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Royal Commission Findings and Recommendations

As you may be aware, the Royal Commission handed down its findings and recommendations prior to Christmas following their three year review of historical Child Sexual Abuse (CSA), our systems and practices. There are volumes of documentation to plow through but for the purposes of this post, I thought many of you would be interested to know some of the comments and recommendations from Volume 9: Advocacy, support and therapeutic treatment services. This 211 page report can be accessed in full through a pdf.

The report overwhelmingly thought that victims of CSA required help to navigate the myriad of service systems with which they had to engage to gain assistance. “Advocacy and support and therapeutic treatment services are an essential part of a holistic service response to victims and survivors” (pg 30). It was thought that if implemented well these services can empower clients and assist them to cope with impacts associated with CSA and provide them with the support to recover from trauma. Those services must be trauma informed collaborative, available, accessible and high quality.

“Research suggests that dedicated advocacy roles for victims of sexual violence ‘assist people to connect to services they need…. and improve the support and experience of people who have suffered violence and trauma’” (pg 46). The report goes on to mention the services we provide. “Evaluations of victim advocacy and support services have been encouraging. Child Advocacy Centres (CAC) such as George Jones CAC in Western Australia provide advocacy and support for victims of CSA and aim to bridge gaps between agencies. The CAC model has been found to be effective at assisting victims and their families to access community resources and increasing multi-disciplinary responses to cases. The evidence for efficacy of advocacy and support also is highlighted within this service” (pg 46).

The commission’s report highlighted that for services like a CAC to be effective in avoiding re-traumatisation it was essential to have an understanding of the effects of trauma associated with CSA. “It is important that advocacy; support and therapeutic treatment services foster safety, build trust, seek to empower victims and survivors and validate their experience”(pg 62). Of note to us was a comment by the commission that said “because CSA compromises the safety of a child; priority for services responding should be to establish safety. Safety and building trust are key to healing and long term recovery”.

The report spoke about the value of models of collaboration seeking to achieve the trauma-informed principle of preventing ‘clients from having to retell their stories to multiple service providers. Eg. One-stop shop service hubs where services are co-located, allow staff from different agencies to communicate and build relationships”. Clients informed the commission this model reduced the need for them to navigate the service system themselves.

Royal Commission Findings and Recommendations

Professional Supervision: Our organisation has had a long standing policy regarding supervision for staff engaging in work whereby you are exposed to ‘traumatic content’. We are aware that continued exposure to traumatic content without supervision and support can lead to burnout and long term undermine the effectiveness of the workforce as a whole. An interesting distinction made by the Royal Commission is the difference between professional supervision and management supervision. “Professional Supervision is distinct from management supervision in that it aims to foster the practitioner’s clinical capacity rather than ensure their day to day activities are in line with the agency’s priorities. “We the Royal Commission consider that providing supervision is an ethical response by agencies seeking to support staff working in the field of sexual abuse and trauma.

The health and wellbeing of the workforce is integral to the development of a trauma-informed workforce (pg 145)”.

There are some very interesting comments regarding the use of Cognitive Behaviour Therapy (CBT) in our work. “Treatments that rely solely on a person’s cognitive capabilities (such as CBT) may not always be effective for victims and survivors of CSA presenting with symptoms of complex trauma” (pg 58). The report suggests CBT as effective in reducing “a range of symptoms, but less known about its effectiveness in promoting recovery” (pg 56). I urge clinicians to read the debate around conceptual knowledge.

Finally some recommendations relevant to us and our work which you may find of interest.

9.1 The Australian Government and state and territory governments should fund fund dedicated community support services for victims and survivors in each jurisdiction, to provide an ingreated model of advocacy and support and counselling to children and adults who experienced childhood sexual abuse in institutional contexts. Funding and related agreements should require and enable these services to:

a. be trauma-informed and have an understanding of institutional child sexual abuse
b. be collaborative, available, accessible, acceptable and high quality
c. use case management and brokerage to coordinate and meet service needs
d. support and supervise peer-led support models

9.6 The Australian Government and state and territory governments should address existing specialist sexual assault service gaps by increasing funding for adult and child sexual assault services in each jurisdiction, to provide advocacy and support and specialist therapeutic treatment for victims and survivors, particularly victims and survivors of institutional child sexual abuse. Funding agreements should require and enable services to:

a. be trauma-informed and have an understanding of institutional child sexual abuse
b. be collaborative, available, accessible, acceptable and high quality
c. use collaborative community development approaches
d. provide staff with supervision and professional development

9.9 The Australian Government, in conjunction with state and territory governments, should establish and fund a national centre to raise awareness and understanding of the impacts of child sexual abuse, support help-seeking and guide best practice advocacy and support and therapeutic treatment. The national centre’s functions should be to:

a. raise community awareness and promote destigmatising messages about the impacts of child sexual abuse
b. increase practitioners’knowledge and competence in responding to child and adult victims and survivors by translating knowledge about the impacts of child sexual abuse and the evidence on effective responses into practice and policy. This should include activities to:

i. identify, translate and promote research in easily available and accessible formats for advocacy and support and therapeutic treatment practitioners
ii. produce national training materials and best practice clinical resources
iii. partner with training organisations to conduct training and workforce development programs
iv. influence national tertiary curricula to incorporate child sexual abuse and trauma-informed care
v. inform government policy making
c. lead the development of better service models and interventions through coordinating a national research agenda and conducting high-quality program evaluation

The national centre should partner with survivors in all its work, valuing their knowledge and experience.

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