Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 188 | September 11, 2023
The Impact of Child Abuse
Executive Director at National Children's Advocacy Center
In this episode of Difficult Conversations, Dr. Orsini is joined by Chris Newlin, Executive Director of the National Children’s Advocacy Center (NCAC) in Alabama, where he’s responsible for providing leadership and management, as well as participating in national and international training programs for the protection of children. He has more than 25 years of experience working as a Forensic Interviewer, Victim Advocate, Therapist, and other leadership roles in child advocacy. Today, Dr. Orsini and Chris delve into the complex world of child advocacy. Chris sheds light on the emotional challenges faced by professionals striving to protect vulnerable children. We’ll hear about his background, tracing his journey from being an army kid to finding his passion for safeguarding children’s well-being. The episode explores the history and evolution of Children’s Advocacy Centers, highlighting their global impact in providing safe spaces for children to share their experiences.
The conversation shifts towards the vital role of forensic interviewers in child advocacy work. These professionals who interact with children and faced traumatic events like child sexual abuse, are discussed in detail. The challenges they encounter in building rapport, extracting accurate information, and creating a supportive environment are examined. Dr. Orsini shares his own experience working with forensic interviewers and child advocates through The Orsini Way and highlights their dedication to improvement. Chris talks about his TEDx Talk focusing on child abuse, the staggering economic costs of child abuse on a national scale, and he cites research on Adverse Childhood Experiences (ACEs) and their impact on health, productivity, and substance abuse throughout adulthood. Dr. Orsini and Chris Newlin discuss strategies for preventing burnout among child advocates, emphasizing the significance of self-care, staying genuine, and maintaining emotional engagement. We end with Chris sharing a personal experience of a difficult conversation with a family member facing a serious medical diagnosis and how he navigated through it. He emphasizes the importance of being patient, providing evidence, and allowing time for individuals to process challenging news.
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Chris Newlin (2s):
Forensic interviewing has transitioned from a task one person does to an actual profession, where we now train Forensic interviewers who, that’s what they get really good at. They’re really good at building rapport with children, assessing their developmental status, making them comfortable in that setting, being able to broach the topic of concern in an empathic engaged way. Really had that real strong relationship between the Interviewer and the child where the child’s feeling comfortable and safe eliciting that information. Which is almost unbelievable, right? That a child will come into a setting they’ve typically never been before and in a conversation with someone they’ve never met before.
Chris Newlin (42s):
Disclose about what may be the most difficult thing for them to talk about. But we’ve seen it happen.
Welcome to Difficult Conversations lessons I learned as an ICU physician with Dr Anthony Orsini. Dr. Orsini is a practicing physician and president and CEO of the Orsini Way. As a frequent keynote speaker and author, Dr Orsini has been training healthcare professionals and business leaders how to navigate through the most difficult dialogues. Each week you will hear inspiring interviews with experts in their field who tell their story and provide practical advice on how to effectively communicate. Whether you are a doctor faced with giving a patient bad news, a business leader who wants to get the most out of his or her team members, or someone who just wants to learn to communicate better, this is the podcast for you.
Anthony Orsini (1m 35s):
Well Welcome to Difficult Conversations lessons I learned as an ICU physician, this is Dr. Anthony Orsini and I’ll be your Host this week. My good friend Anthony DeVincenzo from the Northeast Regional Child Advocacy Center, was a guest on the show back in 2021. In that episode we talked about the Difficult Conversations that happen in the world of child advocacy, and I can’t imagine how difficult working in this field must be, and I believe it’s essential to recognize the emotional toll that this work can take on the amazing men and women who work in this field every day. Today we’re gonna talk more about this problem and what child Advocacy centers are doing to help our most vulnerable population, the children.
Anthony Orsini (2m 19s):
Today I want to introduce you to our guest, Chris Newlin. Chris is the executive director of the National Children’s Advocacy Center in Huntsville Alabama, where he’s responsible for providing leadership and management as well as participating in national and international training programs regarding the protection of children. Chris has more than 25 years of experience working as a Forensic Interviewer, a Victim, Advocate, Therapist and leadership roles in child Advocacy. He has provided training in more than 30 countries at numerous international conferences and continues to provide technical assistance on a regular basis to professionals working to develop multidisciplinary teams.
Anthony Orsini (3m 2s):
Chris is a pass recipient of many awards, including awards from the American Professional Society of Abuse of Children and the International Impact Award from the International Service Council of Alabama. Chris received his master’s degree in school psychology from the University of Central Arkansas. He’s a licensed professional counselor and has completed coursework at Harvard University Business School Executive Education Program. Well Chris, thank you so much for making the time. You’re a busy guy, but I really appreciate you taking an hour or so to come and and talk to us today.
