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Caring for Child Survivors of Sexual Abuse PDF

250 Pages·2012·5.49 MB·English
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Caring for Child Survivors of Sexual Abuse Guidelines for health and psychosocial service providers in humanitarian settings First Edition Cinotreer nCAhtiliodn SAelx uAl AbuSe rKenSoCwulee Cdogme mCoitmtepeetenCieS Cover Photo: UNICEF/Jill Connelly/Democratic Republic of the Congo, 2010 © 2012 by International Rescue Committee All rights reserved. International Rescue Committee Agency Headquarters 122 East 42nd Street New York, NY 10168 U.S.A. +1 212 551 3000 www.Rescue.org For more information about the Caring for Child Survivor’s Resources please contact the IRC Women’s Protection and Empowerment Technical Unit at [email protected]. To down- load the CCS Guidelines electronically, please go to www.gbvresponders.org. This publication was funded in part by the Bill & Melinda Gates Foundation and the U.S. Department of State’s Bureau of Population, Refugees, and Migration (PRM). The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of our funders. CCAArriinngg FFoorr CChhiilldd SSuurrVViiVVoorrSS ooFF SSeexxuuAAll AAbbuuSSee gguuiiddeelliinneeSS ACKnowledgementS The Caring for Child Survivors (CCS) of Sexual Abuse Guidelines were developed to respond to the gap in global guidance for health and psychosocial staff providing care and treatment to child survivors of sexual abuse in humanitarian setting. The CCS Guidelines are based on global research and evidenced-based field practice, and bring a much-needed fresh and practical approach to help- ing child survivors, and their families, recover and heal from the oftentimes devastating impacts of sexual abuse. On behalf of the IRC, I would like to extend a special word of appreciation to the U.S. Department of State’s Bureau of Population, Refugees and Migration, the Bill & Melinda Gates Foundation and the United Nations Children’s Fund (UNICEF) for making the development of these guidelines possible. This generous support has allowed the IRC to develop a child-centered model of care and accompa- nying guidelines to support humanitarian field staff caring for child survivors of sexual abuse. I would like to also recognize UNICEF for their role as technical partners in the CCS Initiative. I would like to extend a special thank you to Abigail Erikson, the principal author of these guidelines. Abigail’s extraordinary commitment, expertise and energy have been central to this effort and we are deeply grateful to all of her hard work. I would also like to thank members of the CCS Technical review panel. This panel of gender-based violence (GBV) and child protection experts were instru- mental in ensuring the guidelines are rooted in best practice and global standards. Deep appreciation and thanks go to the following IRC experts: Laura Boone, Senior Technical Advisor, Child Protection; Eduardo Garcia Rolland, Technical Advisor, Child Protection; Dhammika Perera, Senior Technical Advisor, Reproductive Health; Karin Wachter, Senior Technical Advisor, Women’s Protection and Empowerment; Janel Smith, Clinical Care for Sexual Assault Survivors Specialist, and Eve Puffer, Technical Advisor, Research, Evaluation and Learning. In addition, Mendy Marsh, GBV Emergency Specialist, UNICEF and Chen Reis, Clinical Associate Professor and Director of the Humanitarian Assistance Program at the University of Denver, provided key technical input and technical advice. A very special thank you goes to the IRC Women’s Protection and Empowerment Team in Thailand and the Community Wellbeing Initiative and Child Protection Teams in Ethiopia. The time and effort made available by the IRC Field teams to pilot test the CCS tools and resources has been invaluable to the successful development of the CCS guidelines. We hope these guidelines will benefit child survivors in humanitarian settings throughout the world, as well as the individuals who help to provide for their care and treatment. Thank you, Heidi Lehmann DIRECTOR, WOMEN’S PROTECTION AND EMPOWERMENT TECHNICAL UNIT INTERNATIONAL RESCUE COMMITTEE CCS Guidelines | Page 1 Cinotreer nCAhtiliodn SAelx uAl AbuSe rKenSoCwulee Cdogme mCoitmtepeetenCieS tAble oF ContentS introduCtion 4 Overview of the Caring for Child Survivors (CCS) Resources CCS Theory of Change Using the CCS Guidelines Glossary of Terms ChaptER OnE: CORE Child SExual abuSE KnOwlEdgE COmpEtEnCiES 21 Core Child Sexual Abuse Knowledge Competency Areas Guidelines for Assessing and Monitoring Core Knowledge Competencies ChaptER twO: CORE Child-FRiEndly attitudE COmpEtEnCiES 51 Core Child-Friendly Attitude Competency Areas Guidelines for Assessing and Monitoring Core Attitude Competencies ChaptER thREE: CORE SKillS: Engaging and COmmuniCating with Child SuRvivORS 59 Developing a Helping Relationship through Safe and Healing Communication Strategies Best Practices for Communicating with Child Survivors Guidelines for Communicating with Children about their Experience of Sexual Abuse Addressing Common Communication Challenges Guidelines for Assessing and Monitoring Core Communication Skill Competencies ChaptER FOuR: guiding pRinCiplES and KEy iSSuES 87 Guiding Principles for Working with Child