Identifying the key components of a 'whole family' intervention for families experiencing domestic violence and abuse

'Whole family' interventions for families living with domestic violence and abuse (DVA) are emerging and some international practice examples are available. This study reports a process evaluation of a pilot delivered in Northern England that aimed to work with all members of families experiencing DVA. The evaluation involved analysis of detailed accounts of practice from learning logs and case workbooks as well as interviews with practitioners and family members. The voluntary nature of families' involvement with the pilot, together with an explicit service philosophy of 'meeting families where they are at' appeared successful in engaging families. Pilot staff worked flexibly, seeing family members together and separately, but there was evidence of lower levels of confidence in work with perpetrators. Co-work enabled skills to be transferred to other professionals and social workers increased their use of risk assessment tools in DVA cases. However, there was uncertainty as to whether interagency communication improved across local agencies, and joint protocols and tools were slow to develop. This study is one of the first evaluations of 'whole family' interventions in DVA, and it illustrates how, when additional resources and organisational support are made available, a non-blaming approach that families find engaging can be developed

Submission in response to the Australian Government’s Consultation Paper on the Establishment of the Royal Commission into Institutional Responses to Child Sexual Abuse

A submission in response to the Australian Government\u27s Consultation Paper on the Establishment of the Royal Commission into Institutional Responses to Child Sexual Abuse. Introduction We are a team of academics and researchers, from the disciplines of historical studies, social work and archival science, who have substantive years of experience working on projects exploring the legacy of Australia\u27s institutional \u27care\u27 of children. Our work in this space, particularly since the release of the Forgotten Australians report in 2004, has involved ongoing engagement with a broad range of stakeholders, including care leavers, support and advocacy groups, past and current providers of out-of-home care, state and federal government departments, and cultural institutions. We welcome the opportunity to make a submission in response to the Australian Government\u27s Consultation Paper on the Establishment of the Royal Commission into Institutional Responses to Child Sexual Abuse. Our submission discusses the vital importance that records will play in this Royal Commission, with particular reference to records in the custody of past providers in religious, charitable and government sectors. We submit that records are a key issue for this Royal Commission

Literature review on supervised contact between children in out-of-home care and their parents

This document is a summary review of the literature on contact between children in out-of-home care (OOHC) and their parents. It aims to assist policy makers in critiquing the evidence relating to contact between children in OOHC and their parents. It is focused on face-to-face supervised contact, but also draws on the broader literature on contact

KContact, an enhanced intervention for contact between children in out-of-home care and their parents: protocol for a cluster randomised controlled trial

BACKGROUND: When children are unable to safely live at home with their parents, contact between these children and their parents is considered, in most cases, important for maintaining children's sense of identity and relationships with their parents. However, the research evidence on contact is weak and provides little guidance on how to manage contact and when it is beneficial or potentially harmful. The evidence in relation to contact interventions with parents and their children who are to remain in long-term care is the most limited. A small number of studies have been identified where interventions which were therapeutic, child-focused and with clear goals, particularly aimed at preparing and supporting parents, showed some promising results. This trial aims to build on the existing evidence by trialling an enhanced model of contact in multiple sites in Australia. METHODS/DESIGN: This study is a cluster randomised controlled trial of an enhanced contact intervention with children in long-term care who are having supervised contact with their parents. Intervention sites will implement the kContact intervention that increases the preparation and support provided to parents in relation to contact. Baseline and follow-up interviews are being conducted with parents, carers and agency workers at intervention and control sites. Follow-ups interviews will assess whether there has been an increase in children's emotional safety and a reduction in distress in response to contact visits with their parents (the primary outcome variable as measured using the Strength and Difficulties Questionnaire), improved relationships between children and their parents, improved parental ability to support contact, and fewer contact visits cancelled. DISCUSSION: By increasing the evidence base in this area, the study aims to better guide the management and supervision of contact visits in the out-of-home care context and improve outcomes for the children and their families. TRIAL REGISTRATION: Trial registered on 7 April 2015 with the Australian New Zealand Clinical Trials Registry ACTRN12615000313538

Professional support for children bereaved by domestic homicide in the UK

PurposeChildren bereaved by domestic homicide face unique challenges that are likely to require professional interventions. In this study, the theoretical lens of candidacy, which considers the dynamic factors that affect service eligibility and access, is employed to evaluate current service provision in the United Kingdom.MethodWe conducted a mixed methods survey (n = 90) and semi-structured interviews (n = 7) of professionals working in the children and families sector. Thematic analysis was used to interpret qualitative data, while descriptive and parametric statistics were used for the analysis of quantitative data.ResultsQuantitative results showed that a majority of professionals reported that the current service provision is not meeting the specific needs of children bereaved by domestic homicide, and that professionals reported low levels of confidence in working with the topic, regardless of professional background. This article reports on two key themes identified in the qualitative data: unmet needs and the barriers to candidacy, and developing a more effective provision.ConclusionsUsing the theoretical lens of candidacy, this study identified factors which were found to limit children’s access to appropriate services, indicating the need for a specialist service which provides long-term input, support for caregivers, and access to peer-support

Promoting EArly intervention with men's use of violence in ReLationships through primary care (PEARL study)

The PEARL study will address an evidence gap around early intervention with male perpetrators of domestic violence through primary care.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

Maternal and child health nurse screening and care for mothers experiencing domestic violence (MOVE): A cluster randomised trial

BACKGROUND: Mothers are at risk of domestic violence (DV) and its harmful consequences postpartum. There is no evidence to date for sustainability of DV screening in primary care settings. We aimed to test whether a theory-informed, maternal and child health (MCH) nurse-designed model increased and sustained DV screening, disclosure, safety planning and referrals compared with usual care. METHODS: Cluster randomised controlled trial of 12 month MCH DV screening and care intervention with 24 month follow-up. The study was set in community-based MCH nurse teams (91 centres, 163 nurses) in north-west Melbourne, Australia. Eight eligible teams were recruited. Team randomisation occurred at a public meeting using opaque envelopes. Teams were unable to be blinded. The intervention was informed by Normalisation Process Theory, the nurse-designed good practice model incorporated nurse mentors, strengthened relationships with DV services, nurse safety, a self-completion maternal health screening checklist at three or four month consultations and DV clinical guidelines. Usual care involved government mandated face-to-face DV screening at four weeks postpartum and follow-up as required. Primary outcomes were MCH team screening, disclosure, safety planning and referral rates from routine government data and a postal survey sent to 10,472 women with babies ≤ 12 months in study areas. Secondary outcomes included DV prevalence (Composite Abuse Scale, CAS) and harm measures (postal survey). RESULTS: No significant differences were found in routine screening at four months (IG 2,330/6,381 consultations (36.5 %) versus CG 1,792/7,638 consultations (23.5 %), RR = 1.56 CI 0.96-2.52) but data from maternal health checklists (n = 2,771) at three month IG consultations showed average screening rates of 63.1 %. Two years post-intervention, IG safety planning rates had increased from three (RR 2.95, CI 1.11-7.82) to four times those of CG (RR 4.22 CI 1.64-10.9). Referrals remained low in both intervention groups (IGs) and comparison groups (CGs) (<1 %). 2,621/10,472 mothers (25 %) returned surveys. No difference was found between arms in preference or comfort with being asked about DV or feelings about self. CONCLUSION: A nurse-designed screening and care model did not increase routine screening or referrals, but achieved significantly increased safety planning over 36 months among postpartum women. Self-completion DV screening was welcomed by nurses and women and contributed to sustainability. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12609000424202, 10/03/2009

Protocol for a randomised controlled trial of a web-based healthy relationship tool and safety decision aid for women experiencing domestic violence (I-DECIDE)

BACKGROUND: Domestic violence is a serious problem affecting the health and wellbeing of women globally. Interventions in health care settings have primarily focused on screening and referral, however, women often may not disclose abuse to health practitioners. The internet offers a confidential space in which women can assess the health of their relationships and make a plan for safety and wellbeing for themselves and their children. This randomised controlled trial is testing the effectiveness of a web-based healthy relationship tool and safety decision aid (I-DECIDE). Based broadly on the IRIS trial in the United States, it has been adapted for the Australian context where it is conducted entirely online and uses the Psychosocial Readiness Model as the basis for the intervention. METHODS/DESIGN: In this two arm, pragmatic randomised controlled trial, women who have experienced abuse or fear of a partner in the previous 6&nbsp;months will be computer randomised to receive either the I-DECIDE website or a comparator website (basic relationship and safety advice). The intervention includes self-directed reflection exercises on their relationship, danger level, priority setting, and results in an individualised, tailored action plan. Primary self-reported outcomes are: self-efficacy (General Self-Efficacy Scale) immediately after completion, 6 and 12&nbsp;months post-baseline; and depressive symptoms (Centre for Epidemiologic Studies Depression Scale, Revised, 6 and 12&nbsp;months post-baseline). Secondary outcomes include mean number of helpful actions for safety and wellbeing, mean level of fear of partner and cost-effectiveness. DISCUSSION: This fully-automated trial will evaluate a web-based self-information, self-reflection and self-management tool for domestic violence. We hypothesise that the improvement in self-efficacy and mental health will be mediated by increased perceived support and awareness encouraging positive change. If shown to be effective, I-DECIDE could be easily incorporated into the community sector and health care settings, providing an alternative to formal services for women not ready or able to acknowledge abuse and access specialised services. TRIAL REGISTRATION: Trial registered on 15(th) December 2014 with the Australian New Zealand Clinical Trials Registry ACTRN12614001306606