Strongly committed to excellence in service, the Council’s clinical programs are designed based on best practice and evidence-based research and are delivered by trained specialists in the field under the careful direction and expertise of our Clinical Director of Services. Ongoing evaluation of our services which includes an emphasis on research and consultation with expert advisors in the field helps to keep us accountable to our clients and to our community, on top of emerging best practice in the field, and on target with our commitment to excellence in service – providing the best care possible. We believe children and youth who have suffered sexual victimization or other maltreatment deserve nothing less from us and from their communities.

The Community Child Abuse Council offers two assessment and treatment programs.

• Children and Youth Trauma Services (CYTS)
• Immigrant and Refugee Children’s Mental Health Outreach Program (CMHOP)

CHILDREN AND YOUTH TRAUMA SERVICES (CYTS)

This program offers comprehensive assessment and specialized intervention and treatment as follows:
• For children and youth up to age18 who have been sexually victimized: sexual victimization may have been perpetrated by family members, people known or unknown to the family

• For children under age 12 who have sexually victimized other children: these children are engaged in behaviours that fall outside of what would normally be expected or appropriate at that age and stage of development, e.g., language or games with adult sexual themes, adult sexual behaviours directed towards other children. Many of these sexual behaviours, if engaged in by a youth over the age of 12, would be chargeable offenses. We provide comprehensive assessments in an attempt to determine the cause of the behaviours, identify the resulting disruptions in sexual development, and provide recommendations for treatment and intervention. Treatment is also provided.

• For children under age 12 who have engaged in sibling sexual abuse: because the entire family is affected when this occurs the assessment is more complex and includes not only the children involved in the sexual behaviours but other family members as well

Comprehensive Assessment
In all cases, for the duration of the assessment, the children need to be in a safe and stable living environment. Separate assessments are conducted on each child with specific recommendations for treatment. Family involvement and safety planning is an integral part of the process.

An accurate and comprehensive assessment is the cornerstone of the treatment process. Without it, interventions can be misguided and ultimately ineffective. (Source: Child Physical and Sexual Abuse: Guidelines for Treatment. 2003)

Every child and youth, and their non-offending parent/caregiver who come to us for service engage in a comprehensive assessment process, followed by treatment planning. Recommendations for intervention and/or treatment flow from that assessment.

The assessment takes a holistic perspective in which all aspects of the child’s functioning are viewed so that we may better assess the impact of the trauma/abuse and identify a child’s strengths and potential resiliency factors. The assessment is a process of gathering information in different ways from different sources. Usually, the child participates in one to three interviews which may involve answering questions, drawing pictures, and completing questionnaires.

Assessment of the child and his/her experiences is done in the context of their family and so involving and seeking the perceptions of the parents or caregivers and assessing the nature of the parent-child relationships is a very important part of the process. Parents or caregivers participate in interviews as well as complete some questionnaires. In addition to understanding the child’s early life, the parents or caregivers are asked to provide their perception of the child’s current functioning in many areas of the child’s life; including family, school, social, emotional, and of course the trauma they experienced.

In some cases, we may ask for other family members to be involved to help us better understand the child and the impact of the trauma. Often it is necessary to get official documentation about the trauma from other professionals who have had involvement with the family. These may include child welfare agencies, police, and doctors. No information is obtained however without the parent and/or youth’s written permission.

Assessment in the area of child sexual victimization is complex and demands a specialized approach. There is no “off the shelf” program that can provide for or meet the unique needs of these child and youth victims and their families. However, we do know what makes for effective assessment programs with these children and youth and those particular known components – best practices - form the basis of the CYTS program at the Community Child Abuse Council.

Components involved on the Assessment include:
1. Intake which usually involves a telephone contact and/or one in-person meeting
2. Clinical interviews with one of our trained specialists
3. Psychometric evaluation of the child/youth and parents/caregivers using standardized measures
4. Review of relevant documents/reports and/or liaison with other involved professionals – current and past - if appropriate and required
5. Preparation of a summary report complete with recommendations
6. Feedback session between the the trained specialist and the family (and/or child depending on age of consent) to review the assessment report and discuss recommendations including treatment plans

Intervention/Treatment
Not every child needs extensive counseling as a result of their victimization experiences. The impact of the trauma on the child is influenced by a number of factors including the child’s age, the frequency, duration, and level of intrusiveness of the abuse, the disclosure response, the child’s emotional, psychological and cognitive functioning and family/life circumstances. Therefore, the length of treatment is determined on a case by case basis depending upon the unique needs of the child/youth.

Recommendations for treatment come from the assessment report Treatment planning is therefore very individualized.

The primary treatment model used in the CYTS program is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) although other approaches are also included as appropriate and may include psychodynamic, psycho-educational, experiential, family systems, play therapy, solution-focused, and specific trauma focused interventions.

Counselling is different from the assessment process. In counseling, a child/youth is supported and engaged in different ways to help them understand themselves, their strengths and struggles, the impact of the abuse, and changes they would like to make. Like other forms of counseling, trauma specific treatment can help the child express their feelings openly, and learn new ways to solve problems. Every effort is made to tailor the type of counselling to the needs of the child/youth. Not everyone requires or receives the same type of counselling.