Survivors of Sexual Abuse Caring for Child Survivors Key Issues Issue 1: Mandatory Reporting Requirements Issue 2: Confidentiality Protocols in Child Cases Issue 3: Ensuring the Best Interest of the Child: Balancing Roles in Decision-Making ChaptER FivE: CaSE managEmEnt FOR Child SuRvivORS 105 Introduction to Case Management Steps of Case Management for Child Survivors of Sexual Abuse Step 1: Introduction and Engagement Step 2: Intake and Assessment Step 3: Develop Case Goals and Action Plan Step 4: Implement the Case Action Plan Step 5: Case Follow-up and Monitoring Progress Step 6: Case Closure and Evaluating Service Step 7: Service Evaluation Page 2 | International Rescue Committee CCAArriinngg FFoorr CChhiilldd SSuurrVViiVVoorrSS ooFF SSeexxuuAAll AAbbuuSSee gguuiiddeelliinneeSS ChaptER Six: pSyChOSOCial intERvEntiOnS FOR Child SuRvivORS 187 Integrating Psychosocial Interventions into a Child and Family’s Care and Treatment Assessing the Psychosocial Needs of Child Survivors Guidelines for Implementing Core Psychosocial Interventions ChaptER SEvEn: bESt pRaCtiCES FOR CaSE COORdinatiOn bEtwEEn SERviCE pROvidERS 231 Best Practice in Coordinating Child Case Response Final nOtE tO thE REadER 239 CCS toolS Please note: related staff monitoring tools and/or sample case management forms are included at the end of each chapter. A list of the CCS tools and relevant page numbers are included below. CCS KnOwlEdgE aSSESSmEnt tOOl (CCS-Ka) 45 CCS attitudE SCalE 57 CCS COmmuniCatiOn aSSESSmEnt tOOl (CCS-Ca) 83 Child nEEdS aSSESSmEnt and CaSE aCtiOn plan 170 Child CaSE FOllOw-up FORm 172 Child CaSE ClOSuRE FORm 174 Child CliEnt SatiSFaCtiOn QuEStiOnnaiRE 175 CCS CaSE managEmEnt SKillS aSSESSmEnt tOOl (CCS-Cma) 180 CCS CaSE managEmEnt ChECKliSt 183 Child and Family pSyChOSOCial nEEdS aSSESSmEnt tOOl 225 Tools and other reference documents not specific to a particular chapter are included at the end of the guidelines. minimum StandaRdS FOR CaSE managEmEnt 240 gbvimS intaKE and aSSESSmEnt FORm 241 CCS Guidelines | Page 3 Cinotreer nCAhtiliodn SAelx uAl AbuSe rKenSoCwulee Cdogme mCoitmtepeetenCieS introduCtion OvERviEw OF thE CaRing FOR Child SuRvivORS (CCS) RESOuRCES The International Rescue Committee (IRC), in partnership with the U.S. Department of State, the United Nations Children’s Fund (UNICEF) and the Bill & Melinda Gates Foundation have dedicated resources toward developing a program model of care1 and guidelines for implementing the gOal model of care for child survivors of sexual abuse across humanitarian set- The ultimate goal of the tings. The purpose of developing these resources is to provide guidance Caring for Child Survivors on how to: Resources is to enable » Build the capacity of health and psychosocial service providers on the and empower staff in foundational (or “core”) knowledge, attitudes and skills to work with humanitarian aid con- child survivors of sexual abuse. texts to provide high » Adapt case management for child survivors. quality care to children » Implement targeted psychosocial interventions. » Improve coordinated care across multiple sectors and service providers. and families affected by » Monitor the quality of service provision. sexual abuse. 1 The CCS Program Model is also referred to as the CCS Theory of Change. This refer- ences the logical framework developed to help child survivors recover and heal from sexual abuse. Page 4 | International Rescue Committee CCAArriinngg FFoorr CChhiilldd SSuurrVViiVVoorrSS ooFF SSeexxuuAAll AAbbuuSSee gguuiiddeelliinneeSS The Caring for Child Survivors (CCS) Resource Package is based on global research on child sexual abuse and evidence from field practice. The CCS Resource Package brings a much- needed comprehensive and practical approach to helping child survivors and their families recover and heal from the impacts of sexual abuse. The three main components are: » literature Review: An in-depth literature review of available evidence and promising prac- tice to improve case management, psychosocial care, and clinical care for child survivors of sexual abuse.2 » CCS program model: The logical model or “theory of change” that outlines the service delivery components necessary to help children recover and heal from sexual abuse. » CCS guidelines: The CCS Guidelines (this document) provide step-by-step guidance on how to implement the main aspects of the CCS Program Model. The CCS Guidelines is the “how-to” guide for instructing health and psychosocial field staff responding to chil- dren who have experienced sexual abuse. The CCS Guidelines include multiple tools for monitoring and evaluating the program model, such as: knowledge and skills competency assessments and case management monitoring and evaluation tools. CCS thEORy OF ChangE and intEndEd OutCOmES The technical guidance outlined in this document comes from the CCS program model or “theory of change” outlined on the next page. The CCS theory of change posits that children can be supported in their recovery and healing from sexual abuse with child-specific, compas- sionate and appropriate care and treatment. The theory of change outlines the key elements of care and treatment and the knowledge, skills and attitudes required for health and psycho- social service providers to be able to provide