Peer-reviewed article
Centring the child's experience: A synthesis of evidence for measuring outcomes in Barnahus.
Herbert JL, Tindal RA, Mitchell M, Warrington C, Bovarnick S ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review synthesizes evidence from 51 studies about how children experience child protection and justice interventions, particularly through models like Barnahus (child advocacy centers). Rather than focusing on outcomes like conviction rates, the review identifies five key domains that matter to children: trustworthy professional relationships, having a voice in decisions, feeling safe, receiving holistic support, and having coordinated responses that avoid re-traumatization. The research shows that children value how they are treated during the process as much as the formal outcome.
Key points
- Five primary outcome domains identified from children's perspective: professional relationships based on trust and belief; empowerment through information and participation; emotional, physical and procedural safety; holistic trauma-informed support; and coordinated systems that minimize repeated te
- Children currently in protection systems prioritize immediate safety and clear information, while adult survivors looking back emphasize the long-term impact of respectful, trusting relationships with professionals
- Conventional evaluation metrics like conviction rates overlook what children themselves consider most important about their experience
- High-quality responses are defined by relational safety and empowering children's participation rather than formal procedural outcomes alone
- Evidence came from multiple regions (Europe, North America, Africa, Asia, Oceania) including both current service users and adult survivors reflecting on childhood experiences
Limitations
The review does not evaluate the effectiveness of interventions in reducing abuse or achieving legal outcomes; it focuses only on children's subjective experiences of service quality. The specific countries and regional contexts of included studies are not detailed, limiting understanding of how these domains might vary across different child protection systems.
Abstract
Background Multi-agency responses to child abuse, such as the Barnahus and Children's Advocacy Center models aim to provide holistic, child-friendly interventions. However, evaluation of these services tends to rely on procedural metrics (e.g., conviction rates), overlooking the experiences of primary service users. Objective This review aimed to synthesize qualitative evidence regarding children's experiences of child protection, criminal justice, medical, and therapeutic responses to identify child-centered outcome domains. Participants and setting The review included 51 peer-reviewed studies and reports published between 2015 and 2025. Participants included cohorts of children (n = 33), adult survivors reflecting on childhood experiences (n = 8), and mixed groups (n = 10) from Europe, North America, Africa, Asia, and Oceania. Methods A systematic search was conducted across five databases (PsycINFO, Medline, CINAHL, Scopus, and Proquest Social Sciences). Data were analyzed using a thematic synthesis approach to identify cross-cutting domains of service quality from the perspective of children and young people. Results Five primary outcome domains were identified: (1) The Professional Relationship (trust, kindness, and being believed); (2) Empowerment and Participation (agency and clear information); (3) Safety and Security (emotional, physical, and procedural safety); (4) Holistic Wellbeing (trauma-informed, timely support); and (5) Systemic Efficacy (coordination to minimize re-telling). Children currently in the system prioritized immediate information and safety, while adult survivors emphasized the long-term impact of respectful professional relationships. Conclusions For children, the process of intervention is as significant as the formal outcome. High-quality responses are defined by relational safety and empowering children's participation. Evaluation frameworks for multi-agency models should incorporate these experiential domains to ensure accountability to children.