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Page 1Cara House Centre for Resilience and Recovery – Evaluation

Cara House Centre for Resilience and Recovery

Evaluation

Mary Jo McVeigh,Cara House Elyse Aird, Victims Services

JusticeVictims Services


The information was jointly prepared by Cara House and Victims Services, NSW Department of Justice.

Cara House 148 Majors Bay Road Concord NSW 2137

P: (02) 8765 0261 W: www.carahouse.com.au

Victims Services Locked Bag 5118 Parramatta NSW 2124

P: 1800 633 063 F: (02) 8688 9632 E: [email protected] W: www.victimsservices.justice.nsw.gov.au

November 2015

© State of New South Wales through Victims Services, Department of Justice, November 2015 This work may be freely reproduced for personal, educational and government purposes. Permission must be received from the Department for all other uses.

Alternative formats of this information are available.

This document has been prepared by Victims Services for general information purposes. While every care has been taken in relation to its accuracy, no warranty is given or implied. Further, recipients should obtain their own independent advice before making any decisions that rely on this information.

(VS • 11/2015)


mailto:vs%40agd.nsw.gov.au?subject=

http://www.victimsservices.lawlink.nsw.gov.au


Cara House Centre for Resilience and Recovery – Evaluationby Mary Jo McVeigh, Cara House & Elyse Aird, Victims Services

‘Wrapped’ is a program in which children are encouraged to re-discover the meanings and connections in life. It is a journey of resilience that explores the woven, textured fabrics of the intricacies of life. Each child creates a blanket, which holds a colourful representation of love, warmth, protection, and safety.

Contents

Executive summary 5

Backround 5

Objectives 5

Method 5

Participants 5

Key Findings 6

Conclusion 6

Acknowledgements 7

Chapter 1: Introduction 9

1.1 Crimes against children: Abuse 9

1.2 Cara House 10

1.3 The Approved Counselling Service, Victims Services 10

1.4 Cara House-Victims Services pilot 10

1.5 Wrapped Program 11

Chapter 2: Literature search 13

2.1 Scope and purpose of the review 13

2.2 Method 13

2.3 Findings 13

2.4 Limitations 13


Chapter 3: Overview 19

3.1 Aim 19

3.2 Process 19

3.3 Group structure 19

3.4 Session structure 20

3.5 Partnerships 20

3.6 Theoretical underpinnings 21

Chapter 4: Method 23

4.1 Partnerships 23

4.2 Procedure 26

4.3 Measures 27

4.4 Data analysis 28

Chapter 5: Results 29

5.1 Pre-score results 29

5.2 Pre and post comparisons 31

5.3 Interviews with children and young people 32

5.4 Parent/caregiver comments 34

Conclusion 37

Implications 38

Recommendations 39

References 41

Appendix 1: One girl’s story 43

Appendix 2: Pre-group questionnaire for partipants (v1) 45

Pre-group questionnaire for partipants (v2) 47

Participant final evaluation (v1) 50

Participant final evaluation (v2) 52


Executive summary

BackgroundDuring 2013-14, 143,023 Australian children received child protection services (Australian Institute of Health and Welfare 2015). Of those 99,210 were subject to child protection investigations and 55,007 were on child protection orders. New South Wales had 31,117 children investigated, 11,499 were substantiated cases, 19,618 were not substantiated. The breakdown of substantiation by abuse category showed that emotional abuse and neglect were the highest two forms of abuse with physical abuse and sexual abuse being next in that order. The high rates of emotional abuse were believed to be of those children exposed to domestic/family violence.

The Approved Counselling Service (ACS), operated by Victims Services, offers eligible victims of crime up to 22 hours of individual counselling to assist in their recovery. Whilst this is a largely effective response, in 2014 the Service provided no alternative response to meeting specific client needs outside of individual counselling. Therefore it entered into a partnership with Cara House to pilot a group work program for children and young people.

ObjectivesThe purpose of this evaluation is to determine the effectiveness of the pilot program:

• To identify and evaluate the process of delivering a group work program to children and young people accessing the ACS.

• To identify and assess the effectiveness of a resilience based group work program to children and young people accessing the ACS.

• To document the progress of children and young people engaged in the group work program.

• To illicit the opinions of and integrate the participation of children and young people into ongoing service delivery.

MethodThe pilot was considered in terms of both a process and outcomes evaluation. A mixed methods approach was utilised to meet the evaluative objectives of the pilot.

Quantitative data (pre and post questionnaires) was gathered and analysed to measure improvement in resilience-based factors for children and young people participating in the group.

Qualitative data (interviews) was gathered and analysed to measure progress and participatory factors.

ParticipantsOf the 56 children and young people engaged in the group work program:

• 33 participants were primary victims

• The average age was 9.7 years

• There were 35 females and 21 males

• Most were victims of domestic violence and sexual assault (39 and 17 participants respectively).

• Relationship to offender – 32 participants was a daughter or son, 6 participants was a step daughter or step son


Key findingsThe feedback from the participants was overwhelmingly positive. The results highlighted:

• The success of the Wrapped Group in providing a resilience based experience for children and young people who were victims of crime.

• The success of the Wrapped Group in providing an expressive group therapy experience for children and young people who were victims of crime.

• The success of the Victims Services and Cara House partnership offering group intervention to children/young people as an alternative to the traditional face-to-face counselling.

• The success of the Victims Services and Cara House Expressive Therapies Group Work programme offering group intervention in both urban and rural settings in NSW.

ConclusionThe implications of delivering such a program would be that it could be expanded into other areas, which currently have a gap in service delivery, such as Juvenile Justice detention centres, and schools. The program provides a fixed period of group therapeutic intervention, which can work in with existing programs and allow for cooperative delivery with agency professionals, such as school counsellors, psychologists and social workers.

A long term goal would be that Victims Services be in a position whereby it can offer an expressive therapy group as an alternative to the traditional face-to-face counselling that the ACS is most commonly used for. There would be a requirement to train and “accredit” Approved Counsellors in the use of this program. It is envisaged that this would occur as part of the Approved Counsellor Professional Development Program and offered to selected individuals following an expression of interest.


Acknowledgements

No program can be successful without the hands of many to do the work and the hearts of many to support it.

This pioneering program was a joint initiative by Victims Services and Cara House. There are people I would like to honour. Deep gratitude goes to:

• The children, young people and their carers who engaged with us in this group work program and whose feedback will help improve our service delivery.

• Mahashini Krishna, Commissioner of Victims Rights for her support and belief in this project.

• Elizabeth Morrison, Cara House, ‘Wrapped’ Clinical Lead, whose hard work and dedication contributed to the success of this program.

• The Cara House staff and volunteers, who facilitated the groups, and whose hard work, commitment, skills and passion ensured excellence in service delivery.

• Elizabeth Morrison, Eleanor Britz, Sarah Dillane, Jo Davies, Amanda Boyd, Jennifer Pitty, Alys McLennan, Angela McColl ,Lorraine Walker, Jessica Frew Edel Langan, Conor Roberts.

• The staff at Victims Services whose support and hard work on this project was invaluable, Thomas Dornan, Emmanuel Kassiotis, Amelia Mercieca, and Elyse Aird. Thomas Dornan and Emmanuel Kassiotis in particular whose partnership with Cara House made the success of this project possible.

