Chapter 2: One Example of Successful Collaboration: The Child Advocacy Center

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What People Are Saying About Working Across Boundaries


Chapter 2: One Example of Collaboration That Makes a Difference.

“Police are paramilitary, social services is looser, and these two types of organizations collide.”
- Police sergeant, Baltimore County Police

“It helps when one of our supervisors reminds us that we’re here for the kids.”
- Social worker, Baltimore County Dept. of Social Services

Let’s take the discussion out of the abstract and put it in concrete terms. What difference does collaboration make for those who receive certain services? For the recipients’ families? For those providing the services? For others in the community who would like to help? In this chapter we’ll look at one successful example of collaboration across two very different settings.

Dealing with Sexual Abuse of Children

The crime is the lowest of the low – sexual abuse of a child. In prison, such perpetrators are at the bottom of the hierarchy; other prisoners view them with disgust. The victims’ experiences are horrific enough, and the last thing such children need is to be put through a cold, bureaucratic process by the investigating authorities.

Many communities are taking steps to make the investigation process easier on the child, and to improve the chances of successful treatment for the victims and the perpetrators. One of the most promising approaches is called the Child Advocacy Center (CAC) model, which brings social workers, police detectives, and health department staff together in one location, providing an integrated approach to children who are victims of sexual abuse.

In the CAC model, there’s no need for repeated interviews covering the same information, no parade of strangers asking children the most intimate questions about their abusive experiences. The police and social work professionals do joint interviews with the kids in a child-friendly atmosphere; they work together to identify the suspected perpetrators, they share information and engage in joint training. It’s an excellent model that is spreading around the country. And it requires a high degree of collaboration among professionals from extraordinarily different cultures and backgrounds, as the Baltimore CAC example demonstrates.

The Baltimore CAC

“People drive things, not ideas,” states Mark Vidor, Assistant Director of the Baltimore County Department of Social Services. “In 1983 we hired Kris Debye, a very talented social worker who was extremely interested in the child advocacy center model. She spearheaded the effort to start our CAC. The model is simple to understand – you co-locate police, social workers and health professionals, provide space for the state attorney office, and they work together to identify child sexual abuse (and sometimes physical abuse) problems.”

A Maryland law passed in 1985 mandated written agreements among police, social services, state attorney and health department officials, for the coordination and joint investigations of child sexual abuse cases. “Before that law, relations were strained between our two departments” Debye recalled. “We signed an agreement with the police in 1985 to improve communications on child sexual abuse cases, and we started working together better.
“Then, in 1988 we learned of a federal grant to establish child advocacy centers. The grant required co-location of services. I can tell you, we wouldn’t have been able to try co-location if we hadn’t already been meeting with the police and talking together. The police captain running the family crimes unit liked the idea of co-locating our services and he sold the chief on the idea. That was critical. But relationships between the two departments still had a long way to go. We approached the state attorney’s office (which is involved with child sexual abuse cases) about the co-location idea, and they were very supportive. That support proved important, because the state attorney had solid relationships with the police department.

“We talked with the health department leaders, told them we might apply for a grant to pay for a doctor’s salary, and asked if they would hire the doctor as part of their staff (if we got the grant). They agreed, and also contributed a health department nurse to the team. In this way, the health department would cover the medical liability insurance as well. We had the support of each agency’s director, and that was a key.” The agencies received the grant, social services offered space in one of its buildings, and after several months of planning, clarifying roles, establishing shared goals, deciding funding issues and working out the procedures, the new center opened its doors in June, 1989.

How the Child Advocacy Center Model Works

The CAC allows different professionals to share their insights, information, and hunches on joint cases in a way that helps everyone involved. “The social worker and police do joint interviews when they get a report of sexual child abuse,” Vidor explains. “The social worker usually takes the lead when interviewing the kid, and the police generally lead when they meet the suspected offender. Our social workers can provide preventive services and treatment to both victims and offenders, and they place abused kids in foster care if need be. The police determine if there is enough concrete evidence on the alleged perpetrator to recommend that the state attorney try him for child abuse and determine the punishment if he’s guilty. It’s a very good model, but it’s filled with tensions.”

The Tensions of Working Across Very Different Organizational Cultures

Kathy Miller is a police sergeant in charge of the sexual abuse unit. She says collaborating with social workers is a mutual challenge.

“Police are paramilitary, social services is looser, and these two different types of organizations collide sometimes. Our cops call the social workers ‘tofu eaters’! They see them as overly focused on the victim’s feelings. See, our cops are trained to do law enforcement. They don’t get trained in dealing with relationships – they don’t think they have time for that. They’re moving fast out there, they have to track down the suspect, get the facts on him, and to our cops it’s a black and white world. Either he did it, or he didn’t.

