Understanding the Development and Impact of Child Advocacy Centres (CACs)

Appendix: Site Reports

Sophie’s Place CAC
(Surrey, British Columbia)

Opened in 2012, Sophie’s Place is housed with and governed by the Child Development Centre (CDC), a registered charity that helps developmentally challenged children. Since children with disabilities are vulnerable to abuse, the partnership between Sophie’s Place and the CDC is beneficial. Also when a child and their caregiver enter the building, they are not identifiable as victims, because they could be there for a diversity of reasons. It protects anonymity of victims.

Multi-disciplinary team

The MDT consists of 15 people: a director, a coordinator, seven RCMP officers, a child protection worker, a part-time Aboriginal stream social worker, and four victim services workers. Partners signed a Letter of Understanding to confirm their commitment. Case review meetings occur monthly, and partners follow a procedures manual developed by Sophie’s Place (e.g. how to conduct interviews and how to store videotapes). Since the team members started working under one roof, “barriers have been broken down [and] there are no longer silos” (MDT member).

RCMP officers conduct forensic interviews using the StepWise techniqueFootnote 32 (98 percent of interviews occur on site). Social workers observe from a monitoring room, and interviews are videotaped for further review and court proceedings. Medical evaluations occur off site at the nearby Health Evaluation Assessment and Liaison Clinic (HEAL) or at the BC Children’s Hospital in Vancouver. Mental health services are provided off site by Child and Youth Mental Health, Options Community Services (which specializes in counselling for children with special needs), and Surrey Women’s Centre (which provides services in multiple languages). Victim advocacy includes court preparation, helping caregivers find housing and income support, and developing strategies for the child’s/youth’s safety.

Facilities

Here is a picture of the child-friendly room and hallway at Sophie’s Place. The walls are blue and there is an image of a yellow umbrella over the words Centre … Sophie’s place.

The child-friendly rooms and hallway (above) feature bright colours, comfortable furniture, snacks, art activities, and an Xbox. Additionally, police wear street clothes instead of uniforms. As a result, “there is a light and airy feeling to the place,” which feels more like a daycare than an investigation hub.

Clients

Sophie’s Place works with victims of sexual, physical, and mental abuse. The CAC serves a diverse community, to which it has been able to adapt. Surrey, British Columbia is home to 517,887 people.Footnote 33 Visible minorities comprise 53 percent of the city’s population, with a large group (23 percent) identifying as SikhFootnote 34 and 10,995 people (2 percent) identifying as Indigenous.Footnote 35 During the study, 15 percent of clients were South Asian and 14 percent were Indigenous. Sophie’s Place has hired a South Asian victim services worker, a decision which one MDT member described as “important.” Further, one MDT member was an Aboriginal social worker, who offered cultural teachings, visits with Elders, and smudging for clients.

Results

All clients interviewed for this study expressed satisfaction with the services received. Support was available 24/7 and services were well coordinated. The number of forensic interviews per victim was reduced, which is a key goal of CACs. A community member believed that “from a societal perspective, the [criminal investigation] process has become more empowering because of Sophie’s Place.”

Innovations and next steps

Sophie’s Place offers their own staff de-briefs with police, child protection, and victim services within one week of a triggering incident. The CAC has also developed a committee on vicarious trauma to support MDT members, and organized several provincial conferences, notably “Building Resiliency Through Collaboration” in 2016 which was live-streamed and attracted 180 participants. In 2015, Sophie’s Place became an Affiliate Member of the National Children’s Alliance in the United States, only the second CAC thus distinguished in Canada.

Since opening, Sophie’s Place has renovated and expanded to better serve clients. The City of Surrey has provided access to child-friendly waiting rooms in the old city hall across from the courthouse, where victims can avoid the offender and will soon be able to testify in court using CCTV. Next steps for the CAC include hiring a full-time director since the number of cases and requests for advice from other communities have grown.

Caribou Child and Youth Centre
(Grande Prairie, Alberta)

Opened in 2012, Caribou Centre is housed with and governed by Providing Assistance, Counselling, & Education (PACE) Sexual Assault Centre. Since most CAC clients are victims of sexual assault, the partnership between Caribou Centre and PACE is beneficial. For instance, PACE provides training and school workshops on sexual abuse, like the K-6 ‘Who Do You Tell?’ program.

Multi-disciplinary team

The MDT consists of more than 12 people: a coordinator, a family support advocate, three RCMP officers, several victim services workers, two Northwest Alberta Children’s Services workers, a Crown prosecutor, PACE employees, and two part-time therapists. Case review meetings occur monthly. Since the team started working under one roof, “we have a much better environment… [and] now there is an element of coordination” (MDT member). Another partner explained: “build it and they will come.”

