21st Century Child Abuse: A conversation with Lucy Berliner, a trailblazer in child sexual abuse, trauma, and victim treatment

Lucy Berliner is a renowned giant in trauma and trauma screening and was the former Director of the Harborview Center for Sexual Assault and Traumatic Stress at UNICEF’s global research arm in Italy. She was the long-time Director of the Harborview Center on Sexual Assault and Traumatic Stress at the University of Washington, and Clinical Associate Professor in the School of Social Work and the Department of Psychiatry and Behavioral Sciences. Lucy is a world-renowned advocate and champion for the concept of trauma-informed care.  

In the Radio Kempe Podcast, Lucy discusses her call for “Trauma Screening for Every Child Seeking Treatment.” Lucy argues there is clear evidence that large numbers of children are being exposed to trauma and adversity at an early age and that such exposure is creating significant risk of poor physical and mental health outcomes later in life.  She adds, “children don’t disclose because we simply don’t ask.” Lucy also addresses a key point often heard from children’s health professionals; “we are being asked to do more and more things and capture more and more information, but simply don’t have the time.” She emphasizes that trauma screening is essential and will change treatment strategies.   

Join Radio Kempe for an interview with world-leading trauma expert, Lucy Berliner, as we address the harm to children in this digital age, and work toward real practical solutions.  

Transcript

00:00:00:0 - 00:00:19:6
Unknown
You're listening to Radio Kempe. We value the sense of community that connects people and helps them find ways to move forward. Join us on our journey to prevent child abuse and neglect.

00:00:19:8 - 00:00:48:2
Unknown
Well, welcome to Radio Kempe. Today is the latest podcast in the series 21st Century Child Abuse. I'm Ernie Allen and I will be your host today. I've spent many years in the fight to keep children safe. I'm an advisor to governments, law enforcement, technology companies, and others, including the camp center. Today our guest is Lucy Berliner, a giant in the field of child abuse, trauma and trauma screening.

00:00:48:3 - 00:01:24:2
Unknown
She was the long time director of the Harborview Center on Sexual Assault and Traumatic Stress at the University of Washington, and clinical associate professor in the School of Social Work and the Department of Psychiatry and Behavioral Sciences. She is a world renowned advocate and champion for the concept of trauma informed care. Lucy, you've argued that many children are exposed to trauma and adversity at an early age, and that such exposure can create a significant risk of poor mental and physical health long term.

00:01:24:3 - 00:02:00:8
Unknown
How serious is this challenge today? I think that this is a now very well established. There are tons of different kinds of studies, including studies that have been following cohorts from birth cohorts around the world. So there's no controversy at all about the prevalence of exposure to trauma, which we think about as threat related experiences, but adversities as well, like neglect, which is on the more deprivation side versus the threat side.

00:02:00:9 - 00:02:34:7
Unknown
But I think it's widely agreed that these the there are high rates and we don't always know about it because kids don't come forward, especially for certain kinds of trauma and adversity. And I would say child maltreatment, sexual abuse, physical abuse and neglect are the least likely to be reported because when a family member is the perpetrator, it gets very complicated from the perspective of the child.

00:02:34:8 - 00:03:12:8
Unknown
Well, you you spoke last October at camp's 2023 international conference, and you emphasized the importance of making trauma screening a clinical practice standard. Where do we stand today regarding progress toward achieving that goal? Well, that's a that's a relatively new idea that you would ask, patients or clients seeking some kind of service are coming to the attention of a system to explicitly ask them about their experiences.

00:03:12:9 - 00:03:44:4
Unknown
And many people have been hesitant for the fear that by asking, you are actually harming a child because it would be upsetting, or an adult who might be talking about childhood experiences. But that's a subtle question that, the there's we have now a number of studies confirming that it is perfectly possible to ask, for example, children who are seeking mental health care, nothing related to trauma.

00:03:44:5 - 00:04:14:0
Unknown
They're not presenting with PTSD. They're just coming in asking for help. Turns out, by routinely screening them when, as part of the initial assessment. Lo and behold, children will report pretty high rates of exposure to a whole range of different kinds of traumatic experiences. And it's not harmful. It turns out it doesn't upset kids who haven't been, exposed.

00:04:14:1 - 00:04:43:3
Unknown
The only kids who are somewhat upset are those who already have DSD. And that's actually as it should be. I mean, that is what PTSD is. It's being upset about reminders and memories. And quite often those children were previously completely missed in clinical settings because without direct inquiry, kids on their own will not report. And that's just as true for adults.