such care. 2 The CCS literature review is titled: Advancing the Field, Caring for Child Survivors of Sexual Abuse in Humani- tarian Settings. A Review of Promising Practices to Improve Case Management, Psychosocial & Mental Health Interventions, and Clinical Care for Child Survivors of Sexual Abuse. May 2010 CCS Guidelines | Page 5 Cinotreer nCAhtiliodn SAelx uAl AbuSe rKenSoCwulee Cdogme mCoitmtepeetenCieS CCS theory oF ChAnge Key elementS oF CAre For Child SurViVorS oF SexuAl AbuSe Child SuRvivORS havE aCCESS tO Child CEntEREd CaSE managEmEnt SERviCES Caseworkers have the knowledge, skills, attitudes and tools to provide child- centered case management. » Understand and able to apply child sexual » Understand and able to apply CCS abuse concepts in case management. Guiding Principles in case management. » Possess child-friendly attitudes that » Able to use child-friendly tools to aid contribute to recovery and healing. effective case management services » Able to communicate with child » Able to appropriately engage caregivers survivors according to age and in the child’s care and treatment. developmental stage. » Able to monitor activities using » Able to adapt case management established tools. services for child sexual abuse cases. Child SuRvivORS havE aCCESS tO Child SpECializEd CliniCal CaRE & tREatmEnt SERviCES health providers have the knowledge, skills, attitudes and tools to provide specialized medico-legal care for child survivors. » Understand child growth and » Able to adapt the medical exam and development and child sexual treatment for child survivors. abuse concepts. » Able to ensure safe and appropriate » Able to communicate effectively referrals and follow-up systems are with child survivors. in place. » Understand and able to apply CCS » Able to monitor activities using Guiding Principles in case management. established tools. hEalth & pSyChOSOCial SERviCE pROvidERS COORdinatE CaRE aCCORding tO bESt pRaCtiCE Service providers have the knowledge, skills, attitudes and tools to use referral pathways, reporting agreements and information sharing protocols. » Able to understand essential protocols exist. components to case coordination. » Agreements and guidelines for » Able to demonstrate best practice for interacting with legal and reporting coordinating child sexual abuse cases. systems exist. » Service provider agreements that » Able to monitor activities using outline referral and information sharing established tools. Page 6 | International Rescue Committee CCAArriinngg FFoorr CChhiilldd SSuurrVViiVVoorrSS ooFF SSeexxuuAAll AAbbuuSSee gguuiiddeelliinneeSS CCS theory oF ChAnge Key elementS oF CAre For Child SurViVorS oF SexuAl AbuSe Child survivors are Caseworkers safe and have their provide appropriate immediate needs met. case management to children and families affected by Caregivers engage sexual abuse. positively in their child’s healing process. Child survivors recover and heal Child survivors health care from have improved health providers offer child outcomes and sexual specialized medical appropriate care and treatment. evidence collection. abuse Referral pathways and reporting agree- referral systems ments are developed function and child and utilized properly. cases are effectively coordinated between info-sharing proto- service providers. cols are developed and utilized properly. CCS Guidelines | Page 7 Cinotreer nCAhtiliodn SAelx uAl AbuSe rKenSoCwulee Cdogme mCoitmtepeetenCieS nOtE On languagE The term service provider is used when referring to both health and psychosocial professionals. The term caseworker is used when referencing an individual tasked with the responsibility to provide case management ser- Photo: Photographer Unknown/the IRC vices to child survivors. uSing thE CCS guidElinES The term caregiver is Who can benefit from the ccS GuidelineS? used to refer to the per- son and/or persons exer- The primary target audience for the CCS Guidelines (referred to as “the cised day-to-day care guidelines” from now on) is staff who provide psychosocial, case management for a child. This includes and/or health services for survivors of gender-based violence (GBV) and/ or children in humanitarian settings. United Nations and NGO protection and biological parents and/or gender-related staff can also benefit from the guidelines and other compo- other guardians respon- nents of the CCS Resource Package. sible for the child’s care and well-being. What are the GoalS and aimS of the ccS GuidelineS? The goal is to provide staff with a user-friendly tool that offers best practice guidance on caring for child survivors in humanitarian settings. The guidelines aim to improve care for child survivors (and their non-offending family mem- bers), in order to help them recover and heal from abusive experiences. The guidelines and accompanying tools will equip field staff with the necessary knowledge, skills and attitudes to provide high-quality care to children and families affected by sexual abuse. Page 8 | International Rescue Committee

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Caring for Child Survivors of Sexual Abuse. Guidelines for health and psychosocial service providers in humanitarian settings. First Edition
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