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January 30, 2008
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Dr. Laurence Miller Practical Police Psychology
with Dr. Laurence Miller

On-scene response to crime and accident victims: A practical guide

As first responders, it might seem obvious that police officers are in a unique position to help crime and accident victims deal with the impact of their ordeal, to help restore a sense of safety and control to an otherwise fearful and overwhelming situation. Officers can also make a big difference in how a subsequent criminal or other investigation is handled and in the confidence – or lack of it – that victims, their families and the larger community have in their police department’s ability to protect them.

Police officers themselves may not even be aware of the tremendous impact they have on crime and accident victims, but those victims often report that the treatment they received in the immediate aftermath of a crime or serious accident greatly influenced their future perceptions of, and interactions with, law enforcement, as well as their ability to move on with their lives. Victims who receive the support they need – starting with law enforcement’s first responders – not only recover more quickly but will also be more inclined to fully cooperate with the subsequent investigation and prosecution of the crime. They are also more likely to work with the police officers in their neighborhoods in other, more general, aspects of crime control and community policing. In short, properly supported victims become more effective and more willing participants in the criminal justice system.

Yet many officers feel somewhat uncomfortable dealing with crime and accident victims on-scene, partly as a result of individual factors and partly because of a lack of training. With regard to the latter, this column will offer some practical guidelines. Although crime and accident victims are discussed in separate sections, note that many of the principles of effective intervention and management apply across these groups.

 

The psychology of crime victimization

Each year, more than 25 million people in the United States are victims of crime. Police psychologists Harold Russell and Allan Beigel conceive of crime victimization as comprising several layers in relation to a person’s core self. For example, a property crime such as a burglary generally hurts victims only at the outermost self-layer (that is, their belongings), although the theft of certain meaning-laden family heirlooms can have a much greater emotional impact. An armed robbery, which involves personal contact with the criminal and threat to the physical self of the victim, invades a deeper psychological layer. Assault and battery penetrates still deeper, injuring the victim physically and psychologically. A crime such as rape goes to the very core of the self, harming far more than the body and affecting the victim’s basic beliefs, values, emotions and sense of safety in the world.

Society’s response to crime also plays a role in whether victims feel supported or helpless. For example, when a child comes home from school and tells his parents that the teacher was mean and made him sit in the corner, a common parental response is to inquire, “What did you do to make the teacher punish you?” From experiences such as this, many people grow up thinking that if something bad happens, they must have deserved it. Also, taking the blame for something, even if you logically know it’s not your own fault, is often a more existentially reassuring stance than having to believe that something this terrible can just happen for no reason – because, if there’s nothing you did to contribute to it, then there’s nothing you can do that will prevent it from happening again, or from something even worse happening, any time, anywhere: Life loses all sense of order, predictability and control.

Society often regards victimization as contagious. In modern American culture, with its emphasis on fierce competition for limitless success and “having it all,” being a victim often means being a loser. Most of us want to believe that crime victimization is something that happens to somebody else; the weak, stupid or pathetic victim must have done something to bring it on him or herself, otherwise, a sharp character like me is just as vulnerable, and who wants to believe that? We may thus be reluctant to associate with crime victims for fear that their bad luck will “rub off.” All of these beliefs and reactions further contribute to the feelings of blame and shame that many crime victims experience.

Effects of crime on victims and survivors
 
First responders, such as police officers, may face a confusing scenario when arriving at a crime scene. Traumatized victims may be in a state of shock and disorientation during the initial stages of the crisis reaction. Crime victims have experienced a situation totally beyond their control, and most will feel helpless, vulnerable and frightened. Other victims may be in a state of flight-or-fight panic, and some will actually try to flee the scene of the crime. Some victims may be combative with arriving police officers, adding to the confusion as to who is the victim and who is the offender. In some instances, physical and emotional paralysis occur, rendering the victim unable to make rational decisions, speak coherently or even move purposefully, much less seek medical attention or report an incident to the police.

