1. Pre-Trial Therapy and the Impact of Trauma on Victims and Witnesses
Lesley Donlan, Manchester SARC & Peter Jenkins,
Salford University
Analytic style of presentation?

2. Pre-Trial Therapy and the Impact of Trauma:
Current concerns about pre-trial therapy
‘Reactive model’ of pre-trial therapy
’Proactive model’ of pre-trial therapy
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

3. Current concerns about pre-trial therapy:
Impact of pre-trial therapy on evidence
- ‘coaching’
- contamination
Problematic forms of therapy
Record keeping
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

4. ‘Reactive model’ of pre-trial therapy:
Concern over potential adverse impact of pre-trial therapy requirements
Differing processes / responses by therapists
Changing picture of agency responses re pre-trial therapy
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

5. ‘Reactive model’: Concern over adverse impact of pre-trial therapy requirements:
Concern over potential adverse impact of pre-trial therapy requirements on:
Client
- children
- adults
Therapist
Therapeutic alliance
Recording
Access to records
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

6. ‘Reactive model’: Differing processes / responses by therapists
Court Access to counselling records:
’Consensual disclosure’ eg in abuse cases
conditional on outcome of case
’Contested disclosure’: adverse impact on
- therapeutic alliance / trust
- therapist self-confidence (Jenkins, 2003)
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

7. ‘Reactive model’: Changing picture of agency responses re pre-trial therapy:
‘Reactive’ stance of agencies / therapists
Limited experience
Lack of clear agency policy
Agencies adapting to national guidance (last 5 yrs)
- Agency ‘A’: 65 cases; national & local agency policies
- Agency ‘B’: 64 cases; 6 taken to trial
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

8. ’Proactive model’ of pre-trial therapy: SARC Experience
Liaison with other agencies
Managing boundaries in the therapeutic process
Managing disclosure of records as evidence
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

9. ’Proactive model’: Liaison with other agencies
Provision of training / policy development to:
CPS
Police
Courts
Victim Support / Witness Support
Other healthcare agencies
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

10. ’Proactive model’: Managing boundaries in the therapeutic process
External boundaries:
Separate roles:
- Individual Sexual Violence Advisors (support)
- Experienced counsellors (therapy)
Informing CPS/IO of therapy taking place
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

11. ’Proactive model’: Managing boundaries in the therapeutic process
Internal boundaries (i.e. within therapy):
Pre-trial therapy provided by experienced counsellors (not trainees)
Avoidance of ‘re-exposure’ therapies (CBT, EMDR, trauma focused therapies)
Focus on impact & meaning of trauma
- Statement / Video evidence: ‘telling the story’
- Therapy: Processing emotions & personal meaning
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

12. ’Proactive model’ of pre-trial therapy: Managing disclosure of records as evidence
Records of therapy:
- Brief
- Factual
- Objective
- ‘Triggers’ for recall, not a ‘document of record’
SARC/NHS Trust Policy on non-disclosure of records in response to requests
Emphasis on informed consent by client
Use of PPI to limit disclosure
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

13. References:
Bond, T. and Sandhu, A. (2005) Therapists in Court: Providing Evidence and Supporting Witnesses. BACP/Sage: London.
Home Office, Crown Prosecution Service and Department of Health (2001) Provision of Therapy for Child Witnesses Prior to a Criminal Trial: Practice Guidance. CPS: Bolton. Home Office, Crown Prosecution Service and Department of Health (2002a) Provision of Therapy for Vulnerable or Intimidated Witnesses Prior to a Criminal Trial: Practice Guidance. Home Office Communications Directorate: London.
Home Office, Lord Chancellor’s Department, Crown Prosecution Service, Department of Health, National Assembly for Wales (2002b) Achieving Best Evidence in Criminal Proceedings: Guidance for Vulnerable or Intimidated Witnesses, Including Children. Home Office Communications Directorate: London.
Jenkins, P. (2003) ‘Therapist responses to requests for disclosure of therapeutic records: An introductory study’, Counselling and Psychotherapy Research, 3(3): 232–8.
Jenkins, P. (2007) Counselling, Psychotherapy and the Law. Second edition. Sage: London.
National Children's Home: Action for Children (NCH) (1994) Messages from Children: Children's Evaluations of the Professional Response to Child Sexual Abuse. NCH: London.
Palmer, T. (2003) ‘Pre-trial therapy with children who have been sexually abused’, pp. 152–66, in Richardson, S. and Bacon, H. (eds) Creative Responses to Child Sexual Abuse: Challenges and Dilemmas. Jessica Kingsley: London.
Plotnikoff, J. and Woolfson, R. (2004) In Their Own Words: The Experiences Of 50 Young Witnesses In Criminal proceedings. NSPCC/Victim Support: London.
Plotnikoff, J. and Woolfson, R. (2009) Measuring Up? Evaluating Implementation Of Government Commitments To Young Witnesses In Criminal Proceedings. NSPCC: London
* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist

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* Main critic of this process - Christopher Bollas, key figure in psychoanalysis in US and UK. Characteristic sensitivity to language and wordplay - on the loss of confidence in psychoanalysis, and on the epidemic contamination of the presumed state of confidentiality
* Two functional necessities for psychoanalysis
- freedom to free associate, kind of equivalent to privilege of clergy for analysts
- analyst’s evenly suspended attentiveness
Conflict with reporting requirements and censoring of client material
* The draft IPA ethics code does not defend confidentiality, it colludes with its disappearance
* lack of legal privilege for therapists, despite US case of Jaffee v Redmond
* international issue:
- BCP Conference in March this year
- International Psychoanalytic Association Steering Group on comparative international research into confidentiality in Europe, US
* confidentiality as a binary condition - like a a vacuum, you can’t have a sort of vacuum, or be a little bit pregnant if you don’t have total confidentiality, then you don’t have a therapeutic space for client and therapist