CAC Model

Dedicated to Breaking The Cycle of Child Abuse
What is a CAC?
(Child Advocacy Center)

MCS Child Advocacy is Accredited by the NATIONAL CHILDREN'S ALLIANCE (NCA).

About National Children's Alliance & CACs
NATIONAL CHILDREN'S ALLIANCE (NCA) is the national association and accrediting body for a network of 795 Children’s Advocacy Centers—CACs. We provide support, advocacy, quality assurance, and national leadership for CACs, all to help support the important work that CACs do in communities across the country. CACs provide a coordinated, evidence-based response to child victims of abuse.

Our mission is to promote and support communities in providing a coordinated investigation and comprehensive response to child victims of abuse through child advocacy centers and multidisciplinary teams.

Why do children need Children's Advocacy Centers?
An estimated 1,564 children died from abuse and neglect in the United States in 20141, the most recent year for which there is national data. But child abuse fatalities are not the only consequences of abused children suffer. Sexual abuse, physical abuse, an neglect are forms of Adverse Childhood Experiences (ACEs) that researchers have linked to mental health problems, such as mood disorders, anxiety, substance abuse, and impulse control disorders.2 Child abuse often co-occurs with other ACEs, like witness to domestic or community violence, traumatic loss or separation, or sexual assault. Adults with multiple ACES have even been shown to be more likely to endure poor health outcomes like diabetes, STDs, heart disease, and early death.

In short, without intervention, child abuse causes lifelong problems.

But Children’s Advocacy Centers help kids by providing them with justice and healing from their abuse in a child-friendly setting they can trust. In addition to helping collect forensic evidence to help law enforcement and CPS protect children from abusers, CACs coordinate a complete response to the needs of a child after abuse. Last year, CACs around the country served more than 311,000 child victims of abuse, providing forensic interviews, evidence-based mental health treatments that are proven to reduce symptoms, case management, victim advocacy services, and more.

What is a CAC?
CACs are how communities mount a coordinated response to allegations of child abuse. To understand what a CAC is, you must understand what children face without one. Without a CAC, the child may end up having to tell the worst story of his or her life over and over again, to doctors, police, lawyers, therapists, investigators, judges, and others. They may not get the help they need to heal once the investigation is over, either.

When police or child protective services believe a child is being abused, the child is brought to the CAC—a safe, child-focused environment—by a caregiver or other “safe” adult. At the CAC, the child tells their story once to a trained interviewer who knows the right questions to ask. Then, based on the interview, a multidisciplinary team (MDT) that includes medical professionals, law enforcement, mental health providers, prosecution, child protective services, victim advocates, and other professionals make decisions together about how to help the child. Finally, they offer a wide range of services like therapy, medical exams, courtroom preparation, victim advocacy, case management, and more.
Diagram: Without CACs, children and families have difficulty connecting to services. With CACs, services are coordinated and aligned to serve children and families.
How do we know it works?
We know the services CACs provide work because the evidence shows it does.

Evidence from studies of mental health treatments

In a collaborative partnership among NCA, The Duke Endowment, Yale University, Children’s Advocacy Centers of North Carolina, and the South Carolina Network of Children’s Advocacy Centers, we launched an initiative to bring a promising, evidence-based treatment to children in the Carolinas who needed it. The Child & Family Traumatic Stress Intervention (CFTSI) has already demonstrated significant results. NCA will expand this important work in the coming years.

In this ongoing project, many children came in presenting high levels of Post-Traumatic Stress Disorder (PTSD) symptoms. Caregivers also reported that their children had high levels of PTSD symptoms, as well as other problems like nightmares, feeling scared, feeling worried, or having trouble concentrating in school, feeling lonely, not wanting to play, and having intrusive thoughts.
Diagram: Kids and Caregivers report kids have fewer PTSD symptoms after trauma treatment at CACs | Child reported PTSD Symptom Score, reduced from 20.86 to 8.96 after treatment | Caregiver-reported PTSD Symptom Score, reduced from 13.79 to 6.52 after treatment.
In the chart above,the Child PTSD Symptom Scale (or CPSS, a common PTSD assessment for kids), shows the average child- and caregiver-reported symptom score before and after receiving the CFTSI therapy. Researchers and clinicians agree that scores of 11 or higher reflect significant distress, and indicate that a child may eventually qualify for a diagnosis PTSD upon further assessment. Children with scores of 15 or higher are almost certain to meet the full criteria for PTSD.

Children treated through this program whose symptoms were assessed before receiving CFTSI reported an average score of 20.86. On average, children reported high levels of trauma symptoms at the time they were first seen at the CAC. Following the brief mental health treatment, children and their caregivers both reported much lower levels of symptoms. Children reported with an average score of 8.96, which is below clinically significant levels.

  • Responses from caregivers
Children are usually brought to CACs by caregivers, who will support them in the months and years ahead as they recover from the abuse. NCA provides a standardized tool called the Outcome Measurement System (OMS) to CACs to collect feedback from caregivers and team partners to ensure CACs are doing the best possible job to support children and their families. 580 CACs participate in this program to ensure they are providing the highest quality care to caregivers.

  • Caregivers and kids feel safe
95% of caregivers agree their children feel safe at CACs.

  • Caregivers feel informed
By the end of the first visit, 93% of caregivers report they know what to expect with the situation facing them and their children. Weeks later, 92% of caregivers still agree that, as a result of their contact with the CAC, they knew what to expect in the days and weeks after their visit.4 93% of caregivers agree they received information that helped them understand how to best keep their children safe in the future.4

  • Caregivers and kids leave feeling better
96% of caregivers agree, if they knew anyone else who was dealing like a situation the one their family faced, they would tell that person about the CAC.
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