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The Department of Pediatrics of the University of Arkansas for Medical Sciences (UAMS) has provided physical abuse evaluations at Arkansas Children's Hospital (ACH) since the late 1960's and sexual abuse evaluations at Arkansas Children's Hospital since 1981. The result of this experience is a collaboration of UAMS and ACH in the form of the Center for Children at Risk, an integrated medical, social, and psychological health care system for the whole family that has experienced child abuse. The Center for Children at Risk consist of two functional components, both of which incorporate teaching, clinical research and community service. They are the Team for Children at Risk and the Family Treatment Program.
Background of Drs. Jones and Worley
Dr. Jerry G. Jones, the Program Director, graduated from medical school in 1963, completed his pediatric residency in 1966, served a stint in the United States Air Force and was in private practice before joining the Department of Pediatrics at UAMS in 1978. Shortly thereafter, Dr. Jones was struck by the tragedy of children who suffered physical and sexual abuse. His deep concern manifested itself by raising awareness of other health care providers to the needs of these children at risk. By 1986, he had established the Team for Children at Risk to evaluate and treat abused children at ACH. His passion for their needs put him at the forefront of professionals dealing with this problem. In 1992, a group of concerned citizens, touched by his dedication and ministry to abused children, garnered financial assistance to create the Arkansas Children's House for identification, medical and psychosocial evaluation, and treatment of sexually abused children.
Dr. Jones came to see that abused children and their families suffer a special kind of emotional trauma. He understood it was imperative to address the long-term needs of abused children, as well as those in their families who are devastated and struggling to provide support for their children. The Family Treatment Program was the response to that vision. Dr. Karen Worley, a Ph.D. trained psychologist with over 20 years experience in working with abused children, was recruited to direct the Family Treatment Program the same year the Children's House opened its doors.
For the last ten years, Drs. Jones and Worley have been outspoken advocates for physically and sexually abused children in Arkansas. Their expertise is much in demand by children's advocacy groups and lawmakers. Both she and Dr. Jones frequently are called to testify as expert witnesses in court. They have focused on the problems of child abuse and have made a difference. The hurting children of Arkansas have been beneficiaries of their concern and tireless energy. Almost single handedly, they have built an excellent model for meeting many of the needs of abused children.
Team for Children at Risk and the Arkansas Children's House
The Team for Children at Risk consists of a physician director, two part-time physicians, a nurse practitioner, clinic coordinator, and masters level social workers. They provide gentle evaluations of physically and sexually abused children, as well as attention to safety, crisis intervention for their families, and appropriate referrals.
Their outpatient services are provided in the Arkansas Children's House, the only center in Arkansas devoted to the medical evaluation and management of physically and sexually abused children. Since it opened in 1992, over 4,500 children have received comprehensive evaluations and management. Located on the block in front of Arkansas Children's Hospital, the Children's House is a cozy red brick facility that provides an appropriate place for the evaluation of abused children. The interior features homey furnishings in a pleasant waiting room, as well as child friendly exam and interview rooms. The atmosphere is warmer and more reassuring than one finds in a hospital emergency department, state agency office or police station, creating a needed sense of safety and security for the children.
Children who are suspected of having suffered abuse are referred to the Children's House by law enforcement agencies, prosecuting attorneys, courts, community physicians, the Arkansas Department of Human Services, school nurses and health department clinics in 40% of the counties in Arkansas. Professionals from these agencies work together with professionals of the Children's House, and those from Pulaski County meet weekly to discuss referred cases.
The medical evaluations in the Children's House provide both health and evidentiary (forensic) information. The sexual abuse examinations are performed using a colposcope, a state of the art device that provides magnification. The post-exam management utilizes a comprehensive medical, social, and psychological approach.
The Team for Children at Risk provides consultations on all physically abused children at requiring hospitalization at ACH, about 80 infants and young children each year. In spite of superb multi-specialty medical care, 40% of these children have permanent injuries or die. We relate closely with law enforcement and the Arkansas Department of Human Services on these cases.
The Team also administers an organized training curriculum for medical students and resident physicians in the evaluation of physically and sexually abused children. An attorney on contract with the Department of Pediatrics provides consultations to the residents and team members and presents teaching conferences regarding court testimony. A survey revealed that our residents have excellent attitudes toward their responsibility to testify in court.
Arkansas Children's House Brochure
The Family Treatment Program grew out of the awareness that family involvement is an integral part of psychological evaluation and treatment. It is unique in Arkansas in its specialization in abuse-focused treatment and management of within-family child sexual abuse. Referrals are from the Arkansas Department of Human Services, juvenile courts, Arkansas State Police, local law enforcement units, prosecutors, attorneys ad litem, victim assistance coordinators, schools, physicians, probation officers, mental health agencies, other concerned professionals, and the families themselves.
Since opening in 1991, the Family Treatment Program has provided evaluation and treatment for over 450 victims of child sexual abuse and their families. Collateral services were provided for the parents of all these children, with more intensive services for 70 secondary victims. Secondary victims are family members who also are suffering from the effects of the child sexual abuse and include non-offending parents, siblings, and grandparents of the molested children.
Specialized services in the Family Treatment Program include individual, family, and group therapies for victims, non-offending parents, and non-abused siblings. Treatment is delivered by a multidisciplinary team comprised of two doctoral level psychologists, including the director, and three social workers. Many of the families are coping with other serious problems directly related to the discovery of the sexual abuse including loss of a home, reduced income, and family conflict. Child physical abuse, domestic violence and substance abuse are often present. Treatment planning must take into account all these issues in order for the family to be able to cope effectively with the child's sexual abuse. The therapists must also work with community agencies to coordinate services for children and to minimize system trauma for the child and family.
The Arkansas Sexual Adjustment Project (ASAP) is a specialty treatment program within the Family Treatment Program for treatment of children and adolescents with sexual behavior disorders (e.g. child molesting). This treatment is critical in reducing the risk for re-offense. ASAP has been operational since 1995, during which time, over 175 patients have been seen for treatment and more than 700 have been assessed for treatment.
Family Treatment Program Brochure
Center for Children at Risk University of Arkansas for Medical Sciences Department of Pediatrics Arkansas Children's Hospital 800 Marshall St. Little Rock, AR 72202 (501) 364-1013 |
