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The Support for the Treatment of Abused Children team (ESTIM) offers a multidisciplinary response to all cases in which children and adolescents may have experienced abuse and where a clinical intervention could be indicated.
Our Support for the Treatment of Abused Children (ESTIM) unit was the first in Spain dedicated to those affected by child sexual abuse. Staff in the unit have been treating children and adolescents under the age of 18 since 1995. The unit seeks to help these patients overcome and heal from their experiences, as well as to treat any possible side effects stemming from them.
The main goal of this multidisciplinary team—linked to the Pediatrics Department, Mental Health and Social Work at SJD Barcelona Children's Hospital—is to provide a specialised, comprehensive clinical response.
Over the years, the unit has started treating other forms of violence beyond sexual abuse and has also adopted the Barnahus system: a free public service to help children and teenagers who have suffered sexual abuse, offering safe spaces and access to professionals from various fields.
The Support for the Treatment of Abused Children team also deals with children and teenagers who have been sexually inappropriate towards other minors.
Frequently asked questions about the Support for the Treatment of Abused Children team (ESTIM)
Any family member or professional can get in touch with ESTIM if they know a child or teenager who has experienced an abusive situation and that needs clinical assessment and intervention.
Since the implementation of the Barnahus system, all cases of child sexual abuse must be referred to the Barnahus branch that corresponds to where the child or teenager lives, as this is where they will receive comprehensive, integrated care beyond an exclusively healthcare-oriented approach. If the child or teenager is referred to the El Prat Barnahus and also requires medical attention, they will be treated by ESTIM staff. We also offer mental health coverage at the Granollers and Vilanova i la Geltrú Barnahus branches.
Outside of the Barnahus system, we also treat children and adolescents in other, non-sexual abusive situations who require specialist healthcare and who cannot be seen by other healthcare services. Furthermore, the ESTIM team welcomes consultations from any healthcare professional concerning situations of abuse involving children and adolescents.
You can contact us by phone on 93 253 21 13. Service hours are between 08:00 and 18:00. For professionals who want to submit a query or refer a case, this can also be done by sending the relevant information to: hospitalbarcelona.estim@sjd.es
Outside of these service hours, any urgent cases should go to their nearest emergency care facility (primary health care center, urgent care unit, or the emergency department at the nearest hospital), who will be able to refer them to the corresponding specialist, if so required.
We recommend you call Infància Respon, the free 116 111 number, run by the Directorate General for the Prevention and Protection of Children and Adolescents (DGPPIA), who can guide you on which steps to take next.
You can also request urgent care at any nearby healthcare facility if the child sexual abuse has occurred within the last seven to 10 days. In this case, a physical examination may be conducted, as samples still may be able to be taken or preventative treatment may be indicated for some infections. Depending on the situation, this physical exam will be conducted by both the healthcare team and the legal and forensic medicine team.
If the situation is not extremely urgent, as well as Infància Respon, you can consult the Support for the Treatment of Abused Children team on which steps to take.
Your usual pediatrician or family doctor can help guide you or refer you to the right resources.
Our team treats children and teenagers up to 18 years old who have suffered abuse, especially child sexual abuse or other types that require specialist clinical care. It also provides counselling and support services to families.
Child sexual abuse is when a person in a position of power (an adult or older child) involves a child or teenager in activities of a sexual nature, using deception, coercion or force to do so.
Our team also deals with children and teenagers who have acted in a sexually inappropriate way towards another minor, taking a psychotherapeutic approach to their behaviour, as well as assessing whether they too could have been victims – either now or in the past – of some kind of child abuse.
In light of new healthcare policies, interdisciplinary healthcare teams have been created in Catalonia called EFEs (Functional team of experts in child abuse). These teams can conduct clinical assessments and provide specialist treatment in these situations. The ESTIM team is one of these specialist teams.
When cases like these are received, they are assessed on an individual basis, considering whether to offer a clinical or psychotherapeutic response, based on both the needs that are detected, and also the availability of other healthcare resources that would be appropriate.
Protocols:
Firstly, we assess the level of urgency. If immediate medical attention is required, this will be offered at the same Emergency Department. If no immediate medical attention is needed, or it has already been given, the case is referred to the corresponding Barnahus.