• Conor Roberts, Emmanuel Kassiotis and Elizabeth Morrison for their contribution to the content and editing of this report.

• Those key stakeholders who referred the children and young people to the groups and supported their attendance.



Chapter 1: Introduction

1.1 Crimes against children: Abuse During 2013-14, there were 198,966 Australian children suspected of being harmed or at risk of harm from abuse and/or neglect (Australian Institute of Health and Welfare 2015). This resulted in 304,097 notifications. Of those NSW had 26,215 substantiated cases. The breakdown of substantiation by abuse category showed that emotional abuse and neglect were the highest two forms of abuse with physical abuse and sexual abuse being next in that order. The high rates of emotional abuse were believed to be of children exposed to domestic violence. Figure 1 was taken from the report written by Australian Institute of Health and Welfare 2015.

Figure 1: Breakdown of primary substantiated harm types in Australia in 2013-14, by percentage

Sexual abuse (14%)

Physical abuse (19%)

Emotional abuse (39%)

Neglect (28%)

Neurobiology of trauma

The discipline of Neurobiology has shown us that experience shapes the developing structures of the brain. Repeated traumatic experiences in childhood can result in children’s brains operating from the place of constant hyper-arousal that is required for survival. In addition, when trauma occurs, the body’s natural defences will automatically be activated through the release of massive amounts of stress hormones. These stress hormones assist the body to move into protective behaviours such as flight, fight and freeze however prolonged sustained exposure is toxic to the body and the overall physical and emotional well-being of children.

The effects of trauma can be wide ranging. Some of these are as follows:

Physical effects

Physical effects include digestive problems, headaches, muscle tension, clumsiness, reduced spatial awareness, respiratory problems, sleeping and eating problems and self-harming and risk taking behaviours.


Cognitive

Abuse affects children’s learning. This may be from an actual injury such as brain damage or brain sculpting to wire the brain for survival rather than higher order learning at school.

The brain is “use” dependent. When most of the brain’s effort is focused on helping the body to cope with large amounts of stress then adaptive reactions, (flight, fight and freeze) become well practised and embedded as pathways in the brain. Little of the brain’s energy is left to help the child learn new skills and move through the stages of normal stages of childhood development. In addition, children may have a reduced understanding and capacity to use language. They have problems with the ability to think before they act, their memory, their ability to apply knowledge in different contexts, difficulty with focus and attention, and their ability to take in and integrate new information.

Emotional

The emotional effects of trauma can be wide-ranging and often include loss of children’s ability to identify and communicate their feelings. Feelings that are accessible to children range from one end of the spectrum in the realm of fear and rage to the other end of anxiety and depression and everything in between. They are often steeped in feelings of worthlessness and shame and loss of identity.

1.2 Cara HouseMary Jo McVeigh, CEO of Cara House and CaraCare, began a sole counselling and consultancy practice 22 years ago. Subsequently she established Cara House in 2005 as a therapy centre for children and young people who had experienced trauma as a result of abuse or neglect.

In 2015 she founded the charity, CaraCare, with the sole purpose of providing group work programs to children and young people.

Cara House and CaraCare objective:

• To provide excellence in service to children who have been abused.

Cara House and CaraCare aim:

• To deliver creative and innovative services to children, who have been abused, and their carers, which is trauma, attachment and recovery informed.

1.3 The Approved Counselling Service, Victims ServicesVictims Services administers the Approved Counselling Service (ACS), which provides individual counselling to eligible victims of violent crime. The ACS operates in accordance with eligibility criteria set out in the Victims Rights and Support Act 2013. The service is one of the responses available to victims of violent crime in NSW. It operates to assist victims in coping with the adverse symptoms arising as a direct result of an act of violence and to reduce the impact of the crime on their lives

1.4 Cara House-Victims Services pilotThe ACS, operated by Victims Services, offers eligible victims of crime, up to 22 hours of individual counselling to assist in their recovery. Whilst this is a largely effective response, in 2014 the Service provided no alternative response to meeting specific client needs outside of individual counselling.

Victims Services had been exploring alternatives for responding to specific needs and piloted one such alternative in the community (the Counselling in Prisons Trial is one such example). Another client group that Victims Services wanted to target was that of children and young people accessing the ASC.


In 2014 a number of existing programs were available in the community that could be utilised to meet the needs of children and young people that work within the parameters of the ACS. One such program was a group work resilience and trauma recovery program offered by Cara House in Concord.

From July 2014 Victims Services invited Cara House to conduct a year long trial of one of Cara’s group work programs, (Wrapped Program), for children and young people accessing the ACS.

Prior to the commencement and for the duration of the pilot, extensive planning and negotiation occurred between Victims Services and Cara House. Victims Services were involved in all of the administrative decision-making and their guidance and feedback shaped the pilot every step of the way.

1.5 Wrapped ProgramThis program was developed by Mary Jo McVeigh and has run since the early 2000s. It has been taught at university, has been trained on a state-wide basis to other organisations and is currently being researched as part of Ms McVeigh’s Doctorate at Sydney University. It was evaluated by Domestic Violence Clearing House and recommended as a program of best practice in working with children who have been traumatised.

The Wrapped Program is a 10-week group work program for children and young people of all ages. It offers an integrated approach, which combines traditional therapy with expressive therapy, which sets out to address prior victimisation by focusing on building the child’s capacity for resilience.

The aim of the group is to provide children and young people with an experience of re-discovering the meaning and connections in life that supports them through difficult times. Moreover, it is a journey of resilience, with a key focus on safety, which explores the woven, textured fabrics of the intricacies of life and explores what has sustained and nourished children when facing trauma. Skilled facilitators, who are trained trauma therapists, assist children to create a blanket that holds a colourful representation of love, protection, warmth and safety.

The blankets, made by participants, are a tangible reminder of what holds them and keeps them strong, connected and loved. Children and young people not only experience the ten week recovery program but they take with them their own unique, tangible representation of the process, the blanket.



Chapter 2: Literature search

2.1 Scope and purpose of the reviewGroup therapy has been used as an effective method to treat children experiencing post-traumatic stress due to violence (for example, Stein et al., 2003). Therefore as part of the pilot a small literature review was undertaken to look at the current clinical positioning on effectiveness of group therapy with children and young people who have been traumatised.

2.2 MethodThe approach taken was a narrative review of 10 peer-reviewed articles. The journals selected were: Journal of child sexual abuse, Research on Social Work Practice, Journal of Interpersonal Violence, Journal of Emotional abuse Social work with Groups; Psychoanalytic Social Work; Child Care in Practice, British Journal of Social Work.

A systemic search of literature was done within the year range of 2005 to present from two data bases accessed through Sydney University; Social Service Abstracts and Social Work Abstracts. To avoid author bias towards particular interventions different treatment modalities were chosen from the search. A profile of the studies are identified and summarised in Table 1 on p.14.

2.3 FindingsThe combined number of children and young people in the studies numbered 1128. The literature was not written from a critical theory orientation; therefore, the biographical information summarised was not from the children and young people’s perspective. There was an overall higher percentage of girls in the study than boys. The age range was from three years to 17 years and the ethnicity of the children and young people was varied, for example Hispanic, Caucasian, African American, Native American, European, Irish, Latina, Bi-racial.

The literature search revealed that varying modalities were used and all were seen to be effective, despite the different methodological approaches. This provides a very strong clinical rational for Victims Services to use group work with children and young people who are victims of crime.

