Child Protection Centre of Zagreb
Đorđićeva 26, Zagreb
Standards of Practice in Protecting Children
(Child Protection Policy)
Purpose of this document is to present the standards of legal, professional and ethical practice in the Child Protection Centre of the City of Zagreb, aiming at protecting children’s best interests in cases of abuse, maltreatment, neglect, or risk.
It is based on:
- current Croatian legislation and the Convention on the Rights of the Child
- relevant knowledge about all forms of abuse (physical, sexual, emotional), neglect and exposure of children and youth to domestic violence and peer bullying as well as their impacts on children
- professional knowledge about traumatisation of children and youth and evidence based knowledge about diagnostic and treatment/therapeutic procedures with traumatised children, youth and their families.
The Child Protection Centre of the City of Zagreb is a health institution established with the aim of providing help to psycho-traumatised children and their families through the following activities:
– specialist and clinical case conference health protection in the area of paediatrics, neurology, psychiatry, diagnostic decision-making and medical rehabilitation, except hospital treatments.
– other activities (education, team work, scientific research, raising public awareness, publishing and forensic activities).
Activities of the Centre are conducted based on current Croatian legislation, professional standards, experience, and good practice, as well as on the cross-institutional cooperation, which altogether ensures that every child is provided with specialised team approach in the most efficient and most humane resolving of his/her difficulties.
Current legislation in Croatia, the foundation of work in the Centre is as follows:
– Convention on the Rights of the Child,
– Convention for the Protection of Human Rights and Fundamental Freedoms,
– European Convention on the Exercise of Children’s Rights,
– Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine and other regulations and protocols determining procedures with children, as well as positive practice of other organisations and institutions working with children,
– The Constitution of Croatia and related laws (Domestic Violence Act, Family Act, Criminal Law, Patient’s Bill of Rights, Health Protection Act, Medical Law, Mental Health Act, Data Protection Act),
– Articles of Association of the Centre which also regulates the procedures of the Ethical Committee consisting of the members of the Centre and a youth judge as an external consultant who supervises the application of the standards of medical ethics,
– Protocol of procedures in cases of sexual abuse which sets standardised procedures in protecting the victims of sexual abuse for all professionals in various institutions,
– Protocol of the Croatian Government about the procedures in cases of abuse and neglect of children,
– Protocol of the Croatian Government about the procedures in cases of domestic violence,
– Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse,
– Directive 2011/93/EU of the European Parliament and of the Council of 13 December 2011 on combating sexual abuse and sexual exploitation of children, and child pornography,
– Directive 2012/29/EU of the European Parliament and of the Council of 25 October 2012 establishing minimum standards on the rights, support and protection of victims of crime.
The Child Protection Centre of Zagreb is the signatory of the Pact of Towns and Regions to Stop Sexual Violence against Children within the campaign of the Council of Europe “One in Five”, which includes a list of initiatives and strategies undertaken with the aim of stopping the sexual abuse of children.
Purpose of the Centre is to:
• provide efficient, timely and well-coordinated support for traumatised children and their families,
• provide practice in the best interests of the child,
• promote the rights of the child,
• provide protection measures against abuse through recognising, education and response to abuse and neglect of children, as well as prevention of child abuse, in compliance with the law.
These postulates, as well as following legal and professional standards apply to each and every employee of the Centre.
Core Activities of the Centre
Diagnostic and therapeutic work
The Centre provides specialised team approach to traumatised children. The multidisciplinary team of the Centre includes: psychologists, psychiatrists, social educators, a speech therapist, social workers, a paediatrician, nurses and a jurist. The professional team approaches the child using specific knowledge and skills of each professional, works multidisciplinary, being coordinated in the best interests of the child. Each professional, directly or indirectly, contributes to the quality of diagnosing and making decisions about treatment in accordance with individual needs of every child.
The Centre also provides supervision of cases with the guidance of a psychiatrist.
Other Activities at the Centre
Besides its core activities, the Centre also works in the prevention of abuse and neglect of children and youth at all levels.
– General level of prevention is realised through awareness raising among parents and children, professionals working with children and the public, including social structures which are able to contribute to child protection at the legislative level.
