Yes. Children may be uncomfortable discussing the abuse with their parents because of shame or guilt. Children dislike seeing their parents upset or angry. Therefore, they may try to protect their parents by not telling them about the abuse. Children may interpret a parent’s negative emotions with the situation as negative feelings toward the child. Reassure your child that you are not upset with them, rather that you are upset with the situation. For the above reasons, it is important to give your child the opportunity to talk with a professional. Children have different needs that must be addressed from the incident to recovery. Should negative emotions and reactions to the abuse remain untreated, or if the child cannot properly express discomfort, a child will only experience greater suffering and trauma. Mental health therapists can apply their special training, knowledge, and experience to help ensure that your child recovers as quickly as possible. Family counseling is also a valuable tool in the road to recovery. Allowing your child to talk to a professional child therapist is a positive step toward healing. Your Family Advocate will link you to the mental health services that will help your child recover.

Step One: Intake and Assessment

When you and your child first come to Hopeful Horizons, our team of licensed clinicians will conduct an initial assessment with your child to determine what type of treatment may be needed. 

This appointment lasts approximately 1.5 hours and includes the caregiver and child, each meeting with a trained therapist. In addition, caregivers and children ages 7 and older will answer questionnaires about the child’s emotions and behaviors. The results are used to help guide recommendations for the child and family. 

Step Two: Therapy & Treatment

Based on the needs identified in the mental health assessment, children and their caregivers find the services they need at Hopeful Horizons or are referred to programs available elsewhere in the community.

Hopeful Horizons’ staff are experts in child abuse, domestic violence and sexual assault and the trauma associated with this violence and abuse. Hopeful Horizons’ therapists are trained and certified in evidence-based trauma treatments, are licensed and have Master’s degrees in social work/counseling.

Trauma-Focused Therapy is a specific approach to therapy that recognizes and emphasizes understanding how the traumatic experience impacts a child’s mental, behavioral, emotional, physical, and spiritual well-being. This type of therapy is rooted in understanding the connection between the trauma experience and the child’s emotional and behavioral responses. The purpose of trauma-focused therapy is to offer skills and strategies to assist your child in better understanding, coping with,  processing emotions and memories tied to traumatic experiences, with the end goal of enabling your child to create a healthier and more adaptive meaning of the experience that took place in his/her life.

Assessment of trauma in children focuses on the presenting problem in the context of the child’s overall development. This information can be gathered though interviews with the parents and significant caregivers in the child’s life, observation of the parent/caregiver-child interaction, and standardized assessment tools. Clinical assessment should include review of the specifics of the traumatic experience including:

• Reactions of the child and parents/caregivers
• Changes in the child’s behavior
• Resources in the environment to stabilize the child and family
• Quality of the child’s primary attachment relationships
• Ability of parents/caregivers to facilitate the child’s healthy socioemotional, psychological, and cognitive development

When conducting an assessment of a child, it is also important to assess developmental delays (e.g., gross/fine motor, speech/language, sensory processing), which may indicate that the child could benefit from evaluation and/or services from another professional (e.g., occupational therapist, speech/language therapist, physical therapist). It is often helpful to consult and to work collaboratively with these professionals.

We use the following standardized assessment tools with children and their caregivers:

• Child PTSD Symptom Scale (CPSS)
• Child and Adolescent Trauma Screen (CATS)
• Pediatric Emotional Distress Scale (PEDS) ages 6 and under
• Short Mood and Feelings Questionnaire (SMFQ) ages 7-18

The signs of traumatic stress are different in each child. Young children react differently than older children.

Preschool Children

• Fearing separation from parents or caregivers
• Crying and/or screaming a lot
• Eating poorly and losing weight
• Having nightmares

Elementary School Children

• Becoming anxious or fearful
• Feeling guilt or shame
• Having a hard time concentrating
• Having difficulty sleeping

Middle and High School Children

• Feeling depressed or alone
• Developing eating disorders and self-harming behaviors
• Beginning to abuse alcohol or drugs
• Becoming sexually active

Therapy gives kids a way to safely share their feelings, tell their story, and get support. In therapy, kids learn to talk about what they’ve been through. They learn coping and calming skills. They learn to adjust the way they think and feel about the trauma. Slowly, they learn to face things they used to avoid. Therapy helps kids find their own courage and gain confidence.

