Development and implementation of the Barnahus model in Spain
Summary
Sexual violence against children and adolescents is a widespread problem worldwide, with potentially serious repercussions for their development and health. This public health issue is exacerbated by the child's exposure in a criminal justice system that treats them as a mere witness to the events they have experienced, rather than as the extremely vulnerable victim they are. Therefore, the response to sexual violence against children cannot be limited to a purely legal or healthcare-based approach, but requires an interdisciplinary one.
In Spain, in recent years, partly as a result of major, highly publicized scandals, significant progress has been made in terms of regulations and social awareness regarding this issue. This has prompted public administrations to work on a new model of care that better guarantees the rights of child victims and avoids secondary victimization caused by the criminal process and the lack of coordination between the institutions involved in these cases.
The Barnahus model has begun to be implemented in Spain to address the significant shortcomings in the system that serves children who are victims of sexual violence, who were not receiving comprehensive, specialized care or access to justice tailored to their needs. Currently, there are 14 Barnahus centers operating in Catalonia, and most of the autonomous communities are working on its implementation.
Due to their vulnerability and an adult-centric social structure, children are the group most affected by the worst forms of violence, such as female genital mutilation, forced marriage, and other forms of sexual violence. According to Finkelhor's studies in developmental victimology, children can suffer the same forms of mistreatment and abuse as adults. However, their vulnerability and dependence on adults place them at greater risk. This is widely recognized in the field of victimology, which considers minority status as one of the main factors that increase the risk of suffering abuse or mistreatment. The term "victimogenic factor" refers to a set of circumstances that makes certain groups, such as children, more likely to experience violence (Rodríguez Manzanera, 2008).
Furthermore, when discussing the particular vulnerability of children to violence, it is noted that they face a greater risk of suffering negative emotional, psychological, and physical effects. It has been shown that child victims are more likely to develop long-term problems , such as psychological disorders (like anxiety, depression, post-traumatic stress, or suicidal thoughts); physical effects (like incontinence, chronic pain, or unexplained health problems); difficulties in the sexual sphere (like phobias, hypersexualized behavior, or problems with libido); and social problems (difficulty building relationships, isolation, family rejection, or school problems).
Focusing on sexual violence, we observe that, year after year, this type of violence continues to disproportionately impact children. In 2023, 21,850 reported victimizations (1) of crimes against sexual freedom were registered; in almost half of these cases (9,185), the victim was a child (Ministry of the Interior, 2024).
It is important to note that, in the case of children, their already particular vulnerability is compounded by aggravating factors. One of these is that, in most cases, the very people who should be protecting these children are the ones who abuse them, generating in them a profound confusion between love, hate, desire, and shame—feelings that can affect their social, emotional, psychological, and sexual development (Save the Children, 2020). Studies indicate that in 8 out of 10 cases of child sexual abuse, the perpetrator is a family member or someone known to the child (Save the Children, 2023).
Sexual violence is, therefore, a phenomenon that disproportionately affects children and causes serious consequences.
However, the seriousness of the crime and its repercussions on children is very difficult to verify, due in part to the extreme vulnerability of underage victims who in most cases have difficulty recounting what happened, because they feel shame, guilt, fear of the consequences, or because they normalize the situation (Pereda, 2009).
The lack of a written account is compounded by a lack of physical evidence of this type of violence, as it typically leaves scant physical traces and lasting effects that are not always visible. It is estimated that in less than 10% of cases (American Academy of Pediatrics, 2013) there is any physical evidence of the crime, and there is almost never a witness who can corroborate the facts. The difficulty of proving child sexual abuse partly explains why it is an underreported crime (Pereda et al ., 2016) with a high rate of dismissal due to lack of evidence (Save the Children, 2016).
Sexual violence against children and adolescents is, therefore, a particularly serious and delicate problem, which needs an approach focused on the particularities of the underage victim and on the complexity of the process, in which different actors and institutions converge.
It is estimated that children who are victims of sexual violence speak, on average, with ten professionals from four different institutions and that the process, in addition to being painful, is very long and in few cases ends with the conviction of the perpetrator (Save the Children, 2018).
It is widely demonstrated that repeatedly recounting the trauma is highly detrimental to the child , who has to relive their traumatic experience each time they explain it, hindering their recovery and resilience. Besides being especially harmful to the child, repeated interviews are also detrimental to the justice system itself. Various studies have shown that the child's account becomes distorted by the intervention of professionals. One consequence is a loss of quality in the child's testimony, which can ultimately be completely invalidated by the judge. There are many reasons why proving this crime is difficult. These include the numerous interviews the child undergoes, intimidating courtroom environments, long waits in hallways, the possibility of encountering the accused, and the lack of training among professionals in child welfare issues.
To these failures of the judicial system, we must add the shortcomings of the other services that also intervene in these cases and that contribute to aggravating the secondary victimization experienced by the child, when due to a lack of coordination between them, they duplicate some evidence and may invalidate others.