00:04:43:4 - 00:05:12:2
Unknown
Well, that you raise the question of hesitancy on the part of practitioners. I remember from that conference, last October, one of the participants said, children don't disclose because we don't ask. I know that your goal has been to lower the apprehensive ness over asking. And you added, the most important message is do not ask if you're not going to acknowledge and validate.

00:05:12:3 - 00:05:35:4
Unknown
That's worse than not asking at all. So can you explain a little bit about what you meant by that? Well, that that's the other side of this I think we can put to rest fears about harming patients or clients by asking. I don't think there's any evidence for that. and so that can't be shouldn't be the reason.

00:05:35:6 - 00:06:08:1
Unknown
And to be honest, any mental health person who can't handle hearing about a child or a patient's traumatic experiences is probably in the wrong line of work. So but we did have to go out and prove that did the work that thousands and thousands of cases. You just don't find that it's harmful. But we do have a parallel strain on another side of this issue, which is a craze for screening for everything.

00:06:08:2 - 00:06:33:3
Unknown
And you may realize, you know, the ACS is a good example. It's a laundry list. So a few of them are traumas, but most of them are life circumstances that do put kids at a disadvantage but are not actually traumatic. And many of them are circumstances that your typical provider, medical or otherwise, or, mental health can't do a thing about.

00:06:33:4 - 00:07:05:8
Unknown
But it became trendy to do ACS screening. In fact, California mandated it for all Medicaid providers. And of course, it turns out the research shows that as a score on a list doesn't predict anything with an individual anyway, so it has nothing to do with the individual person's risk. It's just an overall yes. If you have more bad things, you're more likely to have trouble.

00:07:05:9 - 00:07:34:7
Unknown
But what that has led to is this proliferation of screening. Just for the sake of screening. Yeah. And that is not yet. And, you know, a few years ago, Alig and I wrote a report, invited response to a Jama article about, an adult patient who we said she had been repeatedly asked because now it's bad to ask.

00:07:34:7 - 00:07:58:5
Unknown
And she never said anything until she finally said, okay, if they're going to ask, I'm going to answer. And she what happened wasn't even acknowledge. So I think that and she felt that that was worse than not being asked at all to be asked to. Mark. I was seriously sexually abused as a child and the provider doesn't say a word.

00:07:58:6 - 00:08:27:1
Unknown
And that and I think that's why we have to be careful in a clinical setting where you can do something to help the person. I think it should be the standard of care. Absolutely. Because a history of trauma is a counselor. Quite a bit of mental health problem development, not just PTSD, but across the board. Depression is actually more common outcome of trauma than PTSD is.

00:08:27:2 - 00:09:01:1
Unknown
And anxiety disorders, disruptive substance use, the whole shebang. So I think in mental health we should we should always do it. And then we have the skills training to really make the deep dive to talk about it and see where does it fit in for this particular patient. Now when you get to other settings like primary care or juvenile justice or child welfare, I think this asking without responding is not such a good idea.

00:09:01:2 - 00:09:31:1
Unknown
I think some level of screening can be done and it's not a big deal. I think people are afraid. Well then what do I do? And for good reason. You should be prepared to respond. And I think we've overcomplicated that. Clinicians can do the deep dive and get into all the details and feelings and everything, but really all the person needs as a result of a screening by a non-clinical is.

00:09:31:2 - 00:09:59:6
Unknown
Thank you for sharing. I'm so sorry that happened to you. Is there anything I could do to be helpful on that? No, you don't need to be a genius to learn to do that. That's simple. Human kindness. But I think sometimes people have the sense that, well, once I open the door and then I'm suddenly responsible. Well, if you're not in the position you did, it's validation and acknowledgment.

00:09:59:7 - 00:10:32:9
Unknown
And it that is extraordinarily meaningful to, to the patients or clients. Well, you know, as you know, our audience here at the camp center includes physicians, a lot of pediatricians, a lot of mental health professionals, but also nurses, social workers, people in the child welfare system, a host of others. what is what is your message for that range of practitioners who are encountering children in all kinds of settings?

00:10:32:9 - 00:11:04:5
Unknown
Well, I think that I mean, my message is if you're in the business, you know, if you're in a, in the the child welfare business at any level, child, child protection, child protection teams that all that sort of thing that by definition you are interested in this topic and should have additional knowledge and expertise and comfort and know what to do, but you still don't have to do it.

00:11:04:6 - 00:11:45:6
Unknown
You, you, you literally simply have to acknowledge and validate and then let the patient guide you. Just for example, Ernie, it's always been curious to me that child welfare workers rarely seem to ever mention the reason the kids are there to the kids. It's it is not, to my knowledge, a standard training practice in child well. Now, I understand during a CPS investigation you have to do an objective type of investigation and that means you can't jump in and say, gee, that was horrible, what happened to you, and we're going to save you.

00:11:45:7 - 00:12:11:5
Unknown
But when kids are under the auspices of child welfare or they're in care, is it common for a child welfare worker to literally say to a kid, you know, what happened to you was abuse and that wasn't right, and we're going to help you get better and we're going to help your family. I'm not sure it's considered a standard I rarely encounter, and I continue to be involved in working with child welfare.

00:12:11:5 - 00:12:35:6
Unknown
Well, it sounds to me like you believe it needs to be a standard. And how how do we promote that? How do we ensure that that is a part of the training of every child welfare professional? Well, I think that's what entities like the Kemp Center are for, to be always on the alert for the key areas that need building up.

00:12:35:7 - 00:13:20:4
Unknown
Child welfare is really one of the hardest jobs on the planet, because it just so messy and complicated and competing interests and all of that. But I think I just it breaks my heart to think of kids who suffered these terrible experiences. The system got involved and nothing came of it. Yeah, that just seems like a I. I'm waiting to see them when they grow up and they come into their offices and say, well, I was abused and there was a social worker and there were other people who knew about it, and then they left me in the situation or nothing.

00:13:20:4 - 00:13:59:3
Unknown
And no one ever said anything to me about it. I think that's more common than not, to be honest. Well, that's it's, it's disturbing, but it's not surprising. But it's disturbing. And clearly we need to do something about it. I also want to pursue a little bit, the whole issue as it relates to medical professionals. As you recall at that conference that you addressed last October, a pediatrician who was attending said, quote, we're being asked to do more and more things and capture more and more information, and we simply don't have the time.

00:13:59:4 - 00:14:27:2
Unknown
You know, the frustration was obvious. What's the answer to that? Better medical education. I think that's a great point coming from the pediatrician. And it is actually true. If you look, they have more required screenings than you can shake a stick at. it it's pretty. It's in the hundreds. And it, it you always wonder when they come up with all these guidelines.

00:14:27:3 - 00:14:55:1
Unknown
Each one of them individually seemed like a good idea, but you'd have to have very long visits. It's really tough to fit in screening for 100 things in a seven minute visit. So I do think there has to be triaging, of which, screening, measures are used. For example, something like, you know, gun safety. Well that's relevant.

00:14:55:1 - 00:15:31:9
Unknown
That should be triaged up because it's very relevant. but I think that's a conversation that, that primary care doctors need to have because I am completely in sympathy with your your head blowing off at the number of things, I think screening for things that you something can be done about right then and there. like if depression that's a very viable thing to screen for because we have treatments and we can we can actually do them screening for trauma histories in medical.

00:15:31:9 - 00:16:00:5
Unknown
I think that should be, a clinical decision based on relevance. Like, for example, in on the adult side or even the kid side, if some patient is coming in for with a lot of somatic complaints, but they're kind of vague and and the doctor is perfectly qualified to say there's something going on here. This is not a normal or usual presentation.

00:16:00:6 - 00:16:32:2
Unknown
Maybe I should look a little further into seeing if there's something on their mind or something going on. But so I, I, I don't think we should require trauma exposure screening in the medical profession. but high awareness alertness. And if a kid were or a parent, I think it's much better to go through the parents, at least initially, at least for a screening type approach, because most trauma is not committed by parents.

00:16:32:4 - 00:17:02:6
Unknown
Most is things that happen to kids outside the immediate family, but the kid has not told the parent, or the parent has seen the child change or behavior changes and doesn't really know what's going on. And a conversation from a primary care doctor, I think would be extremely helpful to parents. Is your sense that more of that is happening today, or more like your doctor is doing, taking that step?

00:17:02:7 - 00:17:30:7
Unknown
I definitely think they are. I think primary care doctors are extremely sophisticated and fully aware of the psychosocial backgrounds and their relevance to care that they don't. I mean, they're not surgeons who are looking for a kind of a different thing to do in their medical practice. And for example, there's a wonderful program that I don't understand. Why isn't all primary care doctors don't use?