The primary type of counselling provided is individual between the child/youth and a clinician. However, as with the Assessment, family support and involvement is very helpful for the child/youth. We value a family’s input and we recognize that many of the important changes which take place for a child/youth, occur at home. It is especially important to involve the caregivers in the treatment younger children, as they are the primary change agents and ensure what is learned in counseling can be implemented and practiced at home. Therefore, family members may be involved in some or parts of the counseling sessions.

Three Phase Treatment Approach
Like the Assessment, treatment planning in the area of child sexual victimization is complex and demands a specialized approach. There is no “off the shelf” program that can provide for or meet the unique needs of these child and youth victims and their families. However, we do know what elements make for effective intervention and treatment. The CYTS program is based on a three phase approach, each phase having a specific treatment focus. Once treatment goals, which are based on the recommendations arising from the Assessment, are established and agreed on, the first phase of treatment begins.

Phase 1 – The focus is on providing psycho-educational information and teaching cognitive and affective coping strategies to both child/youth and parents/caregivers.

Phase 2 – Using various techniques, the unique impact of the trauma is addressed.

Phase 3 – The focus is on helping the child/youth and parents/caregivers move on and beyond the trauma experience.

Parental involvement in treatment is very important. It increases the effectiveness of treatment overall and for that reason is actively encouraged in all cases and certainly when children under the age of 12 are involved.

Timing of treatment cannot be accurately determined in advance. However, our professional clinical staff remain mindful of the treatment goals and the sessions are intentionally focused on the accomplishment of desired goals and outcomes.

Quality Assurance
The Clinical Director oversees all client involvement in the CYTS program, reviews and approves each assessment and provides clinical consultation to professional staff throughout the assessment and treatment phases. Written policies and procedures guide the operations of the program including code of professional conduct and specify standards of care. Evidence-based best practice informs program design and delivery.

Our Clinical Members, in addition to their professional qualifications, have specialized training and experience working with families, children and youth who have experienced trauma, and in particular, children and youth who have been sexually abused or have engaged in sexualized behaviours.

Research
As with our other programs, a commitment to participating in and supporting research in the field which further improves the delivery and efficacy of services provided to children and youth is important to us. Participant involvement in any research is voluntary and choosing not to participate in no way impacts the provision or delivery of services to the child, youth or family.

Referral Process
Most of the referrals to the CYTS come from child welfare agencies although they may come from a variety of places including schools, family doctors, other health professionals and community agencies as well as individual community members. Referrals can be made directly by calling Janice Floyd, Services Coordinator, at 905-523-1020 ext. 12.

Appointments
We try, as much as possible, to be flexible when arranging counseling session times in an effort to accommodate our clients’ needs. General office hours are Monday to Friday, 8:30 a.m. to 4:30 p.m.

Fees
Residents of the greater Hamilton area pay no fees for the services.

IMMIGRANT AND REFUGEE CHILDREN’S MENTAL HEALTH OUTREACH PROGRAM (CMHOP)

This program offers specialized mental health services to immigrant and refugee children and youth and their families who suffer with mental health concerns such as Post-Traumatic Stress Disorder, depression, or experience symptoms related to trauma or secondary trauma, or are at risk. Children and youth fleeing with their families from their country of origin, or dealing with resettlement and acculturation can face significant stressors and challenges and the CMHOP is designed specifically to meet their unique mental health needs. This program is offered in partnership with SISO (Settlement and Integration Services Organization) and Centre de sante Communautaire.

Assessments
The Assessment aims to identify the traumatic events witnessed by the child or youth or experienced by them, as well as determine the impact these events and the acculturation process have had on the child’s current functioning. Typically, an Assessment will take two to four sessions with the Counselor. Meetings are also held with the parents or caregivers and sometimes additional information is sought from other counselors or professionals with whom the family has had contact. The therapist prepares a final report following the Assessment which highlights and summarizes the information obtained related to various aspects of the child’s functioning and identifies specific recommendations for treatment with possible intervention strategies.

Counselling/Treatment
Counsellors who are both culturally sensitive and competent provide individual and family counselling/treatment and address the recommendations identified in the assessment. Parental involvement and support is critical to the successful participation of the child. Psycho-educational sessions for the parents are also provided.

Trained Interpreters are made available, as needed, through SISO’s supportive programs.

Research
As with our other programs, a commitment to participating in and supporting research in the field which further improves the delivery and efficacy of services provided to children and youth is important to us. Participant involvement in any research is voluntary and choosing not to participate in no way impacts the provision or delivery of services to the child, youth or family.

Referral Process
Referrals come from a variety of sources and include self referrals. For information about the program or to make a referral, call the Community Child Abuse Council.

Staffing
Immigrant and refugee families come from all over the world, representing many cultures and speaking many languages. For this reason, in addition to requiring the appropriate professional qualifications and cultural competencies, we aim to recruit clinical team members who represent cultural backgrounds reflective of our client group and invest in them by providing ongoing training in this specialized field. Trained interpretors are also used as needed.

Fees
There are no fees for services through this program.