– Target level of prevention is realised through everyday work with children and families which are, due to their individual characteristics or adverse conditions for child development, at a higher exposure to various forms of abuse and neglect.
– Indicated level is related to working with children who experienced some form of abuse and is aimed at minimising the impact and preventing re-victimisation of children by focusing on their recovery.
All these activities are realised through:
- Training of the multidisciplinary team professionals of the Centre and the training of external professionals
- Team work and supervision
- Research and scientific work
- Raising public awareness and publications
Course of Procedures in Direct Work with Children in Need of Protection
(diagnosing and treatment in cases of suspected abuse, neglect and exposure to violence)
1. The child reports to the Child Protection Centre of the City of Zagreb accompanied by a parent/legal guardian: at the initiative of the parent/carer or at the recommendation of the physician in charge, social welfare centres, police or other institutions (school, kindergarten, children’s home, NGO, etc.) and with a written referral issued by the physician in charge.
2. Case management starts with the first interview by a multidisciplinary team professional, who then evaluates the condition and the need for the inclusion of other professionals in the team. In cases of suspected abuse, neglect, domestic violence etc., the need of urgency of the intervention is assessed based on the assessment of the level of protection of the specific child.
3. An interview is conducted with the person who accompanies the child and with the child. If possible, in cases of suspected abuse, these interviews are conducted separately, but always having in mind the best interests of the child and the reduction of the risk and stress for the child. The procedure in such situations is the responsibility of the mental health professional and it is compliant with the rules of professional conduct with children of various age and individual characteristics and needs. The first interview also includes providing psychological first aid to the child and the parent, due to possible traumatic nature of the event to which the child has been exposed. After the interview, the parent is informed about the plan of further procedures at the Centre. The child is also informed in a way appropriate to his/her developmental level and in accordance with the right of the child to be informed in compliance with the Convention on the Rights of the Child.
4. Relevant documentation is typically collected in cooperation with social welfare centres, after the first meeting (sending information together with a request for documentation). Cooperation with other institutions is possible and its aim is child protection and collecting relevant information (from social welfare centres, the police, schools, kindergartens, health institutions etc.).
5. Data collecting and informing
If, during the interviews, or in the course of examination, the information received indicate that the child has experienced some form of family abuse (directly or indirectly), the professional will inform the institutions in charge about that: the police and the social welfare centre in charge, and sometimes the State Attorney. In deciding on the above suspicions, professionals are guided by the data obtained. They apply their expertise and competences in working with children and families. Multidisciplinary team professionals are especially educated to conduct, if needed, forensic interviews and forensic evaluations, or some elements of these procedures. Information sent to the institutions in charge contain general data about the child, the reason for the child’s visit to the Centre and the name of the person or the institution referring the child to the Centre. The course of procedure is also described as well as the obtained information (the child’s statements), possible injuries or some other relevant data based on professional evaluation.In cases where exposure of the child to abuse has not been conclusively confirmed (the young age of the child, developmental limitations or conditions, child’s refusal to talk, family factors or other), but a future risk is anticipated, institutions in charge are also notified with appropriate recommendations. If, at the first contact with the child, an exposure of the child to a present threat is found, as well as a possible lack of protection outside the Centre, the professional immediately contacts the institutions in charge (the social welfare centre, the police) due to the urgency of intervention in child protection.
6. Client management
The professional who starts the examination, introduces the team leader and other members of the team with the collected data and findings, as well as indications for a team examination which is then agreed upon. Additional decisions are made and agreements are achieved as to the further diagnostic procedures and treatment plan for every child. These are defined at a team meeting with the guidance and team coordination. The parent/legal guardian of the child and the child have to be informed about the plan of treatment. The child is given only age-appropriate information in an age- appropriate manner.