RCMP and Children’s Services jointly conduct forensic interviews using the StepWise technique (99 percent of interviews occurred on site). MDT members could observe from a separate monitoring room, and interviews are recorded for further review and court proceedings. Medical evaluations occur off site at Grande Prairie’s hospital. No protocols exist for child examinations and victims are seen in the emergency room by any doctor. Mental health services are provided on site, although one therapist position was vacant during the study because the CAC could not offer a competitive salary. Consequently, qualified therapists in the community have pursued other employment opportunities. Victim advocacy expanded over the study, from providing initial information upon first contact at the CAC to assisting with court preparation.

Facilities

Here is a picture of the child friendly rooms showing a sandbox, child-sized table and chairs, and various toys.

The child-friendly rooms (above) are bright and private, featuring snacks and games. Children can select a toy to take home with them. Police wear street clothes instead of uniforms. One child was quoted as saying that they were “not scared of cops anymore.” The parents surveyed appreciated the facilities, especially in comparison to the RCMP detachment.

Clients

Caribou Centre provides services to children and youth (under 18) who have experienced sexual, physical, or psychological abuse, exploitation, and/or neglect. The CAC serves a large Indigenous community, which influenced its choice of name. Grande Prairie is home to 63,166 people.Footnote 36 Indigenous peoples comprise 9 percent (10, 200 people) of the Grande Prairie and Spirit River area.Footnote 37 During the study, 18 percent of clients to the CAC were Indigenous. Staff thus selected the caribou as the CAC’s name and mascot, an important animal in Dene culture. Symbolizing strength and perseverance, Caribou travel in herds and they keep each other together where the young ones are in the centre (with) the elderly and then the warriors and the bulls are on the outside.

Results

All clients interviewed for this study were satisfied with services received. Children felt safe and comfortable at the CAC and caregivers felt that staff were understanding and supportive. The number of forensic interviews per victim was reduced, thus limiting stress. A caregiver indicated that the CAC “felt like a cocoon of safety.”

Innovations

Caribou Centre hosted the 2016 Peace Country Child Abuse Conference, followed by a workshop on child forensic interviewing. CAC and PACE staff also developed a Parent and Caregiver Handbook on Sexual Abuse, which has had a “huge” impact according to a parent since it explained what to expect during the process. Additionally, the site has offered girls’ groups on self-care, self-esteem, and healthy relationships, where girls acquire support and new friends.

Challenges and next steps

A lengthy intake process at Children’s Services has caused delays, and one caregiver reported being misinformed about the Caribou Centre by Victim Services. Caribou Centre also noted that to improve access to mental health support, it is important to fill the vacant therapist position. One MDT member also cited a need for a sexual response unit (i.e., a health care worker trained in administering a sexual kit) to reduce wait times for clients. Next steps for the CAC include the co-location of RCMP officers on site since the number of cases has increased.

Regina Children’s Justice Centre
(Regina, Saskatchewan)

Established in 1997, Regina Children’s Justice Centre is the longest-standing CAC in Canada. Although located in an independent facility, the CAC is a partnership between the Regina Police Service and the Ministry of Social Services. It was developed using the National Children’s Alliance standards from the United States as a guide.

Multi-disciplinary team

The MDT consists of more than 23 people: 12 police officers including a victim services responder, eight social services workers, a Crown prosecutor, Child Abuse Team members, and a handler with a therapy dog. Not all MDT members are located on-site. Partners signed a Memorandum of Understanding and followed the Saskatchewan Child Abuse Protocol.Footnote 38 Case review meetings occur twice weekly. According to members, working as part of a team requires partners to “look at things with several different pairs of glasses,” but is “rewarding [since] I feel like we are making a difference.”

Police and child protection jointly conduct forensic interviews using the RATAC techniqueFootnote 39 (94 percent of interviews occurred on site). Interviews are videotaped for further review and court proceedings. Medical examinations occur off site at the Regina General Hospital’s Pediatric Outpatient Unit with the Child Abuse Team. Mental health services are provided off site by Wascana Rehabilitation Centre and Community Health Services; however, wait lists are very long (up to one year). Supports provided by the victim services responder include home visits, assistance completing compensation applications, and continuing support even after file closure if the child or caregiver remains fragile. Clients can also phone the victim advocate on weekends.

Facilities

Here is a picture of one of the child-friendly rooms showing murals or stickers of brightly coloured giraffes and flowers on the walls.