Long-term psychological effects of crime victimization include persistent anxiety, depression, phobic avoidance, physical symptoms, substance abuse, post-traumatic stress disorder, shattered sense of safety and security, “mean world syndrome,” cynicism and distrust. Victims may be unable to function normally at their jobs or in family life. Indeed, much of the lasting impact of crime victimization depends on the actions of first responders in the immediate post-impact minutes, hours and days. That’s why law enforcement’s proper handling of crime scenes and victims is so important.

What crime victims say they need from police

Police officers sometimes complain that when they try to help crime victims at the scene, their efforts are often misinterpreted or unappreciated. So it might be useful to go right to the source and find out what crime victims themselves would find helpful from a police response to a crime. In just such an investigation, National Center for Victims of Crime Executive Director Susan Herman examined the feelings, perceptions and wishes of crime victims with regard to police interactions at the scene and found that these victims are often very clear about what they most need from the initial police contact at the crime scene. The responses tend to cluster in three categories.

First, crime victims need to regain a sense of safety and control.They want the responding officer to interview them in a safe, quiet location, preferably away from the site of the trauma. They want to be reassured of their safety, that the immediate crisis is over and that the perpetrator can’t harm them again. They would like the officer to speak in a calm, reassuring voice, not pepper them with questions in a brusque, staccato tone. They especially don’t want officers stating or implying judgments about what the victim could or should have done before, during or after the crime; victims feel bad enough without these recriminations.

Second, victims need some time to vent, to talk about their experience. For most victims, the incidents in question are the most horrible things that have ever happened to them, and they need the opportunity to describe the events at their own pace and in their own way. This may prove frustrating to investigators who are eager to get the facts of the case as quickly as possible. Although some gentle prodding and guiding may be appropriate to keep the narrative on track, officers should hold their questions or comments until the victims have finished telling their stories.

The presentation may be emotional and rambling, as it often is with individuals under extreme stress, but ultimately, officers will get a more complete picture if they let victims tell it their own way. What officers can and should do is reassure, normalize and validate victims' experiences and reactions so that they do not feel even more stigmatized by thinking they're acting crazy or being crybabies for expressing their feelings.

Third, victims need to know how to access additional support. Officers should describe the upcoming steps in the criminal investigation and legal proceedings. Without further frightening the victim, they should inform him or her of the possibility that emotional “delayed reactions” may occur over the next few days and, importantly, new memories of the crime may emerge, in which case the officer wants the victim to feel confident enough that he or she will be willing to call with such additional information. Indeed, victims themselves say they’d like officers to make the first move in encouraging further contact with law enforcement, because victims often feel embarrassed or intimidated to call on their own; some don’t want to be seen as a pest or a wuss. Finally, victims are frightened, confused and in pain, and most of them understand that there’s a limit to what the responding officer can do in a law enforcement role. So victims want to be referred to community services and other agencies that are set up for crime victim assistance. Taking the time to ensure that the victim knows what comes next and what to do about it can prove to be a big plus in police-victim and police-community relationships.

On-scene crisis intervention
           
The first point of contact between responding officers and crime victims is often at the crime scene itself, although this contact may take place in an ambulance or emergency room if the victim is already receiving medical care. Here, the officer is confronted with a victim whose emotional behavior may run the gamut from numbed unresponsiveness to raw panic. Aside from providing medical and psychological first aid, a frequent practical task of the law enforcement first responder is to obtain as much information as possible from the victim about the crime itself in order to maximize the possibility of apprehending the perpetrator(s), preventing further violence, and planning for aid to other potential victims. Balancing concern for victim welfare and the need to obtain detailed information is thus a delicate dance and requires some degree of interpersonal skill on the part of the investigator. The following are some practical recommendations for officers who have to deal with crime victims on-scene.

First, introduce yourself by name and full title to the victim and bystanders. Even if you are in uniform, have a picture ID tag or clearly “look like a cop,” the victim may be too distraught to understand who you are. You may need to repeat the introduction several times. Remember that victims who are still in shock may respond to you as if you are the criminal, especially if you arrived quickly on the scene. Children traumatized by adults may respond with fear to any new adult in their environment. An obvious priority is to make sure any physical injuries get treated. In fact, with serious injuries, any further law enforcement interaction may have to be deferred to the hospital after the victim’s medical condition has been stabilized. Yet a substantial number of mugging, robbery and even sexual assault victims may have few or no significant physical injuries, at least not ones that are immediately detectable. If the direct victim is the child or other family member of the interviewee, the parent or relative may be physically untouched, but emotionally in shock at the attack against their loved one.  

