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Forensic, or medico-legal evaluation of the abused child, includes a comprehensive history taking from the caregiver or companion, including an investigation into the personal and socioeconomic conditions of the family. A comprehensive pediatric examination follows, including examination of the genital and anal exam with a colposcope, with photographic documentation of all extragenital and genital findings. Necessary forensic and medical examinations are done: microscopic examination for sperm, gathering specimens for forensic analysis, testing for sexually transmitted diseases, performing other pertinent laboratory examinations, and referring to indicated medical specialties or subspecialties within the hospital.
VIDEOTAPED FORENSIC INTERVIEW
If indicated, a trained forensic interviewer, either a physician or policewoman, conducts a videotaped investigative interview of the child. The forensic interview protocol is both child-friendly and non-retraumatizing, and in adherence with legal guidelines for collecting evidence. Other members of the team like the social worker or lawyer observes thru a monitor in another room. The social worker is in charge of videotaping the interview. The lawyer also observes the interview and asks clarificatory questions through the forensic interviewer, if necessary. The video tape may then be presented in a court of law.
FORENSIC PSYCHIATRIC EVALUATION
The CPU has the only forensic child psychiatrist in the country. The Forensic psychiatrist testifies in court with regards her findings. The forensic evaluation entails at least three visits to the Forensic Psychiatrist.
FORENSIC SOCIAL WORK
Some cases call for the CPU social worker to work with the Family court and to submit her case study reports to the court. She can also be called upon to testify in court.
The police officer conducts crime scene investigations and collateral interviews in criminal cases e.g. Shaken Baby Cases.
CONTINUITY OF CARE AND WELL-CHILD SERVICES
Patients of the CPU can also avail of regular medical check-ups performed at CPU. This service ensures that the physical well being of the patients is being monitored. This includes routine vaccination for children or adolescents who have missed the necessary immunizations, including reproductive health counseling for sexually active adolescents. Missed appointments or recurrent injuries or illness may serve as red flags for continuing abuse or neglect.
DIAGNOSIS & TREATMENT OF SEXUALLY TRANSMITTED DISEASES
Patients are screened for STIs. For diagnosed STI cases, the CPU can provide free medication for treatment. Parents are referred to the PGH Infectious Disease Clinic for testing.
A staff developmental pediatrician performs developmental screening of CPU patients who have special needs. For children 9 years old and below, determination of the mental ages is done specifically by using the Griffith’s Mental Development Scales for Children, an internationally recognized assessment tool. Children diagnosed with developmental disabilities are referred to specific for educational and therapeutic services to address their special needs.
MENTAL HEALTH SCREENING
Child psychiatrists or child psychologists screen CPU patients for any psychopathology having arisen due to abuse. This screening also includes an interview and evaluation of the parent or caregiver in an effort to uncover any mental health concerns that also impact their capacity to care for the child
THERAPY FOR CHILDREN AND FAMILIES
- Abuse-specific therapy for Children
- Individual Psychotherapy and Pharmacotherapy
- Psychodynamic psychotherapy
- Insight oriented psychotherapy
- Cognitive – behavioral psychotherapy
- Supportive psychotherapy
- Trauma – specific psychotherapy
- Problem – solving psychotherapy
- Play therapy for younger children
- Group therapy for older children and adolescents
- Parenting education
- Psychotherapy depending on diagnosis including pharmacotherapy
- Therapy for Parents
- Family Therapy
- Therapy for children with problematic sexual behavior
GROUP WORK ACTIVITIES
Group therapy for sexually abused children of same developmental age who, while not yet fulfilling diagnostic criteria, were considered high risk for psychopathology because of the abuse. A total of sixteen sessions were conducted. Issues discussed at these sessions included self-awareness, self-esteem, motivation, family issues, stress, and crisis.
BEHAVIOR MODIFICATION TRAINING
To maintain the consistency of approach to concerns regarding problematic children’s behavior, the CPU Psychiatrist conduct training sessions on behavior modification for partner government institutions and NGOs. The training curriculum include follow-up monitoring of the trainees for compliance with behavior modification and troubleshooting.
CPU social workers determine the child’s immediate safety in his or her present placement using set criteria. When necessary, children are placed in protective custody with relatives, non-government or government-run shelters.
Social workers conduct home visits for all Metro Manila patients to assess the risk for re-abuse, validate information and to assess other needs that the family may have.
