9. The need for adequate psychological support and counselling during civil claims was raised by many of the victims and survivors who gave evidence. Remembering and reliving the experiences of abuse in order to provide evidence in a civil claim is inevitably a painful experience.^[1] AR-A23 warned that he believed that many people do not come forward and discuss their experiences of abuse in part because of the inadequacy of support services.^[2] Peter Garsden, a lawyer representing claimants, told the Inquiry that his clients often cannot take the process any further and discontinue claims due to the stress of the litigation. With psychological support, he believed, he could keep his clients engaged in the litigation.^[3] AR-A13 told the Inquiry: “Some of us can never fully heal. But counselling goes a long way towards being able to deal with life after a childhood filled with abuse.”^[4] AR-A41 said: “we should have been wrapped in cotton wool and helped … to ease the torments that we go through”.^[5]

10. The experience of victims and survivors in terms of accessing therapeutic support during civil claims was generally poor. Many went through the process with no professional therapeutic support.^[6] AR-A13 found the civil process to be relentless and found that “when it got to the point of sheer blind panic, there was no-one to turn to”. He had no one he felt he could tell that he needed “time out” from the litigation.^[7] AR-A2 also felt that he had no support whatsoever during his civil claim. His solicitor advised him to see his GP but he was left feeling that “there had been no thought for the psychological well-being of the claimants going through the claims process”.^[8]

11. Not all victims and survivors wanted therapy, and some worried whether they could cope with it. Malcolm Johnson, a lawyer representing claimants, told us that in his experience the majority of child abuse survivors are “remarkably robust”. His view is that therapy is a “difficult area” and he told us about instances where psychiatrists have warned that therapy would not help or might even harm his clients. He explained that meetings between solicitors on the issue of rehabilitation concluded that getting rehabilitation is very difficult, as many victims and survivors will not or do not want to engage in it.^[9] AR-A21 told us that he did not pursue therapy or counselling during his civil claim as it was too traumatic to engage further about his experiences.^[10] He said that he felt “pretty miserable” after court, and in hindsight he believed that counselling or therapy during the civil claims would have helped him with the process.^[11] Sarah Erwin-Jones, a defendant solicitor, believed that the take-up of counselling was “not particularly high” but that it was important for a lot of claimants for it to be there as an option.^[12]

12. Lawyers representing victims and survivors told us that very little support is available in the civil process.^[13] They reiterated that they are lawyers, not counsellors, and they identified a clear difference between providing legal advice and therapeutic support. Tracey Storey, a claimant solicitor, told us that she tells her clients from the outset that, as a solicitor, she is not there to provide counselling or emotional support. Instead, she would ask whether they have support, at home or through therapy, to help them with the litigation process.^[14] She explained that, as a lawyer, she has to tell her clients things they may not want to hear, requiring very clear boundaries.^[15] Peter Garsden also emphasised the need to carefully signpost clients to appropriate services and to remember to make sure that “we are lawyers and we are not trying to be counsellors as well”.^[16] Peter Robson, a victim and survivor, touched on this when he explained that his lawyer at this Inquiry was “not a psychiatrist, he can’t deal with me”.^[17]

13. We heard from victims and survivors who believe that the defendants or their insurers should provide for counselling services during claims.^[18] Elizabeth-Anne Gumbel QC, a claimant barrister, explained the importance of this:

“One of the things I feel strongly about is that there should be funding for private therapy as soon as people have made complaints and litigation has started, that there should be – possibly like the Rehab Code in relation to head injuries, that therapy should be provided, even without admissions of liability, at private costing, because the delays in getting therapy to waiting until you’ve settled the case, is just causing more damage.”^[19]

14. The 2015 Rehabilitation Code^[20] is published by the Rehabilitation Working Party, which includes representatives from the International Underwriting Association of London, the Association of British Insurers, Lloyd’s, primary insurers, legal groups, care providers and the NHS. Its purpose is to “help the injured claimant make the best and quickest possible medical, social, vocational and psychological recovery”.

15. The Pre-Action Protocol for Personal Injury Claims, at paragraph 4, requires that parties should consider as early as possible, and throughout the period of the protocol, whether the claimant has reasonable needs that could be met by medical treatment or other rehabilitative measures. It states that the Rehabilitation Code is likely to be helpful in considering how to identify the claimant’s needs and how to address the cost of providing for those needs.^[21]

16. It is possible for a claimant with a good claim in the civil process to obtain an interim payment that could fund expenses such as psychotherapy or counselling. Tracey Storey told us that defendants have become more amenable to requests for interim funding in strong cases. Typically, she would receive interim funding from the defendant to help her clients access private treatment.^[22] Malcolm Johnson did not have the same experience; for various reasons, only a minority of his clients would access therapy during the civil claims.^[23] Paul Durkin, a claimant solicitor, and Peter Garsden, also told us that in their experience defendants do not make interim payments for therapy^[24] – although the former had an experience of defendants voluntarily making interim ‘ex-gratia’ payments, which are payments made out of goodwill and not because of legal liability.^[25]

17. Rod Luck, the Claims and Reinsurance Manager at MMI, acknowledged that where the need for psychiatric support and treatment of a claimant is identified during litigation, that could be dealt with by an interim payment before the end of the litigation, although it could not be done on a “blanket” basis when claims came in due to the need for medical evidence.^[26] The Inquiry was told that Ecclesiastical Insurance has offered support including therapy for some claimants during child abuse litigation against parties it has insured.^[27]

18. At the end of their civil claims, victims and survivors can feel abandoned. For example, AR-A6 felt “cut adrift without any support at all” at the end of his claim. The case had reawakened suppressed memories, and he turned to drink and drugs to block out his feelings.^[28]

19. The payment of compensation to settle a civil case does not necessarily lead to claimants accessing support services, even if they need them. One reason for this is that it is for claimants to choose how to spend their compensation. They are under no obligation to use it in any particular way, even if some of it has been paid for specific purposes such as psychotherapy.^[29] We heard from victims and survivors that the payment of compensation did not always lead to treatment. AR-A21 felt that counselling would re-open his trauma.^[30] AR-A41 received compensation but did not know that he was expected to use it to fund therapy.^[31] Sarah Erwin-Jones noted that although a settlement sum may include a sum for therapy and support, “we have no idea whether that is used for therapy and support and we have no right to ask”.^[32]