The Right to Recover: Therapeutic services for children & young people following sexual abuse
This report looks at what currently happens for children who have already been sexually abused to help them overcome the problems arising from it, and to prevent them from suffering long term harm.
It reports the findings of research which aimed to investigate first, how the emotional needs of children and young people are assessed following disclosure or discovery of sexual abuse, and second, the availability of services when children need help to recover. Its focus is on the West of Scotland, an area which includes 17 local authorities and contains 51% of the Scottish child population aged 18 years and under.
A mapping exercise and survey of services was undertaken, together with facilitated discussion groups with professionals including social workers, police officers, child and adolescent mental health services (CAMHS) practitioners, paediatricians and other health professionals, all conducted during summer and autumn 2016.
Included in the study are all services which offer ongoing face to face therapeutic support or intervention to children and/or young people who have experienced
sexual abuse. This includes services for children up to and including the age of 18, who:
- have experienced any form of sexual abuse, including child sexual exploitation;
- have been identified as at risk of sexual abuse/ exploitation;
- have displayed sexually worrying or harmful behaviour.
This includes both ‘specialist’ services, those which have developed a specialism in sexual abuse, and which devote either all, or a substantial proportion, of their time to this; and ‘generalist’ services, those which help children with a range of difficulties and adversities, and where recovery from sexual abuse is a part of what they do, and may not necessarily involve a substantial proportion of their time.
The Child’s Pathway after Disclosure
- There is currently no standard expert assessment of emotional and mental health provided to children 18 years and under following disclosure of sexual abuse and no routine follow up in the months and years following sexual abuse.
- Readily accessible advice, support and treatment for non-abusing parents and carers is essential to enable them to support their child’s recovery, and constitutes early intervention for the child.
- Resources for carer work are concentrated within services designed for the most vulnerable children and young people, and in services which take a holistic whole family assessment of the child.
- Pathways to specialist help for children with child protection concerns are clear, however practice varies between areas.
- There is no clear pathway for children who do not have ongoing child protection concerns.
- Where local services exist, some of the barriers to referring children to services include professionals’ lack of knowledge of available services, issues around the assessment of suitability and timing, complex referral processes and resource pressures
The Child’s Access to Help
- A total of 39 services in the West of Scotland provide face to face therapeutic support to children following sexual abuse; this includes 21 specialist and 18 generalist services.
- The majority of these offer long term open-ended support tailored to each child’s specific needs, and include outreach work.
- The 21 specialist services are small, with an average therapeutic staff resource of 1.5FTE for face to face work. The vast majority do not have sufficient capacity to meet demand, which means in most areas children cannot access immediate support.
- Most specialist service provision for children under 18 is offered by adult-focused sexual violence and survivor organisations.
- Of the 21 specialist services, 8 provide a service tailored specifically for children which offers open access (i.e. eligibility is not restricted to ‘high tariff’ cases).Local access to specialist help is best for the secondary school age group: 11 out of 17 West of Scotland local authority areas have provision for the 12 year + age group, and 14 out of 17 have provision for the 13 year+ age group.
- Just 6 out of 17 local authority areas have provision for the primary school age group.
- In only 2 out of 17 local authority areas can children aged 5 and under and their non-abusing parent/carers access a local specialist service.
- Services with staff dedicated to the work of engaging with highly vulnerable children at risk of/experiencing child sexual exploitation do not exist in most areas.
- Total therapeutic staff numbers dedicated to work with children with disabilities in the West of Scotland area as a whole comprises two posts (1.5 FTE in total).
Funding and Sustainability
- The majority of specialist and generalist provision is in the third sector and is dependent upon short term, fragmented and insecure sources of funding.
- In over half of the third sector services (56%, 14 out of 25) the main source of funding is due to end in 2018 or before.
- The ethics of accepting children for intensive long-term support and treatment in circumstances in which the security and sustainability of the service is in doubt was raised by practitioners in both the statutory and third sectors.
- Where specialist services have one major source of funding, The Scottish Government and Trusts & Foundations are the most common major funders.
- A Scotland-wide mapping study of post-sexual abuse services conducted in 2008 found there was no consistent or coordinated approach to provision in Scotland and the services which existed were unable to meet demand.
- While the Scottish Government and some key Trusts and Foundations have aligned funding with national priorities around sexual abuse, this has not been sufficient to change the overall picture of patchy and insecure service provision. The broad picture remains the same as in 2008.