St. Mary's Home for Children

What do we do?

St. Mary’s Home continues its Sexual Abuse Project. During the year, St. Mary’s Home for Children implements a unique home-based team approach to the treatment of victims of sexual abuse. A clinician and parent aide team provides therapy, sexual abuse education, case management, and behavior management skills families served during this period. The Sexual Abuse Project serves male and female child victims of sexual abuse ages 2-18 and their families. The intended goals of the Project are to increase the functioning of the family unit by addressing the psychological consequences of the child’s victimization, reduce the risk of further victimization, identify resources and services available in the criminal justice system as well as guide and support the family through the legal process. We also provide in-home psychological and social service support for up to six months to normalize the disruption caused by the sexual assault.

The overall goal of the Project is to preserve the integrity of the family unit by maintaining the victim and all non-offending family members in their home. The disruption created by a disclosure of sexual abuse is overwhelming and often leads to chaos within the family, which can result in the child victim being removed from the home. In most instances, the child feels that he or she is to blame for the problems in the family. Being removed from the home only reinforces this notion and further traumatizes the child. A highly skilled and trained sexual abuse team who provides in-home services to this population prevents these circumstances from occurring and aid in the healing of the child victim and the entire family unit.

The estimated number of families served is 16-20 per year. Of the families served, it is likely that we will serve 20-25 victims of sexual abuse. The Parent Aide and Clinician provides three hours each of in-home services to the families involved and is available to provide crisis intervention when needed.

The St. Mary’s Home for Children’s Sexual Abuse Project has proven beneficial to the families it has served as evidenced by a 100% positive satisfaction rating on surveys provided to recipients of this service. Our solution-focused treatment has resulted in decreases in problem behaviors of the child victim as measured by the Child Behavior Checklist and the parents’ rating of decreased symptomatology on the Outcome Questionnaire that is distributed at termination. We have served five families during the first two quarters of the project year. All of these families are deemed at high risk for removal of one or more children from their homes. Thus far, all child victims of sexual abuse are safely maintained in their homes.

Who are we?

1. Organization Description

St. Mary’s Home for Children, a nonprofit organization, was founded in 1877 as an orphanage and child welfare agency. Located on an eight-acre campus in North Providence, St. Mary’s has adapted and developed a variety of programs to serve the needs of children of all races, religions, and national origins. St. Mary’s Home for Children has become the largest residential treatment center in the State of Rhode Island serving child victims of abuse and neglect. For 122 years, St. Mary’s has been a leader in mental health services. The State of Rhode Island’s Department of Youth and Families and the Rhode Island Department of Education. licenses St. Mary’s Home for Children for children, Accredited by the Child Welfare League of America and the Council on Accreditation, St. Mary’s ascribes to a nationally recognized set of standards. Membership in the New England Association for Child Care, the National Association of Private Schools for Exceptional Children, and the Rhode Island Council on Residential Programs demonstrates the agency’s dedication to child development and care.

St. Mary’s Home for Children provides the following services:

St. Mary’s Home for Children’s Residential Program provides comprehensive residential treatment to emotionally and behaviorally disordered children who are victims of abuse and neglect. DCYF is the primary referral source for the residential program. Outpatient Services includes The Shepherd Program and Home-Based Services. The Shepherd Program, established in 1985, is a specialized outpatient treatment program for child victims of sexual abuse, children with sexual behavior problems, juvenile sex offenders and their families. The Home-Based Services Program provides emotional support, education and modeling to families at risk for child abuse, neglect and serious family breakdown. The Independent Living Program assists young mothers aged 16-21 who are in need of obtaining the skills required to be healthy, independent, responsible adults and parents.

a. The St. Mary’s Sexual Abuse Project provides a Clinician Parent Aide team approach to families who have been impacted by sexual abuse. The Clinician and Parent Aide provide counseling, case management, behavior management and sexual abuse education in order to maintain the child victim in the home.

