Evaluating Harms from Institutional Abuse in Childhood: Leveraging a Trauma-Informed Approach to Assessment and Formulation

Institutional abuse of children (IA-C) is a significant social problem that can have deleterious life-long consequences for survivors. This abuse occurs in settings including but not limited to sports organizations, religious institutions, schools, recreational settings, and foster care. A number of jurisdictions in Commonwealth countries and the United States have dropped or amended the statute of limitations for plaintiffs to bring forward claims related to institutional abuse. This means that mental health professionals are increasingly being retained as experts to assess adult plaintiffs seeking remedy for childhood abuse that occurred in the context of institutions decades prior. This article first reviews some of the distinct harms that can arise from IA-C. We suggest how a trauma-informed approach could be applied to these assessments with respect to an evaluator’s interpersonal stance and assessment procedures. We also discuss interpretive considerations related to psychological testing and diagnoses. Finally, we discuss challenges in rendering opinions related to causality and suggest ways that evaluators can systematically consider a plaintiff’s developmental trajectory in order to weigh in about the impact of this phenomenon.