The child-friendly rooms (above) include toys, couches, and a PlayStation. The ceiling tiles are decorated with cartoon characters, which one child incorporated into his/her drawing during the study. Since police wear street clothes instead of uniforms, children are not afraid, with one client observing that “everybody just looks like people.”

Clients

Regina Children’s Justice Centre provides services to victims of various kinds of abuse, including child exploitation and child pornography. The CAC serves a large Indigenous community. Regina’s population is 210,556 people.Footnote 40 Approximately nine percent of Regina’s population is Indigenous, which is more than double the national percentage,Footnote 41 and 24 percent of clients during the study were Indigenous. The city also features a growing immigrant community. The CAC has developed case plans with Elders and required MDT members to participate in yearly cultural relations courses offered through the police service, which involved The Open Door Society.Footnote 42

Results

Virtually all clients surveyed for this study were satisfied with services received, and many commented on how quickly they were seen. Almost all victims experienced only one forensic interview. One parent explained that the CAC “was relief from a very heavy burden … now justice will be done … Now I can deal with other things, like a mortgage and make plans I couldn’t before.”

Changes and Innovations

Here is a picture of ‘Merlot’ a black Labrador, who is the centre’s therapy dog. He is shown sitting on a bench wearing his therapy dog vest.

Thanks to FVS funding, Regina Children’s Justice Centre hired a victim services responder and purchased new interview software which has since been adopted by police and public prosecutions. The CAC also added Merlot, a therapy dog (above), to its MDT in 2015 to reduce clients’ stress. The Internet Child Exploitation Unit is also now housed within the CAC, providing support and resources. A Domestic Violence Worker is housed at the CAC to ensure that linkages are made for children who witness violence against their parent.

Challenges and next steps

One MDT member suggested that the interviewing technique, RATAC, was outdated. Partners also cited a need for more child development training and annual psychological assessments for MDT members. Meanwhile, caregivers would like to see increased awareness of the CAC through pamphlets at grocery stores, since many clients did not know where to go for help. One caregiver also suggested ‘after programs’ to help parents tackle remaining questions (e.g. how do you love your child after he/she has been abused?).

Koala Place CYAC
(Cornwall, Ontario)

Opened in 2014, Koala Place (previously called PrévAction) is the youngest CAC in this study. While independent, it is located close to a police station, courthouse, and public transit, thus increasing convenience for clients.

Multi-disciplinary team

The MDT consists of the CAC executive director and representatives from the Cornwall Police Service (including its Sexual Assault and Child Abuse Unit), Ontario Provincial Police (OPP), Children’s Aid Society, Akwesasne Mohawk Police Service, Victim Services, Victim/Witness Assistance Program, Cornwall Community Hospital’s Assault and Sexual Abuse Program, Children’s Treatment Centre, and Cornwall Crown Attorney’s Office. Partners signed a Memorandum of Understanding and followed the 2014 Standards and Guidelines for CYACs in Ontario. Case review meetings occur quarterly for complex cases.

Police and child protection jointly conduct forensic interviews (97 percent of interviews occur on site). MDT members could observe from a monitoring room. Medical examinations occur off site at the Cornwall Community Hospital’s Assault and Sexual Abuse Program. Mental health support is similarly located off site at the Children’s Treatment Centre or Child and Youth Counselling Services. French language counselling is available through L’Équipe psycho-sociale or the Centre de santé. Additionally, if there is a wait for public mental health services, the Victim Quick Response Program could provide up to 10 private counselling sessions. Victim advocacy includes on-going information and updates and the Victim/Witness Assistance Program provides court support.Footnote 43

Facilities

Here is a picture of the entrance showing their logo on an awning and balloons near the door.

The child-friendly rooms are colourful, featuring teddy bears, iPads, a Wii, and snacks. One MDT member believed he/she was “yielding more information in my interviews because the kids are more relaxed,” while another partner noticed that “kids say they don’t want to leave. They are at ease here.” Police also use the rooms to interview adult victims of domestic violence, pointing to the “softer, more comfortable, and victim-friendly environment” at Koala Place.

Clients

Koala Place serves children and youth who have experienced sexual abuse, physical abuse, domestic violence and maltreatment. The CAC has been able to meet the specific needs of Cornwall, which is home to 45,723 people.Footnote 44 The region is bilingual (English and French), and includes both urban and rural communities, such as the counties of Stormont, Dundas, and Glengarry. The region is also home to a large First Nations population. During this study, five percent of clients were Indigenous. Koala Place has invited Akwesasne Mohawk police to join the MDT. Services are also offered in both French and English, while Immigration Services provides interpreters for other languages.

