DEFINING CHILD

PROTECTION AND
UNDERSTANDING
CHILD ABUSE
Learning About Child
Protection In Bhutan
DEFINING CHILD
PROTECTION AND
UNDERSTANDING
CHILD ABUSE
Learning About Child
Protection In Bhutan
CHILD PROTECTION AND TYPES OF ABUSE
Child Protection is the prevention of and response to abuse, neglect,
exploitation and violence against children.

Abuse is illegal, improper, or harmful practice or maltreatment.

Child abuse is a deliberate act of ill treatment or an omission that can

harm or is likely to cause harm to a child’s safety, well-being dignity and
development. For child abuse, the intent of the action does not matter;
it is the actual harm that comes to the child that is important.

There are five different kinds of abuse:

1
Physical
Involves the use of violent physical force to cause actual or
likely physical injury or suffering to a child
Examples include: hitting, shaking or torture of a child.
Abuse

2
Emotional
Any humiliating or degrading treatment against a child
Examples include: bad name calling, constant criticism,
persistent shaming or isolation.
Abuse

3
Any involvement of a child in sexual activity by an adult or
person of power, including all forms of sexual violence
Examples include: rape, early and forced marriage, sexual
Sexual exploitation, indecent touching and exposure, using sexually
explicit language towards a child or showing children
Abuse pornographic material.

4
Neglect
Deliberately or through carelessness failing to provide for a
child, their rights to safety and development
Examples include: not providing sufficient food or water or
failing to properly supervise a child.

5
Exploitation
The use of children for someone else’s advantage,
gratification or profit
Examples include: child labor and sexual exploitation.

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THE CHILD CARE AND PROTECTION ACT OF
BHUTAN 2011
The Child Care and Protection Act of Bhutan 2011 (CCPA) includes:
• Guiding Principles for child protection
• Prevention of child offences; the Act addressed the role of
Central and local government, education institutions, mass
media, community and family with regards to child protection.
• Description of children in difficult circumstances
• Description of children in conflict with the law

The Child Care and Protection Rules and Regulations of Bhutan 2015
includes:
• Guiding Principles for child protection
• Roles and responsibilities of all governmental authorities and
institutions with regards to child protection
• Roles and responsibilities of civil society organizations with
regards to child protection
• Procedural matter that relates to children in difficult circumstances
• Procedural matter that relates to children in conflict with the law

A child in conflict with the law according to section 71 of the

CCPA is a child who:
• Is above 12 years of age and found to have committed an
offence.

A child in difficult circumstances according to the section 59

of the CCPA is a child who:
• Is found without having any home or settled place of abode and
without any ostensible means of subsistence and is a destitute;
• Has a parent or guardian who is unfit or incapacitated to take
care of or exercise control over the child;
• Is found to associate with any person who leads an immoral,
drunken or depraved life;
• Is a frequent victim at the hands of individuals, families, or the
community;
• Is being or likely to be abused or exploited for immoral or illegal
purposes;
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According to the sections: 61, 62, and 63 of the CCPA:
If any person is of the opinion that a child is apparently a child in difficult
circumstances as mentioned in Section 59, such person shall:
• inform the police or child welfare officer
• Whenever the information has been given to the police, the
police shall inform the child welfare officer
• When information is given to an officer in charge of a police
station or to a child welfare officer about any child in difficult
circumstances such police officer or child welfare officer shall
record the information and take such action thereon as deem fit.
• A child in difficult circumstances taken into the care of the police
under this Act shall be transferred to the child welfare officer
within 24 hours after being taken into the care of the police
excluding the time necessary for the journey from the place

Guiding principles in CCPA are as follows:

• Best interest of the child: in actions concerning children under
this Act whether undertaken by government, non-government or
private social welfare institutions, courts of law, administrative
authorities, family members or individuals, the best interest of
the child shall be the primary consideration.
• A child shall be treated fairly and equally with respect and dignity
and shall not be discriminated against on the grounds of race,
sex, language, religion, political or other status.
• A child shall not be subjected to arbitrary arrest, detention,
imprisonment or deprivation of liberty. Any arrest, detention or
imprisonment of a child shall be used only as a measure of last
resort and for the shortest appropriate period of time.
• The child justice system is essential to uphold the rights of
children keeping them safe and promoting their physical and
mental well-being.
• The prevention of child offences is an essential part of crime
prevention in the society and requires efforts on the part of the
entire society to ensure the harmonious development of the
child with respect for and promotion of their personality from
early childhood.

