Tuesday, January 24 • 11:45 AM — 12:45 PM
Welcome Luncheon
Addressing the Social-Emotional, Behavioral and Mental Health Needs of Children in Child Welfare
—Bryan Samuels, Commissioner, Administration on Children, Youth and Families, Washington, DC
Commissioner Samuels expands on his comments from the morning's plenary, discussing child welfare strategies for addressing the social-emotional, behavioral, and mental health needs of children who have experienced maltreatment.
Cost $40 • See registration form • Preregistration required
GLOBAL PERSPECTIVES LUNCHEON (Bring your lunch)
D13a. Responding to Child Sexual Violence in Very Poor Resource Setting with No Access to Trauma Counselor—Mercy Chidi Ogbonna, Kenya, sponsored by Ripples International
Ripples International will share the experience in responding to sexual violence at the village level with very limited resources.
Abstract
Increasingly documented in Kenya but only limited post-rape care services exist. Child survivors of sexual violence experience complex needs and many countries have developed one-stop facilities that enable survivors to access medical, legal and social support services. These do not translate easily to the resource-poor Kenyan setting. This workshop demonstrates a case study showing how Ripples Tumaini shelter in the Meru community of Kenya, is helping and continues to help more than 160 girls recover from the trauma by offering post rape care using the available local resources at the grass root village level setting.
Learning Objectives
- Participants will have reflected on knowledge and skills required when working with child survivors within available resources at the village level.
- Participants will be more skilled in responding to the needs of child survivors using the available local resources at the village level.
D13b. Child Sexual Abuse: The Role of Medical Expert Statements in Legal Process and Outcome
—Noora Ellonen, Minna Joki-Erkkila, Jenni Niemi, sponsored by Tempere University Hospital, Finland
The meaning of medical expert statements in legal process.
Abstract
Purpose of the study was to evaluate medical expert statements in criminal process in suspected cases of child sexual abuse (CSA). Alleged CSA cases are challenging for health care professionals as well as for criminal investigation and prosecution. Medical expert statements present findings in examination and translate the meaning of these findings or the lack of them into “multidisciplinary language” understood by other professionals. Previous research has shown that especially physical evidence is rarely obvious enough to support the alleged suspicion.
The role of these unambiguous statements as evidence in the legal process is unclear. In this research we addressed to this problem. First, we analyzed the role of medical statements in the legal outcome of suspected CSA cases.
Secondly, we analyzed medical statement conclusions according to Adams et al. guidelines.The study consists of random sample of 136 CSA cases medically examined by law enforcement referral in one University Hospital in Finland during 2001-2009. All cases were reported to the Finnish law enforcement authorities. The data consists of official investigation documents from police department, crime laboratory, prosecutor, court and hospital. 13% of the medical statements supported the suspected CSA, and worryingly, 9% had a conclusion denying the suspicion. In 38% cases medical statement was supportive, if intercourse was suspected. In 10% cases forensic samples were collected. In 26% cases coercive measures were performed. Investigation was closed in 10 cases with no disclosure from child and no other supportive material of suspected crime. 77 % cases were referred to prosecution. Charges were filed in 56 % cases of those. 78 % were sentenced.
In this presentation the role of expert statements in the legal outcome will be presented. In conclusion, we highlight the fact that medical examination cannot dispute CSA suspicion. Child’s disclosure is main evidence in legal process.Learning Objectives
- The importance of expert statements in legal process and outcome.
D13c. Going Dutch: An Evaluation of the Advice and Reporting Centers for Child Abuse in Holland
—Paul Baeten, Maud Groenberg, sponsored by Ministry of Safety and Justice, Advice and Reporting Centre for Child Abuse, The Netherlands
An evaluation of the Advice and Reporting Centres for Child Abuse in Holland, where there is no mandatory reporting, where offering assistance to abusive families is the primary goal, and where professionals like teachers and social workers take responsibility in tackling child abuse.
D13d. Child Helpline in Saudi Arabia: A Tool for Data Collection and Recognition of Children and Adolescencts Problems in a Conservative Middle East Country
—Majid Al Eissa, Research sponsored by the National Family Safety Program, Saudi Arabia
The session will discuss the strategies for developing the childhelp line in Saudi Arabia highlighting the opportunities utilized and the obstacles we overcame. Preliminary data of one operational year will be revealed to audience showing the patterns of childhood problems in the country.