Allow your child to talk about how they feel and help them to name their feelings. Let your child know that it is okay to have those feelings. Return to familiar routines. Things like a familiar bedtime, story, song, prayer, or other family traditions remind you and your child of your way of life together and offer hope. Reassure your child that they are safe and loved.

A forensic interview conducted by Hopeful Horizons, the CAC serving the 14th Judicial Circuit, is a first step in the investigation process. A specially trained clinician interviews the child to find out if they have been the victim of abuse or neglect or if they have witnessed a crime. The interview is recorded and is viewed live in another room by multi-disciplinary team (MDT) members (law enforcement, child protection, medical providers, victim advocates) so they can gather the information they need to keep the child safe and provide additional services. In addition to obtaining the information needed to make a determination about whether abuse or neglect has occurred, this approach produces evidence that will stand up in court if the investigation leads to criminal prosecution or leads to termination of parental rights. Properly conducted forensic interviews are legally sound in part because they ensure the interviewer’s objectivity, employ non-leading techniques and emphasize careful documentation of the interview.

When law enforcement or child protective services believe a child may be experiencing abuse, the child is brought to the CAC—a safe, child-focused environment—by a caregiver or other “safe” adult. At the CAC, the child tells their story once to a trained interviewer who knows the right questions to ask in a way that does not retraumatize the child. Then, a team that includes medical professionals, law enforcement, mental health, prosecution, child protective services, victim advocacy, and other professionals make decisions together about how to help the child based on the interview. CACs offer therapy and medical exams, plus courtroom preparation, victim advocacy, case management, and other services.  This is called the multidisciplinary team (MDT) response and is a core part of the work of CACs.

You might tell your child, “You and I are going to the Children’s Advocacy Center. It is a special place where kids go to talk. There will be a person there who talks to lots of kids about what happens to them and that person will be talking to you too.” You might also consider telling your child, “That person will need to know everything that you remember so that we can make sure you are safe and O.K. It is important that you tell the truth and only talk about what really happened.” It is important for you to tell your child, “YOU ARE NOT IN ANY TROUBLE.”

When you and your child arrive, you will wait in the waiting room. The waiting room has a TV and toys. A separate interview room is designed to make your child feel comfortable. The room has a video camera and microphones on the wall. Beforehand the Multidisciplinary team (MDT) gathers to discuss the case at hand. The child is escorted to a private room by the forensic interviewer. Upon beginning the interview, the forensic interviewer explains why they are there, shows them the cameras and explains that there are microphones in the room and that the interview is being recorded.

No, only those people who are directly involved in the investigation are allowed to observe the interview. This is done for two reasons; the first is to create a neutral setting to reduce the possible stress that can be placed on a child. Second, is to avoid any influence the child’s statements may have on your own knowledge of the crime as you may or may not have been a witness. This may come into question during the prosecution phase of the case. You may bring a support person to wait with you during the interview. This person may then wait with the child when you have your opportunity to discuss any questions or concerns with the investigative team upon completion of the interview. The interview is recorded to reduce the number of times a child is asked investigative questions regarding allegations of abuse. The video is considered evidence in the investigation.

You may talk to a Family Advocate from the CAC before and after your child is being interviewed. After the interview the Investigative Team may tell you, in general terms, what was learned from the interview. You will have the opportunity to ask questions and voice your concerns.  Your child may have to go to court to testify in the future. If this happens, the Family Advocate can meet with your child to prepare them.

No, not unless your child brings up the subject and wants to talk about it. In that case, listen to your child without commenting or questioning. Be sure to reassure your child that he/she will be alright. If your child tells you something that alarms or upsets you, contact your Family Advocate.

The investigative team members will decide if your child needs a medical exam. If one is needed, Law Enforcement or Department of Social Services (DSS) will contact the CAC to schedule the medical exam. A Family Advocate will attend this exam with you and your child. You might tell your child, “We are going to see a nurse who takes care of kids. The nurse is not going to hurt you. She just needs to make sure your body is okay.”