The purpose of this document is to present the rules for legally, professionally, and ethically sound practices at BHIDAPA, with the goal of protecting children exposed to or at risk of violence, abuse, and neglect, and in their best interests.
This is based on:
- on the valid legal regulations in Bosnia and Herzegovina and the Convention on the Rights of the Child
- on the relevant findings regarding all forms of abuse (physical, sexual, emotional), neglect, and exposure to family and peer violence among children and young people, as well as the consequences for children.
- on expert knowledge of the traumatisation of children and young people, and evidence-based knowledge of diagnostic and treatment/therapeutic work with traumatised children, young people, and their families.
BHIDAPA was founded with the aim of protecting children, young people, and families
- providing education for specialists in the field of child and adolescent integrative psychotherapy and psychotherapeutic counselling, techniques, and skills for working with children through lectures, workshops, and training in accordance with European standards;
- interdisciplinary diagnostics and treatment (psychiatrists, psychotherapists, clinical psychologists, paediatricians, social pedagogues, defectologists/speech therapists, social workers, lawyers)
- continuous supervision of professionals who work with children, young people, and families, conducted by authorised supervisors and educators regulated by EIATSCYP (European Interdisciplinary Association for Therapeutic Services for Children & Young People) and EAP (European Association for Psychotherapy);
- protective measures for traumatised, abused, and neglected children, children at risk of abuse and neglect, and children and young people in conflict with the law, with the aim of establishing and implementing multidisciplinary diagnostics and team-based planning for the best possible treatment for each child and parent, with coordinated cooperation with other mental health professionals and intersectoral cooperation in the best interest of the child and their well-being
- the publication of scientific journals, manuals, brochures, and promotional materials, with the aim of promoting children’s rights, health determinants, and raising awareness in society—especially among professionals—about the seriousness of the problem of child abuse, the possibility of recognition, and the provision of appropriate help and support, and raising public awareness about the importance of preserving and improving the mental health and quality of life of children, adolescents, and families
- orientation towards the development or promotion of psychotherapeutic science in accordance with European standards;
The activities of BHIDAPA are carried out based on existing legal regulations and professional standards, scientific knowledge, experience, and practice. They follow the model and receive support from the “Poliklinika za zaštitu djece i mladih Grada Zagreba” (Child and Youth Protection Centre of Zagreb) and cooperate with other systemic institutions. This ensures a specialised team approach for the most efficient and humane resolution of a child’s difficulties.
Current valid legal regulations
In Bosnia and Herzegovina, the work of the Association and the Institute is based on the following:
- Convention on the Rights of the Child,
- Convention for the Protection of Human Rights and Fundamental Freedoms,
- European Convention on the Exercise of Children’s Rights,
- Convention on Human Rights and Biomedicine, as well as other regulations and protocols that establish procedures for contact with children, and the positive experiences of other organisations and institutions working with children,
- The Constitution of BiH, and a number of laws that deal with this area (Law on Protection Against Domestic Violence, Family Law, Criminal Code, Law on the Protection of Patients’ Rights, Law on Health Care, Law on Medical Practice, Law on the Protection of Personal Data),
- the BHIDAPA Statute, which, among other things, regulates the practice of the Ethics Committee,
- the Protocol on Procedures in Cases of Sexual Violence, which sets out standardised procedures for the protection of victims of sexual abuse for all professionals of various profiles from various institutions,
- Protocol on Procedures in Cases of Child Abuse and Neglect,
- Protocol on Action in Cases of Domestic Violence
- Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse,
- Directive 2011/93/EU of the European Parliament and of the Council of 13 December 2011 on combating the sexual abuse and sexual exploitation of children and child pornography,
- Directive 2012/29/EU of the European Parliament and of the Council of 25 October 2012 establishing minimum standards on the rights, support, and protection of victims of crime.
BHIDAPA is also a signatory member of the EIATSCYP.
The purpose of BHIDAPA
- to provide effective, timely, and well-coordinated support to children and their families,
- to ensure respect for the best interest of the child,
- promotion of children’s rights,
- promotion of the determinants of children’s health and well-being
- to ensure protective measures against abuse and neglect, through the recognition, education, and response to the abuse and neglect of children, as well as the prevention of violence against children, in accordance with the law.
These principles, as well as the adherence to legal and professional standards, apply to and are binding for every employee/volunteer and student of BHIDAPA.
Activities of BHIDAPA Centres
Interdisciplinary Therapeutic Centre for the Protection of Children, Youth, and Families
Diagnostic and therapeutic work
The Centre provides a specialised team approach to children, young people, and parents. The multidisciplinary team consists of: psychotherapists, psychologists, a clinical psychologist, psychiatrists, a social pedagogue, a special education teacher, and a lawyer. Through expert teamwork, the child is approached using the specific knowledge and skills of each professional. The work is multidisciplinary and coordinated to ensure the greatest benefit for the child, with each expert contributing directly or indirectly to better diagnosis and treatment planning according to the individual needs of each child.
