Child and Adolescent Services

We assess youth over the age of 12 who are:

• referred by a Provincial Court Judge
• before the Court being charged with a convicted offence 

Why we do assessments

A judge asks for this assessment when they want to understand the needs and circumstances of the youth and their family. 

We help the youth, their family and the judge:

• understand their difficulties and strengths
• provide suggestions about what may help the youth deal with their difficulties and avoid more contact with the law 

What happens during the assessment

The assessment aims to understand the youth as an individual, and in the context of their family and community.  It does not focus only on the offence that was committed. 

A clinical therapist will meet with the youth, parents or caregivers and family.  We ask parents and family to provide their ideas about what we should talk about with the youth and understand about their circumstances. 

We tailor the assessment to meet the needs of each person but it usually includes:

• Gathering information from the school, doctor and other professionals
• Interviewing parents
• Interviewing family
• A psychological evaluation

Anything you discuss in the interviews could be included in a report. 

What happens after the assessment

We write a report on the assessment, including recommendations to the judge.  The clinical therapist meets with the youth, their parents, guardian or caregiver to talk about the report, including the recommendations, before sending it to the Court. 

The assessment report may recommend:

• specific kinds of individual or family counselling
• educational or special learning needs
• medical, recreational or community support for the youth and their family

We develop a plan to help the youth resolve their difficulties within their family.  However, sometimes the youth’s needs cannot be met at home; in those cases we suggest out of home treatment. 

We will help you find the services we recommend; some may be available at our clinic.

We assess children and youth ages two to 18 for fire-related behaviours.

Why we do assessments

We try to understand the factors and circumstances that contribute to the children or youth's life that may reduce the risk for future fire-related behaviours. 

What happens during the assessment

We follow the model developed by the Arson Prevention Program for Children at the Centre for Addiction and Mental Health. 

We develop a brief intervention to:

• look at factors that contribute to a child or youth's involvement with fire
• evaluate the risk for injury due to fire
• evaluate the risk for further involvement with fire

The assessment takes about two and a half to three hours.  It requires the child or youth and their parents or caregivers to participate.

What happens after the assessment

We develop a plan to reduce a child or youth's risk and improve family fire safety. A referral to a fire education officer at the Hamilton Fire Department is an integral part of the model.

We assess youth age 12 to 17 who have engaged in sexually offending behaviour.

The sexually offending behaviour must have occurred after their twelfth birthday for us to complete an assessment. It is not necessary for the youth to be charged with an offence. Child welfare including Children’s Aid Services or Catholic Children’s Aid, or the police must have investigated the sexually offending behaviour or the youth must make a clear admission of responsibility for the incident. Youth who are before the courts for their offence must plead guilty before our assessment and treatment can proceed.

 Why we do assessments

We do assessments:

• To help the youth and their parents or caregivers develop an understanding of:
  • How and why the offending behaviour occurred
  • What the risk factors are
  • How high of a risk there is for the behaviour occurring again
  • What steps they can take to reduce the risk of re-offending sexually
• To develop a treatment plan identifying other needs the youth and/or family may have.

What happens during the assessment

Our assessment includes developing an understanding of the youth as an individual, and in the context of their family and community and does not focus only on sexual behaviours.

We follow a detailed assessment model, which includes:

• several individual interviews
• use of psychometric measures and questionnaires with the youth and parents or guardians

We ask parents about the history of the family and youth, including questions about school, social and sexual development. We ask the youth questions about sexual history and sexual behaviours and interests, sometimes using questionnaires.

We use the Estimate of Risk of Adolescent Sexual Offence Recidivism, a tool that assesses the risk for future sexual offending behaviour.

If a youth shares details of another sexual offence during the assessment we are obligated by law to disclose and report suspected incidents of sexual abuse to Children’s Aid or police.

What happens after the assessment

After the assessment, we write a report and review results with the youth, and then with their parents or caregivers.

We usually recommend some combination of individual, family, group or residential treatment, in addition to other suggestions. Typically, youth who engage in sexually offending behaviour require 12 to 18 months of treatment, but this varies.