Sometimes you may have to apply first aid until further medical help arrives. If this is the case, calmly explain what you’re doing, especially when you are touching the victim or doing an otherwise intimate procedure, such as applying a breathing mask or removing clothing. If possible, let the victim help you treat her if she wants. This may be as simple as having her hold a bandage on her arm or letting her undo her own clothing, but it can offer a much-needed quick restoration of a sense of control in a situation where the victim is otherwise reeling in a state of helpless disorientation. In particular, many children respond well to this “helping” maneuver.

Other victims may be so paralyzed with fear that they “forget” how to do simple things like untying shoelaces or unbuttoning a shirt. Also related to restoration of control is respect for the victim’s wishes whenever reasonable. If the victim, especially a young or elderly person, wants a family member or friend to remain with him during treatment or questioning, let that person stay. Don’t take offense if the victim refuses to let you touch, treat or even talk to him: you may look, act, speak, smell or have the same name as the perpetrator.

Youthful victims are often unable to express their fears and may just flail or shout for you to “get away from me!”  Perhaps another member of the law enforcement or emergency response team can interview this victim more comfortably. After ascertaining that the victim is physically intact and in sufficient emotional shape to even have a conversation, briefly verify the crime: “Please tell me what happened to you. Did it happen here or in another location?”  Do whatever you can to secure the crime scene while calling for appropriate backup. If possible, remove the victim from the scene to a safer or more neutral location. Be sensitive and tactful with onlookers and media, and cooperate with paramedics and other vital responders.  

Avoid even unintentional accusatory or incriminatory statements such as “What were you doing in that building so late at night?”  These not only needlessly upset and retraumatize the victim, but also erode trust, making further interview and treatment attempts extremely difficult. Try not to overuse platitudes such as “It’s okay” or “Everything will be all right,” which will doubtless sound hollow and insincere to a victim whose world has just been shattered. More helpful are simple, supportive, concrete statements such as “It’s okay now. We’re going to go to a safe place so you can tell us what happened. ” 

Avoid statements or implications indicating to a victim that you think he or she should “snap out of it,” “pull yourself together,” or “act your age. ”  This may be most common when dealing with adult male victims whom the officer believes should be “handling” the situation better. Remember that most people don’t behave nobly, maturely or normally when they’ve been victimized and traumatized, and some crime victims may regress to virtual childlike behavior immediately after the incident.

In such cases, simple, nonjudgmental statements such as “I can understand why you’re shaken up,” “I know this can be rough, pal,” or simply “What can I do to help?” can ease the victim’s distress. Always try to validate the traumatic ordeal the victim has been through and reinforce, as realistically as possible, his or her resilience and coping efforts thus far:  “I can see this must have been a horrible experience for you. Most people would be feeling pretty much like you are under these circumstances. But I’m glad to see you’re handling it as well as you are. ” 

Build on the victim’s own resources to increase his or her feelings of self-efficacy and control. Related to the issue of restoring control is having some kind of clear plan to provide further order and structure to an otherwise overwhelming situation. You don’t have to feel bound to follow the plan to the letter if contingencies change, but some structure is almost always better than none. It’s also useful to back up this plan with concrete suggestions for action:  “We’re going to move to a safe areas, have the medics take care of this laceration, then I’m going to ask you a couple of questions, if that’s all right. After I’m done, I’m going to explain what happens next in the police and legal process, then I’ll give you a card with some phone numbers of victims assistance agencies you can contact. I’m also going to give you my card, and you can contact me at any time for any reason. Do you have any questions?”