The search also highlighted that some studies in seeking an answer to the question of, what is effective, clearly privileged a positivist paradigm. For example Springer et al (2012) described their methodology “as a battery of clinical measures” (Springer 2012 p, 649). It is of note that all the children who experienced this methodology have a lived experience of a ‘battery’ of the power and control dynamic of the abuse they endured. Unfortunately the participation of children and young people in determining what accounts as effective intervention was missing. This lack of findings about children and young people’s evaluations of programs is significant.

A key highlight and one of the unique elements of this pilot is the emphasis of the Wrapped Program, eliciting and recording children and young people’s feedback. Feedback on program entry and feedback at program end and integrating it into future program development.

2.4 LimitationsThe limitations of this research are it’s small sample size, and the lack of Australian research that came up in the two databases that were accessed.


Table 1: Key studies reviewed (* = of participant)

Authors and date Dietz T.J., Davis D., Pennings J. (2011)

Location of study Metropolitan area in southern USA

Treatment description Group: Dog & stories, No dog, Dog No stories

Nature of trauma Sexual abuse

Age* 7-17

Gender* F-143

Ethnicity* 66 Hispanic, 56 Caucasian, 26 African American, 1 Native American, 4 Other

Socio-econ* background NS

Method and sample size143 split into three groups. Pre and post measures using TSCC. Data analysed to compare intervention effects.

Journal study published in Journal of child sexual abuse, Vol. 21: pp.665-683

Authors and date Duffany A., Panos P.T. (2009)

Location of study Utah USA

Treatment description 12 sessions relating to psychoeducational topics

Nature of trauma Sexual abuse

Age* 3-12

Gender* F-26; M-21

Ethnicity* 40 White; 5 Black; 1 Hispanic; 1 Pacific Islander


Method and sample size47 children, The Youth Life Status Questionnaire used. Pre and post group measure

Journal study published in Research on Social Work Practice, Vol. 19:3, pp.291-303

Authors and date Graham-Bermann S.A., Howell K.H., Lilly M., & De Voe E. (2011)

Location of study South East Michigan USA

Treatment descriptionBased on cognitive behavioural theory with a focus on helping children cope with trauma

Nature of trauma Intimate partner violence

Age* 6-12

Gender* F-53%; M47%

Ethnicity*52% White; 33% African American; 11% Biracial; 2% Biracial; 2% Latina/0; 2% Native American

Socio-econ* background 60% of their mothers had some educational background

Method and sample size180 children, and their mothers 120 participated and 60 in comparison group. 5 Measures per and post

Journal study published in Journal of Interpersonal Violence, Vol 26:9, pp.1815-1833


Authors and date Karin K. Grip, Kjerstin Almqvist, Ulf Axberg, & Anders G. Broberg (2013)

Location of study Sweden

Treatment description Psychosocial

Nature of trauma Domestic violence

Age* 3-13

Gender* F-34; M 28

Ethnicity* 93.5% born in Sweden; 25 born elsewhere in Europe; 5% Outside Europe

Socio-econ* background Mothers had 12 years of education or more

Method and sample size315 Children two subscale on the CEDV scale, VDC and TSCC-A. 219 mothers CTS2 & SCL-90

Journal study published in Violence and Victims, Vol 28:4, pp.635-655

Authors and dateGrace S. Hubel, Christopher Campbell, Tiffany West, Samantha Friedenberg, Alayna Schreier, Mary Fran Flood, David J. Hansen (2014)

Location of study Midwest USA

Treatment description 28 groups cognitive behavioural

Nature of trauma Sexual assault

Age* 6-13

Gender* F-77%; M-23%

Ethnicity*80% European American; 6% African American; 5% Hispanic/Latino; 7% Bi or Multi racial; 1% Native American

Socio-econ* background 64% caregivers employed

Method and sample size

97 children administered CDI, CMAS-R, CQL, CITES-R, CFRV, SAFE Evaluation Form.

Caregivers administered CBCL, FACES-III,, F-COPES, PSI, SAFE Eval form

Journal study published in Journal of child sexual abuse, Vol 23, pp.304-325

Authors and date Johnston J.R. (2008)

Location of study San Francisco USA

Treatment description Games, art, pyscho-drama

Nature of trauma Family & community violence

Age* 5-14

Gender* F-106; M-117

Ethnicity* Caucasian (42%); Hispanic (36%); Afr-Amer (10%); Other (12%)

Socio-econ* background 75% no high ed; 42% Gov welfare benefits; 23% VOC funding

Method and sample size223 children. TRS & CBCL used. Pre and post group measure and six months follow up.

Journal study published in Journal of Emotional Abuse, Vol 3:3-4, pp.203-226


Authors and date Kjellgren, C., Svedin, C.G., Nilsson, D. (2013).

Location of study Sweden: Kristainstad, Linkoping Lund, Malom

Treatment description Combined Parent-Child Cognitive Behavioural Treatment (CPC-CBT)

Nature of trauma Physical abuse

Age* 6-14

Gender* F-10; M-15

Ethnicity* Born-Sweden; Born-outside

Socio-econ* background Employed; Self-Employed; Studied

Method and sample size 5 assessment instruments used with 22 families

Journal study published in Child Care in Practice, Vol 19:3, pp.275-290

Authors and date Powell, T. Blanchet-Cohen N. (2014)

Location of study New Orleans USA

Treatment description School based group intervention

Nature of trauma Natural disaster

Age* Six grade

Gender* M-7

Ethnicity* NS


Method and sample size Description of three sessions with 7 young people

Journal study published in Social Work with groups, Vol 37:4, pp.297-313

Authors and date Springer, C., Misurell, J.R., Hiller, A. (2012)

Location of study New Jersey USA

Treatment description Game Based cognitive-behavioural therapy (GB-CBT)

Nature of trauma Sexual assault

Age* Mean 7.3

Gender* F-57; M;34

Ethnicity* Afr-Amer; Latino; Caucas Amer; Biracial; Other

Socio-econ* background Improvised urban

Method and sample size Assessment instruments with children, pre and post

Journal study published in Journal of child sexual abuse, Vol 21:6, pp.646-664


Authors and date Stewart, D. & Thomson, K. (2005)

Location of study Belfast Ireland

Treatment description Story, art, physical activity & talking

Nature of trauma Community trauma (CTSS)

Age* 4-5

Gender* F-10

Ethnicity* Irish


Method and sample size Pre and post questionnaires, girls, parents and teachers

Journal study published in British Journal of Social Work, Vol 35, pp.105-124



Chapter 3: Overview

This evaluation details the participation of 56 children in a pilot program to determine its effectiveness. There were a total of 14 pilot groups run across the period of a year (July 2014 – July 2015) with 3-6 participants in each pilot group. The pilot sites were located in Sydney and rural NSW.

The total number of children and young people assessed for the program was 63. Seven participants withdrew from the group in the first one to two weeks dues to the following reasons:

Carer felt it was too far to travel to the group.

Carer was looking for a behaviour management group.

Psychiatrist did not want any other form of intervention during her treatment.

3.1 AimTo provide children whose lives have been impacted by the trauma of neglect, violence and abuse an opportunity to tap into their own resilience and explore those aspects of life that have sustained them in the face of adversity.

To provide a safe and respectful environment in which each child has the opportunity to design and create a blanket that represented those people, experiences, relationships and activities that has given them a sense of warmth, safety and protection.