BHIDAPA also conducts case supervision led by a psychiatrist and a psychotherapist.
Other activities
The work of BHIDAPA Centres includes preventive activities at all three levels.
- The primary level includes providing a specialized educational program for acquiring academic and professional skills in the field of child and adolescent integrative psychotherapy and counseling. Primary level educational prevention is also achieved by raising public awareness among parents and children, professionals who work with children, and the general public, including social structures that have the opportunity to contribute to the protection of children, through professional seminars, workshops, and training.
- The secondary level of prevention is carried out by the experts of the Interdisciplinary Therapeutic Centre for the Protection of Children, Young People, and Families through continuous education, individual work, supervision, and daily work with children and families who, due to personal characteristics or unfavourable conditions of growing up, are at increased risk of exposure to various forms of abuse or neglect.
- The tertiary level refers to the treatment of children who have experienced some form of violence, with the aim of minimising the consequences and preventing revictimisation by focusing on their recovery.
All the above activities are carried out through:- Professional training
- Teamwork and supervision
- Crisis intervention team
- Research and scientific work
- Public awareness-raising and publications
The procedure in direct work with children (diagnostics and treatment) in cases requiring child protection (suspected abuse and neglect, and exposure to violence).
- The child comes to the Centre accompanied by a parent/legal guardian: either at the initiative of the parent/guardian or on the recommendation of the relevant doctor, the Social Welfare Centre, or other institutions (school, kindergarten, home, NGO, etc.).
- The process begins with an initial interview with a specialist from the multidisciplinary team, who then assesses the situation and the need to involve other professionals in the team. In cases of suspected abuse, neglect, domestic violence, etc., the urgency of admission is assessed by evaluating the child’s level of protection.
- The interview is conducted by speaking both with the person accompanying the child and with the child. Where possible, in cases of suspected abuse, the child and the parent are interviewed separately, always prioritising the best interests of the child and reducing the risk and stress of the situation for them. Handling such a situation is the responsibility of a mental health professional and is carried out in accordance with professional guidelines for working with children of different ages, as well as their individual characteristics and needs. The first interview also includes providing psychological first aid to the child and the parent, due to the potentially traumatic nature of the events the child has been exposed to. After the interview, the parent is informed of the next steps in the procedure. The child is also informed, in a way appropriate to their developmental stage and in accordance with their right to information under the Convention on the Rights of the Child.
- The collection of relevant documentation is most often carried out in cooperation with the Social Welfare Centre, after the first meeting (by sending a notification along with a request for information). Cooperation with other institutions is also possible for the purpose of protecting children and obtaining relevant information (SWC, police, schools, preschool institutions, other healthcare institutions, etc.).
- Data collection and reporting
If, during the interview or assessment process, information is obtained indicating suspicion that the child has been exposed to some form of domestic violence (directly or indirectly), the professional informs the relevant institutions: the Police Department and the Social Welfare Centre in the child’s place of residence, and sometimes also the State Attorney’s Office.
When establishing suspicion, professionals rely on information obtained through the application of their professional knowledge and competencies in working with the child and their family.
For this purpose, professionals from the multidisciplinary team conduct, where necessary, a forensic interview and forensic evaluation, or elements of these procedures, for which they are specially trained.
The notification sent to the relevant institutions contains general information about the child, the reason for their arrival at the P.E.R.L.S. Association, and the name of the person or institution that referred the child.
It also describes the progress of the assessment so far and the findings obtained (the child’s statements), any injuries, and any other relevant information based on professional assessment.
In cases where suspicion of the child’s exposure to violence cannot be confirmed with certainty (due to the child’s young age, developmental limitations or condition, refusal to talk, family factors, etc.), but further risks to the child are observed, the relevant institutions are also notified with an appropriate recommendation.
