First Step seeks to improve the community response to child abuse and adult sexual violence and to support victims of abuse and their families in recovery.
First Step Resource Center is a nationally-accredited Children’s Advocacy Center and adult sexual response program located in Missoula, Montana. First Step serves child victims of abuse and child witnesses to violence and their non-offending family members, as well as adult and adolescent victims of sexual assault.
First Step Sexual Assault Nurse Examiners provide confidential and compassionate medical evaluations, evidence collection, and forensic interviews.
First Step’s mental health and family advocacy staff provide crisis intervention, referrals for follow-up care and counseling, and on-site therapy.
First Step began providing medical exams and forensic interviews in 2000, and has grown in response to western Montana’s needs ever since. In 2010, First Step began offering mental health services, and in 2013, added a care coordinator to provide family advocacy.
As the number of children and families served at First Step continued to increase over the years, the need for mental health services and family advocacy became apparent. First Step is a member agency of Missoula’s Multidisciplinary Team (MDT), which responds to reports of child abuse and adult sexual assault. The MDT includes law enforcement, Child and Family Services, the County Attorney’s Office, and community mental health providers and advocacy agencies. First Step’s Care Coordinator acts as an advocate to the family throughout the course of an investigation.
In recent years, First Step’s mental health and advocacy staff recognized that children with “problematic sexual behaviors (PSB)” resulting from trauma could be served better by our community’s system. Traditionally, law enforcement and the legal system have few options of how to respond to a child who “acts out” sexually, other than to treat that child as a perpetrator, or in some cases, do nothing at all.
Best practices, however, show that rather than a punitive system response to children with PSB, a supportive and trauma-focused therapeutic approach to the child and family is ultimately more effective. With the goal of diverting these children away from traditional criminal justice response, professionals in Missoula formed a task force to design an evidence-based evaluation and treatment process for children with PSB.
First Step’s Licensed Clinical Social Worker (LCSW), Care Coordinator and MSW Practicum Student have developed a pilot program to divert children with trauma-related PSB from the criminal justice system to therapeutic treatment.
As with other children served at First Step, the target group will be served by a multidisciplinary team that includes the County Attorney’s Office and Youth Court, therapists, law enforcement and Child and Family Services, all of whom are familiar with the PSB treatment model. In September 2018, a group of community therapists received advanced training for treating children with PSB related to trauma; First Step has formal linkage agreements with therapists in the community who are prepared to work with these children and their families.
The pilot program has formally launched and is the stage of identifying children and families who will be well-served by the model. Prior to the launch of the pilot, First Step’s LCSW has treated families based on this model, including collaboration with the multidisciplinary team, with positive results from both the families’ perspectives and the MDT’s.
As an accredited Child Advocacy Center (CAC), First Step has a well-established MDT, which is an integral part of the CAC model. Missoula has the good fortune of having a solid MDT after nearly twenty years of collaborative response to child abuse and sexual violence; the strength of this group has allowed the task force to develop at alternative response for this vulnerable population.
Broadly, the family advocacy model is replicable in any community with a multidisciplinary approach to child abuse. As a core function of the CAC model, family advocacy provides the necessary bedrock for the diversion model for children with PSB. The diversion model would also be replicable in any community that is committed to compassionate care with a focus on possibility, accountability and fostering growth.
In anonymous post-evaluation surveys, caregivers of children served at First Step consistently describe being treated with compassion and warmth by staff, and describe feeling reassured in the midst of the difficult situations that bring families to the clinic.