Understanding the Development and Impact of Child Advocacy Centres (CACs)
7. Conclusion
The objectives of this study were to better understand how Canadian CACs are developing and operating; measure client satisfaction with CACs; measure client satisfaction with the criminal justice system’s process and outcomes; and measure how CACs were meeting Federal Victims Strategy objectives related to increasing access to victim services, enhancing capacity to deliver appropriate, responsive victim services, and, reducing financial and non-financial hardship for victims of crime.
The centres that were part of the study were at various stages of development at the outset of the study and some are continuing their development toward a the ideal model, while others are continuing to grow and develop or expand their services.
Results of the study found that each CAC model has its strengths and limitations that need to be weighed according to the best fit for the community and developing CAC. It was found that the hospital-based CAC increased access to medical examinations and health specialists. However, while on-site medical examinations increase convenience for clients, having available and trained medical staff was seen as more important. CACs located within other agencies benefit from a pre-existing infrastructure, funding, and program support. However, parent agencies like police or government services can carry negative connotations for clients. The stand-alone CACs have more flexibility in their operations, however, there were challenges around acquiring space and there is a risk that clients would have less privacy because the purpose of their visit was clear.
The flexibility of the CAC model enables the organizations to respond to the unique needs of the community. Diverse governance structures do not appear to affect service delivery as long as communication is open and the management board is knowledgeable and supportive.
The co-location of MDT members is an important strength of the CAC model. When partners were housed at the same site with CAC staff, such as the CAC coordinator and/or victim advocate, it facilitates quick responses, information sharing, regular case meetings, and coordinated support for clients. While MDTs that are not co-located can still perform well, they must develop trusting relationships, well-negotiated and understood protocols, and regular case review meetings.
The location and physical setting of the CAC was also important. The study found that there is a need for a physical space for the CAC to operate effectively. Although the one CAC that was using a virtual model had a strong victim advocate and a robust MDT response, clients and MDT members expressed a preference for a physical, child-friendly location to increase convenience and reduce stress. Since the study concluded, this site has made efforts to be more child-friendly in as many communities as possible, identifying appropriate spaces for interviews, and adding comfortable furniture and décor.
The study found that the role of the victim advocate was a key strength of the CAC model. It was seen as providing the glue to hold the MDT together and supporting clients throughout the process. Caregivers identified the victim advocate as the most important service received by them and their child(ren). Despite variations in the victim advocate’s role, their presence at the CAC is what mattered most.
These findings are in line with best practices identified in the National Children’s Alliance Standards for AccreditationFootnote 30 and the draft national guidelines for CACs in Canada.Footnote 31 The following were also identified as lessons learned:
- Access to mental health services for clients and MDT members is important. Only two CACs provide on-site mental health services. Both on-site and off-site services were described as a ‘patchwork’ of programs, with long wait lists (e.g., up to one year) and gaps in services for children/youth and specialized adult counselling. Additionally, support for MDT members coping with vicarious trauma, PTSD, and/or burnout, which can “eat you alive,” is limited.
- Child/youth clients want more information. During the investigative process, while most child/youth victims reported that people were nice to them during the interview, three quarters indicated that they were not told what was going to happen afterwards. Compared to caregivers, young victims were also less likely to receive updates and to know who to contact at the CAC. Clients expressed interest in learning more about the process in general and in the progress of their case in particular.
- CACs need diverse staff and MDT members. CACs benefit from having diverse staff and partners – both male and female, and members of local communities, including those who share similar religious and cultural backgrounds as clients. Clients mentioned that young girl victims appreciated being able to work with female staff, while one caregiver lamented the difficulty of finding a male counsellor for her son.
- Privacy. Private spaces within CACs enhance the experience for clients: At one site, the victim advocate often has to speak to families in front of other people due to limited space, reducing clients’ privacy. Clients at other sites also suggested adding sound-proof walls, opaque doors, and/or drop-down shades to increase privacy.
Overall, the CACs reduce both non-financial and financial hardship for clients. They reduced stress and re-victimization by providing a single, safe, and child-friendly place for victims and their families to receive information and support (for five of the six locations); reducing the number of victim interviews (e.g., by videotaping); providing a single point of contact through the victim advocate who provided emotional support, information, referrals to services, and/or assistance navigating intimidating systems; and in some sites providing emergency cell phones, bus tickets, taxi slips, and/or food vouchers.
The CACs have also addressed many gaps in the system, including access to medical examinations, access to child-friendly environments for forensic interviews and court appearances; the need for increased collaboration between partners that respond to child abuse cases; and provided victims and their families with a single point of contact—the victim advocate—to offer emotional support, information, referrals to services, and/or assistance navigating intimidating systems.
The study was the first of its kind on CACs in Canada and contributes to what we know and understand about the development and growth of these organizations. As the number of CACs continues to grow in Canada, further research is recommended. Future research could examine Canadian CACs in comparison to non-CAC communities to assess whether CACs lead to faster investigations, fewer interviews, and better client satisfaction, for example. As noted earlier in this report, few studies have assessed whether or not CACs reduce trauma, which is one of the main goals of the model. Future Canadian research could address this research question. Other research could evaluate the effectiveness of different trauma-reducing strategies at CACs, such as the use of therapy dogs and their impact both on MDT partners and on CAC clients.
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