00:17:30:7 - 00:17:58:2
Unknown
It's called seek and it's safety safe environment for every kid. And it's developed by Howard Dubowitz. And they have a screener in which they screen for things that are highly relevant to child maltreatment. as well as, you know, general family dysfunction. And then they've they've created a way to do it that is simplifies it for the doctors.

00:17:58:3 - 00:18:34:9
Unknown
They have literally written down scripts. So they ask about depression, you know, food insecurity, having trouble getting along with your child. And it's very well, except in, in, by patients. So I think programs like that, I think there should be seat for every kid. And, so I, I think it can be done. And there's exemplars that could get you in the, the door and I in how artists work with screening.

00:18:34:9 - 00:18:57:8
Unknown
They don't include housing. because as he said, everyone already knows if they have a housing problem, they don't. They. And the doctor knows less usually than the patients do about how to get on the list for public housing. So they really put work into what are the things we can do something about and the to the item.

00:18:57:8 - 00:19:28:6
Unknown
So they get a lot of responses on stress of parenting or depression and food insecurity because snap, we have resources for that. But they get a surprisingly lower number of people respond to questions about domestic violence and substance use. And I'm not surprised at all to hear that because, again, the patient always knows what their own circumstance is much better than we'd ever do.

00:19:28:6 - 00:19:56:6
Unknown
But those are problems that, you know, once you bring them out, lead to can lead to more complicated responses or judgment. So I found that a very interesting result of extensive experience with inquiring. So my guess is that there are certain types of things that if you screen for them, you'll get a yield and you can do something.

00:19:56:7 - 00:20:25:6
Unknown
because, we have we have data now to show that. And I would just like to communicate to medical people who are very busy. I have total respect for that, but that it's a simple thing to do to show human kindness to a parent or a child or something terrible that has happened to them. I mean, I think that that's great advice in any setting.

00:20:25:9 - 00:20:55:5
Unknown
One of the things I want to probe a little bit is you spent many years heading the Harborview Center, for on sexual assault and traumatic stress. the theme of this podcast series is 21st Century child abuse. And the. So the our focus is child sexual abuse, in which we already know that it's a kind of abuse that is particularly underreported, under-recognized and under identified.

00:20:55:6 - 00:21:29:2
Unknown
How do we utilize trauma screening as a tool to help identify that kind of abuse? Well, I appreciate you bringing that up, Ernie, because having spent my entire career, starting back when people didn't really know how big of a problem it was, we now know that, child. Well, any kind of sexual assault, it has the highest risk of morbidity of of negative outcomes for many, many, many years later.

00:21:29:3 - 00:22:05:3
Unknown
So it isn't the. So it's even more important to learn from clients or patients about a history of sexual assault. And most doesn't happen in the families, by the way. That's quite a minority. Most children who are sexually assaulted are teenagers who are raped, and they get very little attention because the child abuse field tends to focus on sort of the intra familial or immediate family stuff.

00:22:05:4 - 00:22:35:2
Unknown
And then you have the adult side for which this one time assault by a peer. All right. Which is the most common scenario for adult rape. And then you have these four teenagers who are kind of caught in the, in the midst because child abuse people don't really think about rape that much. And the adult people are, you know, services are artificially divided between adults and kids.

00:22:35:2 - 00:23:06:0
Unknown
So I've always felt like teenage rape victims are on the biggest losing end, and there's no evidence whatsoever that they are less harmed. but then, you know, the younger children or the adults. So I think we need to have a broad view of sexual assault that overall sexual assault is likely to be more harmful, and not just in the development of it has the highest rates of conversion to PTSD of all traumas.

00:23:06:1 - 00:23:39:2
Unknown
On average, for kids, 16% exposed to all traumas, on average, one third if it's sexual assault. So it's quite, you know, it's twice as likely to lead to PTSD and depression, but it's also a kind of experience that's unique. And this is why the screening is so critical. In my experience. It's there are two sides to it. There's what happened and how horrible that was.

00:23:39:3 - 00:24:05:7
Unknown
But there's what happens when you tell if you tell and to me, that's not true for any other kind of trauma, because it isn't the case that when a child says, oh, I was beaten or I was in a flood, that people are saying, well, I mean, really, are you sure? Did you misinterpret? They get full on, unambiguous support, sexual assault.

00:24:05:8 - 00:24:35:0
Unknown
We haven't really moved the needle on that at all. We have moved the needle in the larger society. People everyone knows. Anyone could do it. You know, your neighbor, your coach, your priest, whatever. But when it comes down to the individual circumstance, and the parent or the provider has to change how they think about a person they've known in another context, it all falls away very quickly.