Abstract
The idea of Child Helpline service was contemplated in 2008. Since then, collaborative efforts of multiple agencies helped in utilizing potential strengths and opportunities as well as overcoming various obstacles and challenges. In 2010, the 116-111 line was launched for one year trial phase. Results of the collected data will be presented to audience.
Learning Objectives
- Challenges in establishing a Child Helpline in a conservative country.
- Positive outcome of collaborative national agencies efforts.
- Nature of children and adolescents problems in Saudi Arabia.
Publications
- www.childhelplineinternational.org/assets/cms/File/Fourth%20VAC%20Report%20-%20English%20-%20FINAL%20COPY.pdf
- www.childhelplineinternational.org/en/publications/CTC
- www.childhelplineinternational.org/assets/cms/File/PDF/Manuals/Good%20Governance%20Manual%20-%20final.pdf
Wednesday, January 25 • 11:45 AM — 12:45 PM
William N. Friedrich
Memorial Lecture & Luncheon
Sponsored by Mayo Clinic Child and Family Advocacy Program
When Helping Hurts: Addressing Vicarious Trauma
—Judith Cohen, MD, Medical Director, Allegheny General Hospital, Pittsburgh, PA
Child trauma therapists dedicate our professional lives to helping children heal from abuse, violence and other traumas. Our work provides remarkable rewards but sometimes helping hurts and the work we do can also lead to vicarious trauma. This presentation describes several situations in which vicarious trauma has occurred in child trauma therapists, for example when a therapist became overwhelmed by hearing repeated details of children's personal trauma experiences; when these stories resonated with a therapist's personal trauma history; when the therapist experienced too many demands at work with too little support; and when a therapist was not able to balance work with other aspects of life. The presentation will also discuss how child trauma therapists and their organizations can prevent and respond to vicarious trauma.
Cost $40 • See registration form • Preregistration required
GLOBAL PERSPECTIVES LUNCHEON (Bring your lunch)
H13a. European Approaches: Prevent and Combat Child Abuse and Neglect —
What Works? Overview of National Strategies and Presentation of the Outcomes of an Evaluation With Parents and Professionals in Five Participating Countries
—Peter van der Linden, sponsored by Netherlands Youth Institute, the Netherlands
Presentation of the report on policy on CAN in 5 European Countries: Sweden, Germany, Netherlands, Hungary and Portugal, with focus on practice concerning the prevention, detection, reporting and stopping of CAN. Presentation of evaluation of the experiences of parents with the programmes and policies preventing child abuse in the 5 participating countries.
Abstract
The Netherlands Youth Institute initiated started in January 2011 a European 2-year-comparison of Approaches tackling Child Abuse and Neglect in 5 European Countries: Sweden, Germany, Netherlands, Hungary and Portugal. The first phase of the project is focused at describing the policy and practice concerning the prevention, detection, reporting and stopping of CAN in the participating countries. The overview and report on the situation in these countries will be ready in January 2012. The second phase is an evaluation of the experiences of parents and professionals with the programmes and policies preventing child abuse. The evaluations will also be presented in January 2012. The third and final phase of the project will be concentrating on identifying the effective elements of preventing child abuse based on the experiences in the participating countries and the outcomes of the evaluation with parents and professionals. In January 2013 the result of the project will be a manual on what works in tackling child abuse and neglect.
Learning Objectives
- Overview of approaches in 5 EU-countries
- Evaluation amongst parents of these approaches
- First findings in the making of What Works Manual
H13b. Child Helpline In Saudi Arabia
—Tahani Almajhad, sponsored by National Family Safety Program, Saudi Arabia
The workshop consists of the basic stages of CHI establishment, focusing how to apply it in real life.
Abstract
The main objective is to participate with other countries that had the same experience, comparing it to Saudi Arabia experience in the same field.
Learning Objectives
- To identify the real reasons of "why Saudia Arabia established this line?"
- To identify the challenges and difficulties that we faced when we started the line.
H13c. Lighting a Spark in Difficult Times: Creating Amazing Programs With the Assistance of the Royal Bank of Canada
—Kim Jordan, Kenda Riggs, Judy Shortall, sponsored by the Royal Bank of Canada for the Janeway Family Centre, Newfoundland
Serving children and families; retaining experienced staff; raising the visibility of your agency; building a sense of pride and accomplishment—all achievable in times of restraint when public and private sectors work together.