3.2 ProcessIn the process of “making the Blanket”, the Group facilitators planned and modified each session to meet the needs of the group participants. However, there was an overarching structure designed to provide the children a safe, reliable, predictable, consistent and fun group work experience.

The flexibility of the group timetabling was one of the strengths of the Cara program – groups were largely held after school hours, plus there were several groups held on a Saturday, and there was the one week holiday program. This flexibility means that primarily the needs of the children are met as the groups are run to fit in with their schedule, but it also provides testimony to the flexibility of the staff running the groups.

Clinical supervision by the creator of the ‘Wrapped’, Mary Jo McVeigh and peer supervision by clinical lead, Elizabeth Morrison were vital to the ongoing program success and client accountability of this program. No group work programs at Cara House run without clinical supervision. In addition all facilitators of ‘Wrapped groups’ have to be trained, accredited and supervised to run them. The importance of supervision needs to be highlighted as a necessary part of the ‘Wrapped Group work’ process.

Attunement to the children’s individual needs, emphasising resilience factors in each child’s life and promoting pro-social connection between the children were three main process elements of the ‘Wrapped’ group work program.

3.3 Group structureThe overarching structure was as follows:

• Three 1-2 hour “facilitator-planning” sessions held prior to group commencement.

• A half hour pre-group session held at Cara with each participant and their carer.

• One pre-group facilitator meeting prior to the group commencing.

• Ten two-hour weekly group sessions with the children and young people.

• Facilitators met each week for one hour of planning and set up before group.


• Facilitators held a one-hour post session meetings each week to debrief and plan.

• Two group supervision sessions were held, (end Week 3 and end Week 7), for two hours duration each.

3.4 Session structureEach group session had a consistency to it to encourage safety and group cohesion. While the maintenance of this consistent routine was seen as important by facilitators they were also highly attuned to the needs of the group and able to value individual difference. The routine of each group was as follows:

• A welcome activity

• Planning, designing, sewing

• Afternoon tea

• Planning, designing, sewing

• Closure activity

The Welcome activities often consisted of the facilitators reading the ‘Noticings’1 from the week before, also hearing from each person how their week has been and then stepping through the planned activities for the session.

The session closures consisted of the group coming back together to re focus and relax. Strength cards were sometimes used to explore individuals ‘strengths’ and storytelling also regularly used with the writer of the story being invited into each group for at least one to two of the ten sessions.

Note: In week two of the group, facilitators and group participants held a shopping session together. Here the children/young people were supported to choose fabrics, colours and textures for their blankets. This is an integral part of the process and supports a positive group dynamic.

3.5 PartnershipCommunity partners across the welfare sector were a vital part of the success of the pilot, providing the main referral base for the groups. They included:

• NSW Department of Family and Community Services

• Staying Home, Leaving Violence Liverpool/Fairfield and Penrith

• The Benevolent Society

• Catholic Care

• Anglicare

• Rosemount Good Shepherd NSW

• Red Cross Young Parents programme, Randwick

• Blue Mountains Family Support Service

• Blue Mountains Womens domestic violence refuge

• Tweeds Head Sexual Assault Service

• Tweeds Head Brighter Futures Service

1 “Noticing” is a concept developed as part of the Wrapped Program, which is based on attachment theory. It utilises attunement language to highlight resilience and strengths in children and young people.


3.6 Theoretical underpinnings • The Clinical (Trauma, attachment and resilience)

• The Arts (Storytelling and sewing)

TraumaTraumatic events are those events that can if they catch hold of a person’s life cause pain, distress and unwelcome experiences, the effects of which cause disruption to a person’s preferred way of being in the world. Terr (1991) has described two types of trauma:

Type I Trauma involves experiencing events that are single, unexpected and sudden. Type II Trauma involves the experiencing of recurring and patterned events such as ongoing physical abuse, sexual abuse, emotional abuse and witnessing domestic violence.

It has long been recognised that trauma effects children (Pynoos et al 1996; Rothschild 2000; Scheeringa & Zeanah, 2001; Lubit et al, 2003;Vostanis, 2004. In children and young people these effects range in duration and intensity. It can cause emotional, physical, psychological, cognitive, social and spiritual disruption to a child’s life. Recognising these effects is essential for our profession as it motivates our intervention.

AttachmentAttachment theory is where the notion of a secure base was born. It is important to look at the theoretical basis of secure base before we consider it as an independent concept and its relevance to resilience-based practice.

Attachment between parent and child develops from this bonding point. As the baby ‘learns’ of the parent’s availability to them a rhythm is set up that reflects the quality of this relationship. It is this relationship blueprint we call the attachment pattern. Attachment patterns are described by two categories, secure and insecure with the parent termed as the attachment figure for the child.

Attachment behaviour is described as any behaviour that elicits a care taking response from another who is regarded as capable of meeting the needs that are required. An example of attachment behaviour can be seen in a child who experiences fear at sudden loud noise as they fiddled with the radio volume and turned it up. The child will attempt to move away from the radio towards the parent, show a physical reaction to the source of the fear, for example crying, looking back at the radio and holding up their arms. The response from the parent will be to move towards the child, deal with the source of the fear (turn off the radio), pick up the child, make soothing, reassuring sounds while removing the source of the fear.

While therapists are not in a parental role with children and young people they are in a role that allows for the care-taking response mentioned above. Moreover, therapists use the language of attunement to create safety and connection to a child or young person.

Attunement is that aspect of therapeutic communication that allows a therapist to use empathy to stay in touch with the experience of the person seeking help. The skill of staying attuned requires that a therapist notice the emotion behind the words that are spoken, and demonstrates their willingness to align with the emotional content of the conversation by using language that shows they are connected to the client’s experience.

ResilienceWhile it is important to recognise that children who have been subjected to abuse may be traumatically affected, Robbie Gilligan (2001), reminds us that professionals often ignore the ‘healing potential that may lie naturally within children, (Gilligan 2001:181). It is important to have the knowledge and skills to tap into that which lies naturally within.


In addition there are other resilience factors that are vital in ameliorating adversity. Amongst these factors are, the importance of relationships with supportive adults, peer networks, engagement in activities for promoting self-esteem and efficacy, and positive school experience, (Daniel, Wassell and Gilligan: 1999, Gilligan 2001, Daniel and Wassell: 2002, Masten & Powell: 2003). This is also important clinical knowledge so we know to mobilise these resources for children and not leave resilience as the individual responsibility of the child’s innate healing.

Story telling

Jim Wilson (2000:29) reminds us of the ample documentation of the use of written and spoken stories in therapeutic work. Story work is a very effective intervention to use with children. It allows children to:

• process trauma using a medium familiar and appropriate to them

• retell a painful experience from a safe distance

• process painful experience without using a verbal process

• express difficulties, uncertainties, unspeakable things

• seek meaning and re-evaluate experiences

• find mastery over and solve problems.

The Wrapped Program has a unique story book written for it to be read to the participants and given to them as part of their leaving present. In addition, Ms McVeigh who developed the Wrapped Program, has written specific stories for some of the groups that highlighted the special nature of those groups.

