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
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
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,
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
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
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.
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.
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