“Social workers are from a different world. They’re trained to connect with people, to form relationships, to identify with feelings and to see the world from the client’s point of view. So the social workers come across to the cops as soft liberals who just want to talk about feelings, and the social workers see the cops as people who have no heart, who can only see things in cold factual terms...The social workers want to give treatment to the proven offenders; our cops just want to push those guys off a roof! We don’t think they can be rehabilitated. But we can’t focus on that, because we have to work together. And we do.

TABLE 2.1

The Child Advocacy Model

- co-location of services

- child friendly place (police not in uniforms, interviewing and waiting rooms designed for kids)

- joint interviews, so that the victims don’t have to repeat their horrific stories multiple times

“These cultural differences are reinforced by the system we’re in. See, the police are governed by certain laws. There must be ‘probable cause’ to make a criminal charge against the suspect. Social workers aren’t required to provide concrete evidence. They can go with their gut, and sometimes they do. They’ll say, ‘This guy did it! Go after him!!’ But if the cop doesn’t have any hard evidence, he can’t go with it.” Somehow, Kathy says, it works. “We share information this way, we have two sets of eyes and ears working together. And being together and working cases together, you develop relationships, you get a comfort level with the social workers and learn from them, and that wouldn’t happen if we weren’t co-located in this space. And despite the tensions and teasing, both groups are trying to make a difference.”

 
TABLE 2.2
 
 
Two Different Cultures
 
Police
 
Social Workers
 
View of Other
 
Social workers are too focused on victim's feelings; they're soft-hearted liberals
Police are in a black and white world; they just want the facts
 
Training
 
Law enforcement; separate self from other's feelings
Interpersonal skills; tune into their feelings
 
Method
 
Don't trust, be wary, stay factual, get evidence, don't get taken in
Form relationships, understand client's point of view, connect
 
Pecking Order
 
See selves as higher up the "food chain"
Feel the must prove selves (even though they tend to have more formal education)
 
Joining the CAC
 
Most are assigned; it's not seen as career enhancing
They choose it
 
Attitude Toward
Perpetrators
 
They should be locked up   They can be rehabilitated

It’s Mainly About Relationships

And what is it that keeps these two very different groups working together? Kathy says it’s many things – being co-located, agreeing to disagree on cases, learning how to keep an open mind about the other. But mostly, she says, it comes down to relationships. “If the supervisors on both sides work well together and have a positive attitude about the other group, it works fine.”

The Center’s social workers agree about this clash of cultures, but they say that they are usually the ones trying to bridge the divide. One says, “we make it work, frankly. We put a tremendous amount of effort into these relationships… They see us as soft-hearted liberals trying to save the world, and they don’t respect that. In fact, some cops say, ‘I only respect you if you have more stripes on your sleeve than I do.’ So we work at building friendships with them, sometimes doing ‘informal social work’ with them (listening to their complaints), making time to eat lunch with them, humoring and kidding them. We stroke their egos a lot.

“It helped when we started getting the same investigative training that they get, although even that can lead to problems. If these investigative techniques help us gain a confession from a suspect, it can threaten the cops. These are mostly guys, and they don’t like it if ‘one of those social workers’ gets a confession before they do. That leaves them feeling one down.“ What’s the bottom line for the social workers? “It helps when one of our supervisors reminds us that we’re here for the kids.”

Kris Debye, who has been the coordinator for sexual abuse services since the CAC opened, reinforces that point. “Relationships are a key, no question about it. And building relationships involves seeing what we have in common. We both want successful prosecution of sexual abuse offenders, we both want to protect kids. It helps to acknowledge our differences, to joke about them and be able to vent together as well. But through co-location we bridge many differences because we’ve become like family. In the early phases, we used to have end-of-the-day sessions where we’d vent and talk about what happened that day. It got us closer… I think over time we’ve learned to look beyond the near term, we take a longer view, and we’re aware of our commonalities. That really helps.”

Other Issues and Hurdles

State-Local Funding Streams and Mandates. The Social Services Department is 80% state funded and state supervised; the Police Department is a local government agency. The difference can create problems. One Social Services manager notes that there is far more flexibility in the county budget than in the state’s; “that’s why we usually try to get the county to pay for certain costs like our office lease. It’s just much easier to get that through the county.” It’s a complicated arrangement; many social workers use state-funded computers that sit on furniture funded by the county! There’s no simple solution to this challenge. CAC leaders negotiate with each funding entity annually, and try to keep them informed of the overall CAC needs. “And when there’s a need that neither agency can fund, like for some equipment,” says Debye, “I’ll sometimes write a grant. There’s no set formula stating who pays for some items. We work it out.”