Sewing

Sewing, like story telling, is an ancient art form. Indeed, many cultures have used sewing as a way to tell stories from the medieval tapestries in England that told of battles to the quilting projects used in healing work and political contexts such as Northern Ireland and South America. While writing the Wrapped Group work manual a colleague shared with Ms McVeigh the work she did with a group of Spanish speaking children who had been sexually assaulted.

The basis of the work lay in the Arpilleras, an artistic and political form of expression in Chile between 1973 and 1994. Arpilleras were sewn by women to tell the story of family and friends who were imprisoned and tortured during the military regime of Augusto Pinochet. The Arpilleras ‘were a real testimony of their inner pain and suffering,’ (Escartin:1991). Sewing, like other art therapy methods, releases Gilligan’s (2001) healing potential within and can be either a private or collective form of recovery.


Chapter 4: Method

The program was evaluated in terms of process and outcome. The tools used for evaluation was the Cara Resilience Assessment Tool (CRAT) and interviews with the children and their families on how effective the treatment was and provide any recommendations for improvement.

4.1 Participants Of the 56 total victims, 33 were primary victims. A primary victim is a person who was injured as a direct result of the act of violence, was injured trying to prevent someone committing or had committed a crime, or injured helping someone against whom that crime is being committed. Of the 33 who were primary victims, 24 were female and nine were male.

Figure 2: Number of participants, by gender and victim type

24

119

12

0

5

10

15

20

25

30

Primary Secondary

Female Male


Figure 3a shows the number of participants who were victims of each type of act of violence. There were 12 participants who were victims of two acts of violence, five of whom were victims of three acts of violence. Most participants were victims of domestic violence and sexual assault (39 and 17 participants respectively). Figure 3b is a comparison of multiple abuse forms to single abuse.

Figure 3a: Number of participants, by the act of violence of which they were victim

1

2

2

2

3

8

17

39

0 10 20 30 40 50

Unknown

AOD abuse

Emotional abuse

Other

Physical assault

Neglect

Sexual assault

Domestic violence

Figure 3b: Multiple abuse in comparison to one form of abuse, by percentage

Suffered multiple forms

(72%)

Suffered one form

(28%)


Participants were aged between four and 18 years. The average age of participants was 9.7 years. Figure 4 shows the number of participants by age and gender. Almost three-quarters (73.2%) of participants were aged between 5-11 years.

Figure 4: Number of participants, by gender and age

0

5

10

15

20

4 5 6 7 8 9 10 11 12 13 14 15 17 18

Female Male

Figure 5 shows the relationship of the participant to the offender. For 32 (57.1%) of participants, they were the daughter or son of the offender. There were a further six participants who were the step-daughter or step-son of the offender.

Figure 5: Number of participants, by the relationship to the offender

1

1

2

2

3

3

3

3

6

32

0 10 20 30 40 50

Other

Sibling

Adopted/foster child

Granddaughter/grandson

Family friend/neighbour

Niece/nephew

Student

Unknown/stranger

Step daughter/step son

Daughter/son


4:2 ProcedureData for this study was collected as part of a pilot conducted between July 2014 and July 2015 by Cara House across five locations. Figure 6 shows the breakdown of number of participants to geographical locality. The large numbers of children and young people seen in Sydney was due to the availability of Cara House staff to facilitate the groups in each area.

Figure 6 Breakdown of children and young people attending groups, by geographical area

0

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10

15

20

25

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35

40

Concord Fairfield Katoomba Penrith Pottsville Randwick

No. of groups No. of participants

Description of the group work program and referral forms were sent by Cara House to government and non-government agencies. Figure 7 highlights the percentage of referral from government versus non-government agencies.


Figure 7. Agencies referring children to the program, by percentage

%

13

12

5

7

6

5

4

2

2

2

1

1

1

0 2 4 6 8 10 12 14

SHLV

Benevolent Society

Red Cross

FACS

Catholic Care

Red Cross

Tweed Head SAS

Tweed Head BFS

Blue Mountains FSS

Anglicare

Stepping Stone House

Rosemount

Blue Mountains WDVR

Key: Blue Mountains WDVR (Women’s Domestic Violence Refuge); Blue Mountain FSC (Family Support Service); FACS (Family and Community Services); SHLV (Staying Home, Leaving Violence); Tweed Heads BFS (Brighter Futures Service); Tweed Heads SAS (Sexual Assault Service);

Entry to the group was determined by age (up to 18 years) and if the child or young person was a victim of crime and illegible to access the ACS of Victims Services.

Breakdown of age is described in Figure 4 and exposure to trauma by being victims of a crime is described in Figure 3.

Cara House staff using the information in the referral forms conducted screening for the groups. Upon receipt of referral information Cara House staff conducted a pre-group interview with children, young people and their carers to assess suitability for group attendance

4.3 MeasuresCara Resilience Assessment Tool (CRAT) and interviews with the children and their families were used as the measures. At the start of the pilot participants were administered the CRAT by being asked a series of questions related to the six domains of resilience. Questions that were asked focused on their feeling of safety, their interactions with others, their talents and interests, trying new things, and how they feel about joining the group. For each question, participants could rate on a scale from one to three/four. There were two types of questionnaires given to participants dependent on age; the first used ‘smiley faces’ for the scale and the second used words (often, sometimes, occasionally, never)2.

2 In order to compare the data from the two scales, the two smiley faces on the left were interpreted as ‘Often’ and ‘Sometimes’ respectively. Then the last smiley face was interpreted as a ‘never’. Al though this is not ideal, this was considered most reflective of the appearance of the smiley faces. This was checked against the data by observing the most common responses from each scale and found to be the most suitable.


4.4 Data AnalysisA mixed methods approach was utilised to meet both the process and outcome evaluative objectives of the pilot. All data was analysed for statistical significance.

Quantitative data was gathered using the CRAT pre and post and analysed to measure improvement in resilience based factors for children and young people participating in the group.

Qualitative data was gathered using interviews with children, young people and their carers was gathered. It was used to measure progress and participatory factors. Interviews were also analysed to extract and determine the most common themes arising from the children’s assessment of the group work program.

Figure 8: Smiley faces used in some pre and post questionnaires


Chapter 5: Results

5.1 Pre-score resultsFigure 9 shows the scores given by the participants for each rating scale (see Appendix 1 for the list of questions). The results are shown separately for each quantitative question asked of participants. The colour is reflective of the percentage of participants who gave that response to the question. It is evident that many participants answered with ‘often’ or ‘sometimes’ towards the difference aspects of resilience. Participants ‘often’ felt this way particularly for feelings of safety with an adult, being kind, and helping behaviour. For waiting, staying calm, and trying out new things, there were more participants who responded with ‘sometimes’ or ‘occasionally’ compared to other questions.

Figure 9: Pre-scores for each question, by percentage

6357 55 54

36

52

70 66

2739

30

3034

30 32

45

30

2118

4630 50

74

5 913

45

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4 214

9 11 1425

13

0%

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20%

30%

40%

50%

60%

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100%

Often Sometimes Occasionally Never Missing

Feeling of safetyParticipants were asked if they wanted to comment on their ‘comfy and safe’ feeling when they are with an adult. Half of participants said they felt safe around their mum (50.0%)3. There were also five participants (13.2%) who said they felt safe with dad. Other family members included an auntie or uncle (10.5%), grandmother (10.5%) or just stated family or friends (7.9%). Six participants (15.8%) said they felt safe around people, or more specifically people who are familiar to them. Three participants (7.9%) said it depended on the person or gender, with one stating that they did not feel safe around adult males. Other single responses included; safe with the family cat, sister, when brothers are not around, when playing, and only in the last 12 months. Two participants said they do not feel safe.