Chris Newlin (3m 37s):
I appreciate the opportunity, And I look forward to our conversation today.
Anthony Orsini (3m 41s):
Yeah, so Chris, in the intro I discussed all your accolades and your credentials and a little bit about yourself, but you know, it’s so important to your business and my business to be able to build trust with the people that you’re speaking to. Whether you’re giving a presentation or you’re talking to a mother or father or in my case a patient. It’s so important for them to know you as a person as much as possible because that’s where trust is built. Right. So we try to start out this conversation with, you know, we already know your intro, but tell us a little bit about Chris and as we say, how you reach the pinnacle of your career being on this podcast.
Chris Newlin (4m 16s):
Yeah, and and all roads led to this. That’s right. Exactly. And so I grew up kind of a, maybe a, a little bit of a different background. I was an army kid growing up, And I moved around. I was born in Detroit, lived in France, Germany, Texas, Kansas, Virginia, New York, and then moved to Arkansas to start sixth grade. So I had quite a few moves around. So I never really had a hometown. And. I was always willing to move for my career, you know, move as a kid. I was used to moving every year or every three years, but it was formative in the sense that I was able to adapt to new situations. It, it prepared me to learn how to fit in into a new situation, how to adapt, how to engage because otherwise I was gonna be alone.
Chris Newlin (5m 2s):
And that was early preparatory So. It was hard. I don’t have any of those friends from growing up, right? I don’t have that hometown like you have with Tony. I don’t have all those rich histories. I did obviously grow up from sixth grade on in Arkansas, but I didn’t have that. So for a few things it helped form me in the sense that I learned to be self-reliant in a lot of ways, but also to engage in my environment and to learn how to adapt. And then my interest, my first real job was as a lifeguard. So I don’t know what being a lifeguard and working in the child maltreatment field have in common, except for your number one priority in both is to protect kids. But being a lifeguard, you always paid attention to the more vulnerable children who were in the pool.
Chris Newlin (5m 46s):
The younger kids, the kids who struggled to swim, you were always a little bit more concerned for them ’cause just in a moment’s notice, something could happen. So you’re always keeping an eye on them and it made you attune to what are the most important things I need to pay attention to here? What are my highest priorities? And then how do I do a generalized scan in the meantime? So being a lifeguard, okay, that was kind of my first job, but I always had this interest in protecting kids and working in areas where there was trauma felt comfortable to me. It wasn’t like some people say, oh I don’t see how you ever could do that job. I could never do that. This just felt like the place I was supposed to be. So that has led to me having this career where I’ve moved around.
Chris Newlin (6m 29s):
My family has moved with me to Arkansas, to Missouri, to Georgia and Alabama where I am now in Huntsville. And the opportunity to work at the National Children’s Advocacy Center for the last over 18 years has been a a real pleasure. And I recognize also that any work I do is built on all those people who help form me and help me develop as a professional and my obligations to try to help grow that be behind us. ’cause as you And I, both get older, we recognize our runway’s getting shorter, but we realize that the needs of children is long, much longer than we have. So it’s our obligation to help prepare those coming behind us to be as capable as they can be to pick up the mantle.
Anthony Orsini (7m 11s):
That’s fantastic. We’re gonna talk about the NCAC. I’ll tell you a quick story. ’cause this podcast, anybody who listens to it knows we go off all kinds of tangents. But when you said you were a a lifeguard, I always wanted to be a lifeguard. I kind of grew up in the Jersey shore. The lifeguards were always sitting out in the stand at the ocean. They were always getting all the girls and this was something I wanted to do. And I can swim, but I wasn’t a great swimmer. So when I got into college, one of my electives was lifeguard, advanced lifeguard. And so I get in the pool and we’re swimming and I’m struggling. I’m not that strong of a swimmer. I could save myself, but I’m not safe anybody else. And so after two classes I went to the professor And I said, I’m not so sure I’m struggling in this class. And she’s like, no, no, you’ll pass.
Anthony Orsini (7m 53s):
And then I said, well I’m pre-meds. So like not only do I have to pass, I have to get an A. And she looked at and she looked at me and she laughed. She goes, you ain’t getting no a that’s, she said after two days she said that to me. So I had to drop the class and never realized my dream of getting a lifeguard. So that’s kind of funny.
Chris Newlin (8m 11s):
Yeah, that is funny.
Anthony Orsini (8m 12s):
I’m a little jealous.
Chris Newlin (8m 14s):
Well I’m surprised you survived the Jersey Shore getting in those waters and those can be pretty rough and tumble at times.
