[page 121 begins]

APPENDIX A1.1.1
QUESTIONS

The President of John Jay College, Dr. Gerald Lynch, and members of the faculty met with
Ms. McChesney and representatives of the USCCB to discuss possible approaches to the
study of the nature and scope of child sexual abuse in the Church. After several weeks of
discussion, Kathleen McChesney, on behalf of the USCCB, gave the John Jay College
faculty group a specific set of questions to be answered, and thus defined the scope of the
study. These questions were divided into four categories, as follows:

Information about the alleged offenses

° How many offenses were alleged or confirmed by conviction about any Catholic priest
or deacon in the diocese?

° What was the time frame(s) of the alleged and confirmed offenses?

° Were alcohol and/or drugs used by the victim or offender at the time of the offense?

° In what location(s) did the offense occur?

Information about those who have made accusations

° The age and gender of the victims at the time of the offense.

° With whom did the victim live at the time of the offense?

° What was the relationship between the victim and the offender at the time of the
offense?

° Where there any threats to the victim or grooming behavior on the part of the offender
at the time of the offense?

° How long did the victim wait to report the offense?

° When was the offense reported?

Information about the accused clerics

° What diocese or religious order did the offender belong to at the time of the offense and
what status did he hold in that order?

° What was the offender’s job description/duties?

° If the offender was a deacon, was he married or unmarried at the time of the offense?

° What age was the offender at the time of the first and last alleged and/or confirmed
offense?

° How many years was the offender ordained at the time of the first offense?

° How many alleged or confirmed victims did the offender have?

° Was there a civil or criminal action against the offender and what were the
consequences?

° Was the offender a victim of any type of child sexual abuse?

° Did the offender receive any type of psychological treatment (i.e., for either
psychological, sex offending, and/or substance abuse)?

° Was the offender transferred to another ministerial assignment subsequent to offending,
and if so, did he re-offend?

° Did the offender have a record of having been abused by a fellow priest and/or
deacon?

[page 121 begins]

Information about the financial impact on the dioceses and religious community

° What was the financial cost to the Dioceses or religious community as a result of each
alleged or confirmed offense?

In additional to these questions, the Board and USCCB asked for the best estimates that could
be made of the extent of child sexual abuse in the United States.

 

[page 123 begins]

APPENDIX A.1.1.2
DIOCESAN PROFILE

DIOCESAN PROFILE:
CONFIDENTIAL

[page 124 begins]

FORM #1: DIOCESAN PROFILE

Please answer these ten questions to the best of your knowledge. It should include information between 1950-2002.

1. Is this institution a(n): (Please check one)

   
Diocese
   
Eparchy
   
Religious Institute

(NOTE: If a question is not applicable to your order, please write N/A.)

2. List the approximate number of active and retired Priests and Fathers in the order from 1950 (or since the establishment of the diocese) to 2002:
a. diocesan priests:                           incardinated ______ extern _______
b. religious institute priests:                ________
c. diocesan deacons                           ________
d. religious institute deacon in diocese ________

3. What is the approximate number of Catholics in your order at this time?

   
5,000 - 45,000
   
88,501 - 122,000
   
239,001 - 350,700
   
45,001 - 66,000
   
122,001 - 170,000
   
350,701 - 475,000
   
66,001 - 88,500
   
170,001 - 239,000
   
475,001 - 788,700
   
788,701 - 4,500,000

 

4. What is the approximate number of parishes operated by your order at the present time?

   
8-35
   
57-71
   
98-119
   
36-46
   
72-84
   
120-138
   
47-56
   
85-97
   
139-185



5. Check all regions in which the order is active.

   
I
   
IV
   
VII
   
X
   
XIII
   
II
   
V
   
VIII
   
XI
   
XIV
   
III
   
VI
   
IX
   
XII


6. Based on your review of the records, indicate how many clerics have had allegations made against them while in your order.
Number of incardinated __________      number of extern __________


7. How many clerics with allegations have been completely exonerated? _______________


8. Based on your reviews of the records, please indicate the total number of victims who have made allegations against clerics in your order. ____________________