3 Percentage is based on the number of people who responded to the question (n=38). Some participants listed more than one person they felt safe with which means that the total percentage is greater than 100.0%.


Fun with friends

When participants were asked if they would like to comment about having fun with friends, most respondents said they did so at school (n=13), or when playing sports/games (n=7). Other respondents said they had fun at friend’s houses (n=3), vacation care (n=2), or listed other things (with cousins, at the beach, shops, red cross, generally just love spending time with other kids, music, arts and craft) (n=9). There were four who said they did not like playing with other kids (n=4).

Anger

When asked if there were times that felt angry, 47 (83.9%) said yes. Participants were then asked if there were times they felt angry but managed to stay calm. There were 11 participants who said they like to go to their room/spend time alone. Six used relaxation techniques (relax, breath), two were physically expressive (shakes, hits things), and six did other tasks such as cleaning their room, watching television, reading and writing. Other responses included receiving help from others, looking at the positives, and spending time with family pets. There were five participants who found it hard to deal with their anger.

Talents/interests

Participants were asked some of the things that they like to do. The following were the responses given4:

Sports/games (n=27) Arts and crafts (n=15) Electronic games (n=10)

Friends (n=7) Books (n=6) Family (n=5)

Pets (n=4) School (n=3) Play/making things (n=3)

Cooking (n=2) Music (n=2)

Feeling about trying something new

Participants were able to comment about how they felt trying something new. Six respondents gave a positive response, indicating that they liked a challenge, were excited or believed in themselves. Other respondents (n=8) described feelings of nervousness, explained that they did not like crowds or surprises, they found meeting new people hard and were not sure if they would be mean, or that sometimes it is boring.

Thoughts about joining the program

There were 39 respondents who responded positively about joining the program. The most common words to describe their feelings were ‘excited’ and ‘good’. There were three respondents who were not sure or had mixed thoughts about joining.

Thoughts about making their blanket

In regards to thoughts about making their blanket, 15 of the respondents started listing what they would have on their blanket (colours, shapes, patterns). There were 14 who thought it would be fun and were excited about it. Seven were not sure or had no comment. Lastly, three thought it might be tricky.

4 Many participants listed more than one activity.


5.2 Pre and post comparisonsAt the end of the sessions, participants were asked the same questions (for the most part) as they were at the start of the pilot. This enables a comparison between scores from the start and end of sessions across the six domains of resilience. For analysis purposes, the rating scale was recoded into number values one to four (1 being the happy face/‘often’, and the sad face/‘never’ being 4). Figure 10 shows the mean scores for pre and post. It shows that pre mean scores tended to be higher than post scores for each question. However, there are some areas that only have a small difference in mean scores.

Figure 10: Pre and post mean scores for all participants

1.4 1.5 1.5 1.61.4

1.9

1.2 1.3

1.9

1.5

1.1 1.2 1.1 1.2 1.31.1 1.1 1.2 1.2 1.2

0.0

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4.0Pre mean score Post mean score

A paired-samples t-test was conducted in order to determine whether or not there is a significant statistical difference between the pre and post mean scores. This type of test automatically discounts the participants who did not have both the pre and post result for a particular question. There was a statistically significant decrease in mean scores, indicating an improvement in resilience, for eight of the 10 quantitative questions. These included feelings of security, friendships, sharing, listening, waiting, taking turns, staying calm, and feeling good about themselves5.

Participants were able to make comments about the pilot relating to some of the rating scale questions and also general questions about the pilot. The comments are discussed by question below.

5 There was a decrease in mean scores for feelings of security from pre (M=1.49, SD=.64) to post (M=1.10, SD=.30), t(50)=3.73, p <.05, friendships from pre (M=1.44,SD=.681) to post (M=1.19,SD=.571), t(47)=2.13, p<.05, sharing from pre (M=1.47,SD=.616) to post (M=1.06,SD=.242), t(48)=4.24, p <.05, listening from pre (M=1.61,SD=.750) to post (M=1.18,SD=.434), t(50)=3.71, p <.05, waiting from pre (M=1.91,SD=.838) to post (M=1.26,SD=.560), t(52)=4.96, p <.05, taking turns from pre (M=1.46,SD=.585) to post (M=1.13,SD=.499), t(45)=2.90, p <.05, staying calm from pre (M=1.89,SD=.754) to post (M=1.16,SD=526), t(43)=5.90, p <.05, and, feeling good from pre (M=1.55,SD=.633) to post (M=1.12,SD=.328), t(41)=4.16, p <.05.


Feeling of safety

Participants were asked if they wanted to comment on their ‘comfy and safe’ feeling during the group work program. Twenty three of the participants responded, with all but one saying they felt comfy and safe. The other respondent said that they worried about their mum while they were at the group. Positive comments included that everyone was friendly, welcoming, loved the food, it was a nice room, fun, and made new friends.

Making friends

Participants were asked if they had fun with the other children at the group. There were 37 of the 42 respondents who gave a positive response. There were three respondents who said that they did not like playing with the other children or the other children did not want to play with them, one child just said no, and another was not sure. The positive responses included that they like playing with the other children and making new friends, they like the activities, and the afternoon tea.

Socialising

After being asked about sharing and taking turns, participants were asked if there were any other things they noticed. There were mixed responses from 24 children. The main responses were that some children felt that they were able to socialise better, were able to talk about their feelings, became more confident, concentrating, and were better at planning and being patient.

Positive values

Aside from the questions about being kind, helping others and staying calm, participants were asked if there was anything else they noticed about themselves during the group work program. Some of the comments were similar to what was said about socialising, including patience with others and the activities, more concentration and being patient. There were other comments about being calmer in various situations and being happy about learning how to sew. Two children stated that they were sad that their time in the group work program was finishing.

Talents and new skills

When participants were asked about things they noticed regarding moments when they felt pleased with the things they could do, most said this occurred when they were sewing and making their blanket. Also as expected, most participants discussed sewing and making their blanket when they were asked about the things they had learnt during the group work program. There were a few other things mentioned, such as learning new soccer skills, team work, using streamers, and not taking the lid of the glitter bottle!

5.3 Interviews with children and young people

Meaning of their blanket

Participants were asked to describe what their blanket meant to them. There were some common words which were used to describe their blanket, the most common of which were family, blanket, love, people, special, good, and happy (as seen in Figure 8). Ten respondents said that their blanket represented family. Nine responds said that it made them feel good or happy. There were eight respondents who said the blanket made them feel safe or that it was comforting to them. Six of them said it reminded them of the special people they met during the group work program. Five respondents discussed how it made them feel proud because they designed and made the blanket.

One participant spontaneously wrote a short story about the group and sent it to the facilitators. She willingly gave permission for Cara House to use this story to support the group work program and encourage other children and young people to join the group. The full version of this is contained in Appendix I.


Figure 11: Most common words used by participants to describe the meaning of their blanket

Did not like about the pilot

Participants were asked what they did not like about the group work program. There were 41 (89.1%) respondents out of the 46 who responded to the question who said there was nothing they did not like about the group work program, or that they liked all of it. Of those who said there was something they did not like, one said that there could have been better music for young people, another said it could have been shorter in length because they would get home too late, and another respondent said that it could have been longer (this child did the 5 day intensive sessions).

