Summary: Pynoos RS and Eth S. "Witness to violence: the child interview," Journal of the American Academy of Child Psychiatry vol 25(3): 306-319. 1986

Children who witness violence can be just as traumatized by the experience as those who are victims themselves. This article describes an interview technique that mental health professionals can use to help these young witnesses to violence. During a 90-minute interview, the therapist works to gain insight into the child's own understanding of the event and support the child in processing and recovering from the trauma. This interview can be used with recently traumatized children who are as young as 3 and as old as 16.

The interview has three stages: opening, trauma, and closure. In the opening, the therapist asks the child to draw a picture and tell a story about it. Some children illustrate the trauma they have experienced, but other children draw pictures that seem unrelated to it. Discussing the picture with the therapist gives the child a chance to address some of the feelings that have been brought about by the trauma.

During the trauma stage, the therapist has the child describe the traumatic event. Throughout the retelling, the therapist provides support and empathy for the child. The therapist may also ask the child to describe details of the event and to talk about the worst moment in the experience, all with the aim of helping the child gain a sense of mastery over the feelings of rage, fear, helplessness, and guilt that often arise. In this stage the child may want to talk about issues of accountability, which may be especially complicated in cases of family violence. Child witnesses-especially adolescents-may have fantasies of revenge or may blame themselves for not preventing the violent act.

Finally, in the closure phase, the therapist and child witness review the session together, with the therapist assuring the child that his or her fears and emotions about the event are reasonable. The therapist also explains to the child what he or she might expect to feel in the future. Where appropriate, the therapist will refer the child for further treatment.

This article includes a case report of an interview with a traumatized child.