9. Based on your reviews of the records, please indicate the total amount of money paid out by your order to alleged victims of sexual abuse between 1950 and 2002. ___________________


10. For how many of the victims in Question #8 have:

__________ all of their allegations been shown to be known false
(# of victims)

__________ all of their allegations been withdrawn
(# of victims)

(NOTE: do not include these victims in the remainder of the survey)

For research use only: Dio Code: ___________

 


[page 125 begins]

APPENDIX A1.1.3
RELIGIOUS ORDER PROFILE

ORDER PROFILE:
CONFIDENTIAL

[page 126 begins]

FORM #1: RELIGIOUS INSTITUTE PROFILE

Please answer these nine questions to the best of your knowledge. It should include information between 1950-2002.

1. Is this institution a: (Please check one)

   
Religious Institute
   
Province of a Religious Institute

2. List the approximate number of active and retired clerics who have ministered in your religious institute or province from 1950 (or since the establishment of the religious institute) to 2002:

a. religious priest members: _______

b. permanent deacon members: _______

3. What is the approximate membership of the religious institute or province at this time?

   
1 - 10
   
31 - 40
   
111 – 150
   
541 and up
   
11 - 20
   
41 - 75
   
151 - 305
 
   
21 - 30
   
76 - 110
   
306 - 540
 

4. What is the approximate number of priests and fathers who are now members the religious institute or province?

   
1 - 6
   
22 - 35
   
81 – 110
   
400 and up
   
7 - 14
   
36 - 57
   
111 - 176
   
 
   
15 -21
   
58 - 80
   
177 - 399
   
 

5. Based on your review of the records, indicate how many member religious priests or permanent deacons have had allegations made against them while ministering within your province or religious institute. If any religious priests (not counted as members of your province or religious institute - but perhaps visiting from another province) were subject of such allegations while ministering in your province, please give that information on the second line in the category of "Others."

Religious priests __________               Permanent deacons __________

Others ___________

6. How many clerics with allegations have been completely exonerated? _______________

7. Based on your reviews of the records, please indicate the total number of victims who have made allegations against clerics in your province or religious institute. ____________________

8. Based on your reviews of the records, please indicate the total amount of money paid out by your province or religious institute to alleged victims of sexual abuse between 1950 and 2002.
___________________

9. For how many of the victims in Question #8 have:

__________ all of their allegations been shown to be known false
(# of victims)

__________ all of their allegations been withdrawn
(# of victims)

(NOTE: do not include these victims in the remainder of the survey)

For research use only: Order Code:____________

 

[page 127 begins]

APPENDIX A1.1.4
CLERIC SURVEY


CLERIC SURVEY:
CONFIDENTIAL

[page 128 begins]

FORM #2: CLERIC SURVEY                                                       CLERIC #_________

Please complete the following information. To ensure confidentiality, this information will be encrypted for data analysis and this page will be destroyed.

Cleric’s first initial ____

Cleric’s last initial ____

Date of Birth __ __/__ __/__ __

REMINDER: DO NOT WRITE IN THE NAMES OF ANY CLERICS OR VICTIMS ANYWHERE ON THIS SURVEY. IF YOU HAVE ANY QUESTIONS AND YOU CALL THE JOHN JAY COLLEGE RESEARCH TEAM HOTLINE AT (212) 237-8539, PLEASE DO NOT SAY YOUR NAME, THE NAME OF YOUR DIOCESE, OR THE NAME OF ANY ALLEGED VICTIMS OR ABUSERS.


For research use only: Dio Code: ____________          AB Code: ___________

[page 129 begins]

FORM #2: CLERIC SURVEY                                                       CLERIC #_________

Please fill out this form to the best of your knowledge for every cleric against whom there are or have been allegations of sexual abuse between 1950 and 2002. Do not fill this out for clerics against whom the only allegations were known to be false. For the purpose of clarity and flow, the term “diocese” is used to refer to all diocesan, eparchial and religious orders, societies and communities.

FIRST, WE ARE GOING TO ASK YOU TO PROVIDE SOME BASIC INFORMATION ABOUT THIS PARTICULAR CLERIC.

