Victims of Crime Research Digest No. 11
Understanding the Development and Impact of Child Advocacy Centres (CACs) in Canada
By Cynthia Louden and Kari Glynes Elliott
Child Advocacy Centres (CACs) and Child and Youth Advocacy Centres (CYACs)Footnote 16 are child-focused, facility-based programs in which representatives from many disciplines work together to conduct interviews and make team decisions regarding investigation, treatment and intervention in child abuse cases. CACs provide an array of services to improve the experiences of child victims and witnesses, along with their families, as they navigate various systems, including the child protection and criminal justice systems. CACs can also undertake research, and develop and provide training and public legal-education. In 2010, the Government of Canada announced funding through the Federal Victims Strategy (FVS) for the creation and enhancement of CACs across Canada. This funding – originally $5.25 million over five years (2010-2015) – has been increased to $12.25 million over five years (2016-2021).
The United States is a leader in the development of CACs and established its first centres during the 1980s. CACs seek to minimize system-induced trauma by providing a single, child-friendly setting where child/youth victims and witnesses, along with their families, can access services. It is believed that CACs may reduce the number of interviews and questions children are subjected to during the investigation and court-preparation processes.
The U.S. National Children’s Alliance (NCA) established 10 standards that organizations must meet to become an accredited CAC. Accreditation and NCA membership opens up funding opportunities, as well as other benefits such as shared software for data collection and performance measurement. The 10 standards involve:
- A multi-disciplinary team (MDT)
- Cultural competency and diversity
- Forensic interview
- Victim support and advocacy
- Medical evaluation
- Mental health
- Case review
- Case tracking
- Organizational capacity
- A child-focused settingFootnote 17
CACs in Canada
In Canada, the CAC model is a more recent development; the first Canadian CAC opened in Regina in 1997. As of 2017, 18 communities in Canada are operating CACs and approximately 15 other communities are exploring or developing the model.
Goals and Mandate of CACs
In general, CACs aim to address a lack of coordination between social services and the criminal justice system. Prior to CACs, victims were often interviewed multiple times by professionals untrained in child development and working for different agencies. Interviews and other aspects of investigations were carried out in locations, such as police stations, that were not child-friendly. Victims and their families complained of delays, lack of information and of being re-victimized by the process.
CACs coordinate services by bringing together professionals into a multi-disciplinary team (MDT) located in a single, child-friendly location. Interviews are usually conducted jointly by law enforcement and/or child protection professionals trained in both child development and forensic interviewing.
A key feature of many CACs is a victim advocate, who serves as a “point person” or navigator for victims and families. A victim advocate is involved throughout the entire process, ensuring a welcoming atmosphere, acting as the central point of contact for victims and their families, answering questions, providing referrals, updates, and information about cases, as well as liaising with other MDT members. In some cases, a victim advocate maintains contact with families after the case is completed.
Department of Justice CAC Study
In 2012, the Department of Justice Canada commissioned a five-year study of the development and operation of Canadian CACs. It was designed to measure client satisfaction with CACs and with criminal justice system processes, and to examine specific outcomes of the CACs. Proactive Information Services Inc, an independent firm, was contracted to develop tools such as interview guides, and to conduct interviews and collect data from six CACs.
The six CACs were selected to maximize diversity. The CACs selected reflect a variety of governance structures including stand-alone non-governmental organizations (NGOs), programs of established NGOs, and government entities; they also operate in different regions of the country and serve different populations. The six CACs studied were:
- Caribou Child and Youth Centre, Grand Prairie, Alberta
- Regina Children’s Justice Centre, Regina, Saskatchewan
- Koala Place CYAC, Cornwall, Ontario
- SeaStar CYAC in the IWK Health Centre, Halifax, Nova Scotia
- Project Lynx, Whitehorse, Yukon
- Sophie’s Place Child and Youth Advocacy Centre, Surrey, British Columbia
Since all six CACs received financial support through the Federal Victims Strategy (FVS), the study also examined their progress toward three key FVS objectives:
- Increased access to victim services
- Enhanced capacity to deliver appropriate and responsive victim services
- Reduced financial and non-financial hardships for victims
Researchers at Proactive Information Services Inc. collected data from three main sources:
- CAC case files
- Client interviews (child/youth victims and non-offending caregivers)
- MDT interviews
Researchers conducted 111 MDT interviews (with 125 individuals), and 123 interviews with 26 child victims (aged five to 11), 17 youth victims (aged 12 to 19), five adults who had been victims as children (i.e. historical cases) and 75 non-offending caregivers.