Liked about the pilot

There was also a question about what was liked about the pilot. There were seven participants who said they liked everything about the group work program. The other most common responses were that they like the food, meeting new people (both the adults and the other children), having fun, sewing, and finishing off their blanket. Specific comments from individuals included liking the support from the instructors, that none of the children knew each other beforehand which meant an equal start for all of them, being given the opportunity to speak and be heard, and also, Toby the dog. There was one respondent who the facilitator noted was distressed, and not too interested in sewing. This respondent said there was nothing that they liked or disliked. There was a suggestion that there could be another option rather than just sewing.


Other commentsMost respondents (47 out of 49 who responded, the other two just made no comment) finished by saying that it was fun and would recommend it to others:

“Everyone is nice and other kids should do it.”

“Go for it, try something new, it’s cool. They give you food. “

5.4 Parent/caregiver commentsParents or caregivers were asked to give some feedback at the end of their pilot. They were asked five questions about the experience and the answers are discussed below.

Was your child happy to come to group?Most respondents said that their children were happy to attend. However some children were reluctant or apprehensive at first. This was because the child was unsure of what to expect at first. Once they were comfortable with the environment then they really enjoyed it. Some respondents said that they even planned their week around the group work program:

“More than happy to come, actually planned week and activities around group.”

“Yes, the first time she was not sure what to expect and was very nervous, but every time after that she runs out of the car to get there.”

“Yes, very happy.”

Do you think your child had fun?

Overwhelmingly, the response was positive. There were 38 of the 40 respondents to this question who said that their child had fun at the group work program. The other two respondents said that they think the child did have fun or that their child had fun but did not talk much about the blanket making. The positive responses included comments that the child was proud of their blanket, they were always happy to attend, enjoyed learning new skills, looked forward to attending, and came home happy after attending the group. There were some children who felt upset that it was ending.

What have you noticed in your child that possibly relates to his/her attendance at group sessions?

There were ten responses related to an improvement in verbal communication (talking about feelings, engaging in communication), and a further five responses about improvement in social skills (developed eye contact, improved behaviour with others, can identify emotions). Other common behaviours noted by parents/caregivers was happier/brighter (n=4), confidence (n=3), calmer (n=3), and proud (n=2). One parent stated that attending the group gave a chance for their child to behave normally, however another parent stated that their child’s behaviour was extreme on the days of the group and they were hard to settle. Other comments included improved creativity, better connection with mother, and talked about past experiences again. One comment stated that their child was quieter – it is unclear if this was related to a child who was rowdy at first, or for another reason.

Is there feedback your child has shared about his/her time at the group you think is important for us to know?There were 22 respondents who said that their child liked/loved/enjoyed the program:

“She really enjoyed it.”

“It was amazing and the people were so helpful. He loved the support and loved being able to share his ideas and see them come together.”

“She has told me how much she loves going to group and meeting her new friends.”


There were other respondents who stated that their child discussed certain aspects of the program rather than the program as a whole. There were comments about talking about friends at group, liked the sewing, or found it hard to sew but liked choosing the materials and items, feeling secure with the blanket, and sad about not seeing her friends again. One respondent said that their child was not interested in sewing – suggesting that perhaps the activity could be building something instead:

“I don’t think he is too interested in sewing, just wondered if the activity focus could be more construction/building/hunter/gatherer, that is, building a currach.”

Would you recommend the Blanket Group to others?

There was not one respondent who did not recommend the program. Even the parent who thought that there could be an alternative to sewing stated that ‘staff were very professional, and care very much about their clients’. Selected other comments are below:

“Yes, absolutely.”

“Yes. [Child’s name] has been able to have something special just for him when other things have been hard in his life.”

“Yes I would, I think it’s an important thing for children to be able to have a comfort that they make themselves.”

Have you any other comments?

There were a wide range of comments about the program, most of which were very positive:

“I think it’s been wonderful for her to have fun with other children who she knows have been through something similar (without knowing the details) emphasising that they are still ‘normal’ kids despite their traumatic experience.”

“I personally was sceptical of group therapy but I have come to realise how much [Child’s name] has opened up and enjoyed herself during group. She seems happier at home and more settled at school since attending group and for this I thank you.”

There were no negative comments, but a few suggestions. One respondent said to be mindful of age groupings. One respondent said it would be helpful to have insight into the sessions and some take home tips in order to help manage the child’s behaviours and reactions afterwards. Another respondent suggested that written feedback could be given to parents/caregivers about the child’s behaviour for future.

For the most part, comments were similar and tended to discuss the following:

great facilitators thankful for the program child made friends

calmer and happier loves the blanket helps with confidence

improved social behaviour texts and letters were helpful would recommend



Conclusion

The results of this pilot group work program highlighted several important evaluative issues:

• The success of the Wrapped Group in providing a resilience based experience for children and young people who are victims of crime.

• The success of the Wrapped Group in providing an expressive therapy experience for children and young people who are victims of crime.

• The success of the Victims Services and Cara House partnership offering a group intervention as an alternative to the traditional face-to-face counselling.

• The success of the Victims Services and Cara House offering group intervention in urban and rural settings in NSW.

The evaluation drew attention to the age range and abuse experience of children and young people who access counselling through the ACS. It also highlighted the high percentage of paternal perpetration of abuse against these children and young people.

An issue of grave concern that surfaced from this pilot in relation to children and young people being exposed to domestic violence was their treatment in the family law court. Several of the children and young people disclosed their distress at being told to have access with their violent fathers even after repeated requests not to do so. In addition, court rulings were made that lead to some children and young people being withdrawn from therapists they wanted to continue with and/or being sent to a therapist they did not want to see.

The program was highly valued and overwhelmingly positively assessed by children, young people and their carers. Their evaluation of the program drew out the importance children, young people and their carers attach to the therapeutic relationship and the experience of ‘doing’ rather than mostly ‘talking’ during therapeutic intervention.

The facilitators were all highly trained trauma and group work therapists. The success of the pilot depended upon this high level of expertise and knowledge. While each child and young person had a completed blanket at the end of the process the emphasis of the program on attending to the needs of individual participants meant the facilitators did an immense amount of work out of group session time. The highly, labour-intensive nature of this group meant the use of highly skilled volunteers was vital to the group success.

The limitations of the pilot:

• As only a small number of rural groups ran this did not give a fully comparative analysis of rural versus urban applicability.

• Lack of comparative analysis between Wrapped being delivered as a face-to-face or group work intervention.

• Lack of carer involvement to enable carers/parents who wish to support their children further.

• Early development of Victims Services administrative protocols and procedures for group work intervention added to the workload of all staff involved.


Implications The implications of delivering such a program would be that it could be expanded into other areas, which currently have a gap in service delivery, such as Juvenile Justice Detention centres, and Schools. The program provides a fixed period therapeutic program that can work in with existing programs and allow for cooperative delivery with agency professionals, such as school counsellors, psychologists and social workers.

The long-term goal is to be in a position whereby Victims Services can offer an expressive therapy group as an alternative to the traditional face-to-face counselling that the ACS is most commonly used for. There would be a requirement to train and “accredit” Approved Counsellors in the use of this program. It is envisaged that this would occur as part of the Approved Counsellor Professional Development Program and offered to selected individuals following an expression of interest.