1. Year of birth: __ __ __ __

2. At the time of the alleged offense(s), was this cleric a(n): (check as many answers if necessary if the allegations against this cleric extended over a period of time)

   
Diocesan Priest
   
Eparchian Priest
   
Extern Priest
   
Religious Priest
   
Transitional Deacon
   
Permanent Deacon
   
Eparch
   
Bishop
   
Cardinal
   
Other (specify): __________

 

3. If ordained, year of ordination: __ __ __ __

4. What seminary/seminaries did the cleric attend? ____________________________

5. Was cleric married at time of alleged offense(s)?

   
Yes
   
No

6. Does the cleric have a history of being a victim of abuse?

   
Yes
   
No
(If No, skip to Question 9)

7. If yes, the type of abuse indicated in the record or known to the diocese is best described as (check all that apply)

   
Physical abuse
   
Emotional Abuse
   
Sexual Abuse
   
Verbal Abuse
   
Physical & Sexual Abuse
   
Neglect
   
Other (specify): ________
 

8. This abuse was allegedly committed by: (check all that apply)

   
Mother
   
Peer/acquaintance
   
Father
   
Person in a position of authority (e.g., babysitter,
coach)
   
Sibling
   
Priest
   
Other family member
   
Deacon
   
Teacher
   
Other (please specify): __________


9. Are there indications in the record that the cleric had problems with alcohol or substance abuse?

   
Yes, Alcohol
   
Yes, Drugs
   
Yes, Alcohol & Drugs
   
No (If no, skip to question 13)

10. If you answered “Yes” to Question 9, then please indicate what action(s) was taken to address the alcohol or drug abuse problem? (check all that apply)

   
Referral for Evaluation
   
Spiritual Counseling Provided
   
Referral for Treatment
   
Intervention
   
Spiritual Counseling Recommended
   
No action taken
   
Other action taken (describe) ________
 

11. If treatment was provided, where did it occur? (if none, skip to question 13)

   
inpatient substance /alcohol abuse treatment within the diocese
   
inpatient substance/alcohol abuse treatment outside diocese
   
outpatient within diocese (specify type of program) _________________________
   
outpatient outside of diocese (specify type of program)_______________________

12. During treatment for alcohol/drug abuse, did the cleric admit to sexual abuse(s) of a minor(s)?

   
Yes
   
No

13. Are there other specific medical or psychological problems that raised concerns about this cleric’s fitness for ministry? (if no, skip to question 18)

   
Yes
   
No

14. Please describe the problem to the extent possible__________________________________
__________________________________________________________________________

15. Was the problem recognized before any allegation of abuse?

   
Yes
   
No

16. What is the approximate date the problem was recognized? ____________

17. If the cleric has multiple medical or psychological problems, please specify the year each was recognized (if more than three, please continue question 16 on the back.)

Year ________       problem ______________________
Year ________       problem ______________________
Year ________       problem ______________________
Check here if continued on back _____________

18. How many dioceses has this cleric served in? __________

19. How many times has this cleric transferred within your diocese?

Parishes ________            Congregations ________

20.Does this cleric have allegations of sexual abuse against him at any of these other dioceses in which he served?

   
Yes
   
No
   
No information in file

21. If yes, how many victims made allegations of abuse against this cleric in each diocese, parish and congregation in which he served?
Dioceses ________    Parishes ________    Congregations________

22. Is it known from the files, or by other means, that this cleric had behavioral/boundary problems other than allegations of sexual abuse of minors (e.g., letters of complaint from parishioners)?

   
Yes (specify) _____________________________________________________
   
No

 

NOW WE ARE GOING TO ASK ABOUT THIS CLERIC’S ALLEGED VICTIM(S) FROM YOUR DIOCESE

23. How many victims made allegations of sexual abuse against this cleric in your diocese? ________

24. Is there any indication that the cleric has abused more victims than there are official allegations made (e.g., victims who made a complaint claim that there are other victims who do not want to come forward)?