3. The George N. Hunt Campus School is a special education program for behaviorally and emotionally disturbed children. Students at the school include children from St. Mary’s residential program as well as day students from other Rhode Island communities who cannot be maintained in their local school systems.

Due to VOCA funding of the St. Mary’s Sexual Abuse Project, five families are served through the second quarter. By the end of the fourth quarter, we expect to have served 12-14 families. Our services are available statewide without regard to race, religion, economic, or ethnic background. When in need of interpretive services, we access agencies that specialize in bilingual services.

The following individuals are currently involved with our project:

• Bernard J. Smith, ACSW, LICSW, St. Mary's Executive Director, will be responsible for overseeing the financial and statistical reporting to the Governor's Justice Commission.
• Carlene Casciano McCann, MA, CAGS, Director of Outpatient Services, will supervise the VOCA clinician and parent educators, monitor the project and be responsible for programming issues.
• Paula Anthony, LCSW, Clinician, will provide in-home therapy for our VOCA clients and supervision to the VOCA parent educators.
• Jennifer Bangs, BSW, Parent Educator, will provide Nonoffending Parent Education and case management services to families impacted by sexual abuse.
• Hope Jackson, Parent Educator, will provide Nonoffending Parents Education and case management services to families impacted by sexual abuse.
• Sarah Buffrey, BA, Parent Educator, will provide Nonoffending Parents Education and case management services to families impacted by sexual abuse.
• St. Mary’s respects the privacy of its clients and chooses not to use volunteers in the Sexual Abuse Project due to the confidential nature of the Project.

What is our challenge?

As of December 31,1998, The Department for Children, Youth and Their Families had a total active caseload of 8,064 children. In 1999, there were 3,485 indicated incidents of abuse and neglect. Of the 3,485 indicated maltreatment events, 309 were indicated incidents of sexual abuse (2000 Rhode Island KIDS COUNT Fact book, Rhode Island KIDS COUNT, Providence, RI). These numbers are overwhelming given the relatively small geographical area that Rhode Island encompasses. The number of reported incidents of sexual abuse has steadily increased over the years as public awareness has increased. The demand for services often outnumbers the supply. There are not enough treatment providers who specialize in sexual abuse treatment to meet the increased demand for these services.

A disclosure of sexual abuse affects the entire family. When a child is sexually abused, the family loses its innocence, becomes distrustful, disorganized and overwhelmed. The severity of family dysfunction after a sexual abuse disclosure is extraordinary. The research has shown that their victims know eighty-five to ninety percent of sex offenders. Often the perpetrator is a family member who provided nurture and financial security. When the offender is removed, the family is left emotionally and financially devastated. The child victim often develops severe behavioral problems. If the non-offending parent denies or minimizes the impact of the abuse on the child or is not emotionally available, the child may require psychiatric hospitalization or residential placement.

As of December 1999, 3,056 Rhode Island children were living in out of home placements (1999 Rhode Island KIDS COUNT Fact book, Rhode Island KIDS COUNT, Providence, RI). Many out of home placements can be prevented. The integrity of the family can be preserved when a clinician and parent aide team, skilled in sexual abuse treatment, work with the family in its home to lessen the psychological consequences of the sexual abuse, strengthen the family’s support system, increase the resources available and aid in the healing process.

Other than the VOCA support from the Public Safety Grant Administration Office for the St. Mary’s Sexual Abuse Project, there are no other agencies in the State that provide this service. Outpatient counseling is often ineffective immediately following a disclosure of sexual abuse. The family is often so overwhelmed that they are unable to attend counseling sessions consistently. The child’s symptoms and behaviors worsen and the non-offending parents’ ability to cope is compromised, resulting in out of home placement for the child, yet another traumatic event and loss for the family. Children’s Intensive Services programs serve a vital function in the system’s continuum of care. Unfortunately, in Rhode Island, there are not any intensive home-based programs that employ clinical staff who are experts in sexual abuse treatment. CIS programs are also usually three months in duration and do not include the unique feature of a clinician-parent aide team whom works together to provide the intensive services that this population needs.