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 • A child in conflict with the law shall be provided with the opportunity
to be heard in any judicial and administrative proceeding either
directly or through a representative or an appropriate body in
accordance with the Civil and Criminal Procedure Code.
• A child under confinement shall be provided with conducive
physical environment and accommodation which are in keeping
with rehabilitative aims of residential placement and due regard
must be given to the needs of the child for privacy, opportunities
for association with family, relatives and friends, participation in
cultural, sports, physical exercise, and other leisure activities.
• If a child commits an offence, the child shall be treated in
a manner that would divert the child from the criminal justice
system unless the nature of the offence and the child’s criminal
history indicates that a proceeding for the offence should be
initiated

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UNDERSTANDING CHILD
ABUSE TYPES, INDICATORS/
SIGNS

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DIFFERENT TYPES OF ABUSES AND
POTENTIAL SIGNS
1. Physical Abuse
Involves the use of violent physical force to cause actual or likely
physical injury or suffering to a child
Examples: hitting, shaking or torture of a child.

Possible Signs of Physical Abuse

• Bite marks
• Cigarette burns
• Evidence of old but untreated injuries
• Signs of severe, long term bruising
• Unexplained injuries, burns, bruises
• Explanation of injury does not match with what is observed

2. Emotional Abuse
any humiliating or degrading treatment against a child
Examples: bad name calling, constant criticism, persistent shaming
or isolation.

Possible Signs of Emotional Abuse

• Very difficult to detect as it rarely has obvious signs
• Slow physical, intellectual or emotional development
• Difficulties in forming relationships, withdrawal
• Learning problems or sudden speech disorders
• Disruptive/ attention-seeking behavior
• Poor self-esteem
• Fear of new situations

3. Sexual Abuse
any involvement of a child in sexual activity by an adult or person of
power, including all forms of sexual violence
Examples: rape, early and forced marriage, sexual exploitation,
indecent touching and exposure, using sexually explicit language
towards a child or showing children pornographic material.

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 Possible Signs of Sexual Abuse
• Sudden/ unexpected behavior changes
• Isolation from friends
• Overly affectionate/ knowledgeable in a sexual way
• Medical problems like stomach pain when walking or sitting
• Chronic itching, pain, discharge, bleeding from the genitals
• Sexually transmitted diseases, pregnancy
• Lack of trust or fear of someone they know well

4. Neglect
deliberately or through carelessness failing to provide for a child,
their rights to safety and development
Examples: not providing sufficient food or water or failing to properly
supervise a child.

Signs of Neglect
• Stealing or hiding food
• Losing weight
• Poor personal hygiene
• Constant tiredness
• Behavioral difficulties
• Frequently missing school
• Untreated medical problems
• Few friends

5. Exploitation
the use of children for someone else’s advantage, gratification or
profit
Examples: child labor; child pornography and sexual exploitation.

Possible Signs of Exploitation

• Has money, gifts or expensive items not given by parents
• Over confidence, sense of importance
• Very tired, sleeping in school
• Frequently absences from school or previous activities
• Physical impacts: bent back, weakness, damage to hands

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6. Multiple Signs of Abuse
• Chronic running away, fears going home, refuse to have parents
contacted
• Aggression or being isolated or withdrawn
• Distrust of adults
• Fear of physical contact-flinching if touched
• Regressing to younger behavior or inability to concentrate
• Self-destructive tendencies
• Depression, self-mutilation, suicide attempts

NOTE: The possibility of abuse should be assessed if a child

show:

A number of signs;
OR
One serious sign

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PSYCHOSOCIAL DISTRESS-
CONSEQUENCE OF
VIOLENCE AGAINST
CHILDREN

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 Psychosocial distress is a result of ongoing abuse and
violence against children

Signs of Psychosocial distress can appear on the short and

long term and it can inform us about an abuse and violence the
child has been or is still being exposed to.

As a consequence of exposure to violence, many children will

experience symptoms associated with Post-Traumatic Stress
Disorder (PTSD)

Signs of Psychosocial Distress-Emotion/Behavioral

• Sadness/ Anxiety
• Feelings of fear
• Depression and other mental health disorders
• Difficulty Concentrating
• Isolation
• Aggression/ Self-destructive behavior
• Suicidal attempts or self-harm
• Regression in development mentally
• Difficulty trusting others
• Lack of interest in school/ previous activities
• In some cases, sexual violence
• Lack of sense of safety
• Increased risk of alcoholism and substance abuse

Signs of Psychosocial Distress-Physical

• Problem in sleeping
• Headaches
• Extreme reactions to loud noises
• Bedwetting
• Nightmares
• Regression in development physically
• Delay in brain development as a lack of positive stimulation

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• Physical illnesses in childhood such as asthma, gastro-intestinal
problems.
• Physical illnesses on the long term such as heart and lung
diseases, cancer, high blood pressure.
• Serious impact on the immune and nervous system on the short
and long terms.

