« Child Protection Centre of Zagreb » is contributing to the ONE in FIVE Campaign - a pan-European campaign coordinated by the Council of Europe
The Child Protection Centre of Zagreb is a health institution. It started working in December 2002. The founder was the City of Zagreb. The Centre is in contractual relationship with the Croatian Institute for Health Insurance.
The key purpose of the work of the Child Protection Centre is providing help and support to children with various traumatic experiences, which includes neglected and abused children, children at risk of abuse and their families.
Every child is provided with multidisciplinary approach by educated professionals. Experience of similar institutions abroad shows that the most effective approach to children suspected of having been abused in any form is the multidisciplinary approach.
The work of the multidisciplinary team is carried out through:
- Assessment and treatment of children and their families
- Multidisciplinary team work and supervision
- Training professionals from other child protection institutions
- Research and scientific work
- Publishing and raising public awareness
ASSESSMENT AND TREATMENT OF CHILDREN AND THEIR FAMILIES
- Individual assessment and diagnosing the difficulties of children referred to the Centre for suspected abuse, exposure to traumatic experience, difficulties indicating risk of abuse and other difficulties related to stressful circumstances in children's development.
- Planning treatment for every child.
- Conducting individual treatment according to the child's needs.
- Organising and conducting group psychotherapy of children, support groups of children with various difficulties and socialization groups
- Organising and conducting support groups and personal development groups for parents.
Multidisciplinary team work implies the approach to children with specific knowledge and skills of every professional, work is coordinated for the benefit of the child and every professional directly or indirectly contributes to the better quality of assessment and treatment. Relevant documentation is also obtained during the assessment of children who were exposed to domestic violence, usually in collaboration with the concerned social welfare centre. Aiming at the protection of abused children, the Centre works in close coordination with the social welfare service, Police, State Attorney Office, the Court and professionals from health institutions, schools, kindergartens and children's homes.
If exposure to violence and/or abuse is suspected, it is necessary to conduct a forensic interview or elements of forensic assessment besides clinical assessment, in order to dismiss or confirm some of the hypotheses set at the inclusion of the child in the assessment:
- the abuse has happened as confirmed by the obtained data;
- the abuse has happened, but in a different way;
- there is a wrong perception or interpretation;
- the abuse has not happened.
Generally speaking, suspicion of exposure to violence and/or abuse is determined in accordance with specific details obtained from the child, developmental factors, psycho-diagnostics and medical diagnosing, emotional content obtained from the child, the existence of alternative explanations and motivation of participants, all of these data being obtained in the course of assessment.
The assessment of the child is regularly accompanied by coordination with other institutions if needed, in order to provide the estimated necessary protection and to include the child in the treatment. In the cases of child exposure to high conflict parental divorce, the Centre also collaborates with the social welfare centres, the Police, State Attorney Office, the Court and professionals from health institutions, schools, kindergartens and others. The assessment of the child results in multidisciplinary report. Multidisciplinary assessment is regularly conducted if the reason for the referral of the child to the Centre is suspected abuse or exposure to traumatic/stressful development context.
Multidisciplinary report consists of data about the child's health status, conditions and dynamics of development, developmental and intellectual characteristics of the child and his/her psychological profile determined by diagnostic procedures, characteristics of social and emotional development of the child and his/her competences, presence or absence of psychopathology (diagnosis according to ICD-10) and suspected witnessing or exposure to violent/abusive behaviour in the family, as well as the estimated protection. The opinion includes recommendation for further protection of the child and for the inclusion of the child in some of the treatments/therapy in our or some other institution, recommendation of the necessity of parental inclusion in the counselling or treatment, as well as the recommendation that siblings should be assessed if there is a perceived possibility that they may be the victims of violent behaviour in the family.
In agreement with similar models in the world, the treatment of children in the Centre is conducted based on multidisciplinary estimate: psychological, psychiatric and the treatment conducted by social educator and rehabilitator. Follow up and counselling by social worker and paediatrician is also conducted. Individual and group treatment of children is accompanied by partner and parental counselling and support groups for children. Since a large number of children come for assessment from other cities, the treatment is sometimes conducted closer to their place of residence. Centre's professionals are educated to conduct treatments (counselling, therapy) based on the postulates of contemporary humanistic psycho-therapeutical trends.
Specific issues of children exposed to violence demand specific planning and preparation of their treatment. It has long been thought that the child should not be included in the treatment before the court proceedings involving the offender have been completed, which proved to be a long period even in developed social contexts. The answer to this dilemma is in the Convention on the Rights of the Child (1989) and the definition of the best interest of the child. Adults or organisations making decisions which may affect children must primarily take the best interest of the child into account.