Anthony Orsini (8m 18s):
Yeah, I’m good with myself. And, I can swim, And I. I’m always very comfortable water. I’m a scuba diver but not good enough to save someone else’s life. So kudos to you. So Chris, let’s talk about the NCAC. ’cause last time we spoke you were telling me the history and how it was the first child Advocacy center. So tell me about the one in Huntsville because this is amazing.
Chris Newlin (8m 39s):
So go back to the 1980s. In the early 1980s, our nation was just a few years out from boycotting the Moscow Olympics. Just put that in perspective. Wow. And our nation was beginning to recognize that we were coming out of these times in the seventies where everything was groovy and stuff. And we’d been through a lot of turmoil as a country and we were starting to really question what was happening in our nation. We were out of the Vietnam War kind of, but still impacted by the impact of that lingered. And people were asking lots of social issue questions at the time. And child sexual abuse became one of them. And it was in this move of child sexual abuse transitioning from something that was kind of more a family matter.
Chris Newlin (9m 23s):
It was kept in the family to being a public health issue that needed to be discussed. We had high-profile cases involving daycares, satanic ritual cults, kind of these fringe cases that we see very rarely, but seem to gather more of the attention. And people were struggling. We didn’t have good practices on how to interview children regarding allegations of abuse, necessarily how to conduct examinations on children when there was allegations of sexual abuse, had no evidence-based therapies. And in Huntsville Alabama at the time, Bud Kramer was the district attorney and he was struggling because he could not effectively take cases to court ,cases where he really felt like something had happened.
Chris Newlin (10m 6s):
They were just unable to make those cases in court ’cause kids and families were done. And he actually had a, a woman who worked for the county who came to his office and said, do you all not talk to each other? And Bud was like, what do you mean? She’s like, we’ve had to go through so many hoops, said Child Protective Services and law enforcement, the hospital and your office. And Bud kind of sat back and think, oh my gosh, what the system is doing is actually re-traumatizing kids. They don’t wanna talk to anybody because of what we’re trying to do. And Bud began to look around the country, say, are other people doing things like this?
Chris Newlin (10m 49s):
And there was a hospital-based program in California run by Dr, Astrid Hagger, who was working as part of a team. But Bud’s idea was to say, instead of kids going to a hospital that can feel intimidating, why not have ’em come to more of a child friendly setting? So the idea of having a house, having a house where children could come up on the front porch and walk through the front door almost like they were going to someone’s house. And for all the professionals that needed to be part of that response, to be involved right from the beginning and to eliminate the duplication of government services and to coordinate those across the various agencies. We’d had law enforcement, we’d had child protective services, we’d had medical providers, we had district attorneys all this time.
Chris Newlin (11m 33s):
But they weren’t coordinating those efforts. And instead of children having to go all those places, the idea was let’s have kids come to one child friendly place. And all them worked together. So, it started off as this kind of novel, Hey let’s try this kind of concept quickly began to see the impact of it. Other communities were clamoring for something for like this that they could be impactful. So the Children’s Advocacy Center started to develop. Why it started in Huntsville. Maybe that’s a whole nother rabbit hole that you and, I go down. But Bud was a courageous leader. He was willing to take chances if it was gonna improve the lives of children. He ends up getting elected to Congress not too long after that really shares this message at the federal level.
Chris Newlin (12m 17s):
Fast forward today, there’s over a thousand children’s Advocacy centers in the United States and similar type programs in nearly 50 countries around the world.
Anthony Orsini (12m 26s):
That’s amazing. And you’ve been involved a lot in the training of Forensic interviewers, et cetera. Tell me a little bit about that because really the topic of this conversation is Difficult Conversations, right? That’s the topic of the podcast. You know, most of these people I would guess are either in the law enforcement or their social workers. Correct. And how do you mold them into what’s the training like to get these Difficult Conversations done?
Chris Newlin (12m 52s):
Just to put it in context for your listeners, think about this. When child sexual abuse happens in most situations, there’s two people who know what happened. There’s the child and the person who’s did it. Almost always child sexual abuse happens in private where other people aren’t there. Otherwise you’ll get caught. So we have two people in the world in most situations who can tell us what happened. The person who is alleged to have done this and the child, well if the person who’s alleged to have done it has actually committed that act, they’re not gonna be willing to come forward and say, yeah, I did this. I’m sorry, I feel bad. Rarely will they do that, right? So that now you know, our pool is cut in half. We have now one person in the entire world that can tell us what happened.
Chris Newlin (13m 36s):
And just imagine for children talking about something like this happening to them can be really, really difficult regardless of their age. For younger children it’s more difficult ’cause maybe their developmental status, their like their ability to communicate stories and share a narrative about what they’ve experienced. For older kids, it can be other reasons of not wanting to get somebody in trouble because most child sexual abuse is committed by someone we know. So these are incredibly Difficult Conversations. And you’re right, historically Forensic interviews were something that were done by a law enforcement investigator or a child protective services investigator. Maybe they were done jointly, even in the early early days they were done by therapist because we didn’t really know.