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UNDERSTANDING POTENTIAL CAUSES OF
CHILD ABUSE
Theory of Ecology: The importance of this theory is to illuminate the
multidimensional causes of abuse and to show its dynamic face. Each
causative agent is of real importance and is assessed for other factors
in protection situations. According to the World Health Organization; the
theory of Ecology has 4 levels and each level can cause abuse and
violence against children either solely or unanimously

Individual level:
• biological and personal aspects such as sex and age
• lower levels of education
• low income
• having a disability or mental health problems
• harmful use of alcohol and drugs
• A history of exposure to violence.

Close-relationship level:
• lack of emotional bonding between children and parents or
caregivers
• poor parenting practices
• family dysfunction and separation
• witnessing violence between parents or caregivers
• Early or forced marriage.

Community level:
• poverty
• high population density
• low social cohesion and transient populations
• easy access to alcohol and firearms
• High concentrations of gangs and illicit drug dealing.

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Society level:
• social and gender norms that create a climate in which violence
is normalized (cultural beliefs)
• health, economic, educational and social policies that maintain
economic, gender and social inequalities
• absent or inadequate social protection
• post-conflict situations or natural disaster
• Settings with weak governance and poor law enforcement.

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HOW TO RESPOND TO CHILD
PROTECTION CONCERNS

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Guiding Principles in Early Identification and
Referral Stage
In Early Identification and Referral stage, all stakeholders, service
providers and or any person involved in the identification and referral
process must agree to follow these guiding principles, which reflect
international standards of care and best practice as outlined in the Child
Protection Minimum Standards and the UN Convention on the Rights of
the Child.

Do No Harm
This means ensuring that actions and interventions designed to support
the child (and their family) do not expose them to further harm. At each
step of the referral process, care must be taken to ensure that no harm
comes to children or their families as a result of staff conduct, decisions
made, or actions taken on behalf of the child or family. Caution should
also be taken to ensure that no harm comes to children or families as
a result of collecting, storing or sharing their information. For example,
collecting unnecessary information that is then found out about a child, or
intervening to help a child that then causes conflict between individuals,
families and communities, and unless care is taken, this may expose a
child and his/her family to further harm such as revenge acts or violence.

Best Interest of the child

The “best interests of the child” encompass a child’s physical and
emotional safety (their well-being) as well as their right to positive
development. In line with Article 3 of the United Nations Convention on
the Rights of the Child (UNCRC), the best interests of the child should
provide the basis for all decisions and actions taken, and for the way in
which service providers interact with children and their families. Front-
liners and Service providers should prioritise the child’s health and
safety above all other concerns and consider what is in the best interest
of the child before taking action.

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Factors that determine the best interest of the child:
• The mental/emotional and physical health needs of the child is
the top priority that determines the best interest
• The presence of domestic violence in the home including
violence against the child
• The capacity of the parents to provide the basic needs as safe
home and adequate food, clothing, and medical care
• The mental and physical health of the parents
• The emotional ties and relationships between the child and his
or her parents, siblings, family and household members, or other
caregivers

Confidentiality
Confidentiality requires to protect information gathered about any
individual of concern (child at risk or family) and to ensure it is accessible
only with a beneficiary’s explicit permission. For agencies, service
providers and staff involved in identifying and referring cases, it means
collecting, storing and sharing information on individual cases in a safe
way as sharing information improperly could lead to endangering the
life, health or safety of the child and family members involved.

Specifically, the person making the referral should never reveal

children’s names or any identifying information (i.e. location, phone
number, physical address, family member’s names, etc.) to anyone
not directly involved in the provision of case management services.
More specifically, this means that identifying information should never
be shared beyond the person making the referral, their direct
supervisor and focal point receiving the referral. When information
is shared among stakeholders, it should be communicated verbally in a
private place or attached to an email in password protected file with no
identifying information in the email itself. The referral form should never
be printed and should be saved on a single computer with password
protection.

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Key guidelines in maintaining confidentiality include:
• Always discuss referrals/ child protection concerns in private.
• Don’t reveal personal information to anyone not involved in the
case
• Collect and keep files regarding referrals safely (password
protected, locked cabinets, etc.)
• Limit the number of people who have access to information
about children
• Never include a child’s name, location, date of birth or other
identifying details in the body of an email.
• Always send sensitive information in a password protected
document or communicate details verbally.
• Do not copy multiple people on emails. Send written information
only to the Focal Point designated to receive it
• Avoid informal conversations with colleagues or friends about
child protection cases.
• Only share information with the informed consent/ assent of the
child and parents/ caregivers.