Even the most hardboiled detective should understand that a sympathetic, supportive and nonjudgmental approach can do much to restore the crime victim’s trust and confidence and thereby facilitate all aspects of investigating the case. So listen to the victim if she wants to talk, even if she digresses, rambles or strays off topic. Let her express emotion if she has to “get it all out. ”  At the other extreme, tolerate silence without feeling compelled to jump in with a question or comment. At this stage, don’t press for more detail than necessary for purposes of immediate treatment or case investigation – crime victims will be forced to tell their stories over and over again as the investigation and prosecution of the crime proceeds.

On-scene, use a combination of open-ended and closed-ended questioning:  “Can you remember what your attacker looked like?  Tell me. About what age was he?  What race do you think he was?  Was he taller than me?  Was he thin or stocky?  What else can you remember?  That’s all right – take your time. ”  Always provide assurances of safety, and repeat as often as necessary. Also utilize active listening techniques, such as reflective, clarifying and summarizing statements to let the victim know you understand her and to assure that her information is understood correctly by you.

If the victim seems to be getting more and more agitated, disoriented or frightened during her narrative, employ diversionary reality questions. These serve to deflect the victim’s attention from the most horrifying aspects of the event, while keeping the topic focused on the subject in question, for example:

Victim:  The guy who jumped me on the shop floor was a new hire. I never saw it coming. He just started beating me. They never check the background of these new guys. We’re all going to be killed here. We’re all dead sooner or later. . .

Officer
:  How many people work here?

Employ humor judiciously. A well-placed witticism may put some perspective on the crisis and ease an otherwise tense situation, but many victims become very literal and concrete under stress, and well-meaning humor may be mistaken for mocking or trivializing the victim’s concerns. As with all such recommendations, use your judgment and act sensitively.

Never overlook the interpersonal power of a reassuring presence, both verbally and nonverbally. Provide a model of composure for the victim to emulate. Eye contact should be in the form of a concerned, connected gaze; neither a detached glance nor a fixed stare-down. Stand close enough to the victim to provide proxemic contact comfort, but don’t crowd or intimidate the victim by invading his personal space. Use physical touch carefully. Sometimes a brief tap on the shoulder or comforting grasp of the hand can be very reassuring, but it may frighten a victim who has just been physically assaulted. Take your cue from the victim.

One technique I’ve found useful for both direct victims and distressed responders during critical incidents is what I call the therapeutic hand-clasp, which can be adapted to a regular handshake, usually for men, or a more supportive handhold, usually for female victims. For a subject who feels they’re losing control, ask them to squeeze your hand and sort of mentally transfer the overwhelming emotions to the physical activity: 

Responding Officer: Okay, just squeeze my hand, put the fear into my hand, just hold on and let it drain into my hand like an electric current, like you’re discharging a battery. Feel yourself relax as the fear drains away. That’s it, all the excess fear and tension is flowing out of you: you can handle this, you’re getting stronger, you’ll make it, you’ll be okay. All right, take a deep breath, and let go slowly when you’re ready.

At subsequent intervals, this technique can be repeated silently and unobtrusively when necessary, appearing like a normal handshake. With practice, it can be internalized so all the subject has to do is think about it, or clench his or her own fist to re-evoke the positive feeling. The technique is simple to use and relies on the basic therapeutic principles of psychological suggestion, human physical contact and interpersonal support.

Other kinds of body activity can be therapeutic. To break the sense of physical and mental paralysis that often accompanies posttraumatic numbing, have the victim take a little walk with you, let her get a drink of water, give her some simple but useful task to perform. Just being able to move one’s body around in a productive way can sometimes restore a feeling of efficacy and control:  “See, my legs work, I can move my hands, I guess I can’t be a complete basket case. ” 

Even where there has been a limiting physical injury, there is almost always someactivity or body function that the victim can perform. Anything that will show the victim that there’s some shred of normality left, that something still “works,” contributes to a sense of safety and hope. With extremely distraught or disoriented victims, you may have to provide what trauma psychologists Diane and Louis Everstine call a breakthrough stimulus to capture the person’s attention. This may involve shouting, making a loud noise or gently shaking the severely traumatized victim to “break the spell” of dissociation that he or she is in. This technique should be reserved for situations where it is an emergency matter to get the subject’s attention and cooperation, such as getting out of a dangerous area quickly. Otherwise, you may risk further traumatizing an already overfrightened victim.  