Chris Newlin (14m 21s):
But what we’ve seen is an evolution to where we now have individuals whose job Forensic interviewing has transitioned from a task one person does to an actual profession. Where we now train Forensic interviewers who, that’s what they get really good at. They’re really good at building rapport with children, assessing their developmental status, making them comfortable in that setting, being able to broach the topic of concern in an empathic engaged way. Really have that real strong relationship between the Interviewer and the child where the child’s feeling comfortable and safe eliciting that information. Which is almost unbelievable, right? That a child would come into a setting they’ve typically never been before and in a conversation with someone they’ve never met before, disclose about what may be the most difficult thing for them to talk about.
Chris Newlin (15m 11s):
But we’ve seen it happen and it’s interesting now you think about law enforcement and child protective services. A lot of times now they’re like, no, I want these people doing my interviews. ’cause they’re really good at it. They do it every single day. It’s almost like in your practice of medicine, you could do some stuff but you would really probably prefer to go to a doctor who does that every single day. They get really good at it. They’re up on the research, their practice, they’re comfortable with it ’cause they do it all the time. Same thing with Forensic interviews just been an entire profession that’s grown of people who can get really good at having really Difficult Conversations and under a lot of pressure. Imagine this, that conversation, not only you’re having it in most situations, it’s being recorded and you have your colleagues observing you and potentially critiquing you.
Chris Newlin (16m 1s):
Like how come you didn’t do this? Or how come you didn’t ask this? Why didn’t you So? It’s an intense environment for someone, especially when they’re newer to that environment. So it’s really about getting good at calming yourself down, thinking critically through a situation and being methodical. And you will appreciate this, always prioritizing the relationship between yourself and the individual that’s in the interview. Nothing is more important than that connection.
Anthony Orsini (16m 30s):
And what’s really amazing, I’ve done some work with Tony DeVincenzo at the Northeast Regional CAC And I think three years in a row now I’ve done a talk for them about navigating Difficult Conversations and some of these Forensic interviewers or child advocates. They will volunteer to do these scenes with my professional actors, whether it’s a mother, a father, whatever the scene it is. What’s really impressive about these individuals is they’re already good at it. You can tell that they’re well trained, but they’re or desire to be better at it. If I teach them a little, you know, nuance of conversation or body language or something about their tone inflection, they’re all over it.
Anthony Orsini (17m 13s):
They’re writing it down it, it’s like the perfect student. It’s like Patrick Mahomes saying teach me. And that takes a special kind of person. So that really is very impressive and, and again, these people are doing this every day. Now I’m giving a talk in a couple months. I mentioned to you about remembering your why and physician burnout, et cetera. I know that there’s a a high priority on that for child advocates. And when I’ve talked to Tony DeVincenzo about this in the past and what are you doing at these CACs in order to help these people who are seeing the most incredibly horrible things every single day.
Chris Newlin (17m 51s):
You’re right on. I would say just one thing before even getting off. I was saying what makes it difficult? You’re being recorded. You’re talking about this child, about these incredibly difficult, maybe emotionally charged and powerful experiences they’ve had. And the ultimate arbitrator who will review you is a defense attorney who will cross examinee every single move you’ve made.
Anthony Orsini (18m 12s):
That’s right. It’s much worse
Chris Newlin (18m 13s):
Anthony Orsini (18m 15s):
Yeah, I didn’t even think of that. That’s horrible.
Chris Newlin (18m 17s):
Now. Now I appreciate the defense for they have their role to do. And let me just be really clear about Advocacy centers. We are not advocating for an outcome, we’re advocating for a process. And what I mean by that is we want the truth to come out If something happened, we want to know that. We need to know that. If something didn’t happen, we want to know that too. It’s about the truth. And we’re advocating for the best possible process to elicit the truth. Just like for you, you want the best possible X-ray. I don’t know if it’s a CAT scan, if it’s a x-ray or if it’s an MRI, but you want the best resolution so that you can have an idea of what’s really happening with that child. Same. That’s what we’re we’re looking for.
Chris Newlin (18m 57s):
We’re advocating for the best process for kids. You’re right. One of our biggest challenges in our work is the issue of secondary traumatic stress. People who are doing this work, whether they’re interviewers, advocates, investigators, prosecutors, medical providers, therapists, they are seeing an ugly side of the world day after day. And when you think about the dose exposure, they are being exposed in one day to more than most people would see in a year. And they do that day after day after week after month after month. And so it’s really incumbent that we have to provide a lot of supports around them, making sure that number one, they have reasonable caseloads.