   
Yes
   
No

25. If yes, please indicate how many other alleged victims there are who have not officially made a complaint against this cleric. _____________________

26. How many allegations of abuse of minors does the cleric have in each of the following age ranges and genders at your diocese? (give your best approximation of the age range based on information in the file)

# of victims under 8 years of age ________   # male _______ # female ________
# of victims 8 - 10 years of age ________     # male _______ # female ________
# of victims 11-14 years of age ________     # male _______ # female ________
# of victims 15 - 17 years of age ________   # male _______ # female ________

THE FOLLOWING QUESTIONS HAVE TO DO WITH THE INSTITUTION’S RESPONSE TO THE SEXUAL ABUSE ALLEGATIONS AGAINST THIS PARTICULAR CLERIC

27. What did the diocese do in response to the allegation(s) of sexual abuse against this cleric? (check all that apply)

   
Cleric reprimanded, returned him to duties
   
Cleric referred for spiritual retreat
   
Cleric referred for evaluation
   
Cleric referred for treatment
   
Cleric given administrative leave
   
Cleric given medical leave
   
Cleric resigned or retired
   
Cleric sought laicization
   
Cleric reinstated
   
Cleric removed from clerical state
   
Cleric suspended from ministry
   
Other (specify)________________
   
No action taken
 

 

28. If the cleric was reinstated, was it:

   
Within the diocese, same parish
   
Within the diocese, different parish
   
Different diocese
   
Restricted ministry

29. What year(s) did the diocese take action against the cleric?

Year__________       Action___________________
Year__________       Action___________________
Year__________       Action___________________

30. If the cleric participated in any type of treatment to address the sexual abuse allegations, what kind of treatment was it? (check all that apply) If no treatment, skip to question 35.

   
Specialized sex offender treatment program specifically for clergy
   
Specialized sex offender treatment program for all sex offenders, not just for clergy
   
General treatment program not specifically for sex offenders
   
One-on-one counseling w/ psychiatrist, psychologist, or other mental health expert
   
Psychotherapist
   
Relapse prevention treatment program
   
Evaluation by mental health professional or expert, but no indication of treatment
   
Spiritual counseling or direction provided by the church
   
Other (specify):____________________
   
 

31. If the cleric participated in treatment, at which facility?

   
Behavioral Medicine Institute of Atlanta, GA
   
Servants of the Paraclete, Jemez Springs, NM
   
Issac Ray Center, Chicago, Il
   
Servants of the Paraclete, Albuquerque Villa, NM
   
Johns Hopkins Medical Institutions, Baltimore, MD
   
St. Louis Consultation Service, St. Louis, MO
   
Progressive Clinical Services, Cincinnati, OH
   
Institute of Living, Hartford, CT
   
St. Luke Institute, Suitland, MD
   
Menninger Clinic, Topeka, KS
   
Servants of the Paraclete, St. Louis, MO
   
New Life Center, Middleburg, VA
   
Shalom Center, Inc., Splendora, TX
   
Villa St. John Vianney, Downingtown, PA
   
Southdown, Aurora, Ontario, CN
   
Other (specify)_________________

32. How many times did the cleric participate in a sex offender treatment program? ________

33. Did the cleric complete a treatment program?

   
Yes
   
No
   
No information in file

34. If cleric received treatment, did he re-offend after he finished treatment?

   
Yes
   
No
   
No information in file

35. Provide additional information known or from the record that would assist in understanding the behavior of this cleric.

REMEMBER – DO NOT PROVIDE ANY NAMES OR OTHER IDENTIFYING INFORMATION

For research use only: Dio Code: ____________ AB Code: ___________

APPENDIX A1.1.5
VICTIM SURVEY

 


VICTIM SURVEY: CONFIDENTIAL
FORM # 3: VICTIM SURVEY

CLERIC # ___________

For research use only: AB Code: _______
VM Code ________
Dio Code:_________

Prepare a separate profile for each victim who issued an allegation against this particular cleric. If a cleric had multiple allegations, prepare a separate victim profile for each victim who initiated an allegation. Please answer each of these questions to the best of your knowledge and indicate when an answer is approximate rather than specific. Remember to write the matching cleric’s number in the upper right hand corner.