If, at the very first contact with the child, their exposure to an immediate danger is established, as well as possible lack of protection outside the Association’s premises, the professional immediately contacts the relevant institutions (SWC, police) due to the urgency of acting to protect the child. - Assessment
The professional who initiated the assessment informs the team leader and other team members of the information obtained so far and the assessment carried out, as well as the indications for the agreed team-based assessment. During a joint meeting, under the leadership and coordination of the team, additional joint decisions are made, and agreements are reached regarding the further implementation of diagnostics and the planning of treatment for each child. The planned treatment should be communicated to the parent/legal guardian and to the child themselves in a manner appropriate to their developmental age. - Processing
The professional who initiated the assessment informs the team leader and other team members about the information obtained so far and the procedures carried out, as well as the indications for the agreed team-based assessment. During a joint meeting, under the team’s leadership and coordination, additional collective decisions are made, and agreements are reached on the further implementation of diagnostics and the planning of treatment for each child. The planned treatment must be communicated to the parent/legal guardian and to the child, in a manner appropriate to their developmental stage. Informing the guardian and the child
Once the assessment has been completed, or during its course, the parent/guardian is informed about its progress and results, as well as recommendations for further action. The child receives information in accordance with their developmental stage. - Joint findings and opinion
Each team member prepares their own report and opinion, which also includes recommendations for further action and possible treatment of the child and their family. The joint findings and opinion contain information on the child’s somatic/physical condition, developmental and intellectual characteristics, psychological profile obtained through diagnostics, the conditions and dynamics in which the child is growing up, characteristics of their social and emotional development and competencies, degree of trauma, any psychopathology and difficulties, personal and family risk factors, and any suspicion of witnessing or being exposed to abuse/violent behaviour within the family or another environment.
The opinion includes a recommendation for participation in one or more treatments at the Centre or in another institution. The report also contains recommendations regarding the need for the parents’ involvement in counselling or treatment, as well as for the possible inclusion of the assessed child’s siblings in the process if their risk of trauma is identified. The report may also include a recommendation for further protection of the child.
The report and opinion are issued to the child’s parents unless a potential conflict of interest between the child and the parents is identified, such as when the parent is the source of the child’s trauma and might misuse the report to apply further pressure on the child. In such cases, the report is sent to the relevant Social Welfare Centre, acting in the child’s best interests and in accordance with the professional code of ethics of the professions involved.
If there is suspicion that the child has witnessed domestic violence or has been directly exposed to it, the report is sent to the relevant Social Welfare Centre, and a notification is sent to the police (if it has not already been sent at the start of the process). The report can also be sent to the police and the court, in accordance with the law, upon their written request. - Cooperation with other institutions during and after the completed assessment
In cases where parents are unwilling to cooperate during the assessment, assistance from the relevant Social Welfare Centre is required. For the child and their ongoing protection, it has proven particularly important to avoid repeated questioning, which can contribute to further potential trauma.
In some instances, it is necessary for the relevant Social Welfare Centre to introduce certain measures, or for court decisions to be made, in order to provide the child with the necessary protection and to create safe and stable conditions for their participation in appropriate treatment. Cooperation is often also required when parents refuse to take part in treatment or counselling, especially when they neglect their role and parental responsibilities.
In all of these cases, the professional from the Centre for the Protection of Children, Young People, and Families notifies the relevant Social Welfare Centre and requests cooperation in the process. - Treatment of children exposed to trauma
A multidisciplinary approach is the most effective model for both identifying the child’s needs and determining their further treatment.
The treatment of children uses the most effective methods and therapeutic approaches based on evidence of effectiveness: humanistic approaches (integrative psychotherapy, Gestalt therapy, art therapy, play therapy, EMDR), TF-CBT, and the psychodynamic model. Parents/guardians are regularly involved in the child’s treatment through counselling, as family and close-person support has proven to be a primary protective factor.
Contrary to the long-established belief that a child should not begin treatment before the completion of court proceedings, based on modern professional knowledge and guided by the Convention on the Rights of the Child and its established norm of the child’s best interests, the professional community has developed the concept of “forensically sensitive treatment/therapy”. This therapeutic approach focuses on initiating the recovery of an abused or neglected child who is showing signs of trauma. In such cases, it is justified for treatment to begin even before the court process is concluded, as waiting for it to end is often too long for the child and family, who require a more immediate intervention. This approach has proven valid, and, in many cases, during treatment the child also receives additional support due to stressors related to the legal process (court hearings, family difficulties linked to systemic interventions, etc.).
Rules
All professionals involved are obliged, under the Health Care Act, to keep as a professional secret all information they know about the patient’s state of health.
For each employee, a criminal record check is carried out with the Ministry of Justice of BiH, in accordance with the Law on the Legal Consequences of Conviction, Criminal Records, and Rehabilitation.
Before starting work, every new employee or volunteer is introduced to the regulations relevant to the operation of BHIDAPA, as well as to its statutes and methods of carrying out activities, by the director, legal department, and activity supervisors.
Hierarchical responsibility
The BHIDAPA Centres, in accordance with applicable regulations, are organised on a hierarchical basis, which entails professional accountability to the superior person and department.
Ethical principles in working with children and families
All professionals are obliged to respect the Ethical Code of their profession and the Ethical Code for Research with Children.
Confidentiality of information is protected, except in cases where it is necessary to safeguard the child’s rights, in which case both children and families are informed in accordance with the law.
Particular care is taken to protect the privacy of children and their families in the storage and preservation of documentation.
Informed consent from the parent/guardian is regularly sought when recording or using documentation for educational purposes, ensuring the protection of the child’s privacy, as well as when children participate in research.