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R. Oral MD University of Iowa, Child Protection Program

Establishment of Interdisciplinary Child Protection Teams in a Traditional Society: Experience in Turkey 2001-2010.

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R. Oral MD University of Iowa, Child Protection Program

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  1. Establishment of Interdisciplinary Child Protection Teams in a Traditional Society: Experience in Turkey 2001-2010 Contributors: A. Akin, S. Aksit, C. Aydin, A. Balseven, A. Baransel, U. Beyazova, F. Beyastas, O. Bezirci, B. Buken, E. Buken, A. Camurdan, A. Celik F. Cuhadaroglu, T. Dagli, B. Demirel, O. Derman, Y. Ersahin, N. Gazioglu, B. Gökler, S. Gulnar, M.A. Inanici, E. Iseri, A. Karaoglan, F. Koc, F.S. Orhon, C. Özbesler, D. Ozdemir, F. Pasli, F. Sahin, U. Tiras, A. R. Tumer, B. Ulukol, R. Uslu, F. Yagmur, S. Yalcin, S. Yaylaci, C. Yorulmaz, K. Yurdakok R. Oral MD University of Iowa, Child Protection Program ISPCAN 12th European Conference Tampere, Finland 2011

  2. Glossary • TSPCAN: Turkish Society for the Prevention of CAN • ICCR: International Convention on Children’s Rights • TMA: Turkish Medical Association • MDT: Multi-disciplinary team • PA: Physical abuse • EA: Emotional abuse • HS: High school • SA: Sexual abuse • CAN: Child abuse & neglect • UMSH: University Medical School Hospital • CH: Children Hospital • UI: University of Iowa • CPP: Child Protection Program • CAC: Child Advocacy Center • NGO: Non-governmental organization • CPT: Child Protection Team

  3. Problems in CAN in Turkey • Lack of structured national prevention program • Lack of comprehensive child protection law • Lack of comprehensive definition of CAN • Professionals lack: • Awareness, knowledge, willingness to recognize & report CAN • Inadequate resources for CAN • Lack of collaborative mind-set

  4. University of Iowa Child Protection Program • Mission : • … • Professional education • International education in developing countries • Focus on Turkiye • Portugal • Pakistan • Greece

  5. University of Iowa (2001-2011) • National Collaboration established involving UMSH/CHs in Turkiye • Establish culturally competent, interdisciplinary training activities annually on CAN • To train the trainers: 5 faculty trained in USA • To motivate establishment of multidisciplinary teams:~ 30 MDTs established in 17 provinces

  6. Training Activities (2002-2011) • National conference every year, 2-6 in-service courses/symposia/workshops annually • Focus: Ankara (most advanced teams and policy makers/government) • Secondary focus Izmir & Istanbul • Tertiary focus: Peripheral small provinces

  7. Training Activities (2002-2011) • ~8000 professionals participated • Medicine, mental health, nursing, public health, social work, education, law enforcement, prosecution, NGOs, government, policy makers, prevention…

  8. Outcome of Training Activities (2002-2011) • Regional MDT organizations improved • 5 faculty trained at the UI CPP for 1-6 months • Hospital CPPs are establishing databases • Numerous international peer reviewed publications

  9. Clinical Research in CAN & system response to professional developments Research Clinical translation 1990 1995 2000 2005 2010

  10. Outcome of Training Activities (2002-2011) • Regional MDT organizations improved • 5 faculty trained at the UI CPP for 1-6 months • Hospital CPPs are establishing databases • Numerous international peer reviewed publications • Policy makers and government involved • Bill on CAC-based child protection response to sexual abuse being debated in parliament

  11. Clinical Research in CAN & system response to professional developments 1990 1995 2000 2005 2010

  12. Most structured Child Protection Teams and Centers at metropolitan universities Other CPTs established as a result of UI CPP activities Other international semi-structured CPTs established independent of UI CPP’s activities ANKARA Distribution of the current structured and semi-structured hospital- based child protection teams (CPT) in Turkey.

  13. One case can make a difference… * Newspaper columnist, supporting government * Sexually abused a 14 y/o * Government tried to cover it up * Child psychiatrist exposed government * Two parliamentarians reached out to collaboration * Collaborative drafting of a bill for CAC model

  14. Ankara U MDT Betul Ulukol Policy makers UI MDT Resmiye Oral Child Psychiatrist A. Erdogan

  15. Ministry of Health MoHealth MoJustice MoInterior MoSocialS MoEducation MoLabor CourtofAppeals MoCommunication Ankara University University of Iowa INTERMINISTERIAL HIGHER COUNCIL

  16. ANKARA Ankara CIM=CAC: 11/2010 Figure 2. Distribution of the current structured and semi-structured hospital- based child protection teams (CPT) in Turkey.

  17. Ankara CIM=CAC • Higher council meets every 3 months • Provincial government established regional child abuse task force similar to higher council • Task Force meets every 2 months to refine protocols and emerging needs, reports to higher council

  18. Ankara CIM=CAC • CIM staff consists of • 1 forensic med physician, 1 pediatrician, 1 child psychiatrist • 3 psychologists (forensic interviewers) • 2 social workers (child advocates) • 1 secretary and 1 security staff

  19. Ankara CIM=CAC • Ankara prosecutor’s office, Regional Social Services, law enforcement each has a staff during hours on site • To contribute to forensic interview • To guide psychosocial evaluation • To be part of decision making • To initiate community case-management on-site

  20. Ankara CIM=CAC • Ankara population= 4.5 M • Child population ~ 1-1.5 M • Ankara CIM/CAC is receiving 4-5 cases a day • Still the tip of iceberg!

  21. Current goals for 2010-2015 • Integration of the pilot Child Advocacy Center Model into Child Protection Law • Disseminating the model to all provinces (2013-2014) • Development of a National Database for case and offender tracking • Enhancing government efforts on implementing ICCR

  22. ANKARA Ankara CAC: 11/2010 … Pilot CACs: 2011-12 Figure 2. Distribution of the current structured and semi-structured hospital- based child protection teams (CPT) and proposed CACs.

  23. Certified personnel • Ankara UMS and MoHealth staff are working on developing a licensing program to train and license • Physicians • Forensic interviewers • Child advocates • Ankara CIM will become national educational center

  24. Pts 03 Hzr 2002, 05:15   Türkiye iller haritası In 2013-2014: Nationwide dissemination of the model

  25. Future implications • Integrate university CPCs into MoHealth network of CACs • Collaboration between University CPCs and CACs to conduct research • Assess efficacy and issues • Re-evaluate model and improve cultural competency

  26. Thank you. Resmiye-oral@uiowa.edu

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