7. Informing the legal guardian of the child
In the course of examination and after that, the parent/legal guardian is informed about its course, results and recommendations for further procedure. The child is given age- appropriate information
8. Team findings and opinions
Each team member writes his/her own findings and opinion. This document also contains recommendations for further proceeding and possible treatment of the child and the family. Team findings and opinions contain information about the child’s somatic/physical status, developmental and intellectual characteristics, and the psychological profile obtained through diagnostic procedures, conditions and dynamic in which the child lives, characteristics of the social and emotional development and competences of the child, the level of traumatisation, possible psychopathology and difficulties, personal and family risk factors, possible suspected witnessing and exposure to abuse/domestic violence in the family or somewhere else. The opinion contains a recommendation that the child should be included in some treatment (or more types of treatment) in the Centre or some other institution. The finding also contains a recommendation about the need that the parent is included in counselling or treatment, or that siblings are included if it is necessary, and if there are indication of a risk for their traumatisation. It also contains a recommendation for further protection of the child if needed. Findings and opinions are issued to the child's parents unless there is a possible conflict of interests between the child and the parents, when the parent is the source of traumatisation of the child and might misuse the findings for further pressure on the child. In such cases, the findings are sent to the Social Welfare Centre in charge, guided by the best interests of the child and the ethical codes of the professions involved.
If domestic violence or witnessing domestic violence by the child is suspected, the findings are sent to the Social Welfare Centre and the police is notified (if it was not notified at the beginning of the process). The findings can be sent to the police and to the court in accordance with the law, at their written request.
9. Cooperation with other institutions during and after the examination has been completed. In cases when parents are not willing to cooperate during the examination, assistance is required from the Social Welfare Centre in charge. Avoiding repeated interviews which add to further traumatisation is especially important for the child and his/her protection. Sometimes the Social Welfare Centre in charge or the Court need to manage the case, so that the child is provided with the necessary protection and that safe and stable conditions are created for the child's inclusion in an appropriate treatment. It is not rare that such assistance is necessary because parents refuse to participate in a treatment or counselling, especially when they neglect their parental role and responsibilities.
In all these cases, the professional of the Centre informs the Social Welfare Centre in charge, asking for cooperation in the intervention.
10. Treatment of children exposed to trauma
Multidisciplinary approach is the most appropriate model to identify the child’s needs and further treatment.
The most efficient methods and therapeutical approaches based on efficiency indicators are used in treatments of children: TF-KBT, the psychodynamic model, humanistic approaches (gestalt therapy, art therapy, play therapy, EMDR, etc.). The parent/legal guardian is routinely included in the child treatment through counselling, since the support of the family and close persons is a primary child protection factor.
Contrary to popular opinions that the child should not be in treatment before the court process is finished, contemporary professional findings, the principles in the Convention on the Rights of the Child and the construct of the best interests of the child, professionals have conceptualised the 'forensically sensitive treatment/therapy.
Such treatment approach is directed to starting the recovery of the abused or neglected child who shows signs of trauma, when starting the treatment before the court process has been finished is justified, because waiting for it to finish is too long for the child and the family who are in need of urgent intervention. Such approach is justified and the child also often receives additional support because s/he is exposed to stressors during the process ( interview at the court, family difficulties related to the activity of the system, etc.)
Rules at the Centre
All employees, based on the Health Protection Act, are required not to breach the confidentiality on everything they know about the health status of a patient.
Control at recruitment
A non-criminal record certificate is required from every new employee with the Centre. The certificate is issued by the Ministry of Justice of the Republic of Croatia, based on the Act on the Legal Consequences of Condemnations, Criminal Records and Rehabilitation (National Gazette 143-12).
Instructions to new employees
During the induction period, the director, the legal department and the head of department introduce every new employee to the rules important in working at the Centre, to by-laws and the procedures in the Centre.
Hierarchy of responsibility
The Centre is organised hierarchically, which means professional responsibility both to the superior professional and to the department.
All employees are obliged to follow the Ethical code of their respective professions and the Ethical code in research involving children.
Confidentiality of information is protected except when it is necessary to protect a child’s rights. In such cases, both children and families are informed in compliance with the law.
Due care is provided in protecting the child and the family privacy in storing and keeping records.
Informed consent is regularly required from the parent/legal guardian in cases of video or audio recording or using documentation for educational purposes, taking due care to protect the child’s privacy, as well as in cases of children participating in research studies.