Informed Consent/assent
Prior to providing a referral, person involved in the referral process must
request the beneficiary’s permission to provide services and provide
them with enough information to make an informed decision. This
process is called informed consent.

Informed Consent is the voluntary agreement of an individual who

has the capacity to understand, and who exercises free choice, to be
referred to a third party and/or to a specific service based on full and
transparent information. Before proceeding with a referral, the person/
Front-liner must obtain verbal consent by sharing information on:
service options available, providers, the process and requirements to
access services and potential risks as well as confidentiality and how
information collected will be used and stored. This information should
be communicated clearly and using non-technical language that the
beneficiary can understand.

In the case of a child (under 18), a parent or caregiver’s consent should

be sought in addition to the child’s consent, unless doing so might put

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the child at risk of further harm (e.g. where parents are implicated in
abuse or could take “punitive” measures against a child). Where parents/
caregivers are unavailable or implicated in the abuse, the person/Front-
liner should follow an informed assent process requesting permission
from the child themselves. Informed assent is the expressed willingness
to participate in services by children over 12 years. Informed assent
requires the same process as informed consent, including sharing of
information in a child-friendly format on services and potential risks and
asking the child for his or her permission to help. Informed assent is not
a legally binding process but is an accepted procedure when children’s
caregivers cannot be involved due to their absence (e.g. death, located
in a different area, or role in the abuse).

Caregiver
Age
implicated in Type of consent/assent
range
abuse?
0-5 No Informed consent of caregiver
No consent/assent required – proceed with
0-5 Yes
referral
6-11 No Informed consent of the child and caregiver
6-11 Yes Informed assent of child and trusted adult
12-18 No Informed consent of the child and caregiver
12-18 Yes Informed assent of the child

Maintain Professional Boundaries

Case management staff must act with integrity adhering to the ethical
and professional standards by not abusing the power or the trust of the
child or their family. This includes asking for favours or payments in
exchange for unfair advantage or services. Where caseworkers have a
conflict of interest (e.g. are related to or from the same network as the
child/ family), a new caseworker should be assigned.

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RISK LEVEL GUIDE

Definitions:
High Risk (level 1): Child significantly harmed or at immediate, serious
risk of harm; Urgent response and frequent follow up required within 24
hours.

Medium Risk (level 2): Child harmed or at risk of serious future harm;
Response and follow up required within 2-3 days

Low Risk (Level 3): Child at risk of harm; monitoring required or child
no longer a level 2 but monitoring required ensuring harm removed
follow up within 5-7 days

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Type of
High Risk Medium Risk Low Risk No Risk
Risk
Violence Serious injury Excessive Threats to No violence
(physical Infant or corporal injure present (factors
abuse) toddler injured punishment Non causing
in Domestic Threats to injure injurious, the harm
Violence (DV) Dangerous occasional have been
incident and reckless corporal addressed or
Child attempted behavior punishment removed)
to suicide Child is self- Person causing
harming harm no longer
has contact
with the child
Abuse Any sexual Child is Child is The child and
(sexu- contact between promised to be treated family have
al and a child and an married in the differently received
emotion- adult (where future than other support and
al abuse) person causing The child has siblings there are no
harm has access been sexually and parent/ sexual harm
to the child) violated in the caregiver factors present
Child is being past and not or other Factors
persistently received any relevant causing the
belittled, support person is emotional harm
isolated, or Significant negative have been
humiliated by caregivers towards the addressed
a significant approach to the child (parent
caregiver child is harmful received
(occasional support)
Child is belittling, Person causing
promised to be isolation or harm no longer
married in the humiliation) has contact
following days or with the child
child promised to
married and will
move out of the
area (e.g. back
to Syria) in the
following days

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Neglect Serious injury Lack of Caregivers The child’s
or illness due supervision are basic needs
to neglect Inadequate emotionally are being
(malnutrition basic care distant met and the
with no apparent Failure to protect caregiver
causal factors)
The child is often
left to look after
themselves, or
is undertaking
tasks beyond
his/her
developmental
capacity
Exploita- Child involved Child under 14 Parents are The child is no
tion in worst forms forced to work threatening longer working,
of child labor, Child over 14 to send the supports have
including sexual forced to work child to work been put in
exploitation or in dangerous place to ensure
child associated or harmful Child the child does
with armed circumstances over 14 is not return to
groups and working work
forces in a safe
environment
with little
exposure to
harm
Psycho- The child has The child’s social There No violence
social attempted skills, ability to has been present (factors
distress suicide self-care and sporadic causing
(parent The child is retain school disputes and the harm
not engaging in very attendance is violence, but have been
coping, risky behaviors significantly the child is addressed or
or not Child has impaired over 15 and removed)
protective stopped The child is has support Person causing
and/or no communicating/ using drugs and/ networks harm no longer
services speaking or alcohol has contact
involved) The child’s The child with the child
becomes
sense of reality
frequently
is affected
absent minded
The child has
intense violent
behaviors