Abstract
In times of shrinking budgets and increasing demands, agencies providing mental health services are pressured to do more with less. Keeping the spark of creativity and productivity alive among clinicians and expanding services to meet the increasing needs of both urban and rural populations requires new ways of delivering service. Group programs have long been recognized as a cost efficient, evidence-based method of responding to increasing referrals for mental health services. Obstacles to providing group programs have included lack of resources to develop groups, limited numbers of or lone professionals available in small offices to facilitate groups, difficulty locating programs that are adaptable and the cost of purchasing prepared programs.
This presentation introduces the formation of a partnership between The Janeway Family Centre, a hospital-based children’s mental health service, and the Royal Bank of Canada that enabled the development of a wide spectrum of prevention and early intervention group programs adaptable for both urban and rural settings. This sponsorship also provided for the production of cost free manuals for each program and facilitator training workshops to help communities prepare for group facilitation. The prevention-focused groups in this collection include groups for parents of young children and teens as well as a group for parents coping with complex family situations. The early intervention focused groups include groups responding to family violence, sexual abuse, intergenerational physical abuse and separation and divorce. All programs can be delivered through multi-disciplinary, multi-agency collaboration in small communities with minimal cost.
This workshop will acquaint participants with the RBC Reaching Out project and provide contact information for areas interested in exploring the program for their own communities.
Learning Objectives
- Building partnerships between public and private sectors
- Motivating staff in difficult times
- Providing low cost services for children and families
H13d. Impact of Socio-Demographic Profile and Mother-Child Temperament Mismatch on Disciplinary Practices
—Harmesh Singh-Bains, Research presented by Dayan Medical College and Hospital, India
Sociodemographic factors, mother-child temperament mismatch and disciplinary practices.
Abstract
Despite much research and increasing public awareness campaigns on child abuse, children continue to remain vulnerable to abuse. Abuse seems to be multi-factorial in origin. Various socio-demographic variable and parent-child temperament mismatch which may be correlates of disciplinary practices and child abuse needs to be explored in a greater depth.
This session will present data from a prospective research study of 300 cases in progress. It includes the type of disciplinary practices adopted by mothers of preschool children and associated socio-demographic factors. The socio demographic factors include basic information, literacy level, occupation, socio economic status, rural/urban residence, type of family (nuclear/joint), number of siblings, birth order of the index case and gender. This study explores some of the important mutual influences of disciplinary practices and temperament; hence reviewing the evidence for relations between temperament and disciplinary practices.
The presentation will also provide participants with the opportunity to develop the skill for assessing and rating themselves and their children, if any, on each of the seven dimensions of temperament i.e. Activity level, regularity, response to new situations, adaptability, distractibility, persistence and intensity. It will conclude with a discussion on how to find out any mismatch between the parent and child temperament and disciplinary practices adopted.
Learning Objectives
- To learn the association between socio-demographic factors and disciplinary practices in developing countries
- To develop the skill of assessing temperaments
- To learn mutual influences of disciplinary practices and temperament
Thursday, January 26 • 11:45 AM — 12:45 PM
Global Perspective Lectures (Bring your lunch)
L13a. Screening and Intervening for Intimate Partner Violence in South African Primary Care
—Kate Joyner, sponsored by Stellenbosch University, South Africa
Evidence-based research tested and modified a bio-psycho-social and forensic intervention for female survivors of intimate partner violence in South African primary care sector to ascertain the efficacy and value thereof.
Abstract
Purpose:
South Africa tops international intimate femicide rates (Mathews et al., 2004). Simultaneously evidence-based approaches in primary care for preventing intimate partner violence (IPV) are seriously lacking (McFarlane et al., 2006). Professional action research was used to test the feasibility of a South African protocol for screening and managing IPV (Martin & Jacobs, 2003) and modify it for use. Evidence of the value of this intervention in a South African primary healthcare setting is provided.
Description:
At two urban and three rural community health centres, 168 women living with IPV were recruited for a comprehensive intervention. Seventy five percent returned for their follow-up interview a month later to report to a different interviewer on its usefulness.
Results:
Some relationships had ended following the intervention, while many others noted improved communication and quality of relationship with their partner and children. Personal transformation was also evident in multiple reports of a dramatic improvement in mental health, including cessation or lessening of alcohol abuse. Enhanced awareness of rights, overall health, safety assessment, planning and referral information engendered increased confidence and a proactive approach.
