The CAC Model: A Wraparound Approach to Help Children Heal

Before children’s advocacy centers, or CACs, the response to child abuse was often disjointed, duplicative, and retraumatizing for children. Children had to tell the story of their abuse an average of 13 different times, leading to significant challenges getting successful prosecutions. Sometimes, children received some services, but not others, leaving them hanging when they needed help the most. 

Because of these challenges, the first CAC was founded in the 1980s in Alabama by former Congressman Bud Cramer. He had been a prosecutor and knew firsthand how challenging child abuse cases were, both for the children and for the professionals working them. He wanted to improve the response to abuse by creating a coordinated effort among all professionals working with the child, and ensuring children received wraparound services to begin healing.

After the National Children’s Advocacy Center (NCAC) started, more began popping up across the country, including in Pueblo, Colorado, which was the first in the state and only the sixth in the country. Most CACs at the time were specifically founded to address child sexual abuse, and they have since expanded to serve all forms of child maltreatment. Colorado's 19 CACs can provide specialized services for children who have been victims of sexual or physical abuse, neglect, drug endangerment, human trafficking, and online abuse, or those who have witnessed violence. 

When a child is referred to a CAC for services, the CAC's advocate will reach out to introduce themselves and answer any questions a family might have. The child will arrive on the day of their forensic interview and will be greeted by the advocate, who will collect initial information from both the child and family. The child will then meet with a trained child forensic interviewer, who will listen to the child's story and ask additional questions that will be helpful for investigations. CACs recognize that this process, in addition to the actual abuse, may be traumatizing for the child, and following the interview, they will connect them with mental health resources. Sometimes that involves a staff clinician who is able to do an immediate assessment with the child, and sometimes that involves introducing the child to a specialized community therapist who is experienced in child trauma. In addition, children who visit a CAC will be offered a medical examination. This may be a specialized examination intended to collect any evidence that might remain on a child, but more often, this is a non-acute examination that helps children understand that their bodies are okay and safe now.

In addition to all of those services for the child, CACs also ensure families have any support that may be helpful. This looks different for every family. One family may need some transportation assistance to bring their child to the CAC for ongoing mental health treatment, and CACs have partnerships with local transportation companies to ensure that need is met. Another family might want mental health treatment for a parent; CACs will make referrals for any caregivers to receive specialized treatment from a community provider who understands their needs. Our CACs have even helped families find housing when that need arises. Each CAC has partnerships within their communities with a variety of organizations to make sure all families can be connected to resources that will help them.

One of the most important things to note about CACs is that they never charge families for their services. All of the services highlighted are available at no cost to a child and their families. This ensures that all children can access critical resources after being abused, without a cost barrier in place.

The CAC model has expanded across the entire United States and is now being replicated in many other parts of the world under the Barnahus model. The research is clear: children receive improved services when they go to a child advocacy center.