P.S. Forget about slapping: that’s for the movies and almost never works in real life, besides, you could risk a lawsuit. No cold water in the face, either; but giving the victim a sip of a cold drink often helps. More rarely, you may have to physically restrain a traumatized victim or others at the scene for their own protection.

Here, however, you should think more in terms of containment than restraint per se. Sometimes people who are out of control will derive a primitive sense of safety and peace by being enveloped in a cocoon of comforting external containment. Use the minimum force and restraint necessary, for example, wrapping the victim in a blanket as opposed to using handcuffs. Again, remember that if the subject is not actually being arrested, physical restraint should be used as a last resort, and only in the interest of the subject’s own safety.

Another technique that often works with severely traumatized victims has been referred to as augmented behavioral mirroring. For example if a victim is sitting on a curb or on a hospital cot, rocking rhythmically back and forth, humming to herself, gradually imitate and replicate her movements, until both of you are in a comfortable rhythm, and then augment with the repeated phrase, “It’s all right, you’re safe. It’s all right, you’re safe. ”  Once again, these types of specialized techniques should be reserved for extreme situations.

Crisis intervention and victim advocacy

In the aftermath of a criminal assault or homicide, the direct police role with regard to victims or families will gradually be taken over by existing victim service agencies. In the United States, an estimated 10,000 such victim service agencies are providing direct help to millions of crime victims and families. A small but growing number of victim service programs operate within law enforcement agencies, prosecutors’ offices, juvenile justice departments, probation and parole offices, and correctional institutions. Crime victim advocates also are located in community-based settings, such as rape crisis centers and domestic violence shelters.

These professional groups provide a wide range of services, including supportive counseling, crisis intervention, safety planning, emergency financial assistance, witness assistance and court escorts. Victim service providers also assist victims and families in accessing victim compensation, and advocate on behalf of victims when they are not able to receive the services they are entitled to.  

Nevertheless, most victims of crime are still not being referred to the resources they need. According to a recent survey of crime victims in Washington DC, some of this is due to the responding officers’ failure to provide victims with information about available resources. As noted earlier, simple, authoritative information delivered by a credible source can often provide a much needed sense of safety and control in a crisis situation. The type and timeliness of support services provided to victims and families in the immediate criminal aftermath can have a profound effect on long-term psychological functioning.

Postincident crisis intervention may include support services at the crime scene, hospital, medical examiner’s office, survivor’s home, police station or court setting. Interventions at this stage may include nonjudgmental listening, provision of practical information and referrals to additional services. This information should be provided verbally and in writing, in language the recipient can understand. Ideally, phone numbers should be provided where the victim or family member can get information 24/7.

Many court jurisdictions assign a victim advocate to victims of violent crime, and some jurisdictions may provide this service to homicide family co-victims as well. The advocate’s accompaniment of the survivors to court can provide them with the needed strength and support to deal with the painful and intimidating court proceedings. Unfortunately, victim advocates themselves may sometimes feel frustrated because they seem to be primarily serving the criminal justice system, especially the prosecutor’s office and the police, and only secondarily the victims or survivors.

Accident victims

Patrol officers will probably have to deal with accidents far more frequently than with serious crime victimization. Most commonly, these will involve traffic accidents and medical emergencies. In the latter, such as an elderly citizen’s having a heart attack in a public place or a worker falling off a ladder, the officer’s first responder role will typically be limited to providing emergency first aid while summoning paramedics. Motor vehicle accidents add another element, because here a misdemeanor or felony traffic violation may have occurred.  

In general, much of the same on-scene crisis intervention techniques that are useful with crime victims also can be applied to accident victims. These include the following:

  • Encourage relaxation. “Take a deep breath, we’re going to help you relax and get through this.”

  • Provide realistic reassurance. “It’s over, you’re safe now. The paramedics are on their way, and they’re going to check you out and make sure you’re okay.”