 We can only share the report with outside agencies, including referral sources, with consent from the youth and their parents.  We only share information disclosed by the youth with their parents and caregivers with the youth’s consent.

We see families where a child above the age of 12 engaged in sexually abusive behaviour toward a sibling. Siblings can be full siblings, step siblings, foster siblings or half siblings.  They may, but do not have to be, living in the same home. We assess both siblings.

Why we do assessments

We do assessments for sibling sexual abuse to:

• Help children and parents or caregivers understand how and why the child initiated the sexually abusive behaviour
• Find out how likely this kind of behaviour may happen again
• Find out how it impacted the child who was sexually abused 
• Develop a treatment plan  

What happens during the assessment

We follow a structured and detailed assessment model. We try to understand both children, as individuals and in the context of their family and community.  We do not focus only on the sexual abuse. 

The assessment process includes:

• one or more interviews with parents
• parent and child interviews
• several individual sessions with each child

We use psychometric measures and questionnaires with both children and their parents or caregivers.  We ask parents about the history of the family and children, including questions about school, social and sexual development. We ask children about family, school and social relationships as well as their sexualized behaviour. We help child victims explore the impact of the sexual abuse in a sensitive and child-friendly manner. 

When a child sexually abuses a sibling, it is usually difficult for the victimized child to express their thoughts and feelings because of conflicting feelings of loyalty and worry.  In order to get a realistic picture of how the abuse affected the victimized child, we require that the child who initiated the abuse does not live in the family home where the victimized child lives when they are both being assessed. This is usually a two-week assessment. 

What happens after the assessment

In many cases, we recommend that the child who initiated the sexually abusive behaviour live in a different house than the victimized child until some treatment goals are accomplished.  We often recommend this in situations where our assessment indicates that there is a fairly high chance of a re-offense, or where our assessment indicates that the child who was abused is experiencing distress. 

Treatment usually includes individual counselling for the child who initiated the abuse and individual counselling for the child victim as well.  Counselling with parents and each child, at various points in treatment are a typical part of the process to help with the impact of sexual abuse on relationships between parents and children. 

Our agency can usually provide individual and family treatment to children we assess, although there may be a waiting period to begin treatment.  We make referrals to other programs.  

We write a report that can only be shared with outside agencies, including the referral source, with consent from the child's parents or legal guardians unless compelled by a court order.  

Complex trauma occurs when children are exposed to or have experienced multiple traumatic events within the caregiving system.  It includes:

• Emotional, physical or sexual abuse
• Neglect
• Domestic violence
• Disruptions in the initial parent-child bonding
•  Abrupt or multiple separations from their birth family

Treatment for complex trauma

We complete an assessment with the child or youth and their caregiver.  We may be able to see older teenagers who self-refer on their own. 
 
Treatment focuses on two things:
1.    the behaviours identified
2.    the impact of multiple and chronic trauma exposure
 
Parents or caregivers must participate for longer-term outcomes and continuity after treatment is complete.  We integrate a variety of therapeutic approaches and methods into treatment, such as:

• Cognitive behavioural therapy
• Family therapy
• Expressive therapies
• Play therapy
• Affect and behavioural regulation
• Induction of effective coping skills 
   

The treatment is a phase-oriented approach with the initial focus on ensuring safety and stability.  

Brief therapy includes solution-oriented family therapy, strength-based collaborative therapy and narrative therapy.  It focuses on what you want to achieve through therapy rather than on the problem that made you seek help.  We focus on strengthening the relationship within the family.  While this therapy considers the pain and troubles of the past, it primarily focuses on hopes for the present and future.

What happens during therapy

The therapist has you imagine what life would be like when your problem is no longer an issue in your life.  The family and therapist find ways to get you onto your preferred track of life by highlighting small steps or large changes toward your preferred life.  

To support this, we ask questions through conversation, storytelling and play about:

• your story of the problem and how it affects you and others
• your strengths and resources
• times when the problem is not influential or not around at all  

The goal of therapy is to find ways for you and your family to be on track for the life you want.