Results

Koala Place developed its own Client Satisfaction Survey and MDT Partner Satisfaction Survey and then agreed to forward the results to Proactive for inclusion in this research. Almost all clients surveyed in the Koala-specific survey indicated that Koala Place had made a positive difference in their lives. Clients were satisfied with services received and almost all victims were interviewed only once during the investigation, thus reducing stress and re-victimization.

Innovations

Koala Place has demonstrated several innovative practices. For instance, it organized a full-day workshop on child abuse in 2014, entitled “Making A Difference,” which attracted 80 participants. It also designed a one-day MDT workshop on collaboration with 50 participants in 2016. Furthermore, the CAC developed a Guide for Caregivers Booklet and a Network of Support Services Booklet in partnership with Victim Services, which is provided to caregivers upon their first visit. It includes information about the CAC and referral services, and answers to frequently asked questions.

Challenges and next steps

Sustainable funding remains a challenge for Koala Place. FVS funding cuts in 2015 led to reduced hours for the CAC’s executive director. Staff have struggled to find financial support beyond the Department of Justice. The amount of time required to seek funding is onerous. Next steps for the CAC include developing protocols and securing the co-location of all partners at the CAC on a full-time basis. Clients also suggested enhancing the privacy of rooms by adding soundproof and opaque doors.

SeaStar CYAC
IWK Health CentreFootnote 45
(Halifax, Nova Scotia)

Begun in 2012, SeaStar grew out of the IWK Health Centre’s pre-existing child protection team, called Suspected Trauma and Abuse Response Team (START). Governed by and located in the health centre, SeaStar increases victims’ access to medical services, including Child Life Services. While currently a pilot project, SeaStar is seeking to establish itself as a full-scale CAC, although location and implementation remain to be determined.

Multi-disciplinary team

The MDT consists of more than 60 people: the SeaStar project coordinator, members of START (including three pediatricians who specialized in child maltreatment, a clinical nurse specialist, a clinical social worker, and two child/youth advocates), 10-12 police officers, 40 child protection workers, and Mi’kmaq Family and Child Services workers. Case review meetings occur quarterly for more complex cases and for cases in court. While SeaStar follows the hospital’s protocols, it has developed a Reference Guide for MDT members which outlines a typical case and procedures.

Police and the Department of Community Services jointly conduct forensic interviews using the StepWise technique (almost all interviews referred to SeaStar occur on site). Other MDT members could observe from a monitoring room, and interviews are video recorded. Unique to this CAC, most medical examinations are conducted onsite, while some take place elsewhere either within the hospital (i.e. Emergency Department) or at other centres (i.e. family doctor). Mental health treatment is also available onsite, although wait times are long. Some victims have been referred to the Criminal Injuries Counselling Program (Victim Services), although only if charges were laid, or to the Avalon Sexual Assault Centre. Victim advocacy expanded over the study, including support for caregivers during forensic interviews and help to navigate the criminal justice system.

Facilities

Here is a picture of an examining table, scale and table with an image of flowers on the wall.

The child-friendly rooms feature colourful murals, toys, and a fish tank which one child incorporated into his/her drawing during the study. However, limited space (SeaStar only occupied 900 square feet) and a lack of private rooms reduced victims’ privacy.

Clients

Located in Halifax, SeaStar provides services to children and youth who have experienced abuse. The population of Halifax is 390,096 people.Footnote 46

Results

Victims and caregivers felt safe and welcome at SeaStar, although young victims reported mixed ratings of the CAC (e.g. one did not want to be videotaped during the forensic interview). Caregivers identified victim advocacy as the most important support received. One parent revealed that “[without the SeaStar Centre,] I would have walked away.”

Innovations

Here is a picture of Rocsie, a therapy dog.

Despite limited space and resources, SeaStar has demonstrated several innovative practices. For instance, one child/youth advocate has received training in compassion fatigue to support MDT members. Further, two therapy dogs, Munich and Rocsie, and a therapeutic clown served as icebreakers with children. One child kept a picture of Rocsie (right) at his bedside, which helped him to fall asleep. Additionally, the CAC has organized 32 psycho-educational workshops for caregivers, which trained over 800 people (including children/youth and professionals). Classes included self-care, trauma-informed yoga, and navigating the legal system. SeaStar also organized a one-day conference in 2014 entitled “Responding to Child and Youth Maltreatment: Collaboration, Coordination, Compassion,” which attracted 115 participants.