If the case is referred to the El Prat de Llobregat Barnahus and clinical intervention is required (medical or mental), patients will be treated by the ESTIM team working there. The ESTIM team also provides mental health coverage at the Granollers and Vilanova i la Geltrú Barnahus.
Social aspects will be handled jointly between primary care social services or other bodies authorised by the DGPPIA.
In all cases, the core of our intervention is providing restorative treatment for the situation and any possible side effects of being a victim. This is provided via consultation with the team, as well as providing counselling and support to the child or adolescent’s protective family circle.
If other clinical needs that are unrelated to the patient's abusive situation are detected during the assessment, the patient will be referred to the department or service that will provide the best response.
No. We can help guide families on where to start if a legal process were to begin, as well as offering the minor and their family emotional support for the stress that can occur during legal proceedings, but we do not offer any kind of legal counsel.
In cases of child sexual abuse, the services offered by Barnahus may include legal counsel, independently of whether there has been any clinical involvement from the ESTIM team. When required, the team can draft clinical reports about already evaluated cases which, at times, may be used in social or legal proceedings, but these do not constitute an expert report.
Cases assessed by the unit are only discussed when legally (Art. 262 of the Criminal Procedures Act) and morally obliged to do so by the competent authorities, which, aside from the DGPPIA, is the justice system. The ESTIM team's scope of practice does not extend to legal proceedings (modifying conditions, abandonment, custody and fostering, complaints, etc.). These processes are managed directly by the DGPPIA or by the relevant legal entities.
- Social and family assessment and subsequent monitoring: Providing protection, handling initial family contention, providing assistance, offering psychological and emotional support to the family and coordination with the community social system, if required.
- Pediatric assessment: Pediatric appointment (consultation, physical examination and any required additional tests), pediatric treatment and subsequent monitoring, if required.
- Psychopathological assessment of mental health: Evaluation of overall mental health (interview and application of additional tests), assessment of emotional impact stemming from abuse, specialist psychotherapeutic treatment when needed, and counselling and support for the protective family circle.
- Referral to other psychology services within the healthcare system, if needed (patient or family members).
- Coordination and collaboration with legal entities when required, as well as support for the child before and after any oral proceedings, if clinically indicated.
- Strengthening protections for minors and their family members, as well as reducing risk factors – on both an individual level and in their environment – that could contribute towards future abusive situations.
- Guidance for professionals at other facilities when requested.
The ESTIM team works on an interdisciplinary basis. It consists of medical professionals from several fields—mental health, pediatrics, social work, nursing and gynecology—and, when required by cases, it coordinates with all other departments and units at the SJD Barcelona Children's Hospital (Emergency Department, Mental Health, Traumatology, Neurology, etc.). In addition, for cases of sexual abuse, the team works in cooperation with professionals at Barnahus facilities.
Its primary goal is to take a comprehensive approach to children and teenagers who have been victims of abuse, promoting both their recovery and continuity of their previous functional state, avoiding the development or worsening of other associated mental disorders.
This comprehensive approach entails a clinical and psychosocial diagnosis plus a psychotherapeutic intervention for possible side effects of abuse, as well as providing ongoing monitoring.
The team also works toward ensuring children and adolescents are protected, giving them tools and resources to protect themselves, thereby preventing further episodes of intrafamilial abuse or abuse of any other kind.
Prevention and training on abuse in childhood and adolescence
Training and education is another cornerstone of the ESTIM team. As such, we offer tools and resources in several areas – not only for healthcare professionals, but also for educators, families (AFAs) and other professionals working with infants and youths. Prevention and detection are the main objectives of the workshops we run for schools, families, children and teenagers. Sessions are adapted to the needs of each individual case. For more information about our sessions, you can contact ESTIM by email at: hospitalbarcelona.estim@sjd.es
We also offer professional training – such as residency programs in Pediatrics and Psychology, and sessions for Social Work undergraduates or students undertaking related Master's studies – to provide them with the tools they need to handle cases of child abuse.
The ESTIM team collaborates in the design of detection and care protocols for abused children and teenagers.