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 The child The child’s
The child has is sad and psychosocial
distressing flash- withdrawn wellbeing
backs The child is is restored;
The child is bed- displaying the child is
wetting anger engaged in
The child is often a range of
crying and/or activities and is
sad not displaying
The child has behaviors of
unexpected and concern
intense fears,
phobias and
anxiety
The child has
sleeping and
concentration
problems
The child
is suddenly
behaving much
younger than
his/her age
The child is self-
harming
Do- Child under 5 Child is
mestic Child is displaying
violence witnessing emotional
present domestic distress and
in the violence and difficulties
home there are level 2 learning and
harm factors socializing
Significant
injuries to the
parent suffering
the violence

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HOW TO GET INFORMED CONSENT
For children under 10:
Part of my job is to make sure the children I work with are safe. I care
about you and what happened to you, and I want to keep you safe. What
you tell me is between you and me only, unless there is something that
you tell me that worries me or if you need help that I cannot give you. If
I am worried about your safety, I may need to talk to someone who can
help you.

From what you have told me today, it sounds like you need help to stay
safe and healthy. There are people at another organization who work to
help keep children safe, and I would like to contact them to ask if they
can help. They will keep information about you secret and won’t tell
other people without your permission. Is it okay if I contact these other
people?

For children 11 and above:

Part of my job is to make sure that children I work with are safe and get
help when they need it. Although most of what we talk about is between
you and me, there may be some problems you might tell me about that
we would have to talk about with other people.

There is another organization {insert name of appropriate agency} that

has people who work with individual children to help keep them safe and
healthy. Based on what you told me today, I think this organization may
be able to help you.

I would like to share with them your name, location and how to contact
you or someone you trust. The people at [name of organization] will not
contact your family, neighbors or friends without your permission. Would
it be okay if I contacted {insert name of appropriate agency} to ask them
to help?

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For adults:
Based on the information you have given me today, I think your child
might benefit from individual assistance from [name of CP agency]. This
organization works with individual children and their families to help
ensure children are safe and healthy. They will assign one person to
work with you and that person might refer you or your child to other
services. If you wish, I can refer your child today to my colleagues at
[Name of CP Agency] and ask them to get in touch with you to better
explain the kind of support they offer. You will then be able to decide
whether you are interested in accessing additional services or not.

The only information I will share with my colleagues are your name,
location and best way to contact you (e.g. phone number, time to call,
etc.). They will only use this information to contact you and will not share
it with anyone else without your consent. We will not contact your family,
neighbours or friends. Your name and personal details will always be
kept private. Participation in services they offer is always voluntary – it’s
up to you. You can ask questions at any time today or in the future. You
can also decide at any time to stop receiving services, and there will be
no negative consequences for you or your family

Do you have any questions about the referral process?

Do you agree to allow me to make a referral to [Name of CP Agency]for

further assistance? [Yes or No]

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ROLES AND RESPONSIBILITIES OF FRONT-LINERS VERSUS
CHILD PROTECTION SPECIALIZED STAFF
Requirements of Child
Requirements of Front-liners
Protection Specialized Staff
Identify individual child protection Accept referrals from Front-liners
cases through regular presence in and other non CP agencies and
the community and direct contact community partners.
with children and families.
Positive communication with the Once referral is received, Conduct
child through Listening and trying initial (rapid) assessments for
to memorize all the details the CP cases and prioritize them
child would like to tell you about according to risk level. Directly
the abuse. assist the child and family if there
is any urgent need.
After completing the interview, Develop case plans that respond
write down all the important to needs addressed in initial and
details. Do not force the child comprehensive assessments and
to answer questions. It is not seek support of supervisor when
permissible to investigate necessary.
Ensure that abuse is documented Regularly follow up to ensure
in a safe and confidential manner all services and action points
listed in the case plan are carried
out within agreed time frames.
Ensure that progress is regularly
reviewed.
Complete the referral form and Regularly monitor and support
send in a confidential manner. to children and families through
home visits, providing guidance,
advice and emotional support,
community mediation and
referrals.
Refer the Child protection case Work with supervisors and
to the CP Specialized staff and managers to arrange case
inform them about the initial risk conferences for complex cases
level and the urgent needs of the and ensure children receive multi-
child and family. disciplinary support.

