The I.N.T.I.T Project
I.N.T.I.T. – Integrated Treatment and Services for Child Victims of Violence is a 24-month project co-funded by the European Commission DG Justice and Consumers.
Coordinated by the Psychoanalytic Institute for Social Research (IPRS) in Italy, I.N.T.I.T involves five other partners in five EU Member States: Christliches Jugenddorfwerk Deutschlands (Germany), Azienda Unità Sanitaria Locale Roma D (Italy), Tartu Ulikool (Estonia), University of Cyprus (Cyprus), and Asociacion Consensus (Spain).
I.N.T.I.T. works to better respond to the needs of child victims of violence and abuse via a coordinated effort to support systemic change, mutual learning and the expanded use of integrated, evidence-based trauma informed care (TIC).
I.N.T.I.T. recognizes the need to re-examine and improve the response of services and the justice system in order to prevent re-traumatization or re-victimization by the system while assuring that children and their families receive appropriate services, support
s and protections including child friendly justice.
First Transnational Best Practices: Barnahus and Trauma Informed Approaches
I.N.T.I.T. held its first Transnational Best Practices Exchange on March 17th, 2021 and March 26th, 2021 as an online Zoom Video Conference. The two-day event brought together 12 experts representing best practices in all five partner countries. Practices included Barnahus in Cyprus, Estonia, Germany, and Spain as well as various trauma informed/multi-agency approaches in Italy, Cyprus, Estonia, Germany, and Spain.
The exchange highlights the diversity of both Barnahus and other trauma informed/multi-agency within the EU. This diversity reflects both differences in local/national cultures and recognized needs as well as creativity in the development of uniquely suited solutions. This can even be seen in the development of Barnahus models that, while striving to adhere to the quality standards established by the PROMISE Barnahus Network of which all presented Barnahus practices are members.
Key considerations that emerged in relation to the various Barnahus models that are of notable relevance for other countries or areas considering adopting the model include:
- The reason for development and documented need (e.g., data showing the prevalence of abuse)
- The founding private organization(s) and/or public body and associated funding sources
- Private or public body assigned with the duty of managing the Barnahus
- Long-term sustainability and funding plans
- Multi-agency cooperation including the identification and involvement of all key actors in the areas within social services, law enforcement, prosecutor’s office, judiciary, and any other relevant external services
- The scope of the service and types of eligible offenses/abuse as well as the geographical reach
- The legal system and requirements regarding child testimony and the collection of forensic evidence
- Building choice which includes both the physical structure and its location within the community
- Referral procedures
- Means by which to establish a greater degree of child friendly measures, allowing for innovative approaches and greater inclusion of children in Barnahus design and operation
- Involvement of the family (siblings and non-abusing parents)
The practices presented adopted different approaches in regards to the issues specified above thereby demonstrating the potential for variety and unique adaptations. Common threads include a “start small” approach with the intent and aim of expanding beyond geographical limitations (e.g., only placed in one or more large cities) and restrictions on the types of abuse addressed that, in all countries except Germany, is limited to sexual abuse. There was also a quest for the incorporation of more child friendly and trauma informed aspects.
Other Trauma Informed and Multi-agency Approaches
Multiple other practices provide alternatives to the Barnahus model whether focusing on specific forms of abuse (such as the trauma informed care for victims of child sexual abuse offered by Foundation Meninos in Spain), or on victims of different type of violence offering specialized diagnosis and treatment for children who fall through the cracks of the system (Kind in Diagnostik in Berlin, Germany), using roundtables for ensuring multi-agency cooperation as utilized by social services in the Nonnes District of Tallin, assuring extensive multi-agency cooperation operating outside of a fixed Barnahus as done via the GIADA project in Italy’s Apulia Region, or early prevention policies such as Italy’s “First 1000 Days” policy.
Combined, these policies and practices demonstrate a growing sensitivity and awareness to the need for trauma informed care and services as well as the importance of multi-agency work in addressing child abuse and violence. Implementing them has and continues to require a shift in mentality and culture for individual professionals, services and public institutions who collectively are shifting the mindset both in relation to how the children and their families are viewed and how they – as professionals – can and should work together on a more even playing field based on cooperation, respect and mutual trust.
Fundamentally, the experts all demonstrated the need for professionals working with children exposed to child abuse and violence to develop specific trauma informed competences, with a focus on how all the professionals involved need to establish new connections with colleagues across sectors and services. Interagency cooperation agreements must move from paper to practice in order to make a difference and this depends both on the individual professionals involved and on the way services are managed. In addition to specific trauma informed skills, the exercise of professionalism by all involved represented a cross-cutting theme.
Country Focus – Italy
Italy has a regionalized approach to service provision leading to significant variety in the development and provision of services for child victims of violence within the country. While the trauma informed concept is relatively new, innovative actions have developed beginning with the creation of the GIADA project (www.giadainfanzia.it) in the southern Apulia Region. Initiated in 2004 in response to an appearance of previously unidentified child abuse and trauma within hospitals, the project has grown into a regionwide system for identifying child abuse and trauma, providing trauma informed and trauma specific care, and taking appropriate steps to ensure child friendly justice in cooperation with law enforcement and prosecutors.
At the national level, a preventive policy was established in 2018 focusing on the first 1000 days of life, beginning at conception. Entitled “The First 1000 Days”, the multi-agency policy aims to reduce the risk of child abuse and maltreatment as well as other problems (e.g., changing unhealthy lifestyles such as smoking and encouraging correct nutrition) via early intervention with parents to be and continued follow-up after birth.
Actions are being taken by the National Observatory on Childhood and Adolescence to develop a national plan and guidelines to treat child maltreatment and abuse.
Even if there are notable advances in some areas, overall Italy has a poorly defined framework to meeting the needs of child victims of violence in regards to policies, laws and approaches used. Italy lacks a system for the sharing of responsibility amongst all involved actors that places the child in the center while reducing and preventing the risk of secondary and repeat victimization. Italy has yet to construct a valid national instrument to collect and analyse child abuse and maltreatment data. In addition to highlighting a notable weakness in comparison to other countries, this failure to collect and analyse data compromises and delays the development and implementation of legislation and the adoption of effective policies.