Challenges and next steps

Like most sites, SeaStar requires more mental health workers, who can provide trauma-informed support with a focus on post-traumatic stress disorder (PTSD) for victims, families, and MDT members. Again, similar to almost all CACs in the study, SeaStar requires greater funding. Although staff successfully secured funds from a private foundation to expand their mental health support, greater financial support is required to re-locate and expand the centre. Next steps for SeaStar, which hopes to become a full-scale CAC, include securing stable operational funding, finding a suitable location, and determining governance and operations models.

Project Lynx
(Whitehorse, Yukon)

Project Lynx began in 2012 as a virtual MDT to accommodate Yukon’s dispersed population and to serve as many clients as possible. It meets clients at two different locations: the Yukon government’s Victim Services offices and the RCMP detachment.

Multi-disciplinary team

The MDT consists of the Project Lynx coordinator, who is the CAC’s only dedicated staff member; representatives from Victim Services, RCMP, Family and Childrens Services, Regional Services, Public Prosecution Service of Canada, Child and Adolescent Therapeutic Services, Court Services, and Council of Yukon First Nations. Case review meetings occur bi-weekly facilitated by the Project Lynx Coordinator with participation from RCMP, Family and Childrens Services, Regional Services, Public Prosecution Service of Canada and Child and Adolescent Therapeutic Services. Key documents include Terms of Reference, consent forms, information sharing guidelines, and Case Review processes although the CAC still lacks a Memorandum of Understanding. The Yukon government has also developed a Resource Guide for Justice Professionals which assists partners.

Police conduct forensic interviews at the RCMP detachment using the StepWise technique, although some interviews are jointly conducted with Family and Childrens Services and Regional Services. Clients almost universally disliked the interview facility, citing it as cold, intimidating, and isolated. Medical examinations occur at the Whitehorse General Hospital. However, while 14 nurses had received specialized training (before Lynx existed), they still needed permission to practise at the hospital. Mental health support is provided by Child and Adolescent Therapeutic Services. However, access to specialized adult counselling remains poor. Options for counselling and for adults can be accessed by referral to any community agency of the client’s choosing. Victim advocacy is offered by the coordinator through the Victim Services office or via phone, email, and text messaging. She provides case tracking, updates, and information, and also sits on the community’s Sexual Assault Response Committee.

Facilities

Here is a picture of a desk with a basket of toys and stuffed animals.

Project Lynx lacks a dedicated child-friendly space. However, the coordinator has created a welcoming atmosphere in the Victim Services offices by providing toys and colouring supplies (pictured left). Police officers also wear street clothes instead of uniforms, which helps to put kids at ease. Child friendly enhancements have been made in some communities, identifying appropriate spaces for interviews, and with additions of comfortable furniture and décor. Improvements have also been made with technology and infrastructure in partnership with Court Services, Dept. of Justice, to enable out of courtroom testimony in all communities.

Clients

Project Lynx provides services to children and youth who are victims of any crime, whether charges are laid or not, up to age 19 years and their families. Project Lynx serves a large Indigenous community, to which it is adapting. Whitehorse is home to 26,028 people and lies in the traditional territory of the Kwanlin Dun and the Ta’an Kwach’an people.Footnote 47 Indigenous peoples comprise 23 percent of Yukon’s populationFootnote 48 and 67 percent of clients at Project Lynx. The city is also home to a large Francophone community. Consequently, it is essential that any services provided in Yukon be culturally responsive. In response, the Lynx coordinator has invited the Council of Yukon First Nations to join the MDT. The two groups are developing strategies and training to enhance cultural competencies and increase Indigenous participation.

Results

Project Lynx has established a culture of collaboration among MDT members, thus strengthening victim services and reducing the number of forensic interviews per victim. According to feedback received during the study, clients were satisfied with services received.

Innovations

Project Lynx has increased the use of technology, such as access to videoconferencing for young witnesses in Dawson City and Watson Lake. Technological improvements have made it easier to testify from alternative locations out of court across the territory. Some MDT members have also received training in coordination, forensic interviewing, and child maltreatment, although more joint training is needed. The CAC is also planning workshops on compassion fatigue for MDT members.

Challenges and next steps

One MDT member noted that “we have done the foundational work before building the walls.” Project Lynx is in development as a CAC; it still lacks several elements of the CAC model: a physical neutral, child-friendly location, co-location of MDT members, and MOUs between partners. Since Whitehorse is a small community where victims can easily encounter offenders, a dedicated space would help provide a sense of safety for families. Indeed, realizing that “it is more difficult as a virtual centre,” Project Lynx staff are developing a child-friendly ‘soft room’ for interviews at the Integrated Services for Yukon Youth location. Staff hope that this facility can also be used for remote testimony.

Project Lynx is also striving to achieve the following: