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How Multidisciplinary Teams Achieve Success in Indian Country

By Pamela Elton and Michelle Stewart, Office of Victim Assistance, Federal Bureau of Investigation, Washington, D.C.

n Indian Country, there is a significant problem with child abuse. In response to this, multidisciplinary teams (MDTs) are put in place to effectively combat child abuse crimes. Law enforcement leaders can benefit from MDTs by fostering and strengthening cooperation in the fight against child abuse. This fight can prove even more difficult in an investigation and prosecution of a child sexual abuse case in Indian Country, making this team of highly trained and compassionate individuals more vital. Indian Country can also be a complex jurisdictional maze with federal, state, local, and tribal participants. Jurisdictional complications can result in difficulty in determining the provisions for concurrent jurisdiction for certain cases. Due to the complex nature that is inherent in overlapping jurisdictional areas, law enforcement agencies and other professional service providers need to work together to avoid inefficient investigations and prosecutions. Ultimately, the key to any good investigation is commitment, communication, and effective cooperation between all law enforcement professionals involved. MDTs are the way to make this work.

Child sexual abuse continues to profoundly affect children in Indian Country. The multiple interests of the professionals involved can conflict with each other and with the best interest of the child. There are so many cases and so few resources. An MDT provides an effective means to investigating and prosecuting a case without further victimization and trauma to the child and to focusing on empowering the child victim. The benefits of MDTs are beneficial to agencies. Benefits include

  • improved treatment of victims throughout the criminal justice system;
  • different views that enhance the investigative and prosecutive stages;
  • accountability through case tracking and action plans;
  • improved coordination including civil, criminal, tribal, state, and federal entities;
  • increased access to records and information;
  • greater investment from team members, which fosters more effective and efficient investigations;
  • the ability to avoid investigative and prosecutorial duplication of efforts;
  • streamlined evidence preparation;
  • more effective witness and evidence preparation;
  • and access to federal expertise and resources.

MDT Definition and Picture of Success

MDTs provide investigative and prosecutorial support with a variety of issues including witness preparation and evidence analysis. Ultimately, an MDT’s team approach is necessary to conduct effective investigations and prosecutions, to avoid undue trauma to child victims and their families, and to protect the rights of the accused.1

What does a successful MDT look like? The central goal of a successful MDT is to come to desirable investigative and prosecutorial outcomes while safeguarding the victims’—in most cases, the child’s—welfare.2 The focus of MDTs should be treatment of the child and outcomes for victims. The point is reducing system impacts of trauma. An MDT focuses on investigations, policies, victim treatment, perpetrators, and myriad other functions. An MDT comprises a group of professionals working together in a coordinated, collaborative effort to ensure an effective investigation, prosecution, and disposition in a child sexual abuse case.

Because of the nature of crimes present in Indian Country, MDTs serve a vital role. MDTs were developed to be law enforcement, prosecution focused, and victim focused as opposed to the Child Protection Teams (CPTs), which are victim focused and already readily present in the law enforcement landscape. Like MDTs, CPTs recognize that child abuse is a huge problem in Indian Country. There is no single law enforcement agency that has all the necessary skills and expertise to truly combat the issue. Therefore, CPT members work together to prevent child abuse and neglect, forming a similar multidisciplinary approach as MDTs.

Law enforcement found it difficult to participate in CPTs that were child neglect focused. Law enforcement and prosecutors take a different approach to a child abuse case and, therefore, needed a different type of multidisciplinary team approach.3 In contrast to the prosecutorial approach that an MDT offers, a CPT provides protective services to secure a child’s safety and health. CPTs promote the prevention of child abuse and serve as advocates for children.4

The development of MDTs in Indian Country is an incredibly useful vehicle for coordinating the investigation, the prosecution, and the disposition of child sexual abuse cases. To be truly effective as an MDT, there must be participation from all law enforcement, social services, mental health, medical, child welfare, victim assistance, and judicial agencies with jurisdiction over child sexual abuse cases. In addition, tribal representation is essential. In fact, participation in MDTs is mandated for federal agencies under the Victims of Child Abuse Act of 1990 and the Indian Child Protection and Family Violence Prevention Act (Public Law 101–630).5

The Nuts and Bolts of MDTs

MDTs offer an ideal opportunity to discuss investigative and prosecutorial action. Representatives from U.S. attorneys’ or district attorneys’ offices meet with tribal prosecutors and determine the best venue for initial criminal prosecution. Information on the status of various investigations should be available on a regular basis. Lack of access to information regarding the status of cases has long been a problem for tribal police and prosecutors, and the MDT offers an appropriate forum to share information and plan strategies.6

In 2011, the United States Attorney General Guidelines for Victim and Witness Assistance stated that federal prosecutors must consult with local MDTs: “[t]he court and the attorney for the government shall work with established multidisciplinary child abuse teams designed to assist child victims and child witnesses, and shall consult with such multidisciplinary child abuse teams as appropriate.”7

MDT functions are dictated by the attorney general. The MDT shall be established to provide

