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The Israeli Emergency Centre for Treatment of Children-at-Risk and their Families

Yitzhak Lander,
MSW, Ph.D.

Effective care for neglected and abused children is one of the major challenges facing contemporary Israeli society. The problem of child maltreatment has become an urgent national priority due to the alarming increase in the number of reported and substantiated cases, as well as children and families in treatment. There are approximately 10,000 reported cases each year in Israel, and some 40,000 maltreated children currently receive treatment within community-based or institutional programs. Exacerbating the situation is the growth of poverty in Israel. 300,000, or 21% of the country's children live below the poverty line. This group includes large numbers of children at risk of neglect and abuse. A related contributing factor is the social and economic pressure faced by many new immigrant families from Ethiopia and the former Soviet Union.

In 1989, a special parliamentary sub-committee established to study the problem of child maltreatment and make recommendations for improvement in the national service delivery system cited three critical missing links in Israel's continuum of care. These were:

• the relative ineffectiveness of the foster care system in providing shelter care appropriate to recently apprehended children

• the lack of high quality assessment and short-term treatment services for apprehended children and their families

• the unavailability of assessment and treatment services for children, and their families, at high risk of apprehension

In response to the report of this special sub-committee, the national Ministry of Labor and Social affairs, along with such major international Jewish philanthropic organizations as the American Jewish Joint Distribution Committee and the Rashi Foundation of France, decided to commit significant energies to finding answers to these service gaps. An inter-agency planning committee was convened, and in September 1992 the first Emergency Centre for the Treatment of Children-at-Risk and their Families was opened in Jerusalem. By 1994, three additional centres were operating in Tel Aviv, Haifa and Beer Sheva, creating a national network. The purposes of these centres were:

• protection of children-at-risk

• helping parents and children cope with family situations that lead to risk of apprehension, and utilization of apprehension as an opportunity for change

• development of new practice interventions for application in child protection

• provision of guidance and training to the range of helping professionals exposed to cases of child maltreatment

Each of these centres is comprised of three components:

• The shelter, which is designed for children who must be removed immediately from their homes. Open year round, it is staffed by professional child care counsellors, social workers and psychologists who provide emergency placement and initial assessment services for five children for a period of up to seven days.

• The internal unit, which in addition to placement provides a therapeutic environment for assessment and short-term intervention for 10 apprehended children for up to three months. Treatment methods activated and evaluated, upon conclusion of a multi-system assessment process, include Theraplay and Structural-Strategic family therapy.

• The ambulatory unit offers a similar range of assessment and treatment services to children-at-risk of apprehension, who are living at home, and their families. Long term treatment is available each year to 150 children and families who are either referred prior to any apprehension by community professionals or who are discharged for the Centre's internal unit.

All three units provide consultation to community professionals who continue to work in their own settings with maltreated children and their families.

It is the combination of a single agency providing protective services for children and rehabilitative services for the entire family which makes the Emergency Centre unique within the Israeli continuum of services to children and families. Indeed, working with the parents of maltreated children is a major function of the Centre. It is believed that making every attempt to keep families together, where feasible, is in the best long-term interest of all involved. There is an acknowledgement of the need for in-depth assessment of parents' abilities and motivation to effect change in their behavioral patterns. Though children may initially be taken out of destructive home environments, during their stay at the centre they maintain regular contact with parents and other family members by phone calls and visits.

This approach is thought to help prevent the need for long-term institutionalization in a country where the rate of institutionalization of children and youth is amongst the highest in the world. From 1992-1994 two-thirds of the centres' children were returned home post-apprehension where they continued in long-term treatment with their families.

For more information on the Israeli Emergency Centres for Treatment of Children-at-Risk and their Families, feel free to contact:

Dr. Yitzhak Lander
The Spitzer Department of Social Work
Ben-Gurion University of the Negev
Beer Sheva 84105
P.O.B. 653 ISRAEL