WE ARE NOW GOING TO ASK YOU TO PROVIDE SOME BASIC INFORMATION ABOUT EACH VICTIM WHO BROUGHT AN ALLEGATION AGAINST THIS PARTICULAR CLERIC.

1. Gender of victim (check one)

   
Male
   
Female

 

2. When did the alleged abuse occur? (Be as specific about the date or range of dates as possible)

Month __ __ Day __ __ Year __ __ __ __ OR range of dates _______________________

3. When was this abuse reported? (Be as specific as possible)

Month __ __ Day __ __ Year __ __ __ __

4. Who initially made the allegation?

   
The victim
   
The victim’s parent(s) or guardian(s)
   
A teacher
   
A police officer
   
A cleric
   
A lay person in the Church
   
Other (specify)____________________
   
A doctor
   
 
   
Victim’s attorney

 

5. How was the allegation initially made?

   
Called the parish
   
Called the diocese
   
Sent a signed letter to the parish
   
Sent a signed letter to the diocese
   
Sent an anonymous letter to parish
   
Sent an anonymous letter to diocese
   
Went to the parish
   
Went to the diocese
   
Told trusted priest/deacon who brought complaint to diocese or order
   
Called the Provincial or Major Superior of the order or congregation
   
Information obtained through the media
   
Sent signed letter to the Provincial or Major Superior of the order or congregation
   
Other (specify): ___________________
   
Sent anonymous letter to the Provincial or Major Superior of the order or congregation


6. Is there a record of the victim or victim’s family following up on the allegation?

   
No
   
Yes (specify method of follow up):______________


7. If the victim/victim’s family did follow up, how many times? __________________

8. How many times was the victim allegedly abused?

   
Once
   
More than once (number __)
   
numerous (unknown number)

9. Did the victim allege abuse by more than one cleric? (If no, skip to question 12)

   
Yes
   
No
   
Information not in the file

 

10. If yes, how many clerics allegedly abused this victim? _________

11. Did the abuse by the other cleric(s) occur before, concurrent with or after this cleric? (check all that apply)

   
Before
   
Concurrent with
   
After

12. Age (in years) when alleged abuse began (or occurred, if only happened once). ___________ years

13. Age (in years) when abuse ended (if occurred more than once). ____________ years

14. Age (in years) when victim first told someone about the abuse. ______________ years

15. Number of months/years the victim waited to report the abuse. _____________

16. Where did the victim first meet the cleric?

   
Mass
   
Choir
   
Boys club/youth recreation
   
Sunday school teacher
   
Teacher in preschool, kindergarten, or elementary school (up to grade 6)
   
At an altar service
   
Teacher in middle school (grades 7-8)
   
In the rectory
   
Teacher in high school (grades 9-12)
   
Work in a hospital
   
Orphanage
   
Seminary faculty
   
Home of victim
   
In jail/prison/youth offender residence
   
At a vocational inquiry
   
Home of cleric
   
At a social function w/ victim’s family
   
Seminary administrator
   
Other (specify)________________
   
While assigned to the victim’s parish (e.g., as an extern priest)


17. What was the cleric’s primary duty when he met the victim? (check all that apply)

   
Pastor
   
Associate pastor
   
Resident priest
   
Seminary faculty
   
Boys club/youth recreation
   
Catechism teacher
   
Teacher in preschool, kindergarten, or elementary school (up to grade 6)
   
Choir
   
Teacher in middle school (grades 7-8)
   
Chaplain
   
Teacher in high school (grades 9-12)
   
Worked in a hospital
   
Seminary administrator
   
Saying Mass
   
Guidance counselor
   
Bishop, Vicar, Chancellor, Cardinal
   
Other (specify)________________
   
Coach

 

18. Did the cleric socialize with the family of the alleged victim(s)?

   
Yes
   
No
   
Information not in the file

 

19. If yes, in what way? (check all that apply)

   
In the church
   
In church day activities (e.g., picnics)
   
Spent time with the family in his residence
   
He spent time with the family in their residence
   
Vacations