  • medical diagnoses and evaluation services, including provision or interpretation of x-rays, laboratory tests, and related services—as needed—and documentation of findings;
  • telephone consultation services in emergencies and in other situations;
  • medical evaluations related to abuse or neglect;
  • psychological and psychiatric diagnoses and evaluation services for the child, the parent or parents, the guardian or guardians, other caregivers, or any other individuals involved in a child victim or child witness case;
  • expert medical, psychological, and related testimony;
  • case service coordination and assistance, including the location of services available from public and private agencies in the community; and
  • training services for judges, litigators, court officers, and others who are involved in child victim and child witness cases and in handling child victims and child witnesses.8

MDTs Overcoming Issues

MDTs that are truly successful have complete commitment and participation from all members. By pursuing a multidisciplinary team approach, MDTs reduce the number of interviews child victims face and the length of the investigative process, thereby preventing further trauma to these children. Indian Country can oftentimes have a lack of resources. For the FBI, this can mean that agents are out in the field, solo, investigating a crime; performing an interview; or even making an arrest. With a lack of resources to investigate these crimes, it is even more imperative to have a functioning MDT in place.

A crime committed in Indian Country can potentially be subject to investigations by local, state, federal, and tribal law enforcement, including the Bureau of Indian Affairs (BIA) and the Federal Bureau of Investigation (FBI). A case also can be subject to multijurisdictional prosecution, further confusing the process. One can imagine that these complications can cause needless and undue trauma to an already fragile child victim. In addition, even with the presence of MDTs, there can be a lack of clear protocols among agencies. How is it determined who does what? Criminal jurisdiction is determined by where the crime occurred; the type of crime; the race of both the victim and the perpetrator; and statutes specifying federal, state, and tribal jurisdiction over certain cases.9

The Need for MDTs and Key Players
An MDT Success Story

A mandatory reporter called the FBI about a historical child sexual abuse allegation involving an early school age child. The referral was immediately cross-reported to BIA law enforcement and to BIA social services—both of whom are members of the MDT. Same-day discussion focused on the alleged offender’s immediate access to this child and on coordinating a child interview. An MDT decision resulted in the child being scheduled for an evaluation at the Child Abuse Referral and Evaluation (CARE) Center, located at the Indian Health Services (HIS) hospital on the reservation. The MDT, which included FBI and BIA special agents, an FBI victim specialist, a BIA social worker, and a tribal child protection attorney—as well as the IHS pediatrician and child psychologist—responded to the CARE Center to work as a team to coordinate the investigation, address child protection concerns, and provide victim assistance. By early evening the child and parent had been interviewed, a safety plan and treatment plan had been implemented, and the offender had been interviewed and arrested on tribal charges. During the interview, the offender disclosed that as a child, he was a victim of child sexual abuse by a relative. Ultimately, tribal and federal charges were filed in the case. The second allegation was investigated and also charged in federal court. A third individual was charged by complaint after retaliating against the child victim.

The coordinated efforts of the MDT ensured a timely, coordinated response and an investigation that impacted two generations of child sexual abuse. At the same time, child protection and victim assistance that met the needs of the child and family were provided to those who needed these services.

Source: Stewart, Michele, FBI Office of Victim Assistance, 2012

MDTs look very different in Indian Country. In Indian Country, child abuse cases are prevalent and are the focus for MDTs. However, there is a movement to bring all cases involving children in Indian Country in front of an MDT, and in many areas of the United States, this movement is gaining momentum because of the success of current MDTs and the federal mandates in place. Types of child abuse cases that an MDT might discuss could include sexual assault, drug endangerment, domestic violence, and homicide. The scope of the cases that an MDT is able to handle is determined by the capability of the team itself.10

MDTs can be extremely successful when all parts work together toward common goals. It is important that the MDT be formed around mutual respect and trust. Each member of an MDT plays an important role and fulfills a certain need within the group. The talents from each participant make for a well-rounded, well-thought-out approach to child abuse cases, which in turn fosters great contribution, collaboration, and partnerships among law enforcement, medical services, child protective services, legal entities, and victim services.

The United States Attorney’s Office. The United States Attorney’s Office will assign an assistant U.S. attorney (AUSA) that typically leads the MDT case review meetings and presents elements of the crimes (federal statute), evidence, victim information, and witness information.

Law Enforcement. There can be many participants from law enforcement agencies. The FBI special agent is mandatory. Others involved include the Bureau of Indian Affairs; tribal law enforcement; and state, county, and local law enforcement.

Child Protective Services. There are two entities that are typically involved in MDTs in Indian Country: the Bureau of Indian Affairs Child Protective Services and the Tribal Child Protective Services. A case worker from the agency will participate in the meeting and coordinate services for the protection and well-being of the child and the family.

Health Services. In Indian Country, due to the cultural sensitivities required of MDTs, they will try to involve an Indian Country “traditional medicine” participant in the meeting. This participant provides a spiritual perspective and could be someone such as a Medicine Man from the tribe. Other participants include Indian health or tribal health services personnel such as a physician, a physician’s assistant, or a registered nurse—basically, anyone educated from a “western medicine” perspective.