In summary, although sexual violence against children is a widespread and complex problem requiring a high level of specialization from all professionals involved, the current system for assisting children and adolescents who are victims of sexual abuse does not adequately meet their needs . Instead of offering them effective protection, the system exposes them to ongoing suffering. The lack of coordination between the judicial, healthcare, and child protection services prevents the best interests of the child from being guaranteed at every stage of the process. For the justice system to fully guarantee the rights of children who are victims of sexual violence, and for health and protection systems to provide them with more appropriate care, a change of model is essential. This new model must place the well-being and rights of children at the heart of the institutional response and unify the judicial and social services systems to offer each child a single response tailored to their needs and rights (Save the Children, 2018).
The Barnahus model
The most efficient response to the problem of secondary victimization in cases of child sexual abuse, and one that also has scientific validity, are the so-called Children's Houses, known internationally as Children's Advocacy Centers (CAC) , Barnahus or Children's House .
Since the 1980s, Children's Advocacy Centers (CACs) have existed in the United States (Huntsville, Alabama, 1985). These are comprehensive, child-friendly centers that serve children and adolescents who are victims of sexual abuse and maltreatment. They bring together all the services and professionals involved in a case in one place, reducing the number of evaluations and interviews thanks to the coordination of multidisciplinary teams composed of highly trained professionals. The response offered by CACs has proven to be much more effective than the judicial process and more satisfactory for the child (Herbert & Bromfield, 2016). It has been shown (for example Cross et al , 2008) that the multidisciplinary intervention of the CACs significantly improves the experience of victims and their families, ensuring greater participation of professionals during the interview with the child (in 81% of cases), better adaptations in physical spaces (56% in the CACs, compared to only 6% in the traditional model), greater access to medical-forensic examinations (48%) and mental health services (72% in the CACs, compared to 31% in the traditional system).
In Europe, since 1998, Iceland has had the Barnahus model , meaning "Children's House" in Icelandic. Like the American model, Barnahus coordinates all the services involved in a case of child sexual abuse in a single location. In these houses, the police, child protection services, justice system, and health services work together under one roof to care for child victims.
In these centers, the child tells their story once, in a comfortable environment, and the various professionals from the relevant departments (interior, justice, protection, and health) attend this interview via closed-circuit television. The interview is also recorded to avoid the child having to appear in court to testify (Pereda et al., 2021). The use of pre-constituted evidence is one of the main differences between the Icelandic model and the American model, which does not allow it. This practice, recognized internationally and in Europe, is one of the most effective ways to prevent secondary victimization of children, as it reduces the number of interviews, ensures that the professionals involved are trained to avoid leading questions or influencing the testimony, and limits the need for the child to appear in court during the trial. The inclusion of pre-constituted evidence in the Barnahus model is based on the legal tradition of the Nordic countries, which prioritize the protection of child victims of crime by preventing them from having to appear in court. These countries have a long history of awareness regarding the risk of revictimization that children may suffer within the judicial system, and they do everything possible to prevent minors from being present during the trial.
It is worth noting that the use of comprehensive services in a child-friendly environment like Barnahus not only benefits victims but also improves the functioning of the justice system. These services reduce waiting times and avoid unnecessary delays, allowing for better preservation of the child's memory. This approach fosters a higher quality, more detailed, and more accurate account from the child, which can then serve as stronger evidence in criminal proceedings. By being attended to by specialized professionals, the child can offer clearer and more detailed testimony about the accused and the crime suffered. Furthermore, the rate of reports and convictions is significantly higher when the victim receives multidisciplinary support. With all services under one roof, the judicial process is expedited, and the secondary victimization often experienced by child abuse victims is reduced.
Benefit for the well-being of children and for the judicial process
One of the greatest advantages of the Barnahus model is its proven efficiency over time, supported by numerous studies and data that validate its effectiveness, both in terms of the well-being of the child and their family, and in improving the judicial process. Data from Iceland's Barnahus system shows that, since its implementation, the number of judgments in favor of the child has tripled, and investigations have doubled. One possible conclusion drawn from this data is that the child's account, being collected more carefully, is presented as more decisive evidence in court (Gudbransson, 2021).
In Sweden, other data show that the implementation of the Barnahus has led to an improvement in the reporting of cases, demonstrating that this model not only improves care, but also the detection and reporting of cases of child sexual abuse.
The children's experience in the judicial process
The effectiveness of this model lies in both the quality of the intervention and its flexibility. In some countries, Barnahus (child protection centers) are part of the child protection system, and psychologists from this department interview the children. In others, however, Barnahus are run by the health system or municipalities, and often the interviewers are police officers. The common thread is multidisciplinary work and interdepartmental collaboration in a child- and youth-friendly environment.
Although there may be variations between different centers, Barnahus are always friendly environments, in which the child never comes into contact with their alleged aggressor, and in which specialized staff are in charge of the interviews and forensic assessments, both medical and psychological.
Ensuring quality of care
To ensure the quality of the model without hindering its expansion and adaptation to the territory, the PROMISE network , a collaborative project between countries that seeks to guarantee a high level of quality for the Barnahus model, proposes 10 quality standards to promote its implementation in different countries, maintaining its essence and founding objectives:
- Standard 1. Put the best interests of the child at the center of the intervention.
