1. Short and long term psychological support
Bruxelles
14 June 2017
Child and Youth Protection Center of Zagreb, Croatia
Gordana Buljan Flander, PhD, Director

2. Abused children are:
Terrible
Crazy
Fat
Cowards
Stupid
Bad
Black
Loose
Dead
Small
Lazy

3. Importance of support
Many relevant research highlight the importance of providing support to children victims and/or witnesses of violence
Evidence-based support without undue delay
Kim, Noh & Kim, 2016; Miller-Perrin &Perrin, 2007; Cohen, Deblinger, Mannarino & Steer, 2004; Kolko & Swenson, 2012

4. Introducing Standard 8 Standard 8. Therapeutic Services
8.1 Assessment and treatment : Assessment and treatment is routlinely made available for child victims and witnesses that are referred to the Barnahus/Center.
8.2 Staff: Mental health services and treatment are provided by professionals with specialised training and expertise.

5. Introduing Standard 8 (cont.)
Standard 8. Therapeutic Services
8.3 Information and child participation: Children and family/care-givers receive adequate information regarding available treatments and can influence the timing, location and set up of interventions.
8.4 Crisis intervention: The Barnahus has a clear organisational structure and permanent staff, which routinely offers crisis support intervention for the child and non-offending family members/care-givers if needed.

6. Modalities of supporting the child/family
Support and access to information
Crisis support interventions
counselling
psychotherapy
Treatment
Short term support
Long term support

7. Support and access to information
Children and family/care- givers receive adequate information regarding available treatments
Importance of information and psychoeducation:
e.g. myths and facts about child abuse, signs and consequences, information about treatment and other sources of support

8. Treatment plan
Multidisciplinary team assessment results serve as a basis for developing an evidence-based and trauma- informed treatment plan
Treatment is adapted to the individual characteristics of the child, including age, development, linguistic, cognitive and social level, cultural background and emotional state

9. Ensuring child participation
Children and family/care-givers are given opportunity to influence the treatment plan and process

10. Trauma focused treatment
Interventions with the parents (support and counselling)
Joint sessions
(children and parents prepared)
Interventions with the child
Trauma-focused cognitive- behavioral therapy as therapy of choice in most trauma cases (TF-CBT)
Cohen & Mannarino, 2008

11. “WORKING THROUGH THE TRAUMA”
Placing the trauma into child’s life experience so it could become it’s constituting part which is not omnipresent and will not disturb further normal functioning.

12. Training of professionals
Educated professionals – importance of specialised training in treatment approaches
evidence-based trauma-informed therapy
regular training opportunities: continous training, supervision and counselling

13. Forensically sensitive therapy
Challenges
What if child needs support, but due to ongoing court process, we do not want the treatment to jeopardize child`s testimony?
Forensically sensitive therapy
court proceedings are unfinished, but the child needs immediate treatment
projective techniques and interpretations of child’s play and drawings are avoided
working on symptoms without going into content of child`s story

14. 6 year old boy, child victim of abuse
„I feel a thousand times sad.”

15. From non-abusive to supportive parent
Support from a non-abusive parent is one of the most important predictors of child’s adjustment
(Cohen i Mannarino, 2008)
more important than characteristics of the abuse itself
more important than the form of treatment
Path from being the non-abusive parent to being a supportive parent - identification of the protective role

16. „I want to withdraw my statement because of my mom, they love each other so I don't want him to go to jail. She called me a hundred of times, asking me not to take her husband away from her.
Now mom will be happy, and I will be happier for her. It's my fault that he behaves badly towards her.
All of it happened, but my mom never believed me, nor did my teacher, or anyone else I told. Often I can't sleep at night because my mom doesn't trust me. I feel like I don't have anyone. I want my mom to be happy, then she will love me.”
From non-abusive to supportive parent

17. FOLLOW UP A child needs help; not only after the abuse,
but also in several different phases
s/he is going through

18. during the court process, if the treatment has ended
if new circumstances in child’s life appear
assessment in a new phase
another traumatic event
appearance of old or new symptomatology

19. Because without the dark we could never see the stars
Don`t underestimate yourself – we are all worth the same. Find your strength, inner drive for life and all it is bringing.
Because without the dark we could never see the stars

20. gordana.flander@poliklinika- djeca.hr
Thank you
djeca.hr