Clients and Cases
Researchers studied 1,804 case files and found that:
- Victims were primarily female (67%).
- Almost half of all victims were aged 8 years or younger; the average age was 9.4 years.
- Over half of all victims were Caucasian (56%) and the second-largest group was Indigenous (17%).
- Offences were primarily sexual in nature (72%). Physical assault was the second-most common offence type (28%).
- The accused were primarily family relatives (64%) and most were adult males (64%).
- Police and child protection services were the two most common referral sources (together accounting for 94% of all referrals).
- The average elapsed time between first contact at the CAC and file closure was 187.7 days, and the median was 126.5 days.
During the five years of the study, the CACs developed and changed; in many cases, MDT members reported that communication improved.
The study concluded that the diverse governance structures of the six CACs featured did not appear to influence service delivery, as long as communication was open, and the management board was knowledgeable and supportive. The study found that specific, clear documentation of agreements among partners (such as memoranda of understanding) facilitated better working relationships. These findings highlight the CAC model’s flexibility.
The study included CACs with different physical locations. One CAC was located in a hospital, two shared locations with other agencies, and two had their own facilities. One CAC was a virtual site, meaning it did not have a single location, rather MDT members used many different methods to communicate.
A dedicated physical, child-friendly space is a core component of the CAC model and the study confirmed that a CAC needs a physical space to operate effectively. The virtual CAC was designed to serve as many people as possible across a region where potential clients are widely dispersed. However, despite a strong victim advocate program and a robust MDT response, both clients and MDT members expressed a preference for a single, physical, child-friendly location. Since the study concluded, Project Lynx has made child-friendly enhancements in some communities, finding appropriate spaces for interviews and adding comfortable furniture and décor.
The study confirmed that co-location of MDT members is also important. MDT members report better communication when team members work alongside CAC staff at the same site. While off-site MDTs can still perform well, they must develop trusting relationships, and well-negotiated and understood protocols, and hold regular case-review meetings.
The study found that the role of victim advocate is a key component of the CAC model. Such advocates support clients throughout the process and provide the glue that holds the MDT together. Caregivers identify the victim advocate as the most important CAC service for both themselves and their children. The victim advocate’s impact on clients was evident:
The victim services responder is our rock through the whole process. I don’t know what we would do without her.
Forensic interviewing is an important CAC service. A forensic interview is a non-leading, non-suggestive interview that seeks to identify the facts of a case involving allegations of child abuse. Interviewers, specially trained police officers and child protection workers, ideally conduct joint interviews to gather information for criminal investigations, assess the safety of the child’s living arrangements, and determine the need for medical or psychological treatment. Most CACs use the Step-Wise Interview Technique,Footnote 18 although one site in the study uses Rapport, Anatomy Identification, Touch Inquiry, Abuse Scenario and Closure (RATAC).Footnote 19
Two sites offer therapy dogs as an additional service, although this not part of the CAC model. The dogs help to calm young victims before forensic interviews and during court preparation. In at least one instance, a therapy dog provided support to a young CAC client waiting at the courthouse for legal proceedings to begin.
Among the 36 victims who provided overall ratings of CACs, 83% rated their experience as either “good” or “great.” The two victims who rated their experience as “not good” were from the same site. One did not want to be videotaped during the forensic interview, and the other was concerned that the offender would be present. No victim gave a rating of “terrible.”
CACs and FVS Objectives
The study concluded that CACs were able to address noticeable gaps in the system. The CACs increased access to services for victims, including medical examinations. They provided training on how to work with child victims, made child-friendly environments available for forensic interviews, increased coordination and collaboration between partners that respond to reports of child abuse, and provided a consistent support person for children, youth and their families throughout their interaction with the criminal justice system.