This is why the meaningful forensically sensitive treatment/therapy (Carnes, 2005), focused on the child recovery, emerged in the context of multidisciplinary teams work, when the results of the assessment show suspected abuse experienced by the child and the child shows signs of trauma. In such cases it is justified that the treatment starts before the court proceedings because the child and the family need as early intervention as possible to prevent the reinforcement of symptoms and to provide the adequate help and support for the child. Since court proceedings take a long time in our circumstances, such an approach proved justified in the Child Protection Center of Zagreb, too. The child often receives additional support for being exposed to stressors during the proceedings (interrogation at the court, family difficulties due to the operation of institutions and other).
The Child Protection Center of Zagreb conducts medical, psychiatric and psychological multidisciplinary evaluations ordered by courts. Evaluations are conducted by permanent court evaluators - expert witnesses in the fields of psychiatry and psychology. The Center is recognised as an institution for forensic assessment of children and adolescents who have been exposed to high conflict parental divorce and for assessment of the credibility of testimony (in cases of child abuse), as well as for assessment of parents in various court proceedings (e.g. recommending custody arrangements in divorce, various types of abuse in the family, etc.)
Interviews of children in the Center by two expert witnesses of the Center and in the presence of the judge, court recorder, state attorney and the party attorney were conducted in collaboration with the County court in Zagreb in the course of judicial (preparatory) investigation in several cases. In these cases, the issue which is the focus of professional dilemma in Croatia, has been resolved by conducting an interview of the child by a mental health professional once, recording the procedure and using the recorded material in the proceedings, thus reducing a repeated traumatisation of children in court proceedings.
MULTIDICIPLINARY TEAM WORK AND SUPERVISION
Contemporary models (integrative, ecological, transactional, multifactorial) explain abuse as a complex social - psychological phenomenon caused by multiple factors in mutual interaction: individual psychological characteristics of the abuser, relationship between parents and the child, family environment, situational factors and social context.
The only way to comprehend such a complex social-psychological phenomenon is a multidisciplinary approach. It is not sufficient to rely on only one of the professions involved in working with abused children in order to understand risk and protective factors in a child's life.
Multidisciplinary team approach is the main feature of professional work in the Child Protection Center of Zagreb. The model of team work promoted in the Center:
- Respecting specific knowledge and skills of every professional
- Coordination for the benefit of the client
- Direct and indirect action of team members
- Personal involvement of professionals
A form of supervision has been provided for the Center's professionals since the beginning of its work (team supervision, supervision directed on secondary traumatisation of professionals, case supervision).
The multidisciplinarity principle, besides being promoted within the Center, is also promoted in collaboration with other institutions in the system with the purpose of better child protection at all levels of prevention. The Center often functions as a facilitator and collaborator.
Center's professionals continually cooperate with the non-government association 'Brave Phone' help-line for children. Cooperation is realised through exchange of experience, referring children who ask for help by telephone to be assessed and treated in the Center, training and supervision of 'Brave Phone' volunteers by Center's professionals, team research and activities.
TRAINING PROFESSIONALS FROM OTHER CHILD PROTECTION INSTITUTIONS
Center's professionals are permanently included in various kinds of professional training in the following:
- Forensic interview and forensic evaluation of abused children
- Treatment/therapy of psycho traumatised children
- Psycho-crisis interventions
- Topics from developmental psychopathology
- Psychotherapeutic training
- Participation in professional and scientific conferences in Croatia and abroad
Center's professionals conduct various training programmes for professionals from collaborating institutions and the system. These include lectures and workshops in the Center and other institutions in Zagreb and other Croatian cities (in schools, kindergartens, health institutions and social care institutions, police, non-government associations, professional associations, public forums, city and county organisations, etc.). The primary goal is sensitisation of professionals to recognise the abuse and neglect of children and other risk factors of child development: peer bullying, exposure to high conflict parental divorce, effects of domestic violence on children, stress and trauma in childhood and other. Besides the professionals' sensitisation, the dissemination of specific knowledge and skills in working with children helps establishing a better collaboration with cooperating institutions and expanding the network of child support. Several systematic trainings were realised in the Center with the support of concerned ministries and the City of Zagreb
Evaluation of the seminars clearly indicated that professionals from various systems graded them as exceptionally useful and on the whole successful. Besides sensitising the professionals for the issues of abused children protection andacquiring new knowledge and skills, the aim of such meaningful trainings is also introducing changes in the existing practice.
