Healing: Promising Mental Health + Medical Trends

Family Engagement Starts with Screening and Assessment

Family time: a woman and girl are smiling as they use a tablet computer together. Photo by Michael Morse from Pexels.

For Children’s Advocacy Centers (CACs), family engagement refers to the process of family members accepting a referral for mental health treatment, then attending and participating in that treatment to successful completion.

CAC staff know the importance of mental health treatment to help children and families who have experienced trauma heal from that trauma.  We also know that there are barriers that interfere with families participating and successfully competing this treatment. Based on our CAC mission and our knowledge that treatment can help our clients move beyond the trauma of abuse, we have a responsibility to improve our ability to communicate this knowledge to the families we serve. Our goal is to collaborate with our client families to increase their participation and completion of the evidence-based mental health treatment they need and deserve.

As not all child victims and their families need these services, how do we determine who does and who does not need mental health treatment? The first step in answering this question involves screening: engaging the caregiver through an empathetic conversation that identifies their concerns, answers their questions, and provides information about what they can expect from their participation with the CAC. Collaboration with the caregiver begins from this initial contact. We identify the caregiver as the expert about the child and ask about their immediate concerns and about any history of their child’s exposure to potentially traumatic events. When such exposure is shared, we elicit the caregiver’s observations regarding any negative impact of that exposure on their child. Then, we gather additional information by having the caregiver and possibly the child (based on age) complete a written questionnaire (a screening instrument). CAC staff can then use this information along with information from the forensic interview to determine the need for a more formal mental health assessment of the need for treatment. And it’s not just the child we should ask about. The screening process also offers us an opportunity to identify any caregiver history of past traumatic events and to determine the need for an assessment of the caregiver’s treatment needs.

Screening usually takes place during the first visit to the CAC, following the completion of the forensic interview. It offers CAC staff the first opportunity to initiate engagement with the child and child’s caregiver.

And, the screening for potentially traumatic events, the assessment of the impact of those events, and the determination that the child and/or caregiver deserve evidence-based treatment to support their healing gives the family advocate, the mental health professionals, and other multidisciplinary team (MDT) partners a way to engage with the family and to support their participation to completion in the most appropriate mental health treatment available.

DEADLINE EXTENDED! Enhance Early Engagement (E3) Training for CAC Victim Advocates

Enhancing early engagement of families in mental health assessment and evidence-based practices is a priority for CAC leaders through NCA. To address this need, NCA is partnering with the University of Oklahoma Health Sciences Center on a new training initiative, Enhance Early Engagement Training for CAC Victim Advocates, or E3. E3 aims to increase the proportion of children and their caregivers served by CACs who engage in mental health services. Applications are being accepted through October 31, 2019.

In support of the goal of family engagement, CAC staff and MDT partners have the responsibility to educate themselves regarding the potential impact of trauma on an abused child and their family, the purpose of a trauma assessment, and the effectiveness of the evidence-based mental health treatments available to their clients; identify resources to reduce tangible barriers; “sell” the family on the value of these services; and create a collaborative relationship with families by engaging them in the development and implementation of interventions including mental health treatment.

Only by engaging our families in understanding the need for and value of treatment, collaborating with the family to identify and remove barriers to treatment, convincing them that they deserve these services to heal, and providing the information and resources they need to successfully participate in this treatment will we see improved outcomes for the children and families we serve.


Libby Ralston is director emeritus of Dee Norton Child Advocacy Center in Charleston, S.C., and co-director of Project BEST. This is the second of three posts from Libby about family engagement. The first post was “Engaging Families in Treatment: Whose Responsibility Is It?