Support for the Treatment of Abused Children

The unit deals with cases that are referred to it by families. It also cares for children and adolescents referred by paediatricians or other professionals from the health and justice services, Child and Youth Mental Health Centers (CSMIJ or CDIAP), schools, social or leisure entities such as cultural groups, police forces, services social or teams of the child protection system. In cases where minors arrive through a professional, a referral report will be required.

Please call the telephone number +34 93 253 21 13. Office hours are from 8.30 a.m. to 6.00 p.m. (with treatment preferably given in the mornings). In the case of professionals who want to refer a case, the information can also be sent by email.

Outside of these hours, cases that are felt to be urgent should preferably be taken to the A&E department at the closest hospital or health centre,
(the nearest health center or hospital) who will refer you to the corresponding specialist team if necessary.

If the situation has occurred beyond 72 hours, ask the Support for the Treatment of Abused Children Team about the steps to take. You can also call the free helpline Infància Respon (child protection) on 116 111. This department of the Directorate General of Child and Adolescent Services (DGAIA) also has an email address where you can report cases of child or adolescent abuse (infanciarespon.bsf@gencat.cat).

It is advisable to request urgent care at a nearby health center if child sexual abuse has occurred in the previous 72 hours. In that case, it will be assessed whether a physical examination by a doctor is necessary, when there may still be some form of physical evidence.

The patients in the unit are boys and girls between the ages of zero and 18 years who are suspected to have suffered a type of sexual abuse. Child sexual abuse is considered to be the situation in which a person with a position of power (an adult or an older child) uses coercion or forces a boy or girl to perform any type of sexual activity.

The abusers are also sometimes treated if they are children or adolescents in order to correct their behavior, if required, or to rule out the possibility that the aggressor—when he/she is underage— has not also been a victim of prior abuse.

The cases are studied and the possibility of offering an answer is evaluated. Traditionally, ESTIM has only dealt with cases of child sexual abuse, but we are in a time of change. As a result of the new Health protocols (Protocol for action against child and adolescent abuse in the field of health and Framework protocol for action against child and adolescent abuse in Catalonia) work is being done on the design of new attention model. In this sense, there are functional teams of experts in abuse who can make the clinical assessment and treatment of these situations. ESTIM will be part of these specialized teams.
 

The patient is assessed, a diagnosis is made and they are treated in accordance with the needs of each individual case. The treatment (medical and psychological) may be given directly at SJD Barcelona Children’s Hospital or in coordination with nearby services such as Child and Juvenile Mental Health Centres (CSMIJ).

We treat the consequences directly associated with the abuse while considering the experience suffered by the child and their age. We take a biopsychosocial approach to treating patients. In all cases, we work to provide self-protection mechanisms to the underage victims of abuse and to prevent them from being abused again.

We also offer support and guidance to the core family members not involved in the abuse on how to tackle the situation and how they can try to overcome it.

No. We can guide families in an initial phase if a legal process occurs, as well as offering accompaniment and emotional support to the minor and the family due to the emotional stress that may appear related to legal processes, but in no case do we offer service of legal attention.

The team prepares clinical reports on the cases assessed, which can sometimes be used in social or judicial files but do not amount to an expert report.

All cases assessed in the unit are reported to the General Directorate of Childhood and Childhood (DGAIA). In addition, in cases where suspicion of substantiated abuse is considered, the professionals of the Functional Unit for Child Abuse have a legal obligation (Art. 262 LECrim) and a deontological obligation to notify the situation to the competent bodies that are, apart of the DGAIA, the justice services.

The ESTIM has no competence regarding the processes of guardianship of minors. These procedures are managed by the DGAIA itself or by judicial bodies.

• ​Initial family support, accompaniment, psychological, and emotional support to the family.
• Assessment in relation to the protection requirement.
• Pediatric visit (anamnesis, physical examination, and complementary examinations if necessary).
• Pediatric treatment and subsequent follow-up if necessary.
• Psychopathological evaluation of minors, individual psychotherapeutic treatment in cases in which symptoms compatible with an abusive situation develop, and family therapy of the non-abusive nucleus.
• Referral to other psychological services in the healthcare network if the patient or family requires it.
• Coordination and collaboration with judicial bodies, among others, when required.
• Psychological preparation of the minor before the oral trial and subsequent accompaniment if necessary.
• Work on the protective factors of minors and their families, as well as the reduction of both individual and environmental risk factors that may contribute to possible future situations of re-victimization.
• Orientation to professionals from other centers when requested.

The team consists of two paediatricians, two psychologists, a psychiatrist and a social worker, in addition to a member of administrative staff. The main objective of the professionals is to provide children who are suspected to have suffered abuse with a comprehensive approach to help them fight the damage that can be caused by these experiences.

The Support for the Treatment of Abused Children Team (ESTIM ) works in coordination with the other Departments and Units at SJD Barcelona Children’s Hospital (Gynaecology, A&E, etc.) The team gives a diagnosis and treats children who have suffered a situation of child sexual abuse from an adult or another minor.