Building collaborative teams in neonatal intensive care.

The complex multidisciplinary nature of neonatal intensive care combined with the numerous hand-offs occurring in this shift-based environment, requires efficient and clear communication and collaboration among staff to provide optimal care. However, the skills required to function as a team are not typically assessed, discussed, or even taught on a regular basis among neonatal personnel. We developed a multidisciplinary, small group, interactive workshop based on Team STEPPS to provide staff with formal teamwork skills, and to introduce new team-based practices; 129 (95%) of the eligible 136 staff were trained. We then compared the results of the pretraining survey (completed by 114 (84%) of staff) with the post-training survey (completed by 104 (81%) of participants) 2 years later. We found an improvement in the overall teamwork score from 7.37 to 8.08 (p=<0.0001) based on a range of poor (1) to excellent (9). Respondents provided higher ratings in 9 out of 15 team-based categories after the training. Specifically, staff found improvements in communication (p=0.037), placed greater importance on situation awareness (p=<0.00010), and reported that they supported each other more (p=<0.0001). Staff satisfaction was rated higher post-training, with responses showing that staff had greater job fulfilment (p=<0.0001), believed that their abilities were being utilised properly (p=0.003), and felt more respected (p=0.0037). 90% of staff found the new practice of team meetings to help increase awareness of unit acuity, and 77% of staff noted that they had asked for help or offered assistance because of information shared during these meetings. In addition to summarising the results of our training programme, this paper also provides practical tools that may be of use in developing team training programmes in other neonatal units.