The Child Abuse Functional Unit (ESTIM) offers a multidisciplinary response to all cases of suspected possible sexual abuse of children.
SJD Barcelona Children’s Hospital’s Child Abuse Functional Unit was the first in Spain which was created to treat children affected by sexual abuse. Since 1995, the Unit’s staff have been treating girls and boys under the age of 18 and assessing all patients who are suspected to have been a victim of such acts. The goal is to help them to overcome this traumatic experience and try to ensure that they don’t suffer this type of abuse again.
The main objective of this multidisciplinary Unit linked to the Paediatrics Department, Mental Health and Social Work is to provide medical and psychosocial response in cases where minors have reported situations of abuse. The Child Abuse Unit staff also treat adolescents that have sexually abused other underage children.
FAQs about the ESTIM
The Unit deals with cases that are referred to it by families. It also cares for children and adolescents referred by pediatricians or other professionals from the health and justice services, Child and Youth Mental Health Centers [CSMIJ or CDIAP], schools, social or leisure entities such as cultural groups, police forces, services social or teams of the child protection system. In cases where minors arrive through a professional, a referral report will be required.
Please call the telephone number +34 93 253 21 13. Office hours are from 8.30 a.m. to 6.00 p.m. (with treatment preferably given in the mornings). In the case of professionals who want to refer a case, the information can also be sent by email.
Outside of these hours, cases that are felt to be urgent should preferably be taken to the A&E department at the closest hospital or health centre,
(the nearest health center or hospital) who will refer you to the corresponding specialist team if necessary.
If the situation has occurred beyond 72 hours, ask the Child Abuse Functional Unit about the steps to take. You can also call the free helpline Infància Respon (child protection) on 116 111. This department of the Directorate General of Child and Adolescent Services (DGAIA) also has an email address where you can report cases of child or adolescent abuse (firstname.lastname@example.org).
It is advisable to request urgent care at a nearby health center if child sexual abuse has occurred in the previous 72 hours. In that case, it will be assessed whether a physical examination by a doctor is necessary, when there may still be some form of physical evidence.
The patients in the Unit are boys and girls between the ages of zero and 18 years who are suspected to have suffered a type of sexual abuse. Child sexual abuse is considered to be the situation in which a person with a position of power (an adult or an older child) uses coercion or forces a boy or girl to perform any type of sexual activity.
The abusers are also sometimes treated if they are children or adolescents in order to correct their behavior, if required, or to rule out the possibility that the aggressor—when he/she is underage— has not also been a victim of prior abuse.
The cases are studied and the possibility of offering an answer is evaluated. Traditionally, ESTIM has only dealt with cases of child sexual abuse, but we are in a time of change. As a result of the new Health protocols (Protocol for action against child and adolescent abuse in the field of health and Framework protocol for action against child and adolescent abuse in Catalonia) work is being done on the design of new attention model. In this sense, there are functional teams of experts in abuse who can make the clinical assessment and treatment of these situations. ESTIM will be part of these specialized teams.
The patient is assessed, a diagnosis is made and they are treated in accordance with the needs of each individual case. The treatment (medical and psychological) may be given directly at SJD Barcelona Children’s Hospital or in coordination with nearby services such as Child and Juvenile Mental Health Centres (CSMIJ).
We treat the consequences directly associated with the abuse while considering the experience suffered by the child and their age. We take a biopsychosocial approach to treating patients. In all cases, we work to provide self-protection mechanisms to the underage victims of abuse and to prevent them from being abused again.
We also offer support and guidance to the core family members not involved in the abuse on how to tackle the situation and how they can try to overcome it.
No. We can guide families in an initial phase if a legal process occurs, as well as offering accompaniment and emotional support to the minor and the family due to the emotional stress that may appear related to legal processes, but in no case do we offer service of legal attention.
The team prepares clinical reports on the cases assessed, which can sometimes be used in social or judicial files but do not amount to an expert report.
All cases assessed in the Unit are reported to the General Directorate of Childhood and Childhood (DGAIA). In addition, in cases where suspicion of substantiated abuse is considered, the professionals of the Functional Unit for Child Abuse have a legal obligation (Art. 262 LECrim) and a deontological obligation to notify the situation to the competent bodies that are, apart of the DGAIA, the justice services.
The ESTIMhas no competence regarding the processes of guardianship of minors. These procedures are managed by the DGAIA itself or by judicial bodies.
- Initial family support, accompaniment, psychological, and emotional support to the family.
- Assessment in relation to the protection requirement.
- Pediatric visit (anamnesis, physical examination, and complementary examinations if necessary).
- Pediatric treatment and subsequent follow-up if necessary.
- Psychopathological evaluation of minors, individual psychotherapeutic treatment in cases in which symptoms compatible with an abusive situation develop, and family therapy of the non-abusive nucleus.
- Referral to other psychological services in the healthcare network if the patient or family requires it.
- Coordination and collaboration with judicial bodies, among others, when required.
- Psychological preparation of the minor before the oral trial and subsequent accompaniment if necessary.
- Work on the protective factors of minors and their families, as well as the reduction of both individual and environmental risk factors that may contribute to possible future situations of re-victimization.
- Orientation to professionals from other centers when requested.
The team consists of two paediatricians, two psychologists, a psychiatrist and a social worker, in addition to a member of administrative staff. The main objective of the professionals is to provide children who are suspected to have suffered abuse with a comprehensive approach to help them fight the damage that can be caused by these experiences.
The Child Abuse Functional Unit (ESTIM ) works in coordination with the other Departments and Units at SJD Barcelona Children’s Hospital (Gynaecology, A&E, etc.) The team gives a diagnosis and treats children who have suffered a situation of child sexual abuse from an adult or another minor.
Some of the objectives of the Child Abuse Functional Unit include the diagnosis and assessment of the boy or girl who has suffered a case of sexual abuse and working to help them recover properly. It also acts to ensure the protection of the child and treat the physical and psychological consequences of the abuse in both the child and other family members. Providing tools that help to prevent other cases of abuse from occurring (whether within the family or elsewhere) is another of the main missions of this Unit.
The work carried out at SJD Barcelona Children’s Hospital guides the families of children who are suspected to have suffered sexual abuse, both in cases in which abuse is confirmed and those in which it is not.
Training and prevention in the area of child sexual abuse
Training is another of the main activities of the ESTIM. We provide training to several types of group: teachers, student parent associations, adolescents and young children. Prevention is the main objective of the sessions aimed at schools, families, children, and adolescents. The sessions are adapted to the needs of each individual case. For more information about the guidance that we offer, please contact the ESTIM at the Unit’s email address.
We also train professionals (paediatric and psychology residents, Master’s students and social workers) to provide them with tools to help them deal with child sexual abuse. We have also participated in the Department of Health’s steering committee to update the Health Protocol on the Mistreatment of Children and Sexual Abuse.
Minors treated during 2019
Follow-up or non-face-to-face visits
Discharges from Mental Health