Chris Newlin (19m 44s):
We’re not overwhelming them with too much trauma all day long. For example, our therapist, they have a much smaller caseload than you would like a regular mental health provider. Because if you’re the seventh client I’m seeing of the day and it’s been all trauma, how good am I gonna be? Right? So we have to give space to our employees to breathe. We also recognize they need a lot of support. They need the training. And it’s interesting, Tony, I used to think as a professional, but you may relate to this, I’m gonna be the best doctor there, so I’m gonna work harder than any other doctor. I’m gonna come in there and I’m gonna work really hard. I’m gonna show everybody that I can get this work done. And as a leader, all you’re really doing is modeling, putting yourself in the danger zone.
Chris Newlin (20m 27s):
You’re modeling. Like go to the extreme redline yourself all the time. What I began to figure out over time is the most important thing I could do is create a healthy work environment to unleash the full potential of our 67 employees. In that situation, they can always do more than I can. And that way they can not only do it, but do it sustainably. I had an interesting board member that one time who said, you know what’s better than growth And? I was like, I don’t know, is that a, I mean growth is good. And she was like, Nope. Sustainable growth. And that’s what we want with our people sustainably growing their expertise. Because the old model used to be, Hey, come here for three years, hang on as long as you can.
Chris Newlin (21m 9s):
Then you’ll leave and then we’ll hire somebody new and start over from scratch. That’s not how we ever get good at anything. Medicine, children’s advocacy centers, whatever. So it’s about that growth and sustainable growth where we’re supporting our employees. And really you go back to why that’s part of every one of our interviews. Why would you wanna work here? How do you think this is gonna impact you? We start that from the initial screening process through the entire onboarding process and maintaining that over time. Because if You don’t have a reason, you’re doing this work. It’s really hard to stay. And everybody I know who’s sustained in this field, they have their why.
Anthony Orsini (21m 48s):
Yeah. And it’s not only knowing your why, but and I talked a little bit about this in previous episodes. It’s remembering your why. What happens in medicine, and I’m sure it happens to your people too, is that a certain amount of compassion fatigue starts to set in and things become routine, right? This is my job, this is the sixth interview I’m doing today. And studies have shown that when things become routine and you become task oriented, that your risk of burnout actually goes up. Because there’s this, as we say, when you act contrary to your common beliefs and core values. And so you have this person who knows their why, you hired them, they’re in, and then they go home and they realized as they’re driving home, gee, those last three interviews I went through the numbers, And I think the most important thing to try to help these people prevent burnout is to have a team member or sometimes yourself kind of just remind you.
Anthony Orsini (22m 49s):
And we do this in the hospital all the time, Dr. Orsini, we have a code. We say it’s all in the delivery, but it means that you’re becoming task oriented. And maybe that interaction with that patient was a little bit rushed. And I find that to be extreme and studies have backed us up. That’s extremely helpful.
Chris Newlin (23m 6s):
I could not agree more. First off, I would never ask someone to do six interviews in a day unless it was an incredibly emergent because in that you’re right by the end of it. And that’s a dangerous flywheel to start turning, right? Because At, the end of the day, I was like, Hey, I phoned it in the last couple of interviews, I wasn’t there. And if I’m phoning it in, and you know this, if I’m not 100% present for that kid or that parent who I’m talking to, if there’s one thing kids are good at, it’s genuine reading. If someone’s genuine, if someone’s just here, it’s just like, you don’t really care. Why should I talk to you? You’re just here ’cause this is a job.
Chris Newlin (23m 46s):
And so you have to show that emotional engagement and connection with them. And it has to be genuine because if you don’t, you’re not gonna have a good interview. Then your colleagues are gonna like, we don’t have anything on this case. Chris couldn’t get ’em to do anything, then I’m gonna feel bad. And then the whole system’s gonna start to get a little wonky. People are gonna start to lose confidence. And then I’m like, what am I even doing this for? Why am I even trying to, I should’ve listened to my parents when they said, you’re gonna do what with your career? So that flywheel can start to turn really quickly. So we have to make sure we’re keeping on top of that. To not allow that and to provide support when someone’s having a rough day, when they’ve had a tough time, is to try to be supportive, to allow them the space if they want to talk about it, to talk about it.
Chris Newlin (24m 34s):
I always say, Tony, in my line of work, it should be that the cases you’re seeing are the biggest stressor you have during the day. But when I give you the stressful cases and then the printer’s not working, the phone system’s out my computer, the J key is sticking again, And I, don’t know why they won’t get me a new computer. And you have that bundling of things. And then there’s something going on in my personal life at home with my family or loved ones with all those things start to compound. And I don’t have supervisory support, that’s when we really see the breakdown. So we can do a lot of things organizationally and from a supervisory level to prevent us from getting in the ditch.