FVS funding made it possible for these CACs to enhance capacity to deliver appropriate and responsive victim services by: supporting the coordination of services for children, youth and their families; hiring experts; and training MDT members. As the teams worked together, they shared expertise and enhanced their skills and knowledge. Some CACs provided training in forensic interviewing and/or child abuse and maltreatment. Some MDT members received training in cultural competency and diversity.
Overall, the CACs reduced 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 obtain information and support. Some sites provided emergency cell phones, bus tickets, taxi slips and/or food vouchers. Staff also helped clients to complete applications for government support (e.g. housing, counselling services).
Sites also reduced non-financial hardship by providing a single person – the victim advocate – who offers emotional support, information, referrals to services and/or assistance navigating intimidating systems. This reduced stress and saved time, since families did not have to deal with multiple people. As one caregiver explained: “It was a life saver. I would have lost my mind without them.”
The following were identified as lessons learned:
- Clients and MDT members need mental-health services. Only two CACs provided on-site mental-health services. On-site and off-site services were both described as a “patchwork” of programs, with long wait lists, and gaps in services for children/youth and for specialized adult counselling. Working with victims of abuse can take a toll on the mental health of service providers, but there was limited support for MDT members coping with vicarious trauma, Post-Traumatic Stress Disorder (PTSD), and/or burnout, which one interviewee noted can “eat you alive.”
- Clients want more information. The interviews revealed some client frustration about the general lack of information. Only 27% of child/youth victims were told what was going to happen after the investigation concluded. Young victims were less likely than parents/caregivers to receive updates and to know whom 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 is important. Private spaces are essential at CACs, but not every site had an adequate area. At one site, the victim advocate often had to speak to families in front of other people due to limited space, reducing clients’ privacy. Clients at other sites also suggested adding soundproof walls, opaque doors, and/or drop-down shades to increase privacy.
The flexibility of the CAC model allows for a number of innovative services. Notable services among the sites studied include:
- Workshops/community education: Several sites delivered workshops to families and professionals in the community on topics such as trauma, how to support child victims of abuse, dealing with vicarious trauma, helping kids develop better self-esteem, and navigating the criminal justice system. Other CACs hosted conferences and created caregiver handbooks.
- Girls’ groups: One site offered workshops specifically for girls on self-care, self-esteem and healthy relationships.
- Cultural competency: Three sites added representatives of local First Nations to their MDTs to increase cultural competency, and one site offered smudging and case planning with Elders in a circle. A CAC that served a large immigrant and Sikh community required MDT members to attend yearly cultural-relations courses, and employed a South Asian victim advocate. While the CACs in this study served diverse populations, the need for culturally sensitive services at other CACs across Canada may vary.
Challenges of the Criminal Justice System
Although CACs alleviate many problems, they are not designed to address clients’ biggest complaint: delays in the criminal justice system. Clients complained of frequent court adjournments and cross-jurisdictional issues. Many clients indicated that speedier resolutions would reduce hardship. However, while CACs assist investigations and court preparation, they have no influence over court delays and outcomes. As one caregiver observed: “[the CAC] is excellent, but in the end, it is not a people issue, it’s a systems issue.”
Future Research Directions
It should be noted that study findings are specific to the CACs reviewed and may not apply to others operating in Canada. It was difficult for the study to follow clients throughout their cases. In addition, it was difficult to recruit victims and family members for surveys and interviews. Some clients were deemed too vulnerable; some were understandably reluctant to talk about anything related to the trauma they had experienced.
Future research could compare the long-term outcomes experienced by Canadian CAC clients with those experienced by victims who go through the court process without accessing CAC services. It is difficult to measure whether CACs actually reduce trauma for clients, although this is among their goals. Other research could evaluate the effectiveness of various trauma-reducing strategies at CACs, such as the use of support dogs and other initiatives.
The study is the first of its kind on CACs in Canada, and contributes greatly to what we know and understand about their development and growth. The full report, Understanding the Development and Impact of Child Advocacy Centres (CACs), will be available from the Department of Justice Canada in 2018.
Cynthia Louden is a law student in the common law program at the University of Ottawa.
Kari Glynes Elliott is a researcher with the Research and Statistics Division, Department of Justice Canada.
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