VOCA funding has enabled St. Mary’s Home for Children to provide in-home services to families affected by sexual abuse for the last eleven years. The Parent Aide performs a case management function and acts as a liaison among all St. Mary’ s programs involved with the family as well as many different agencies throughout Rhode Island. She refers to community agencies when there is a need for housing, food, and clothing. The Parent Aide and Clinician collaborate with local law enforcement agencies and the Attorney General’ s office when there is court involvement and assist the parents in accessing the legal system. The Team also networks with other mental health agencies that are working with family members. When the family is involved with DCYF, St. Mary’ s and DCYF work together to maintain the child victim in the home. When necessary, the Parent Aide and Clinician work with the child’s school system to help ensure consistency in the child’s life. In general, St. Mary’s advocates for the child victim and the family, but more important, assists the parents in advocating for themselves and their child.

The Clinician works with the Parent Aide to advocate for the family with all involved agencies. In addition, the Clinician provides individual therapy to the child victim and family therapy to all non-offending family members. Providing these services ensures that the family is getting consistent treatment, that the severe symptomatology of the child victim is mitigated and that non-offending family members experience success in preserving the integrity their family.

The Shepherd Program of St. Mary’s Home for Children provided this unique service through first two quarters only to five families at high risk of losing the child victim or victims to out of home placement. We have been successful in maintaining the children in the home in all five cases. Results of the Child Sexual Behavior Checklist have shown a decrease in behavioral symptomatology for the identified child victims.

This is not a service that is funded through DCYF or any of the HMOs. The Public Safety Grant Administration Office’s VOCA funding has enabled us to provide this treatment effectively and to the benefit of our clients. These services require an intensive involvement with the family. The family receives three direct contact hours from the Clinician and three direct contact hours from the Parent Aide for a total of six hours of service each week. The Parent Aide and Clinician team continues to serve families as they can per quarter with the option of staying involved with any families who continue to require services.

What is our action plan?

Goal 1:

Increase functioning of the family unit by addressing the psychological consequences of the child’s victimization.

Objective A

The Parent Aide educates parents about victim/offender dynamics. It is necessary for parents to understand and reinforce the innocence of the child and place responsibility on the offender for the sexual assault. The Parent Aide Uses informational videos, books, and discussion to emphasize the offender’ s abuse of power.

The Clinician assists the child victim to clarify the victim/offender status. The child understands that the perpetrator is completely responsible for the sexual assault. Methods used include play therapy, bibliotherapy and videos.

Objective B

The Parent Aide educates parents about the unique needs of the sexually abused child and provides informational materials about the effects of trauma on the victim and on the victim’s family.

The Clinician addresses psychological consequences such as low self-esteem, feelings of betrayal, powerlessness, stigmatization, etc. using Jan Hindman’s Scrapbook technique.

Objective C

The Parent Aide educates parents about appropriate forms of discipline. Parents learn how to positively reinforce their child’s appropriate behavior. Through observations of parent-child interactions, the Parent Aide reinforces positive interactions and suggests alternate methods of parenting when necessary.

The Clinician develops with the child victim and his or her parent(s) a behavior management plan that addresses the child’s problematic behaviors.

Goal II

Reduce the risk of further victimization

Objective A

The Parent Aide educates parents about the necessity for healthy physical, sexual, and role boundaries within the home. A lack of clearly defined boundaries in the home can add to the trauma the child victim experiences. Healthy boundaries aids in the child’s healing.

The Clinician helps the child to develop an awareness of body integrity, personal space, and role boundaries. This is accomplished through play therapy and bibliotherapy.

Objective B

The Parent Aide educates parents about child protection issues and the need for supervision. Resources such as books and videos that teach children and their parents about safety rules are utilized.

The Clinician addresses safety rules and rehearses them regularly with the child victim and non-offending family members.

Objective C

The Parent Aide and Clinician promotes no secrecy in the family and encourage parents to listen to their children. The Parent Aide and Clinician uses abuse specific workbooks with parents and their children to explain the consequences of secrecy and the need for open, honest communication.