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Important note:
1. Only, in urgent cases, Front-liner can take the child for emergency
services but after informing the CP agency.
2. According to the CCPA sections: 61, 62, and 63

If any person is of the opinion that a child is apparently a child in difficult

circumstances as mentioned in Section 59, such person shall:
• inform the police or child welfare officer
• Whenever the information has been given to the police, the
police shall inform the child welfare officer
• To do the mentioned above steps you need to conduct a
confidential referral

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COMMUNICATING WITH
CHILDREN

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PRINCIPLES OF COMMUNICATING WITH
CHILDREN

1. Nurturing, Comforting and Supportive

Children who are at risk/have experienced abuse rarely seek help
independently, especially younger children, and will usually be identified
by someone else. Children may not understand what is happening
to them or may experience fear, embarrassment or shame about the
abuse. This can affect their willingness and ability to talk to you or
other service providers.

Your initial reaction will impact their sense of safety, willingness to talk,
and psychological well-being. A positive, supportive response will help
abused children feel better; A negative response (such as not believing
the child or getting angry) could cause further harm.

2. Reassure the Child

Children need to be reassured that they are not at fault for what has
happened to them and that they are believed. Children rarely lie about
being abused. Caseworkers should encourage children to share their
experiences.

Healing statements are essential to communicate at the outset of

disclosure and throughout case management. Find opportunities to tell
children that they are brave for talking about the abuse and that they are
not to blame for what they have experienced. Tell children that they are
not responsible for the abuse and emphasize that you are there to help
them begin a process of change.

– “I believe you” which builds trust

– “I am glad that you told me”, which builds a relationship with the
child
– “I am sorry this happened to you”, which expresses empathy
– “This is not your fault”, which Is non -blaming
– “You are very brave to talk with me and we will try to help you”,
reassuring and not making promises

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 Say that you accept that their feelings (anger, fear, anxiety…) are
natural in the situation.1
– “These are difficult things you are telling me”, or
– “Many children feel upset after a thing like that happens”

3. Do NO Harm: Be Careful Not to Distress the Child Further

Try to limit any interactions that might distress the child. Do not:
• Become angry with a child
• Force a child to answer a question that he or she is not ready
to answer
• Force a child to speak about the situation before he/she is ready
• Have the child repeat the story of abuse multiple times to
different people (follow-up conversations with children who
become distressed are not considered “multiple interviews”)

4. Speak So Children Understand

Information must be presented to children in ways and language that
they understand, based on their age and developmental stage.

5. Help Children Feel Safe

During Registration and/or Assessment, children often like to have
trusted adult present, especially young children and those who are
scared. Always offer children the choice to have a trusted adult present,
or not. Do not force a child to speak to/in front of someone they appear
not to trust. Do not include the person suspected of the abuse in the
interview.

There may be times when it is appropriate to talk to children and parents

separately as children may hesitate to speak in front of caregivers. Tell
the truth —even when it is difficult. If you don’t know the answer, tell
the child, “I don’t know.” Honesty and openness develop trust and help
children feel safe.

1 Source: Communicating with Children: Helping Children in Distress (2000) Save the
Children

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6. Tell Children Why You Are Talking with Them: Every time you
communicate with a child take the time to explain to the child the
purpose of the meeting. It is important to explain why you want to
speak with them, and what they will be asked and what will be
asked to his/her caregiver. At every step of the process, explain to
children what is happening.

7. Use Appropriate People: In principle, only female service providers

and interpreters should speak with girls about sexual abuse. Boys
should be offered the choice. If this is not possible use a more open
space or have someone the child chooses to be present. The best
practice is to ask the child if he or she would prefer.

8. Pay Attention to Non-Verbal Communication: It is important

to pay attention to both the child’s and your own non-verbal
communication during any interaction.

9. Respect Children’s Opinions, Beliefs and Thoughts – Right to

Participate
Children have a right to express their opinions, beliefs and thoughts
about what has happened to them as well as any decisions made on
their behalf. Service providers are responsible for communicating to
children that they have the right to share (or not to share) their thoughts
and opinions. The child should be free to answer “I don’t know” or to stop
speaking with a service provider if he/she is in distress. The child’s right
to participation includes the right to choose not to participate.