Learning objectives:
Assess how this bio-psycho-social and forensic intervention benefited participants or not.
Understand patients’ narratives regarding their stage of change (Zink et al., 2004).
Appreciate how motivational interviewing techniques (Miller and Rollnick, 2002) may enhance work with IPV survivors.
Examine the pervasive impact of abuse on the mental health of clients and family systems.
Desired Outcomes:
From a developing world/ resource-poor context, participants appreciate:
The value of motivational interviewing techniques, and stages of change theory in bio-psycho-social and forensic IPV-related work.
Learning Objectives
- To assess how this bio-psycho-social and forensic intervention benefited participants or not.
- To understand patients’ narratives regarding their stage of change (Zink et al., 2004).
- To appreciate how motivational interviewing techniques (Miller and Rollnick, 2002) may enhance work with IPV survivors.
- To examine the pervasive impact of abuse on the mental health of clients and family systems.
Publications
-
Joyner, K., Theunissen, L., De Villiers, L., Suliman, S., Hardcastle, T., & Seedat, S. (2007). Emergency care provision for, and psychological distress in, survivors of domestic violence. SA Family Practice, 49, 15a-15d.
- Martin, L. & Jacobs, T. 2003. Screening for Domestic Violence: A Policy and Management Framework for the Health Sector. UCT: Institute of Criminology.
- Mathews, S., Abrahams, N., Martin, L. J., Vetten, L., van der Merwe, L., & Jewkes, R. (2004). "Every six hours a woman is killed by her intimate partner": A National Study of Female Homicide in South Africa—MRC Policy Brief [5]. Pretoria: MRC & CSVR.
- McFarlane, J.M., Goff, J.Y., O’Brien, J.A. & Watson, K. 2006. Secondary Prevention of Intimate Partner Violence: A Randomized Controlled Trial. Nursing Research, 55(1), 52-61.
- Miller, W. & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change. New York: The Guilford Press.
- Zink, T., Elder, N., Jacobson, J., & Klostermann, B. (2004). Medical management of intimate partner violence considering the states of change: precontemplation and contemplation. Annals of Family Medicine, 2, 231-239.
L13b. It’s Just Not Fair! Leveling the Playing Field for Children and Families in Smaller Communities
—Jocelyn Bourgeois, Bridget Byrne, Donna Ronan, sponsored by the Royal Bank of Canada for the Janeway Family Centre, Newfoundland
Unlikely partners—children’s mental health services and the Royal Bank of Canada have opened doors to group prevention and treatment programs for children and families in both urban and rural areas. Can this approach work for you?
Abstract
The benefit and cost efficiency of group programming has long been recognized, both in prevention and early intervention literature. Unfortunately, group programs are often only accessible to children and families within driving distance of urban areas. In 2007 the Royal Bank of Canada joined forces with the Janeway Family Centre, a hospital based children’s mental health service, to manualize a series of group programs and accompanying facilitator training workshops designed to encourage the expansion of group programs for children and families in any community.
Recognizing the challenges of geography and small / sole charged offices, the “RBC Reaching Out” project focused on providing cost free materials and training, fostering multi-discipline / multi-agency collaboration and providing support to communities wishing to develop group programming in their own areas. Following through with this project required comprehensive management and planning. Innovative program development is difficult to achieve in times of restraint – new money is rarely available in the public system! In order to create something new we must find new ways of using the resources we already have. The “RBC Reaching Out” project has truly achieved this goal.
The program has been reviewed by external consultants and continues to grow in exciting and unexpected ways. This presentation will focus on lessons learned along the way – both through the process of fostering staff collaboration and developing partnerships with / in communities. It will provide a model that can be replicated in other communities interested in increasing services to children and families at minimal cost.
Learning Objectives
- Presenting a model for delivery of low cost group services
- Fostering multi-discipline multi-agency collaboration
- Expanding services for rural areas
Published Articles on Evidence-Based Topics
- Trocome, N. & Wolfe, D. (2000). Child Maltreatment in Canada—Canadian Incidence Study of Reported Child Abuse and Neglect.
- Health Canada, 1-51 Malchiodi, C.A. (2008) Creative Interventions with Traumatized Children. New York: Guildford Press. Cunningham, C. E., Bremer, R., & Boyle, M. (1995).
