Despite the increasing number of child psychological, physical and sexual abuse cases, and the subsequent need for interagency interventions, professional knowledge about the dynamics, nature, strengths and difficulties of the integrated response to child abuse is not universal. In addition to this, training programs for the delivery of a multidisciplinary approach to child abuse cases has always received little attention. The purpose of this chapter is to describe the postgraduate training course “Assessment and treatment approach when handling child abuse cases and paedophilia”, developed by the University of Modena and Reggio Emilia (Italy), as an example of a university based and multidisciplinary training to child abuse professionals. This program is aimed at assisting graduated communities’ professionals - such as child psychiatrists, psychologists, social workers, educators, law enforcement officers, judges and lawyers - to develop evidence based strategies to respond to child abuse. First the training program will be presented, describing contents and methods used to facilitate critical reflection and analysis of practice/policy: lectures, case studies, work-groups and team-building, web-based and experiential learning. Furthermore, the impact on trainee knowledge, attitudes, and behaviors will be described and discussed on the basis of the existing literature. Barriers to multidisciplinary work such as work style and communication differences among professions, attitudes and behaviors toward children, will be also critically discussed.
TopChild Abuse And Neglect: The National Data
Child maltreatment is one of the major public health issue and a worldwide concern. The knowledge about nature of child abuse has changed dramatically since Kempe and Caffey in the 1960s identified child abuse as a medical problem. If in the 1960s the term child abuse normally referred to only physical maltreatment, since then its application has expanded to include sexual and psychological abuses as well as neglect and the failure to provide children with proper care.
Today, new areas of victimizations such as sexual tourism (defined as travelling to a foreign country with the intent to engage in sexual activity with children and adolescents), ritual abuses, child pornography and sexual offences via the Internet have been recognized. Internet, in particular, as a potential mean for paedophiles to stalk and seduce children as well as to make child pornography widely available, has raised several new demands.
Although there is growing awareness among the public and professionals about this issue, the prevalence of victimization among youth remains a source of ongoing debate and controversy. What percentage of children and adolescents are exposed to abuse and neglect in Italy? Unfortunately, Italy lacks of a national register and the only available official data concern sexually abused children. According to the Italian Police database, in 2005 approximately 699 reports of sexual abuse cases were made and approximately 605 children were referred for investigation.
More data are made available by Telefono Azzurro, a non-profit Italian organization, dedicated to enhancing children and adolescents' well-being, especially for those living situations of developmental difficulties, abuse and trauma. Telefono Azzurro manages several projects and initiatives, being involved in primary prevention, emergency intervention, treatment, research and training activities. One of the main project is represented by the helpline for children and adolescents. Launched in 1987, this help-line is a confidential service that enables children, adolescents and adults to talk to professional counselors, toll free, 24 hours a day. The service provides assessment, emotional support, information, and whenever necessary referrals to local agencies.
From 2000 to 2007 Telefono Azzurro’s help-line received 11,545 phone calls concerning child abuse cases (27.9% of the total number), with more than 1,400 cases per year (Table 1).
Table 1. Telefono Azzurro’s phone calls concerning abused and neglected children (Source: Telefono Azzurro, 2008).
| Abuse (2000-2007) N. | | % |
| Physical | 4,083 | 35.4 |
| Sexual | 1,733 | 15.0 |
| Psychological | 3,084 | 26.7 |
| Neglect | 2,645 | 22.9 |
| Total | 11,545 | 100.0 |