Respect is the key to proper communication

All persons involved in the referral process/ Front-liners should treat
children and their families with respect and consider their wishes
regarding the referral or reporting of a case. They should treat all children
and their caregivers with dignity and accept them without judgments. It
is important that you respect the wishes, the rights and the dignity of a
child, consider his/her best interests, when making any decision on the
most appropriate course of action to prevent or respond to violence,
abuse, exploitation or neglect. Respecting beneficiaries in terms of
referrals includes:

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Using Respectful Communication Techniques
• Discussing potential referrals in private settings (including
outside of a home when others are present, asking beneficiaries
if they would prefer to speak alone, etc.)
• Using language that the beneficiary can understand (i.e. speaking
in the same dialect as the beneficiary; not using technical terms;
in the case of a child, using simple language suitable to their age
and developmental stage)
• Use appropriate communication techniques and body language,
e.g. to demonstrate that we are interested in what they are
saying and appreciate the trust they put in us, use the right tone
of voice, do not interrupt, sit at the same level, etc.
• Asking the beneficiary only relevant questions required to
facilitate a referral (do not investigate yourself)
• Using non-blaming language – never express judgment of the
beneficiary, their families, parents or partners/ husbands, even
when the latter may be implicated in abuse
• Use reassuring and validating language and demonstrate
empathy towards the beneficiary
• Never forcing a child to answer a question
• Avoid requiring a child to repeat the story in multiple interviews

Involve the Child in Decision-Making

Children have the right to participate in decisions that have implications
in their lives. This can be achieved during the referral process by taking
the following actions:
• Communicating in simple, clear language appropriate to the
child’s age
• Asking children if they would like their family members (like
caregivers or siblings) to be present during discussions
• Asking the child what they would like to happen next
• In cases where a child’s wishes cannot be prioritized, the
reasons should be explained to the child

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Not Raising Expectations
• Never promising an outcome or that a service will meet all of a
beneficiary’s needs

DO’S AND DON’TS OF COMMUNICATING WITH CHILDREN

Do’s Don’ts
• Find a quiet place to talk to • Do not discuss sensitive
the child matters with the group or in a
• Believe the child and take his/ place where others hear
her fears seriously • Don’t ask embarrassing
• Use familiar expressions for questions
children. Speak in a language • Do not behave too officially or
the child understands use complex expressions
• Reassure the child that he/ • Do not judge the child or
she has done the right thing family member
by coming to you • Don’t ask too many questions.
• Listen carefully and try to Don’t make the child repeat
understand what is happening what happened
• Assure the child of privacy • Do not force the child to share
and you want to ask someone the abuse with his or her
for help parents or caregivers
• Be patient, and let the child • Do not force the child to
tell you his/her story in a way answer questions that he/she
that is comfortable for him does not want to answer
• Use non blame expressions • Don’t ask the child why. Don’t
such as: judge this talk as a child’s fault
o This is not your fault • Don’t promise children that
o Sorry that it happened to their problems will be solved
you
o I believe you
o That must be difficult/hard
• Tell the child about the next
steps.

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Best Practice for Responding
and Referrals

33
Best Practices
• Reassure the child
• Do not attempt to investigate reports yourself
• Ask only the number of questions necessary to gain a clear
understanding of what is being said (i.e. what, who, where,
when)
• Explain that you would know an organization that provides
services to children and you would like to call them to ask for
help
• Explain confidentiality – what the child tells you will not be shared
with other staff members, friends, etc.
• Use inter-agency form to document and email in a password
protected document to CP focal point in the area

If a Front-liner receives a report of a child at risk

1. Speak to person reporting to understand nature of the risk or harm
taking place. Ask who, what, where, when?
2. Tell reporter you would like to ask someone for help and that
information about the case will be kept confidential from friends,
family, other staff, etc.
3. Contact your line manager to alert them of the situation.
4. Complete the Referral Form and Contact appropriate Child
Protection Focal Point by phone immediately.
5. Save and password protect the referral form. Send by email to the
Child Protection Focal Point only.

If a Front-liner suspect a child is experiencing a form of abuse

1. Speak to your line manager or supervisor to explain your concerns.
2. Call the Child Protection Focal Point for your area and explain your
concerns.
3. Complete the Referral Form, save and password protect the form.
Send by email to the Child Protection Focal Point only.

If a child reports his/her experience of abuse

1. Find a quiet, private place to speak to the child.
2. Stay calm and reassure the child they have done the right thing in
coming to you.