Child Adovcacy Center. A child advocacy center provides a child-friendly facility where forensic interviews and sometimes medical examinations and treatments are conducted. A forensic interview follows a neutral fact-finding protocol coordinated to avoid duplicating interviews. These forensic interviewers are not victim advocates.

Victim Services. FBI victim specialist must provide services to victims as mandated by law. These include (1) assisting case agents to identify victims, (2) providing written and oral information to the victims on their rights and available services, (3) keeping victims informed of their case status, and (4) relaying information to agents from victims about threats they have received.

FBI victim specialists also assist in investigative support, providing for services such as on-scene assistance to victims, accompanying agents to interview victims or to deliver bad news, explaining forensic identification processes, cleaning and returning property, arranging for forensic exams for sexual or physical abuse victims, and conducting follow-up visits with vulnerable victims.11

Elements of an Effective MDT

Given the nature of child sexual abuse cases, there is no single profession or agency that has the ability to respond adequately to an allegation of child sexual abuse. The child needs MDTs. The team players need each other. Ultimately, children’s futures depend on the cooperative best effort of the MDT on their behalf. So many times children are the silent victims, and MDTs need to ensure that they are protecting these children.12

Confidentiality. For an MDT to be truly successful, there must be confidentiality. Memorandums of understanding should include this as well. On the flip side, there must be open lines of communication among coordinating agencies to ensure MDT success. This can be a tricky. What is necessary is that information be disseminated to agencies so that the MDT can carry out its legal responsibilities and ultimately the responsibilities to protect the child. This requires the integrity of all team players. This can sometime prove difficult in Indian Country in that some of the key players are tribal members who may have close ties to the victims in the cases that the MDT discusses.

Personal Commitment. Every member of the MDT is there to fill a crucial spot. This requires 100 percent commitment to working together to provide services to the child victim and family. The MDT meeting is an important means for communication for the whole team, however, team members should be communicating all the time to truly function effectively.

Protocol. There must be a thorough understanding by all team members about what is to be accomplished. The purpose of the MDT is to address impact and needs of all persons directly affected by the crime against the child. Teams that are successful have both tribal and federal participants and take a holistic approach to child abuse cases. This means that they do not focus on dispositions only. They focus on timely investigations, the welfare of the child, and other related factors. Needless to say, this makes information sharing between members a vital aspect to an MDT. Information sharing in MDTs is a needed part of an effective investigation. Because of the jurisdictional nightmare of working Indian Country cases, it is best that all parties work together toward a common goal. Working in Indian Country is often about sharing information with limited resources.34


Ultimately, an MDT method can prove successful with the commitment of dedicated law enforcement, child welfare, and legal professionals. Successful investigations coordinated through the MDT process significantly improve the response to child abuse cases. Forming and maintaining an investigative MDT can sometimes prove challenging in that buy-in is essential to have a universally successful outcome. Perhaps the best way to ensure that the government fulfills its obligations to protect children and bring to justice those responsible for mistreating them is the cooperation, the coordination, and the collaboration of responsible agencies in an investigative MDT.14  ♦


1William J. Roach and Faith T. Coburn, Indian Country Coordinators, “Tribal Affairs,” Indian Country, U.S. Attorney’s Office, Eastern District of Wisconsin, (accessed February 6, 2013).
2Michele Stewart, FBI Office of Victim Assistance, personal interview with author, November 19, 2012.
4Child Protection in Indian Country: A Handbook for Indian Health Service and Bureau of Indian Affairs, Indian Country Child Trauma Center, (accessed January 15, 2013).
5Victims of Child Abuse Act of 1990 (Pub. L. 101-647; 42 U.S.C. §§ 13001– 13031) and the Indian Child Protection and Family Violence Prevention Act of 1990 (Pub. L. 101–630; 25 U.S.C. § 3201–3210).
6Kathryn Turman, Program Director, FBI Office of Victim Assistance, material from internal training material, 2012.
7Attorney General Guidelines for Victim and Witness Assistance (U.S. Department of Justice, 1995) quoted in Eidell B. Wasserman Multidisciplinary Teams and Child Protection Teams (U.S. Dept. of Justice, Office of Justice Programs, Office for Victims of Crime, 2000), (accessed January 14, 2013).
8Stewart, personal interview with author, November 19, 2012.
14Mark Ells, JD, Forming a Multidisciplinary Team to Investigate Child Abuse, U.S. Department of Justice, Office of Justice Programs (March 2000), (accessed February 6, 2013).

Please cite as:

Pamela Elton and Michelle Stewart, "How Multidisciplinary Teams Achieve Success in Indian Country," The Police Chief 80 (March 2013): 42–45.



From The Police Chief, vol. LXXX, no. 3, March 2013. Copyright held by the International Association of Chiefs of Police, 515 North Washington Street, Alexandria, VA 22314 USA.

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