  • Emphasize the practical. Even in the presence of victims who appear unconscious, avoid potentially alarming or upsetting statements like, “Oh-oh, this looks like a broken neck;” or even, “It’s not a good idea to move him. ”  If you need to communicate with fellow officers or other first responders on the scene, stick to concrete, task-specific statements: “Let’s keep his head and body stabilized until the paramedics get here with the backboard.”


The citizen-observer victim

Remember that the ordinary citizen who observes a crime, accident or other crisis situation may also suffer traumatization, especially if the scene was especially grisly or violent. Especially where officers must quickly gather on-scene information about a crime or accident that has just occurred, they may first have to calm down one or more emotional citizen-observers before they will be able to carry out other necessary police duties. Several techniques are useful in calming observers, which are similar to the techniques described earlier for direct crime or accident victims.

  • Show understanding. By tone of voice, facial expression and gestures, become an ally the respondent can trust:  “It’s pretty frightening when something like this happens. I know you’re feeling very upset." 

  • Model composure. If officers respond calmly to the crisis, their appearance of control serves as a model and support for the involved citizen.

  • Reassure by authority and experience.  “We’ve handled lots of calls like this; we’ve got the situation under control.”  

  • Encourage talking. Sometimes you have to get the subject to calm down before he can speak coherently; paradoxically, it can work the other way, too. That is, encouraging the subject to talk can be an effective means of easing his distress because it is difficult for somebody to yell, scream, cry, fight or hyperventilate if, at the same time, he is trying to answer questions posed slowly and calmly. Sometimes police officers may encourage the person to talk about the crisis itself. This can be a form of ventilation. However, if talking about the crisis gets the citizen more agitated, officers may calm the situation by continuing to ask questions themselves and taking notes at a slow and steady pace. At first, don’t be too concerned with the cohesiveness of the narrative, just let the subject talk, rephrase questions as necessary and eventually the respondent will ease into a more articulate form of communication.

  • Use distraction. As noted above, distraction is useful for defocusing from traumatic perceptions or feelings, although its effect may be temporary. Distraction may be accomplished by asking the subject to perform a task (“May I have a glass of water?”) or asking a question that is not directly related to the crisis situation (“How long have you worked here”).

  • Use humor. Humor can help keep the crisis in perspective and cool tempers in a very tense situation. However, as noted above, humor must be used cautiously. At no time, must the subject feel she is being dismissed or made fun of.  

  • Temporarily ignore, if there is a more pressing need. Sometimes officers can calm the emotional citizen by temporarily ignoring him her while handling someone in more acute distress, such as a bleeding accident victim. This reminder of reality may help calm the emotional citizen, but again, don’t give the impression that you are deliberately snubbing the citizen.


Conclusion

Law enforcement officers should not underestimate the impact they have on traumatized crime and accident victims from the first moments of incident. Sensitive, competent handling of victims in the immediate aftermath of the crime can have a tremendous impact on both the victim’s subsequent psychological recovery and on law enforcement efforts to solve the case.

To learn more about these topics:

 

Disclaimer: This article is for educational purposes only and is not intended to provide specific clinical or legal advice. 

NOTE:  If you have a question for this column, please submit it to this website.


About the author

Laurence Miller, Ph.D., is a clinical and forensic psychologist and law enforcement educator and trainer based in Boca Raton, Fla. Dr. Miller is the police psychologist for the West Palm Beach Police Department, mental health consultant for Troop L of the Florida Highway Patrol, a forensic psychological examiner for the Palm Beach County Court, and a consulting psychologist with several regional and national law enforcement agencies. Dr. Miller is an instructor at the Criminal Justice Institute of Palm Beach County and at Florida Atlantic University, and conducts continuing education and training seminars around the country. He is the author of numerous professional and popular print and online publications pertaining to the brain, behavior, health, law enforcement, criminal justice and organizational psychology. His latest books are "Practical Police Psychology: Stress Management and Crisis Intervention for Law Enforcement" (Charles C Thomas, 2006) and "Mental Toughness Training for Law Enforcement" (Looseleaf Law Publications, 2008).

Disclaimer: This article is for educational purposes only and is not intended to provide specific clinical or legal advice. If you have a question about this column, please submit it to this website.

Contact Laurence Miller





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