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3. Listen and try to understand the basic details about the incident of
abuse.
4. Do not ask too many questions or force the child to answer. Being
forced to describe abuse repeatedly can lead to trauma and further
harm.
5. Say you will do your best to help the child. Explain that you know an
organization that provides services to children, and you would like
to call them for help.
6. Explain confidentiality, provide information on the services available,
and ask the child if it would be ok for you to contact the appropriate
Child Protection Focal Point in your area.
7. Ask the child if he or she would like you to contact their parents/
caregiver (if not implicated in the abuse). With the permission of the
child, contact the non-offending parents or caregivers and obtain
their consent to do a referral.
8. If the child is in immediate danger to their health and safety, contact
your line manager/ supervisor and call the appropriate Child
Protection Focal Point in your area while you are still with the child.
Do not leave the child without coming up with a plan.
9. Explain to child what will happen next
10. Complete the Referral Form, save and password protect the form.
Send by email to the Child Protection Focal Point only.

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 Early Identification Referral form

36
Referral By: Referred To: Date of Referral:
Name of Agency/organization: Name of Agency/ organization:
Level of Risk:
Name of staff/ Individual: Name of focal person:
High (follow up within 24 hours)
Address: Address:
Medium (follow up within 2-3 days)
Phone number: Phone number:
Low (follow up within 5-7 days)
Email: Email:
Child Information: Caregiver information in case of a child:
Name: Name of caregiver:
Date of Birth: Relation to child:
Address: Address:
Nationality: Phone number:
Gender:
Female Male Caregiver gave consent to referral?
Child gave consent to referral? yes No if No explain why?
Yes No if No explain why?
_______________________________________________________________
_______________________________ _______________________________________________________________
_______________________________ _______________________________________________________________
_______________________________ _______________________________________________________________
 Type of case:
Child in difficult circumstances: Child in conflict with the Law:
Specify: Specify:
Is found without having any home or settled place
Child committed an offence; please specify:
Incapacitated parent or guardian to take care and control
Associate a person who leads to immoral life
Being exploited for immoral, illegal purpose
Victim at the hands of individuals, families or the community.
Exposure to physical abuse
Exposure to emotional and verbal abuse
Exposure to sexual abuse, harassment
Exposure to neglect
Child labor
Worst forms of child labour
Witness of domestic violence
Others - please specify:

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 Health Condition:

38
Disability Medical condition
Deafness/Hard of Hearing (Mild/Moderate/Severe) Addiction
Chronic Illness
Blindness/Low Vision (Mild/Moderate/Severe)
Mental Illness
Physical Disability (Mild/Moderate/Severe)
Pregnant
Intellectual Disability (Mild/Moderate/Severe) Child in need for forensic medical examination
Others - please specify: (evidence should be collected by forensic services
in 72 hours).
Life threatening medical condition requiring
immediate intervention and treatment
Injuries
Other please spesify:
Services required
Case management services (protection)
Physical Health
Mental Health
Shelter
Others please specify

Explanation:
 Previous Services provided if any:
Agency:       Type of service:       Date:      

Agency:       Type of service:       Date:      

Agency:       Type of service:       Date:      

Description of the case (Problem)

39
 Consent for referral: (Optional)

40
I __________________________ [person of concern name], understand that the purpose of the referral and of disclosing
this information to ________________ [referral agency)] is to ensure the safety and continuity of care among service
providers seeking to serve this family. The service provider, _____________________ [referring agency], has clearly
explained the procedure of the referral to me and has listed the exact information that is to be disclosed. By signing this
form, I authorize this exchange of information.

Signature of Responsible Party: __________________________

Caregiver __________________________ Date: __________________________

Receiving agency

Referral received by:       Response provided to referred agency by:      

Date:       Date:      

Guiding notes:
• This referral form is to be used by any front-liner who contacts
children, women, and elderly on regular basis and suspects abuse,
or received a report regarding abuse.
• This referral from should be used to refer cases.
• The consent of care giver and child is required, however, if for any
reason consent was not able to be taken from a care giver the best
interest of the child should be sought and a referral should be done.
• A front-liner should not carry any investigation or assessment as
this might cause more harm; therefore, it is recommended to carry
the referral on just need to know basis (only main information about
abuse or basic need)
• Only, in urgent cases, Front-liner can take the child for emergency
services but after informing the CP agency.
• If any person is of the opinion that a child is apparently a child in
difficult circumstances as mentioned in Section 59, such person
shall in accordance to the CCPA of Bhutan:
ο Inform the police or child welfare officer (Protection Officer or
NCWC)
ο Whenever the information has been given to the police, the
police shall inform the child welfare officer (Protection Officer or
NCWC)

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 མ ་་དང་ཨ་
ངས་ཨ ་
ལ་ ན
།།

་ག
༄༅

ས །།