- Standard 2. Work from a formal, multidisciplinary and interdepartmental regulatory framework.
- Standard 3. Include all children who are victims of any form of violence as potential users of the center.
- Standard 4. Provide a child-friendly environment for children and adolescents.
- Standard 5. Interdepartmental case management.
- Standard 6. Forensic Interview.
- Standard 7. Medical examination.
- Standard 8. Therapeutic services.
- Standard 9. Continuing education and skills development.
- Standard 10. Prevention: sharing information, raising awareness and building external competence.
Interdepartmental collaboration
The collaborative work, under one roof, of all professionals from different institutions is the cornerstone of the Barnahus model, which aims to serve the best interests of the child with a shift in perspective: professionals come to Barnahus , not the child. This paradigm shift literally puts the child at the center.
In the Barnahus model, it is not the child who adapts to the system, but rather the system that adapts to the child. This change has proven positive not only for the child, but also for their family, for the professionals who have greater support and confidence in their decision-making regarding the case, thanks to collaboration with other professionals, and also for the judicial process itself, which benefits from increased prosecutions and investigations and higher-quality expert evidence.
We must be clear that interdepartmental collaboration does not mean that all professionals from all services are always present in the house, but rather that we must differentiate between two teams of professionals: the fixed team, which is always present in the house, and the mobile team, which only travels to perform its tasks.
The permanent team consists of at least three people: a professional coordinator, an expert in child and adolescent victimology and knowledgeable about the criminal process; a social work professional in charge of the relationship with the family; and a psychology professional in charge of conducting the initial exploratory interviews in cases of suspicion and of therapeutic care.
The professionals on the mobile team are linked to the Barnahus (Child Protection Units), but they are not always present. They only go to the Barnahus to perform their duties and maintain constant communication with the permanent team. The mobile team consists of the investigating judge, the prosecutor, and the defense attorney, who travel to the Barnahus to participate in the pre-trial hearing, or they can participate remotely from the courthouse. In addition, a forensic psychologist travels to conduct the forensic interview with the child, and a forensic medical professional, accompanied by a pediatrician or gynecologist, is also present to perform the forensic medical examination and detect any physical indicators of abuse.
The Barnahus model in Spain
Since 2020, the Barnahus model has been a reality in Spain. In the midst of the COVID-19 pandemic, the first Barnahus in Spain opened in Tarragona (Catalonia), promoted by the Directorate General for Children and Adolescents of the Government of Catalonia, in collaboration with the Departments of Justice, Interior, Health, and Education of the same administration. The Catalan Barnahus model follows the principles of the original Icelandic model and offers a team of permanent professionals and mobile teams, providing the following services: a single reception/entrance;monitoring and coordination of cases with local stakeholders; the forensic interview conducted by a mobile team from the Department of Justice; the medical examination in non-acute historical cases conducted by a team from the Institute of Legal Medicine and Forensic Sciences of Catalonia; and the psychological support offered, depending on the needs of the case, by mental health professionals from the Department of Health or by the psychosocial team of Barnahus itself.
Three years after opening, the Barnahus in Tarragona has handled more than 700 cases, and in this area the number of reported cases of child sexual abuse has increased fourfold.
In fact, the province of Tarragona has a significantly higher notification rate than the other Catalan provinces, demonstrating the effectiveness of the model and the single-point system, which brings clarity to a previously very confusing process and encourages the reporting and referral of cases. Following these positive results, the Catalan government opened 13 new Barnahus centers throughout the region in 2024.
Over the past two years, several other Autonomous Communities have followed the path set by Catalonia and have begun working on the implementation of the Barnahus model in their territory, such as the Basque Country, the Valencian Community, the Community of Madrid, Navarre, Cantabria, Andalusia or the Balearic Islands.
Finally, it is worth highlighting two major milestones at the national level that have been decisive in promoting the Barnahus model in Spain. First, at the regulatory level, two recent organic laws strongly encourage its implementation.
On the one hand, there is Law 8/2021, of June 2, which reforms civil and procedural legislation to support people with disabilities in the exercise of their legal capacity, better known as LOPIVI , and on the other hand, Organic Law 10/2022, of September 6, on the comprehensive guarantee of sexual freedom. Both texts emphasize the need to create comprehensive, specialized centers for children who are victims of sexual violence, and Law 10/2022 insists that these centers follow the principles of the Barnahus model.
Towards a childhood free from violence
At the political level, the Barnahus model enjoys the support of the Spanish State Government, which has demonstrated on several occasions its commitment to the model and is implementing, together with the Council of Europe and the European Union, the two-year project Strengthening Child-Friendly Justice through effective cooperation and coordination between different Barnahus services in the Regions of Spain , which will end in 2027, and whose objective is to publicize and promote the implementation of the Barnahus model in Spain.
Grades
(1) Victimization is understood, according to the definition of the Report on crimes against sexual freedom (Ministry of the Interior, 2024, p. 59): the number of incidents reported by people in which they claim to be victims or harmed by some criminal offense.
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