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Forensic Psychologist Involved in Sexual Sexual Harassment at work and Posttraumatic Stress: Sexual Harassment is usually an unreasonable and inappropriate expectation or conducts unrelated to work by a supervisor in work setting. It involves the use of power differential to directly or indirectly threaten or coerce the recipient of harassment to gratify the harasser’s wish or need. Sexual harassment also may involve statements, words, or behaviors in sexual nature that is unwelcome and upsetting to any reasonable woman. Often the main factor in creating long-term emotional scars and symptoms is the continues psychological agony that the victim endures, which consequently effects victim’s family and personal relationships as well as future career and financial damages The link between the sexual harassment and Posttraumatic Disorder was found be certain studies such as the following: Department of Psychiatry, Rhode Island Hospital (McDermut JF, Hagga DA, Kirk L., 2000 Jul;13(3):397-411) evaluated stress symptoms associated with academic sexual harassment and the result indicated the diagnosis of Posttraumatic Stress Disorder. University of Toronto (Abraham KM, Robinson GE. 2002 Jun;47(5):468-472), with regard to a study of occupational effects of stalking, indicated that the stalking resulted the victim to suffer from depression, anxiety, guilt, shame, helplessness, humiliation, and Posttraumatic Stress Disorder (PTSD). The cumulative effects of sexual harassment may result in Posttraumatic Stress Disorder (Arch Psychiatic Nurs. 1994 Jun;8(3):177-83. Therefore, the length of the traumatic experience can have a large psychological impact equal to a sudden life threatening trauma in life. If the symptoms are not addressed with appropriate treatment plan, the symptoms may become chronic and much more difficult to treat. The psychological evaluation and treatment should begin as soon as feasible. Not only it is important to capture the psychological effects of harassment as early as possible, providing the treatment would help to treat the symptoms, cope with the stress, and prevent long-term chronic fixation of symptoms.
When it comes to establish the psychological injury due to sexual harassment, a Forensic Psychologist would perform a valid and reliable evaluation, by selecting appropriate and court admissible assessment tools and scientific data. The psychological assessment should indicate how the victim was affected psychologically, while assessing the effect of pre-existing conditions as well. Then determination of the link between the damage and the sexual harassment events and establishing the causation is the central issue. In assessment of sexual harassment by forensic psychiatrists unique biases arise by these psychiatrists of gender, diagnostic types and sociopolitical types. Department of Psychiatry, Georgetown University School of Medicine, Washington, Journal of Acad. Psychiatry Law, 1998) concluded that such biases arise from lack of knowledge regarding sexual harassment or lack of formal psychiatric training. No doubt that such biases would violate their ethical obligation to accurately assess the psychological effects of the sexual harassment. Such biases also might stem from an inadequate psychological testing and evaluation on the part of the psychiatrist or other mental health professionals.
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Psychological Evaluation To Establish Treatment Approach for Forensic Trauma cases: By: Nina T. Rodd, Ph.D., QME, DABPS
A severe traumatic experience or a series of pervasive traumatic events have the power of destroying one’s life by seriously impairing one’s ego-strength, emotional-social, cognitive and occupational functioning. Per DSM-IV (Diagnostic and Statistical Manual -IV-TR) the Global Assessment of Functioning indicates is used as a measure of severity of these consequences. whether these manifestations are diagnosed as Posttraumatic Stress Disorder, other Anxiety Disorders or Affective Disorders such as Major Depressive Disorder.