Anthony Orsini (25m 13s):
I love that. Just the other day I had a conversation with the IT guy at the hospital, well gee, I have a password to get into the computer. I have a password to get into the electronic medical record. I have a password and the three passwords all renew at different times. So now I’m trying to remember, was it the password that I changed in the beginning? And if I’m off a few days, I’ll come back and it’ll take me 15 minutes to sign in. And it’s like, why does this have to be? So that’s a great point.
Chris Newlin (25m 40s):
Yeah. I had the binary experience yesterday. I’ve been here for over 18 years. I’ve had the same access card the entire time. Yesterday, I am going down to go into the building with a we serve children and it won’t open the door. And I’m coming, come on, what’s the deal? I went to the IT And. I was like, Hey Cory, my pass key’s not working at this one door. It works other places. And he was like, well how long you been had it? I said, 18 years. He said, what? He said, that’s gotta be like an absolute world record. And he said, and it still works. You know what was a stress reliever for me? Two minutes. He’s given me a new card. New card works like a breeze Now that whole stressors gone. Yeah, that’s, I think organizationally what we have to do when people are engaged in tough work is make sure we make everything else as smooth as butter as we can.
Anthony Orsini (26m 26s):
Fantastic. Yeah, exactly. I wanna get to your TED talk ’cause I’ve heard it twice now. And as you know, I’m a a TED Talk graduate too and all the presentations that I’ve given it, I think the TED Talk was the hardest one to give because you’re so limited on time. I think yours was like 12 minutes just I was limited for 12 minutes too.
Chris Newlin (26m 44s):
And you know, you’re doing a TED talk and people will be watching it and it’s a little bit of a different format and, and then you don’t know who’s in the audience.
Anthony Orsini (26m 52s):
And then they tell you if you wear the wrong thing or you’d say the wrong thing, it’s not gonna go up on YouTube and you’re not gonna, nobody’s gonna hear it. But anyway, tell me about the incredible number and I’m drawing a blank, I’m gonna say 498 billion or that you started out. I think this is amazing. And I would feel really bad if my audience didn’t hear about this. ’cause this is outstanding
Chris Newlin (27m 12s):
A lot of times. You know, we talked all this time, Tony, about child abuse and the Difficult Conversations and the challenges associated with it and all the complexities of creating a new social entrepreneurship model to address it. And that’s all super important. But my TED talk really generated out of a conversation I had with one of my board presidents who said, Chris, he said, I think you really need to get a BHAG And. I was like, Barney, I’m not sure exactly what you’re referring to. I’m married, I’m good. I dunno what you’re saying. And he was like, no, you need a big hairy, audacious goal. So we sat there and he challenged me.
Chris Newlin (27m 53s):
It’s like, why is it so important to address child abuse? You know, child sexual abuse? What would happen if we didn’t do it? And finally what it got to me is getting to At. The end of the day, what we’re trying to address is Improving our nation’s health and economy that annualized costs for the impact of child abuse on our nation is absolutely staggering. Staggering, like you said, about $500 billion a year that our country expends or loses as a result of child abuse happening in our society, 9% of all Medicaid costs are associated with child abuse. Every state struggling with Medicaid costs, women who were sexually abused in Childhood have their cost of healthcare is 16% higher if they were both sexually and physically abused.
Chris Newlin (28m 42s):
It’s 36% higher. People who were abused during Childhood earn on average $8,000 less per year, less likely to own a car, less likely to have stock, less likely to own a house. All these things. And I was looking at that literature and, and all this research after this conversation, And I was like, yes, we are addressing child abuse, but we’re also working every day in economic development and human rights and these other areas that we are impacting. And if we were able to reduce, which we have, child sexual abuse is down almost 50% over the last 25 years, we’re making our nation healthier, more economically viable.
Chris Newlin (29m 23s):
And what if we did that around the globe? What if every nation was more economically viable and healthier and we could actually allocate the funds that used to pay for those things to things that are more pro-social and actually advance society. So yes, it’s a moral imperative, it’s a human right. I think for children, children to grow up free from abuse and if they experience abuse to get the help they need. But it is, even if you don’t have a heart, it’s a financially smart investment. Like it is super smart to invest in. And that’s why I even said at one point in our fundraising folks went crazy. I was like, we’re no longer accepting donations at the NCAC, the model we’ve created. We know it works. We know it has its impact.
Chris Newlin (30m 3s):
So we’re now only accepting investments because what you’re investing in is our future society. You’re not throwing money at a problem. Hope it gets better But, if you invest in us, it’s gonna have a long-term payoff. The challenge is Americans don’t like to wait one or two generations to see impacts. They want immediate impacts. Yeah. So I think some of our most impactful work is gonna be coming in the next 20 years.
Anthony Orsini (30m 27s):
It’s crazy that even children of child abuse have higher rates of C O P D. You said in your 10 x. Oh yeah. And at first I thought, how could that be? Then I thought, well maybe if their child abuse led to them a higher instance of smoking or, or whatever it is. But that’s not something anybody would ever even think about.
Chris Newlin (30m 44s):
Well, there were people, Robert
Anthony Orsini (30m 47s):
Nda. I mean the average person would. Yeah,
Chris Newlin (30m 48s):
Yeah, no, no. Robert Nanda, the folks of Kaiser Permanente who did the Adverse Childhood Experiences research, absolutely mind blowing. And a lot of people say, oh, this is what that happens. And what they found is bad things happen in Childhood Adverse to Childhood experiences. You add up the number of those, you have three or four, the risk goes up dramatically. And it’s not just around health related issues, it’s about worker productivity and performance, all kinds of issues. Risk of substance abuse, all these things. And I. Think what the Adverse Childhood experiences research really tells us is, here’s what happens if we don’t intervene. Because that research was done at a time when the people who were participating were born in the thirties, forties, fifties.
Chris Newlin (31m 32s):
And we didn’t have any meaningful interventions for child abuse or exposure to these adverse experiences. We didn’t have those programs. So these individuals lived out their lives expressing what happens if we don’t do anything. And it, the research is absolutely overwhelming. 12 and half percent of our adult population had at least four Adverse Childhood experiences. And if you did, your risk of suicide increased, you know, by over a thousand percent compared to those that had none.
Anthony Orsini (32m 1s):
That’s crazy. That’s so sad. And now we have an an emphasis lately on increased sex trafficking and all those worries and, but the downstream effect of this is something I think your TED talk was really important, And I encourage and we’ll put a link on that so that everybody can watch this because it really does And I love, by the way that you call it investment now. That’s fantastic. I love that. And that’s what we do. We talk about how one word can change things.
Chris Newlin (32m 27s):
Think about you in medicine. You have things in medicine now like this works. Like I can tell you, this works in 98.6% of patients. This is gonna be successful. That’s not just throwing money at a problem or whatever. And we all need that too. I think there’s some amazing research around the science of hope, about hope is really having a desire where you want to go and seeing a realistic pathway. Chan Helman does some amazing work in that arena. And I think that’s what we’re actually doing. Is it used to be without children’s Advocacy centers that if your child was sexually abused, people are like, oh, my child’s life is ruined forever. They’ll never be the same. We literally are that pathway of being able to go from this tragic experience to being like, you can still live a happy, healthy, and productive life as a member of society if we intervene and support you.
Chris Newlin (33m 17s):
If we don’t, you know, the chances are people will end up like those Adverse Childhood experiences. So we have to continue to break down this idea that we can’t talk about child sexual abuse. We need to de-stigmatize it. I’ll give you an example. It’s no big issue at all for me to put on a shirt and run at a Susan g Komen breast cancer run and to say, I’m running for my sister, I’m running for myself, I’m running for my mom. It’s just like, oh, I’m so sorry or whatever. But if we were to say, let’s put on a blue shirt for child abuse prevention month and say I’m running for myself, or I’m running for my spouse, or I’m running for my partner, I’m running for my daughter, there’s a lot more stigma there, right?
Chris Newlin (33m 57s):
And so we need to overcome that. Children are not at fault when child sexual abuse happens. It is adult’s responsibility to protect them.
Anthony Orsini (34m 5s):
That’s extremely well said. I really love that. Chris, we always finish the same way. I don’t know if we warned you about this or not, but the last question we ask every person who comes on our podcast is, can you think back through your long career, whether it’s a professional conversation or a private conversation that you’d remember as being very difficult and give our audience a little knowledge about how you were able to navigate through that and maybe give them some tips. Anything sticks out in your mind? I mean, it’s probably, you have so many of them, but,
Chris Newlin (34m 37s):
Well, I do. I, I have some professional and some personal ones. I think I’ll probably just use a personal one. And this is my father who was elderly and had had multiple knee surgeries and he kept having your failure on the knee construction, all kind, you know, failure, again, patella’s was split. So another reconstruction ends up getting pseudomonas and a couple other bad guys in there. And you know, I’m taking my father to, you know, he thinks he’s getting out of the rehab hospital. They’re gonna remove the cast that goes from his leg all the way down to the bottom of his foot with his knee reconstruction. It’s this nine month journey’s finally gonna be over.
