Creating a continuum of recovery: learning from European and UK Barnahus therapeutic models for child sexual abuse victims

Purpose Child sexual abuse (CSA) remains a critical concern, with substantial gaps in access to therapeutic support for victims, even in some specialist CSA support services, such as Barnahus. Barnahus (meaning “children’s house”) is an established, child-friendly, multi-agency response model to child sexual abuse and other violence, originating in Iceland more than 25 years ago and now operating across Europe and the UK. Barnahus services bring together forensic interviews, medical examinations, therapeutic support and advocacy under one roof, and aim to minimise trauma while supporting children’s recovery. Supported by the Barnahus Network, Barnahus services function independently in each country but follow the Barnahus Quality Standards such as multidisciplinary and interagency interventions (Barnahus Quality Standard 5), organised under one roof in a child-friendly setting (Barnahus Quality Standard 4), placing the best interests of the child at the centre (UNCRC article 3, Barnahus Quality Standard 1.1), and with joint case management and review (Barnahus Quality Standard 5). While some Barnahus provide a range of holistic long-term therapeutic support for children and families, others can only offer crisis support. Taking a flexible child centred approach and offering choice in the journey of healing and recovery, can make it difficult for Barnahus to describe their offer to children and families and to identify outcome measures for funders/commissioners. This paper aims to highlight the need for a cohesive, evidence-based framework of therapeutic support in Barnahus and the ongoing research to define Barnahus outcome measures (Herbert 2026). Design/methodology/approach This paper presents a practice-based integrative learning synthesis, drawing on conversations with ten European and UK Barnahus, five site visits and a scoped literature review, to articulate a typical therapeutic recovery journey in Barnahus. It is not based on primary empirical research but rather on the triangulation of professional practice learning with existing evidence, with a specific focus on participation of children. Findings The learning from Europe and UK identified examples of best practice to create a model that includes: therapy integrated into multidisciplinary collaboration; a holistic approach to therapeutic support for CSA victims and their parent/carers; a focus on participation to ensure children’s hopes and needs are heard and shape their support; creating a narrative of what happened and strength through their story; and enabling them to leave a legacy after their journey at Barnahus has ended. Originality/value The Continuum of Recovery model provides a framework to enable Barnahus (and other specialist CSA support services) to describe their offer to children and families, to guide child-led service development and to enable measurement of outcomes and impact.