Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13(th) St Suite 4900, Oklahoma City, OK 73104, USA.
Paul Baerwald School of Social Work and Social Welfare at The Hebrew University of Jerusalem, Jerusalem, Israel.
Child Abuse Negl. 2021 Dec;122:105371. doi: 10.1016/j.chiabu.2021.105371. Epub 2021 Oct 29.
Harmful sexual behavior (HSB) is sexual behavior exhibited by children and adolescents that is developmentally inappropriate and/or harmful or abusive towards themselves or others. Victims of children with HSB are commonly siblings. Multiple professionals may be involved in cases of youth HSB involving siblings, which places Children's Advocacy Centers (CACs) in a key position to directly address intrafamilial HSB. Approximately 25% of all cases seen at CACs in the U.S. are youth-initiated HSB. However, no known research has examined how CAC professionals approach decision-making and response to intrafamilial and sibling HSB, particularly across regions and cultures.
To examine the perspectives of professionals from three separate CACs in Israel, eastern U.S., and southwestern U.S. regarding their decision-making and response process for sibling HSB.
Thirty-seven multidisciplinary team members from the three CACs, including representatives from child welfare, law enforcement, family advocacy, mental health, and the court system, among others, participated in the study.
Participants completed focus groups that asked them to discuss how their system would respond to a vignette case. Dedoose was used for thematic analysis.
Using qualitative thematic analysis, results indicate all sites perceived sibling HSB as a family crisis, and they prioritized establishing safety and providing therapeutic interventions. Differences across sites were on how to establish safety and when to use legal actions.
The study draws attention to the influences that formal policy and community contexts have on CAC decision-making, particularly around the availability of evidence-based treatments and caregiver engagement.
有害性行为（HSB）是指儿童和青少年表现出的不符合其发展阶段的性行为，对自己或他人是有害或虐待性的。儿童 HSB 的受害者通常是兄弟姐妹。在涉及兄弟姐妹的青少年 HSB 案件中，可能会有多个专业人员参与，这使儿童倡导中心（CAC）处于直接解决家庭内 HSB 的关键位置。在美国，CAC 中心大约 25%的案例是青少年发起的 HSB。然而，目前尚无研究探讨 CAC 专业人员如何处理家庭内和兄弟姐妹间 HSB 的决策和应对，特别是在跨地区和文化的情况下。
探讨来自以色列、美国东部和美国西南部的三个独立 CAC 的专业人员对兄弟姐妹 HSB 的决策和应对过程的看法。
来自三个 CAC 的 37 名多学科团队成员参加了研究，包括来自儿童福利、执法、家庭倡导、心理健康和法院系统等领域的代表。
参与者参加了焦点小组，要求他们讨论他们的系统将如何应对一个情景案例。使用 Dedoose 进行主题分析。
使用定性主题分析，结果表明所有地点都将兄弟姐妹 HSB 视为家庭危机，并优先考虑建立安全和提供治疗干预。各地点之间的差异在于如何建立安全以及何时采取法律行动。
该研究提请注意正式政策和社区环境对 CAC 决策的影响，特别是在基于证据的治疗方法和照顾者参与的可用性方面。