00:24:35:1 - 00:25:09:7
Unknown
And the ultimate worst is sibling abuse. If, by the way, because a parent can't choose their kids, I mean between them, you can't fully support a victim child and an offender child. so I think that's actually even worse than when it's a parent who is the offender. But the that's why validation and acknowledgment has such a higher valence for sexual assault victims, because they they're afraid of what will happen if they tell.

00:25:09:8 - 00:25:47:2
Unknown
And they have good reason to be, because if they tell about somebody and the listener has to make a choice, the choice doesn't always go the right way. So I have I really feel, though, that you're actually doing a huge thing to validate and acknowledge a sexual assault case by comparison to other traumas. Not to say I mean everyone lives their own, so I'm not judging the individual experience, but what from what we know, the lasting effects are so severe, potentially severe.

00:25:47:3 - 00:26:12:3
Unknown
Well, you've been the voice in the wilderness on that for a long time. Are we making progress? Well, everybody's more aware that's there's no question about that. We have treatments that work. People do these treatments. But I'm talking about that moment in time. Yeah. And no child is faced with should I tell or not? And what happens when they do?

00:26:12:3 - 00:26:40:9
Unknown
And I don't think we've really we've never really addressed it in terms of prevention education or what would be the best way to make sure that the parent, does the right thing? Like, I continue to work on our foster care assessment program, and I recently had a situation that just literally did break my heart. I just felt so sad for this little girl.

00:26:41:0 - 00:27:15:7
Unknown
So at this point, she's telling she's reporting the stepfather for the second time. The first time another state. Nothing came of it in that other state that her older sister had previously made a report, and nothing came of it. I'm worried that nothing will come of it here because the new, you know, child welfare law that would not consider a child living in a home with a mother who says, no, I don't believe that happened at all.

00:27:15:7 - 00:27:42:7
Unknown
I think you are the issue here. And the minute these child welfare people are gonna. He's coming back. And a judge that is not considered sufficient basis to keep the kid out of the home. So it was that was my role, temporary custody. And the decision was that, non-believing, non supportive. I plan to keep having him in your life.

00:27:42:8 - 00:28:07:4
Unknown
Was it was not that the judge didn't see that as bad, but it wasn't just legal justification for imminent harm, which is the standard, right. So I think the child welfare people need to really grapple because I wrote in my report, well, the harm might not be imminent, but it's almost certain. Wow. No, I mean, that's that's terrifying.

00:28:07:4 - 00:28:39:0
Unknown
And it's particularly because the assumption of most people is that the problem is that these child victims just don't tell out of shame or out of fear or whatever. They don't tell anybody. But this the scenario in which they tell and nothing happens is almost worse. It is worse. I think it is. I do think it is. so and that's why I'm so happy to be able to continue to at least have my foot a little bit in it.

00:28:39:0 - 00:29:18:4
Unknown
And I completely appreciate the dilemma for the child welfare system and all of the players, because once the federal law says you can't consider psychological like lack of support as a basis for keep. And then there's another same problem that goes with that, Ernie, that I am really upset about, which is we don't have providers who are interested in working with non supportive parents or abusing parents, and where you not the kind of working with them where you don't mention it, but the actual directly addressing the harm.

00:29:18:4 - 00:29:45:2
Unknown
Like in this case we had to providers who would recognize that sometimes it's hard for a person to believe this person abused their child or the parent has beaten their child and they have shame about it. Well, we there are there's very few providers willing and interested in working with bad parents, bad parents, you know, they they run from it.

00:29:45:3 - 00:30:24:0
Unknown
So if a child is in foster care. The foster parents are the people that the providers work with. The kids go to counseling. It's they they don't reach out to the via parents in any way. And so here we have all these kids who are going to have to go home, because that's the law. And no one has done one thing to repair the parent child relationship, which I think is one of the strongest preventative interventions you could make when the parent understands and feels close to the child, they will be more protective, but you can't find it anywhere.

00:30:24:0 - 00:30:55:0
Unknown
So that's a project I would like to see more people take on. I know of exactly one intervention that does that, and I think you do have it in Colorado, which is alternatives for families, and it's for physical violence in a family, DV physical abuse. But a lot of it is relevant to non supportive parents of sexual abuse cases as well, because it does explicitly address the what happened and how to move past it.

00:30:55:1 - 00:31:19:6
Unknown
And we are validating is great and very important. But you know what really matters to a kid? If the parent acknowledges that their failures or the harm they caused and says, I am now changed and I'm going forward, and that will not happen again, and I'm sorry, that is the most powerful gift we could ever give an abused child.