Students from graduate study of psychology of the Faculty of Philosophy (Zagreb and Osijek), post-graduate specialist study of Clinical Psychology of the Faculty of Philosophy in Zagreb, graduate study of Social Work and Educational - Rehabilitational Faculty have their practical training in the Center.
Center's professionals are lecturers and assistants at several study groups at the University of Zagreb and the University of Osijek.
RESEARCH AND SCIENTIFIC WORK
What is child abuse? What is its incidence, what are the consequences, what are the risk factors? What sort of treatment helps children to recover? How can we prevent abuse?
These are the questions for which it is important to provide scientifically based answers. That is why research activity is part of what the Child Protection Center of Zagreb does. Its aims are:
- Expanding the knowledge in the field of psychotraumatisation and victimisation of children, including the abuse and neglect of children
- Using research results in designing prevention and intervention programs
- Analyses of cases in everyday work in the Center on the basis of 300 variables related to the data obtained in assessment, which enables systematisation of knowledge about the incidence of abuse and traumatisation of children and related factors
Center's professionals, in collaboration with the Brave Phone association conducted research into:
- Prevalence of peer bullying, characteristics of children who abuse and of children victims of abuse (N=4900), conducted in 25 primary schools in 13 cities.
- Exposure of children and youth to the Internet content (N=4000).
- Attitudes and knowledge of physicians in Croatia related to child abuse and neglect (N=600).
- Prevalence of childhood abuse and other traumatic experience (N= 4191).
- Habits and experience of children and youth during the Internet, the mobile phone and other modern technologies use (N=2700).
- Parental conflict during divorce and the adjustment of children (N=300).
Conducted research, as well as the overall research activity of the Center including the analyses obtained in clinical work are compliant with the Ethical code in research with children. The code lays down a consideration and undertaking of measures necessary to reduce possible negative effects of research on children if it is reasonably presumable that the content of research might disturb them.
Besides the mentioned research, several surveys focused on specific problems on the clinical sample of children in the Child Protection Center of Zagreb, aiming at better understanding of the manifestation, consequences and aetiology of abuse. Results were presented in scientific and professional journals and at professional and scientific conferences in Croatia and abroad.
PUBLISHING AND RAISING PUBLIC AWARENESS
One of the goals of the Center's activities is raising public awareness about the issue of child abuse and neglect, as well as the promotion of children's rights, the importance of responsible parenting and understanding children's developmental needs. This activity is considered to be the general prevention directed at all children, parents and professionals. The goal is pursued by publishing and continual communication with the public via the media and the web site.
Center's handbooks and leaflets are published in collaboration with the City of Zagreb
- Child Protection Center of Zagreb
- Peer Bullying
- 25 questions (and answers) for professionals working with abused and neglected children
- Hyperactive child
- I Can Do It, Too! Children with Learning Disabilities
- May I! – Workbook for hyperactive children
- Helping the Mourning Child
- Cyberbullyng – Abuse via the Internet
- Child sexual development
- Child neglect
- Should we worry? – Handbook about adolescents
- Is It Possible That Is Love? - Handbook on violence in youth relationships
- Attachment and youth violence: Why is love important (Guide for parents)
- The child and the trauma
- It's happened, what now? – Leaflets for sexually abused child's parents
- Witnessing domestic violence - Leaflets for parents and professionals
Conducting forensic iterview with a child in a child friendly atmosphere, by Centres professional, who is audio and video conected with a judge who is placed in another room (together with state attorney, defendant, defense lawyer, social worker, policeman) is listening and watching the interview. Judge is questioning a child through the expert, who is then adapting questions to a child, taking into account child's age, developmental level, level of psychotraumatization, etc.
Room in which a judge, state attorney, defendant, defense lawyer, social worker, policeman and other parties included in the case watch the forensic interview with a child and from where they can ask questions through professional (who is conducting an interview and who is audio and video connected with them).
Child Protection Centre is an educational base for students and is also organizing various trainings for professionals from collaborating institutions and the system about the issue of child abuse and neglect.
Child Protection Centre publishes handouts, brochures and leaflets as prevention or psycho-educational material for parents, children and professionals. They are free of charge.
On the picture are leaflets for the parents of sexually abused children that are given to parents in order to better understand child's symptoms and reactions after abuse. Sometimes parents are too stressed while seeing a professional for the first time after discovering their child was sexually abused, so these leaflets are given to them in order to read everything once again after they calm down.
Professionals in the Centre have different psychotherapy backgrounds. Most of professionals combine cognitive behavioral, humanistic and/or analytic approach. Treatment is specifically designed for each child. Some children are included in individual therapy and some are included into group work. Professionals in the Centre also work with parents, through counseling, individual therapy, conjoint sessions with children or include them into group therapy.