Different Incentives and Levels of Choice. The social workers in the CAC usually choose that role; the police are assigned to the CAC. Further, a tour in the CAC may not be career enhancing for cops. One social worker comments that “It’s not considered ‘real police work,’ some call it a ‘kiddie cop’ job.” The police have no lack of motivation to do their job well; they are just as committed to helping the victims and catching the perpetrators as the social workers. But they may not feel as committed to collaborating initially; that’s a major change for them, and it requires constant work and attention. “And some people don’t have the stomach for this, frankly,” says Kathy Miller. “Most of our officers stay here for several years, but dealing with these kinds of problems can be a shock at first.”

“It helps when our social workers have joint training sessions with the police,” notes Mark Vidor. “That, plus the shared experiences of investigating the cases together, help the police see the value in collaboration here. But it takes constant attention and work … and accommodation.” A colleague of mine likes to say that there are two types of problems. Some problems get solved, other problems have to be managed. Vidor’s response: “if you think you’ve solved this problem, then you really have a problem! We have to manage it over and over.”

Who’s In Charge? There is no one position designated as the CAC director or coordinator. Kris Debye and her police counterpart oversee the operations of the CAC on a daily basis. A committee has responsibility for longer-term planning and policy matters. It is comprised of a police commander, Kris, representatives from the Health Department and State Attorney’s Office, Mark Vidor and a senior Police Department official. The absence of a CAC director doesn’t seem to be a problem, according to some middle and senior managers of the key departments (one called it a “perceived problem”). There are front-line staff who do worry about this, however, especially the social workers. With two different cultures and different levels of motivation, it seems that some of them would appreciate having one senior CAC manager to resolve conflicts and emphasize the importance of collaboration. Lacking that, they are frequently negotiating issues and relationships at their own level. “I just wish we had more involvement from our senior leaders,” is how one front-line staff put it.

“I don’t think it [a single CAC director] would ever work,” is Kris Debye’s response. “Each department wants to maintain its own leader and its own accountability here. I don’t think either department would want to give that up.” She notes that a CAC administrator who manages facility and other administrative items might be helpful, but not a true center leader. The two cultures need their own designated leaders, it seems.

Results

It’s clear that the CAC model offers many potential benefits to the staff and the people they serve. What are the results? There’s been a large increase in confession rates and in arrest rates,
and these are occurring without the victim testifying in court. “That’s very important because the perpetrator is usually the father or another family member, and having to testify against a family member would only add to their trauma,” Debye explains. The CAC opened in 1989. Here are the numbers for “indicated cases” (those in which the staff believe that sexual abuse did occur):

Table 2.3
 
 
 
 
Baseline
1992
1999
Arrest rate:
27% (1988)
73%
Over 95%
       
Confession rate:
20% (1990)
40%
50%

Chris Debye cites three ways that the CAC model helps produce such positive results:

1. Co-location and integrated teams increase the timeliness of response,
2. The model also increases the percentage of coordinated responses. Coordination prevents one person (police officer or social worker) from preceding the other and tipping off the offender prematurely, and
3. The model increases the emphasis on training and professionalism by improving the staff members’ skills at forensic interviewing and interrogations.

Debye also notes that the joint interview approach has radically reduced the number of victims who must tell their stories repeated times. And, interestingly, fewer victims are being placed in foster care. “Because of this model, the mom now sees that the dad did it. Without the confession (and subsequent successful prosecution), and without being able to incarcerate the perpetrator, we sometimes had to remove the child and put her or him in foster care.”

Human services professionals are learning that child sexual abuse is a complex challenge, and like other complex issues, it is best handled through a multidisciplinary approach. It can be tough to get people from very different disciplines to collaborate. The CAC model fosters collaboration when the professionals have the support of their leaders, when they have a common project, and when they use co-location to support their working relationships.

…………………………………………….
This case, like the others in this book, demonstrates the power as well as the challenges of collaboration. The leaders and staff members who created the CAC worked at it for years; their passion, political smarts and people skills were demonstrated over and over. And their collaboration is working. The huge increase in arrest and confession rates is impressive. Harder to quantify, but equally important, is the fact that the victims of sexual abuse now experience a far more humane process. The children only tell their story once, in a supportive setting which includes a trained social worker. Fewer of them are being sent to foster care. The family is more likely to acknowledge what happened, get needed treatment, and begin a healing process.

Some of the key elements in this success include the presence of a champion (Kris Debye), open relationships among the front-line staff, the high stakes involved in this work, and collaborative leaders who support the approach. We’ll look carefully at these and other key elements and skills involved in collaboration in Chapters 4-9. Before going there, however, we need to enter the world of collaboration with our eyes wide open. For, as we saw in this case, true collaboration across agencies is very hard work. The differences in work cultures, values, training, background, reward systems and professional approaches are continual challenges to the CAC staff. And these are only a few of the collaboration challenges. There are many other hurdles to working across boundaries, and they’re detailed in the next chapter.