Clinical expertise and the assessment of child sexual abuse.

OBJECTIVE Mental health specialists (N = 48) were surveyed as to (1) their estimates of the likelihood that a 3-year-old child had been sexually molested (as alleged by her mother in the context of a child custody dispute) by her father, and (2) their recommendations, given their estimates, as to child visitation/custody. METHOD Specialists heard a detailed presentation of the court-appointed clinician's findings in this case, which included parent interviews and videotaped child-parent interaction sequences. RESULTS The array of estimated likelihoods was extreme despite that all the clinicians heard the same case. Recommendations to the court strongly tended toward restriction of child-father contact, even when estimates of the likelihood of abuse were low. CONCLUSIONS Courts should be highly cautious in relying on clinical experts in child custody cases entailing allegations of child sexual abuse. Practitioners should be candid with courts concerning the absence of diagnostic precision in such cases.

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