Chris Newlin (35m 19s):
And the attendants take off before the doctor comes in, takes off the cast and it just doesn’t look good. The looks on their face was everything. And. I immediately went into kind of work mode. Tony, I went into, okay, slow down, think logically, let’s just figure out kind of what’s happening here. The doctor comes in, they’re talking about we need to direct admit and here’s our options of what we can do. And it’s not something I wanted to do, but I was like, you’ve mentioned about putting a spacer in. You’ve put a, had mentioned about fusing it and being done, is amputation on the table. My mom’s sitting there, my dad’s there, they’re both not sure what’s going on and, and I’m kind of going into, you know, I’m trying to engage and say, I’m just trying to think of all of our options, which appeals to the engineer in my dad.
Chris Newlin (36m 11s):
But they were just caught completely off guard and So. it was a difficult conversation, the idea of having to bring that up. And then ultimately a few days later, my father made the decision that that was the best thing. And actually I thought maybe the doctor should have brought it up.
Anthony Orsini (36m 26s):
Well, that’s what I do. That’s where I come in. The doctors don’t want to talk about that. Yeah,
Chris Newlin (36m 30s):
I, you know, because, well, I don’t want, and the doctor even said, I, you know, I don’t like to bring that up. And that’s kind of a last thing. But then right before the surgery I said to the doctor, I said, I know you’re not gonna tell us what to do, but if it was your dad, would you advise him and would you be supportive of this? And he said, absolutely, that’s a tough situation. But I think you have to approach it with being genuine and genuinely concerned for their wellbeing and wanting to look at what are the various options in the child abuse field all the time. People are saying that surely any excuse any kind of explanation for this other than my child has actually been sexually abused. We see that all the time. And it’s okay to doubt. I’ll give you another real quick one.
Chris Newlin (37m 10s):
I’m sorry for running over. No, you’re fine. My adult son is disabled. He has a mitochondrial disease. He lives at home with my wife, And I. He at age 18 was found to have a malignant melanoma, which I had had when I was 21 when we first got that diagnosis. You know, my initial, there’s gotta be something wrong. Surely someone messed up the lab messed up. We need to send those results to another lab. I was grasping at straws, Tony, right? Like I wanted any explanation, you know, well, we sent ’em to Harvard for the second review. Okay, that’s not gonna do me much good in my argument to come up with a solution, So. it was a tough situation, but I think it makes me understand why sometimes parents have a hard time believing and we have to be patient with them.
Chris Newlin (37m 55s):
They’re not gonna go at the same speed that we do when we’re having a difficult conversation. Embracing internalizing something is actually negative happen to your child, takes time, and it’s not a sign of a bad person. In fact, over 60% of parents at some point in our line of work will doubt whether their child was actually abused because they want that alternative hypothesis to be true. Of course, yeah. And you’ve probably seen it too, like surely doctor, there’s gotta be another explanation. It can’t be this thing that’s got some grave concern. So having those conversations and giving people time and space, and not judging them quickly, but allowing them to process this and to walk that with them, that is what helps in a difficult conversation.
Anthony Orsini (38m 39s):
That is great advice. And when we train doctors all over the country about how to give bad news, we always tell them, make sure you get, bring them along with your thought process. We talk about giving the evidence first because the way I I say to the doctors is, when you give bad news, the patient’s job is to prove you wrong. That’s the first thing that they’re gonna do. So make sure you give all that evidence first and then show them how you came to this reluctant diagnosis and things will go a lot more smoothly. So I That’s
Chris Newlin (39m 9s):
That’s great, Tony. Perfect. Yeah,
Anthony Orsini (39m 10s):
That’s fantastic. Well, Chris, we’ve taken up enough of your time. This has been absolutely fantastic and anybody wants to get in touch with, we’ll leave all your links and your ways of getting in touch with you. If, you enjoyed this podcast, please go ahead and hit subscribe. Go ahead and download the other 80 something episodes that we’ve had in the past three years. And if you’d like to get in touch with me, you can can reach me at TheOrsiniWay.Com. Chris, thank you so much and we appreciate it.
Chris Newlin (39m 34s):
Thank you very much. It’s great chatting with you again today. Take Care.
Anthony Orsini (39m 37s):
Chris Newlin (39m 39s):
If you enjoyed this podcast. Please hit the subscribe button and leave a comment and review. To contact Dr. Orsini and his team or to suggest guests for future podcast, visit us at TheOrsiniWay.Com. The comments and opinions of the Interviewer and guests on this podcast are their own and do not necessarily reflect the opinions and beliefs of their present and past employers or institutions.
Dr. Anthony Orsini
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Ep. 169 – April 18, 2022