Case management is the systematic and structured helping process to help individuals regain self-confidence and become functional in society. If such task requires that the family also be strengthened, then plans for the family’s welfare become part of case management. Among the diverse areas addressed by case management are safety of child’s placement, legal assistance, mental health assistance of patient and youthful offenders, as well as coordination of services provided. Case conferences are held within the CPU and with partner agencies as well. The partner agencies include government and non-government organizations.
CPU holds regular parenting classes to teach parents the basics of child development and behavior. The objective of these sessions is to help the parents manage their expectations of their children, to help them understand their children’s behavior and to adjust their methods of discipline in the context of what they have learned. Child Psychiatrists recommend attendance at these sessions as a form of intervention as well as prevention for child physical abuse. Three categories of parenting classes are now offered: Basic Parenting, Advanced Parenting and Seminars for Parents of Minor Offenders.
PARENT SUPPORT GROUP
A venue for parents of PGH-CPU patients to share information on prevention of re-abuse and increase coping skills, while decreasing feelings of isolation and providing encouragement and hope.
A strategy to prevent re-abuse in children and strengthen families by helping individual members understand and improve their processes of interaction and conflict resolution.
Since 2001, the livelihood assistance program aims to reduce stressors within the family by providing interest-free loans to patients’ families demonstrating both need and the willingness to create small-scale businesses. Social workers coordinate with recipients’ barangay councils to monitor repayment of loans.
Since 2001, CPU provides educational assistance for abused children of very poor families. Each grant covers the cost of enrolment, transportation to and from school, and school uniforms. Social workers work with local government units to monitor the progress of recipients and to initiate activities, such as parenting classes, support groups and advocacy sessions, for recipients’ families.
LEGAL COUNSELING FOR INDIVIDUAL CHILDREN AND THEIR PARENTS
- Children and their families receive education regarding rights as well as the procedures of the criminal justice system.
- The justice system in the Philippines is such that during the preliminary Investigation, the prosecutor acts like a judge in deciding whether there is probable cause to file the complaint in court. It is during this stage that the child victim has the most need for a private lawyer to help her.
LEGAL EXPERTISE AT CASE CONFERENCES
- Monthly multi-disciplinary case conference with the Manila Social Welfare and Development Office (MSWDO)
- Case conferences with government agencies and NGO’s
- Conduct of family legal case conference
PREPARATION OF LEGAL DOCUMENTS
- supplemental-affidavits, reply-affidavits, supporting affidavits of witnesses, affidavit revoking affidavit of desistance, motion to reopen case, motion to inhibit investigating prosecutor, pre-trial brief, manifestations, and formal notice of protective custody
ASSISTANCE TO PARENT VICTIMS OF DOMESTIC VIOLENCE
- Referral of domestic violence-related cases to women legal NGO’s and the Public Attorney’s Office for legal assistance
MENTORING OF POLICE
- strategizing with police regarding filing of cases at Prosecutor’s Office and Preliminary Conferences
- legal mentoring of police trainees
Since 2004, a policewoman from the Philippine National Police has been detailed at the PGH CPU. Her jurisdiction is nationwide, giving her the authority to investigate cases from anywhere in the country. With her presence, the CPU has become more of a one-stop-shop in offering services for abused children. In addition to forensic services, the policewoman’s functions include the following:
ON-SITE CASE FILING
The Police at CPU conducts forensic interviews and submits the “Sinumpaang Salaysay” (Sworn Statement) to the prosecutor.
PRELIMINARY INVESTIGATION HEARINGS
The Police officer attends preliminary investigation hearings and testifies in court.
SUBMISSION OF POLICE REPORTS FOR BOARD OF CLAIMS
The CPU police officer submits the report requirements of the Department of Justice Board of Claims for victim assistance.
TRAINING OF OTHER POLICE OFFICERS
The Police officer stationed at CPU serves as the trainor for police trainees who are part of multidisciplinary teams.
CHILD SUPPORT DURING LEGAL PROCEEDINGS
Kids in Court was introduced in 2003. It aims to prepare children who need to testify in court by educating them on their rights, orienting them and their parents/ caregivers on basic court proceedings, and helping normalize their feelings, experiences, and struggles before going to court. Activities include an interactive Powerpoint presentation on Children’s Rights, Feelings, and What Children Expect to See in the Courtroom; a small group discussion about feelings and experiences; and a tour of a Family Court where they meet the Judge and the court staff.
OFFENDER CASE MANAGEMENT
- Mental Health Services for child offenders of sexual abuse
- Individual therapy (1to 6 sessions)
- Group therapy (5 sessions for groups of 5 to 6 children)
- Parenting classes
- for parent offenders
- for parents of child offenders