00:31:19:7 - 00:31:52:6
Unknown
Well, I think that's a terrific challenge for the Kemp Center. And let me ask one, one final question. on a couple of occasions, including in your last discussion, you mentioned the importance of law. earlier you talked about, the fact that mandating things like screening for Aces was less than than productive. you know, the other thing the Kemp Center is doing is actively engaging in, legislation or even statutory advocacy for important change.

00:31:52:9 - 00:32:26:8
Unknown
What are the change? What kinds of changes do we need in law and policy? That is such a good question. I mean, Ernie, I don't know the full answer to that because I've kind of given up on the criminal legal side for justice. I just don't think it's there, to be honest. I mean, we have moved the needle on identification and services for victims, but we haven't actually made any progress on prosecution of sexual assault cases.

00:32:26:9 - 00:32:59:4
Unknown
And so I'm in a quandary. I don't know how what law we could pass, what policy we could develop that would give justice. See, justice is a different thing. And that's I mean, there is the child protection side. And that's often very much dictated by the federal statute. I think we could build up the service side of repairing the family relationships in a better way, so that we aren't just putting kids back into the same old, same old.

00:32:59:5 - 00:33:27:1
Unknown
But on the criminal legal, I don't know. Well, I think you have the answer. I'm not so much talking about, criminal legal as I am. You mentioned I know you mentioned earlier that mandates, trauma screening is probably not the right answer. And mandates like the California law. The screen for aces is probably not the right answer.

00:33:27:3 - 00:34:05:0
Unknown
The other thing that the Kemp Center is working tirelessly to do is to reform the child welfare system. So, is there a combination of law and policy that that you would recommend moving forward? Well, I do think on the child welfare side, it would be really helpful if we, I mean, I am seeing these situations where, kids are languishing in foster care because, that there is not a service system that's designed to address that.

00:34:05:2 - 00:34:31:7
Unknown
And this goes back to what I just said is we have rules. You kids are supposed to get permanency after like 18 months, and most of them do, because most don't go into foster care and they remain in the home anyway. But the kids who are taken out, we just don't do very much to focus on helping the family recover and repairing family relationships.

00:34:31:8 - 00:35:04:6
Unknown
So simply removing an immediate risk, I really don't think that's sufficient. And I, I worry that too much focus on, oh, they might beat them again or rape them again. That's the not the biggest worry. It's the toxic environment of living in a place where you don't feel secure and you don't feel loved, and I don't I personally don't think you can get there without explicitly addressing what happened or what didn't happen.

00:35:04:7 - 00:35:32:7
Unknown
And anything that promotes more comfort level for mental health providers should always be reaching out to the bio parents if they're treating their child. It's it's not the providers child. It's not the foster parents child. And so anyway, I that's the area from because I am a clinician at heart. So my concern is orienting people to certain, more challenging areas.

00:35:32:7 - 00:36:10:9
Unknown
So my number one thing would be can we put in place sort of expectation is that there will attention will if a kid has been harmed and traumatized. You cannot fix that without mentioning it. And providers can do that in their offices. And if they can't, that, you know, another line of business. But I don't see it as a common, even on the radar screen, that simply sending the kid off to counseling over here and sending the parent off to a parenting class over there, that doesn't change what already actually happened.

00:36:11:0 - 00:36:44:0
Unknown
And. I the residual, the memories. Where where are we in our field of actually care about that? so that's I'm going to just circle back to my final thing. I really want to make the point. Us professionals who encounter children or abuse children, we need to always validate and acknowledge in some way and of course, treat any clinical conditions.

00:36:44:0 - 00:37:18:8
Unknown
But nothing beats the parent who did the abusing, the neglecting, or the failing to protect doing the validating and acknowledging we are not that important. Parents, sadly, sometimes are always important. No, it's a it's a great message and your leadership and impact in this field is absolutely unparalleled. So Lucy, thank you for being with us today. Thank you for the extraordinary work you have done and continue to do.

00:37:18:9 - 00:37:37:7
Unknown
we're grateful for all you have done to enable progress in the fight against child abuse in this country and around the world. And thank you to our listeners for joining us today. We hope you will tune in again to Radio Kempe as we continue this podcast series on 21st century Child abuse.

00:37:37:7 - 00:37:54:3
Unknown
Thank you for listening to Radio Kempe Stay connected by visiting our website at Kempecenter.org and follow us on social media.