T.C. MİNİSTRY OF HEALTH İZMİR PROVINCIAL HEALTH DIRECTORATE S.B.Ü. DR.BEHÇET UZ CHİLDREN'S EDUCATİON AND RESEARCH HOSPİTAL
T.C. MİNİSTRY OF HEALTH İZMİR PROVINCIAL HEALTH DIRECTORATE S.B.Ü. DR.BEHÇET UZ CHİLDREN'S EDUCATİON AND RESEARCH HOSPİTAL

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CHILD ADVOCACY CENTER (CAC)

Updated: 31/01/2019

İZMİR CHILD ADVOCACY CENTER

Child Advocacy Centers (CAC) are established to evaluate suspected child sexual abuse cases in a child friendly environment with a multidiciplinary approach. CACs contains many professionals including prosecutor and lawyer for forensic evaluations, medical doctors and nurses to provide health services, forensic interviewers to perform forensic interviews and social workers to determine social needs.   İzmir CAC is one of the 33 CACs in Turkey and the only CAC in İzmir to provide services to both center and counties of İzmir. It also serves as one of the two education centers for forensic interviewers to work at CACs all around Turkey.

One of the most important aims of CACs is to prevent reccurent testimonies of the abused children at forensic process. Before CACs were established at Turkey, it is speculated that children were obligated to declare what they lived up to 17 times to various professionals. These reccurent testimonies are potential to cause secondary emotional abuse at both the children and families. When a suspected child sexual abuse case is referred to CAC, firstly the forensic interviewer performs a preliminary interview to build trust with the child, evaluates the child’s developmental properties and acknowledges for the forensic interview. The forensic interview is a semi-structured, single session, recorded interview designed to elicit a child’s unique information when there are concerns of possible abuse. It is conducted in a supportive and non-leading manner by a professional trained and certificated by Forensic Interview Model. Interviews are remotely observed by representatives of the agencies involved in the investigation (such as law enforcement and child protective services).

The other aim of CACs is to provide professional services for 7 days and 24 hours. Previously, the response to child sexual abuse was poorly coordinated between the various entities with a responsibility for conducting the initial investigation and response to child sexual abuse. The multidisciplinary team concept is a core aspect of the original Child Advocacy Center model developed by Bud Cramer during the early 1980’s. The model has been enacted to serve 7/24 in Turkey and forensic interviewers stay on duty to provide a child-friendly, safe and supportive environment for sexually abused children.

When a forensic examination is needed to investigate the abuse, forensic mediciners perform the physical examination including genital organs and hymen according to Turkish Law. The examination is also performed with full consent of the child and is also recorded in order to create evidence in forensic process. In addition, evaluation of pregnancy risk, urgent contraceptive drugs, evaluation of sexually transmitted diseases and providing prophylactic regimens, considering necessary vaccines are performed by a pediatrician and two nurses at CAC. Children are also evaluated by a child and adolescent psychiatrist and assess the risks of psychological disorders and help the victims to overcome the trauma.

During the process at CAC, families and victims are also evaluated for social needs by social workers. They also organize home visits to detect the child in his/her environment and report their needs to related sevices.

İzmir CAC serves children and families primarily in İzmir; however, the Center also accepts clients in need from neighboring counties. İzmir CAC has the 2nd highest child abuse rate in Turkey with over 1000 reported cases annually. The center currently employs 7 forensic interviewers, 1 pediatrician (associate clinical proffessor as medical director) , 1 child and adolescent psychiatryst (consultant specialist),  2 nurses, 2 social workers and two secretaries. Our multidiciplinary team contains 5 prosecutor from child and adolescent department, 1 police from child department, alternating lawyer from Bar Association, 6 forensic medicine specialists to work as a team to coordinate investigations and interventions for each child abuse case.