Providing Medical & Mental Health Services to Victims of Abuse & Neglect
The Center for Safe and Healthy Families (SHF) is a program through Primary Children’s Hospital that provides medical and mental health services to suspected victims of child abuse and neglect and their families. The therapy team at Safe and Healthy Families is trained in working with children who have suffered trauma such as physical or sexual abuse as well as children with behavioral problems. They provide outpatient therapy on a weekly basis for children and their families.
We also provide outpatient medical exams for children who have suffered alleged abuse or neglect and consults on children who are inpatient at Primary Children’s Hospital when there is a concern of abuse or neglect.
SHF works closely with the Division of Child and Family Services as well as law enforcement to ensure the safety and well-being of each patient.
- Outpatient medical exams for suspected abuse/neglect
- Inpatient medical exams/consults for suspect abuse/neglect
- Individual, outpatient therapy
- Phone consultation
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Mental Health Information
Childhood trauma can emerge from child abuse (physical, sexual or emotional) or from being a victim of or witnessing violence such as domestic violence, community violence and or school violence. Trauma can also be suffered through being in accidents, disasters, war/terrorism or being forced to flee from one’s home country. Other types of trauma include trauma related to medical conditions (transplants, cancer etc.) and traumatic grief over the unexpected loss of a loved one.
The way that children work through trauma and the symptoms that they can display after being through a trauma vary, but some of these affective (emotional) symptoms include fear, sadness, anger, anxiety, affective dysregulation (emotions all over the map), and emotional numbing.
In terms of behavioral symptoms, children who have suffered a trauma can respond by trying to avoid memories, places and other trauma reminders. They may also experience difficulty concentrating, sexualized or violent behaviors, substance abuse, regressive behavior (such as bed-wetting or being extra clingy to parents), self-injury or behaviors that look like ADHD.
Cognitively, children who have been through a trauma can have irrational beliefs, distrust of people, a distorted self-image, unhelpful ideas/thoughts and may re-experience the incident in their minds.
Some children may suffer immediately following a trauma but within a few weeks are able to move through the trauma without any lingering problems. Other children will need the help of a professional to work through the trauma and to address emotional, behavioral and cognitive difficulties that are a result of the traumatic event.
Studies demonstrate the superiority of TF-CBT as a treatment method for traumatized children with regard to the improvement of PTSD, depression, anxiety, internalizing problems, externalizing problems, sexualized behavior, shame and abuse-related cognitions. In addition, children with strong parental support often have a better chance of recovery than those without support caregiver relationships. See the following section on mental health treatment to learn more about TF-CBT and the other therapeutic modalities that SHF utilizes.
Mental Health Treatment Models
Mental health services are provided to assist children who are experiencing post-traumatic stress disorder and other mental health problems related to child abuse including sexualized behavior and aggression. Our therapists are specifically trained to work with children who have been abused, neglected, witnessed domestic violence and or other traumatic events. SHF uses evidence-based practices that are based on scientific research and data and have been proven to be effective.
Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)
This is a short-term treatment typically between 12 to 16 weeks of 60 to 90 minute sessions. TF-CBT helps non-offending caregivers and their children (aged 4-18). Most children who receive this treatment have emotional or behavioral problems because of traumatic experiences such as sexual abuse or witnessing a traumatic event. Treatment typically fosters fewer negative emotions/behaviors, fewer feelings of guilt/shame, less fear and anxiety, less depression and irritability.
Parent Child Interaction Therapy (PCIT)
A short-term treatment typically between 12 to 20 weeks of 60 to 90 minutes sessions. PCIT helps caretakers and their children (2-7 years old). Most children who receive this treatment have behavior problems such as ignoring rules, losing their temper and arguing. Treatment typically encourages fewer oppositional and defiant behaviors, fewer behavior problems, more positive interactions between parent and child and better parent-child communication.
Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT)
A short-term treatment typically lasting between 12 and 16 weeks of 60 to 90 minute sessions. AF-CBT helps caretakers and their children (8 to 18 years old). Most children who receive this treatment have problems related to physical abuse. This treatment typically promotes less hostile and aggressive behavior, fewer negative interactions with family members, better social skills and better developmental abilities.
Treatment for Children with Sexual Behavior Problems
Includes individual and family therapy for children up to age 13 who have exhibited sexually inappropriate behaviors with other children. The following list are things the child and their caregivers might expect to achieve with this treatment model: Child will accept responsibility for inappropriate sexual behaviors, child will develop empathy for the feelings of others (especially victims of abuse), child will develop and/or enhance social competency skills, child will develop relapse prevention and safety skills, child will learn to manage sexual feelings, thoughts and behaviors to prevent further sexually aggressive behavior, caregiver and child will cope with and resolve feelings related to child’s potential prior trauma, caregiver will improve their relationship skills, regarding communication, discipline, and teaching the child healthy sexuality, caregiver will establish functional boundaries in the home and facilitate child’s responsibility for inappropriate sexual behavior.
Frequently Asked Questions
What types of medical services does SHF provide?
SHF provides outpatient medical exams for children who have suffered neglect and/or some form of abuse. Unlike in hospital settings, our exams are scheduled for up to an hour and a half, leaving plenty of time for our providers to answer any questions that patients or their parents may have. Our exams are not traumatizing for children and our pediatricians are trained specifically to work with children who have been abused or neglected. SHF also provides medical consultation on patients who are hospitalized with concerns of abuse or neglect.
Can a medical exam for alleged sexual abuse prove if a child was abused?
A medical exam on its own very rarely provides sufficient evidence to indicate that a child has been sexually abused. The purpose of the medical exam is not only to check for signs of physical injury, but also to reassure both the child and his/her caregivers that the child is physically healthy. It is very important for a child who has disclosed sexual abuse to be forensically interviewed.
When should I call Safe and Healthy Families?
Please feel free to call us anytime with any questions regarding a case or if you want to set up a medical exam. We are NOT a walk-in clinic so it is important that you call our intake line to have a child scheduled for an exam. If a child needs to be seen urgently, we will make arrangements for him/her to be seen as quickly as possible. In cases of suspected sexual abuse, when the last alleged event was more than 72 hours ago and the child does not have complaints of pain or bleeding the child DOES NOT REQUIRE AN URGENT EXAM. Exams conducted in our clinic, rather than an in an emergency room setting, can reduce the anxiety surrounding sexual abuse investigations. We do all that we can to ensure our exams are not traumatizing for the child or caregiver.
Will you have to report to the Division of Child and Family Services?
If anyone discloses alleged child abuse or neglect that has not already been reported to the Division of Child and Family Services (DCFS), we will have to make this report. Everyone in the State of Utah who has a reason to believe that a child has been abused or neglected is a mandated reporter and must report this to DCFS. Although we make this report, we are not DCFS and we do not determine what happens with the investigation nor do we determine plans for the future care of the child.