Objective D

The Parent Aide and Clinician educates parents about normal stages of a child’s sexual development. Books, pamphlets and audiovisual materials are used.

Goal:III

Identify resources and services within the criminal justice system and guide and support the family through the legal process.

Objective A

The Parent Aide guides parents through the restraining/no contact order process when necessary. Often a restraining order against the perpetrator helps the victim and his or her family feel safe and empowered.

The Clinician educates the child as to the reasons for no contact with the perpetrator of the sexual abuse and assesses the child’s reaction to this.

Objective B

The Parent Aide educates parents about the Victims of Crime Act and the Victim’ s Compensation fund and reinforces the positive aspects of the criminal justice system and its mission to assist victims of crime.

The Clinician completes the appropriate paperwork to help the child victim access the Victim’s Compensation Fund. Cooperation with the criminal justice system often expedites court proceedings and helps families begin the healing process sooner.

Objective C

The Parent Aide assists parents and victims in all criminal justice system contacts (e.g., Attorney General, Family Court, hearings and other court-related matters) and explains the processes involved.

The Clinician assesses the child victim’s willingness and/or ability to testify in court. Once established, the Clinician prepares the child for grand jury and court testimony. When warranted, the Clinician accompanies the child to court.

Goal IV:

Provide in-home psychological and social service support for up to six months to normalize the disruption caused by the sexual assault.

Objective A

The Parent Aide encourages parents to participate in educational and support groups that address the needs of non-offending parents and provides information as to such services in the community.

The Clinician makes referrals to top child victims’ group treatment when appropriate.

Objective B

The Parent Aide works closely with the child victim’s therapist and helps the parents to support treatment goals in order to provide consistent care to the child and family.

The Clinician reviews treatment goals with non-offending family members, child victim, and Parent Aide every six weeks.

Objective C

The Parent Aide supports the parent’ s efforts to resolve practical problems that arise as a result of the child’s victimization. Such issues include, but are not limited to, food, clothing, shelter and child-care. The Parent Aide identifies resources in the community that assist families in need.

The Clinician networks with resources in the community to help stabilize the child. The Clinician works with school personnel involved with the child. The Clinician attempts to involve the child in age-appropriate activities.

Carlene Casciano McCann, MA, CAGS, Director of Outpatient Services, oversees the Parent Aide - Clinician Sexual Abuse Project. She ensures that the Project is meeting reporting and budget requirements. She acts as a liaison to the Public Safety Grant Administration Office.

Pat Cohen, MS, Clinician, provides direct supervision and ongoing in-service training to the Parent Aide and Clinician. She ensures the Project’s accountability by tracking the number of families served, reviewing mileage reports, weekly activity reports, and progress reports.

How do we measure ourselves?

Program effectiveness is measured in the following ways:

• 1. Progress Reports - These reports are completed by the Parent Aide and Clinician after three months of service to the family and again at six months. These reports are a quantifiable measure of the parent and child’s progress toward the accomplishment of their respective goals. The Parent Aide and Clinician share their reports with the clients.
• 2. Parent Aide Evaluation Form - Families complete an evaluation of the Parent Aide upon completion of services. It is a measure of the family’ s satisfaction with the Parent Aide services they received.
• 3. Child Outcome Questionnaire - Families complete an evaluation of the clinical services they received. This measures the client’ s satisfaction with the clinical services and a reduction of their child’ s symptomatology. We expect the parents’ report to reflect an observed decrease in problem behaviors.
• 4. The Child Behavior Checklist -This is an objective measure of the child’s behavior. It is administered upon initial contact with the family and upon completion of services. A change in the parents’ interaction style with the child often results in a change in the child’s behavior. We expect to see a decrease in the child’s problem behaviors because of our intervention in the home.

For more information please contact:
Carlene McCann, Director of the Shepard Program
St. Mary's Home for Children
135 Norwood Avenue
Cranston, Rhode Island 02902
Telephone: (401) 784-3530
Web Page: www.smhfc.org