- Large group community-based parenting programs for families of preschoolers at risk for disruptive behaviour disorders. Utilization, cost effectiveness and outcome. Journal of Child Psychology and Psychiatry, 36, 1141-1159.
L13c. An Integral Model of Prosecution and Psychological Support in Cases of Child Sexual Abuse Resulting in Death
—Solange Bertrand, Alejandro Bustos, Paulina Leiva, sponsored by Fundación Amparo y Justicia, Chile
Since year 1998, Amparo y Justicia Foundation has prosecuted all the cases happened in Chile of child sexual abuse resulting in death. Our lawyers are the most specialized professional of the country in this particular type of cases. Our unique litigation model has allowed us to be successful, by obtaining the maximum sentences existing in Chile for the perpetrators of these crimes. In addition, our Foundation has implemented an integral model of psychological and social support whose goal is to help the affected families to overcome the lost and to empower themselves.
Abstract
Fundación Amparo y Justicia (Protection and Justice Foundation) started in 1998. That year, the rapist and murderer of the 5-years old Elena Yáñez was given jail benefits by the Chilean Justice. Her family was very poor and they could not afford a private lawyer. They were claiming for help.
Andrónico Luksic, a successful Chilean business man, realized that this situation was unfair. That is why he hired the most specialized lawyers in order to support Elena´s families. Those lawyers, Ramón Suárez and Alejandro Espinoza, continue to date prosecuting all the child sexual abuse resulting in death cases happened in Chile since 1998. Ramón is the current President of the Foundation and Alejandro is a board member.
Since the beginning, Amparo y Justicia Foundation has litigated more than 40 cases and helped more than 200 people, members of the affected families. The unique model applied by Amparo y Justicia Foundation includes not only the prosecution of these cases, but also a specialized psychological and social support to the affected families. We work very hard in order to provide hope to them and to empower them through psychological resources and through trainings.
In addition, Amparo y Justicia Foundation has made a great contribution to Chile by helping to reduce the secondary victimization of abused children. The Foundation has organized 2 international seminars, in 2007 and 2008, where we have learned from the American, European and Israeli model of investigation and prosecution of child sexual abuse cases. Currently we are organizing the third seminar, oriented to prosecutors, lawyers, policemen, detectives and doctors. It will be held in August 2011 and its focus will be in forensic interview and online sexual abuse.
Learning Objectives
- Learning about the unique model of Amparo y Justicia Foundation, that includes legal, social and psychological support for families that have lost a child because of sexual abuse resulting in death
- Learning tips about successful prosecution child sexual abuse cases resulting in death
- Learning about our model of social support that result in the empowerment of families
L13d. Genital Trauma Following Consensual Intercourse in Adult Volunteers Evaluated by White and UV Light
—Minna Joki-Erkkila, Research presented by Tampere University Hospital, Finland
UV-light, an additional method visualizing acute hemorrhages and old scars in anogenital area.
Abstract
Objective:
Genital trauma is reported in only a minority of females even after sexual assault, partly because of difficulties visualization of medical findings using conventional examination methods. We evaluated the benefit of UV light compared to white light for detecting minor genitoanal injuries by colposcopy following consensual sexual intercourse among adult volunteers.
Study design:
Physical examination performed to eighty-seven adult female volunteers after consensual intercourse comparing medical findings in white and ultraviolet light. Colposcopy with photographic documentation was used. Anatomic issues were recorded. We evaluated and compared acute and old medical findings after consensual intercourse by UV-light in contrast to white light and its additional value for forensic purposes in medical examination performed to adult female volunteers.
Results:
Submucosal haemorrhages in genital area were documented in white light 6.9 % (6/87) and in UV-light 12.8 % (11/87) after consensual intercourse. Five out of eleven submucosal haemorrhages were not documented in white light and were identified in early phase after consensual intercourse several hours before becoming visible in white light. Of the scars negative in white light, 63.9 % were visualized with the use of UV-light (p< 0.001).
Conclusions:
UV-light may give an additional value in the evaluation of medical findings in forensic examination after sexual assault, and is especially useful in detecting otherwise invisible early bruises and genital scars.
Learning Objectives
- Basic knowledge and restrictions with UV-light.
- Use of UV-light in acute and old anogenital trauma.