We provide medical and mental health services to suspected victims of child abuse and neglect and their families.
Doctors and nurses at the Center for Safe and Healthy Families help to determine the cause of injuries and illnesses. Children who are suspected of physical sexual abuse receive specialized medical evaluation to determine the child's well-being as well as document any existing evidence of injury or neglect. Not all patients who are sent to our team for medical evaluation are diagnosed with an injury, even if that was the initial concern. Our job is to medically evaluate a patient to determine if there is another explanation for the finding such as a medical condition or illness.
Physical Abuse Evaluation
When a medical provider or community partner, such as law enforcement or child protective services, has a concern that a finding on a child may be an inflicted injury, the Center's medical assessment team can assist in the evaluation of the child to determine the cause. When physical abuse is suspected, a child requires a specialized evaluation that includes a comprehensive history and a physical exam. Depending on the concerns and the age of the child, they may also need to have laboratory studies, imaging tests, and other pediatric specialists to evaluate them. Children may be evaluated by the Center's medical team in the outpatient clinic located in the Eccles Outpatient Center, in the emergency department at Primary Children's Hospital or when admitted to Primary Children's Hospital. When a child is evaluated for physical abuse, the Center's doctors, nurses and social workers work together to provide a comprehensive evaluation and to facilitate communication with other medical providers and community partners such as law enforcement or child protective services.
Sexual Abuse Evaluation
Often, a child discloses sexual abuse long after the event occurred. When this happens, the child may benefit from a medical evaluation from child abuse specialists in a clinic or at a Children's Justice Center. Cases like this can be scheduled and do not necessarily require an emergency room visit because the goals of the exam are different than when a sexual assault has just occurred. When a patient is seen in the Center's outpatient clinic located in the Eccles Outpatient Services building or at a community Children's Justice Center staffed by one of our child abuse experts, the child will receive care that is appropriate for their age by pediatric specialists. They may be seen by a child abuse pediatrician, a nurse practitioner, a pediatric nurse, and/or a social worker. What is most important for our providers is to ensure that the medical exam is not a traumatic experience for the patient, while addressing their safety and wellbeing. When a child is seen in one of our clinical settings for past sexual abuse, we will take a comprehensive medical history, conduct a complete physical examination and do any testing that is necessary based on the type and timing of the events that led to the evaluation. We will communicate with a patient's primary care physician, if they have one, as well as with the community partners involved in the case.
Sometimes a child has not disclosed sexual abuse but has a finding that causes a caregiver or healthcare provider to be concerned that they may have been a victim of sexual abuse. Our team may be able to help with a medical evaluation to clarify the concerning finding.
Acute Sexual Assault (Rape) Evaluation
When a child or teenager discloses that they have been a victim of sexual assault that has very recently occurred, there may be a need to collect forensic evidence or provide immediate medical evaluation and care. In these cases, our team works to determine the best place to receive that care no matter where the patient lives in the state. When possible, we attempt to provide care in a location that is as close to the patient as possible using our Children's Justice Centers that are located in communities around the state. It may be necessary however, depending on the timing and location of the patient to bring the child to Primary Children's for this specialized assessment. A child seen at Primary Children's for this assessment may be seen in the outpatient clinic located at Eccles Outpatient Center or in the Emergency Department at Primary Children's Hospital. They will be seen by either one of our child abuse pediatricians or one of our specially trained pediatric nurses. We will do a complete medical history, a complete physical exam and depending on the case, collect forensic evidence and/or do photodocumentation of injuries. We may also need to do laboratory studies and/or given medicines to prevent infections or pregnancy after an assault has occurred. We will communicate with other medical providers caring for the patient as well as the investigators in the case. We will also help a family find appropriate therapy for their child.
Mental Health Services
Therapy is provided to assist children who are experiencing post-traumatic stress disorder and other mental health problems related to child abuse including sexualized behavior and aggression. Psychiatric evaluation and follow-up services are also available for children who need them. Therapists specialize in evidence-based practices that are based on objective data and research. These therapies include:
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Designed to reduce children's negative emotions and behaviors after they have experienced some form of trauma, including sexual abuse. It also provides support and skills to help parents cope with their own emotional distress and optimally respond to their child.
Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT)
Helps children and their caregivers by promoting less hostile and aggressive behavior, fewer negative interactions with family members, better social skills, and better developmental abilities. Most children who receive this treatment have experienced some form of physical abuse.
Parent-Child Interaction Therapy (PCIT)
Uses step-by-step, live-coached behavioral parent training to improve parenting skills, decrease child behavior problems and improve the quality of the parent-child relationship.
Child and Family Traumatic Stress Intervention (CFTSI)
A 4-6 session early intervention designed to prevent the development of chronic PTSD and associated symptoms.
Eye Movement Desensitization Therapy (EMDR)
A trauma-informed treatment used to treat children and adolescents who have experienced abuse and trauma. Current symptoms are reduced when distressing memories associated with these events are reprocessed into a more adaptive and integrated state.
Trauma Specialized Child Psychiatry Services
Child psychiatrists are part of our core team at Safe and Healthy Families and are available for consultation with medical providers at Primary Children's and the Children's Justice Centers. They are able to evaluate and treat children receiving trauma therapy services at Safe and Healthy Families when appropriate.