It is my experience that a treatment plan for such disorders should have a systematic and evidence based approach. During last few years I have put together an approach to address the treatment and healing from the traumatic response and symptoms. It focuses on the treatment of psychological trauma that occurs due to such injury incidents. Whether it’s only physical injury that causes secondary psychological damage, or the trauma is purely psychological in nature, I have called this approach GAP Model of Treatment, because it addresses the following steps: 1. Evaluation of pre-morbid levels of psycho-social, emotional and cognitive functioning by extensive standardized psycho-diagnostic interviews and testing. Establishing the pre-injury level of functioning is not only important for the medico-legal process, it is of vital value to treatment planning and evaluation of the prognosis. 2. Establishing the pre-trauma and post-trauma’s functioning level and the significance of the discrepancy between the two, by valid and reliable quantitative and qualitative measures. The methods of establishing pre-morbid levels of functioning has to be in combination with highly valid instruments such as Minnesota Multiphasic Personality Inventory, Millon Clinical Multi-axial Inventory, Personality Assessment Inventory, Test of Variables of Attention, Wisconsin Card Sorting Test, and other neuropsychological measures. 3. Reviewing medical and psychological history. The correct analysis of the historical records is vital in the discovery of previous psychological, psychiatric, medical, employment and social functioning. 4. Evaluation of validity of psychological complaints or assessing malingering. This is as important as any other part of the comprehensive evaluation. Otherwise the validity of any conclusion is questionable. 5. Establishing the causation, which is not only vital in forensic situation as well as for effective treatment plan, it is vital to the discovery of facts and evidences in legal process. 6. Place measurable treatment goals and specific time schedule for evaluation of the treatment progress for each goal. Such evaluations should be measurable and provable by valid psycho-diagnostic techniques. 7. Therapeutic approaches employed for treatment would be evidenced based as demonstrated in research. 8. Periodical evaluations of the efficacy of the treatment plan would open doors to redesign the treatment plan as needed. 9. Regular monitoring the progress and valid decisions about the long-term effects of the trauma and prognosis in future. Gap treatment could be any combination of the following treatment approaches: * Behavior Approach * Cognitive Therapy * Graded exposure in imagination and in vivo * Cognitive-Behavior Therapy (CBT) * Processing trauma in Supportive Therapy environment * Psychotropic medication management by a psychiatrist The Final evaluation would be an effort to determine prognosis and or establishing the extent of the permanent psychological injury.
Bibliography: Beck, A. T. (1976). Cognitive therapy and the emotional disorders. NewYork: International Universities Press/Meriden. Beck, A. T., Hollwon, S. D., Young, J.E., et al. (1985). Treatment of depression with cognitive therapy and amitripryline. Archives of General Psychiatry, 42, 142-148. Boudewynes, P., Hyer, L., Woods, M., Harrison, W., & McCraine, E. (1990). PTSD among Vietnam veterans: An early look at treatment outcome using direct therapeutic exposure. Journal of Traumatic Stress, 3, 359-368. Foa, E. B., Davidson, J., & Rothbaum, B. O. (1995). Treatment of post-traumatic stress disorder. In G. O. Gabbard (Ed.), Treatment of psychiatric disorders: The DSM-IV edition (2nd ed, Vol. 1). Washington, DC: American Psychiatric Press. Jacobson, N.S., Wilson, L., & Upper, C. (1988). The clinical significance of treatment gains resulting from exposure-based interventions for agoraphobia: A re-analysis o outcomes data. Behavior Therapy, 19, 539-554.
Dr. Nina Rodd is a clinical and forensic psychologist practicing in Los Angeles and Orange County, with extensive experience in psycho-diagnostic evaluation, forensic evaluations, and treatment of depression and anxiety disorders. Dr. Rodd is a Board Certified Forensic Psychologist, offering her expert opinion in civil cases in California and Federal jurisdictions since 1990.
The United States Merit Systems Protection Board (USMSPB) (1995) found that only 6% of employees who believed they were sexually harassed ever report the incidents. Sexual harassment behavior is reported to range from jokes, sexual teasing, sexual remarks and questions, deliberate touching or pinching, writing letters, telephone calls, pressure for dates or sexual favors, to sexual assault, attempted rape and rape. The psychologist’s role is essential in such cases when the patient has sustained psychological harm. A psychological evaluation and a comprehensive report could be valuable in assisting the attorney, in determining the damages and the extent of future treatment needed. Often these victims need psychological intervention and treatment as well.
* Clinical and history taking
As an Expert Witness the role of the psychologist is mainly forming an opinion based on admissible and credible research information. The expert’s role is to determine (1) whether the patient/litigant is psychologically damaged and whether there is a relationship between the damages and the alleged harassment or discrimination. The Expert’s testimony regarding causation and damages in sexual harassment is subject to the standard for expert testimony set by the U.S. Supreme Court in Daubert v Merrell Dow Pharmaceuticals, Inc. (1993). Such testimony must be relevant to the facts and be reliable.
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