Cara House has developed a number of group work programs. These programs address various aspects of trauma recovery and resilience growth. Victims Services could add to their long term goal a more extensive directory of group work services that could tailor more widely to the individual recovery needs of children and young people who are victims of crime.


Recommendations

The following recommendations are based on the findings from the data analysis, interview contents and interpretation of the results:

• Victims Services offer therapeutic group intervention as an alternative to the traditional face-to-face counselling to children and young people who are legible to be seen under the ACS.

• Victims Services develop protocols and procedures to support the group work intervention services that they will offer.

• Victims Services train and “accredit” Approved Counsellors in group work speciality and in Wrapped.

• Victims Services and Cara House pilot further group work programs with children, young people and their carers to provide a more comprehensive group work program

• Victims Services and Cara House engage in further research in the area of group work intervention to victims of crime to establish an evidence base for effectiveness.



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Appendix 1: One girl’s story

Mondays were the worst, after a fun and exciting weekend studying at my dad’s work, (which was the most fun we had the entire week because mum looked after us and dad had to work), we would have to get up and get dressed. It was stereotyped that kids hated school, so I had to go along with it, even though I secretly loved it. But the reason I loved school wasn’t because all my friends were there, it was because I had a short appetiser of the taste of freedom. I wasn’t supervised by my dad, I didn’t need to be forced to eat nauseating foods, study meaningless exercises, or practise mock speeches. I was free.

Then the 3:00 bell rang, the dreaded sound of a condemning bell. Children screamed with laughter and happiness, while I simply wished the day to start all over again. The bell was the one bringing me back down to reality, to where I really lived. In a household where nothing was right and we were constantly in trouble for nothing. I just wanted to be free, to stop hearing the sounds of violence every day. I wanted to hear the sound of laughter. Happiness. Hope.

My one and only dream was for my family and I to be happy and safe, but I gave up on it as it was a hopeless dream. I prayed to God, Jesus and all the angels in heaven to keep my family safe. I had my doubts, but I stayed faithful to my prayers. No matter how much I got in trouble, how many times I was hit and yelled at, I still stayed strong.

Now, when I wake up each morning, I appreciate where I am and how I got here. After God has sent his angels down to help free me, I always want to enjoy the new day ahead of me. Something that has made my day even better, is that I get to enjoy the company of my new found friends from Angel Blankets, a group dedicated to making children who have been a victim of crime feel better about themselves and appreciate the world around them. Angel Blankets makes you feel calm and relaxed, with the peaceful sounds of the waterfall slowly dripping. It makes you feel comfortable and safe in a small room with plush pillows and cozy cushions.

No one has a bad bone in their body, they are open people waiting with open arms. The leaders forgive the children when they slip up, without a thought. The children are grateful for everything and have manners towards the leaders without a problem. There is no exclusion or ignorance towards any one in or outside the group.

When I first went for a meeting with Angel Blankets, I thought it would be a weird counselling session. I thought that there would be a group of shy people who didn’t like to do anything fun. I was clearly wrong. When I went there, there were a group of young girls around my age. They looked a little nervous at the start, but once the leaders introduced us, we found we were a group that could be described as an affinity group, as one of the teachers called us.

We were a little bit shy at first, which is to be expected, but within five minutes, we were chatting and socialising as if we were best friends from many years before.

Our leaders are selfless and kind, loving and forgiving. They are the gardeners of life, whilst we are the seedlings in drought. Watering us to survive, nurturing us to grow and flourish. They help us to grow up to be who we want to be, even if it isn’t easy. They stretch us beyond our abilities, no matter the cost. They dedicate endless hours to help us become strong and confident so that we can tackle anything that comes our way.


Angel Blankets has assisted and encouraged me to socialise with strangers, and persevere even when things are new to me. I learnt to easily socialise with new people, as we were a group of four girls who didn’t know each other, with completely different personalities. We started talking about things that we liked, and the conversation began. I also learnt how to try new things such as designing, making templates and sewing. It was different and hard at first, but the leaders there helped me and encouraged me to have persistence. In the end, my blanket came out better than I expected, but more importantly, I developed my self-confidence. I could not have achieved this without the assistance of my guardian angels – the leaders at Angel Blankets.


Appendix 2: Pre-group questionnaire for participants (v1)

Child’s name ..........................................................................................................................................................................

Gender .....................................................................................................................................................................................

Age ............................................................................................................................................................................................

Referring agency details ...................................................................................................................................................

WIA facilitators .....................................................................................................................................................................

Dates and location of group ............................................................................................................................................

(The following questions are designed to determine competencies across the six domains of resilience. Please circle as answered)

(Secure base)

Let’s think together how it feels when you are “comfy and safe”. Discuss with child and then ask – Do you notice this “comfy and safe ”feeling when you are with an adult?

often sometimes occasionally never

Note any comments .................................................................................................................................

(Friendships)

Are there times/opportunities you get to meet other kids?

Yes No If yes do you notice you have fun together?



(Social competencies)

Do you notice times that you are good at: (Give examples for each if necessary)

Sharing often sometimes occasionally never

Listening often sometimes occasionally never

Waiting often sometimes occasionally never

Taking turns often sometimes occasionally never

(Positive values)

Do you notice times when you are good at:

Being kind often sometimes occasionally never

Helping others often sometimes occasionally never


Do you notice times when you get angry?

Yes No If yes, are there times when you feel angry but you manage to stay calm?


(Talents and interests)

Can you tell me some things that you like to do? ......................................................................................

................................................................................................................................................................

................................................................................................................................................................

Do you feel pleased/ good about yourself and what you can do?


(Learning new skills)

Are there times when you get to try out new things?


Do you like to try new things?

Yes No

Note any comments ..............................................................................................................................................................

(Summary questions)

How do you feel to come to the Angel Blanket group?

You are going to make your own Angel Blanket. Do you have some thoughts about what you hope it will be like for you? (Record) ......................................................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Do you have any other questions? (Record) ...................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Thank you


Appendix 2: Pre-group questionnaire for participants (v2)

(The following questions are designed to determine competencies across the six domains of resilience. Please Circle as answered)

Child’s name ..........................................................................................................................................................................

Gender .....................................................................................................................................................................................

Age ............................................................................................................................................................................................



Dates and location of group ............................................................................................................................................

Secure base

Let’s think together how it feels when you are “comfy and safe”. Discuss with child and then ask – Do you notice this “comfy and safe” feeling when you are with an adult?


Friendships

Are there times/opportunities you get to meet with other children?

Yes No If yes do you notice you have fun together?


Social competencies

Do you notice times that you are good at? (Give examples for each if necessary)

Sharing

Examples .................................................................................................................................................................................

Listening

Examples .................................................................................................................................................................................


Waiting

Examples .................................................................................................................................................................................

Taking turns

Examples .................................................................................................................................................................................

Positive values

Do you notice times when you are good at:

Being kind

Helping others

Do you notice times when you feel angry?

Yes No If yes, are there times when you feel angry but you manage to stay calm?

Talents and interests

Tell me some things that you like to do? ..........................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Do you feel pleased/ good about yourself and what you can do?

Learning new skills

Are there times when you get to try out new things?

Do you like to try new things?

Yes No



Summary questions

How do you feel about joining the Angel Blanket group? ............................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

You will get to make your own Angel Blanket. Do you have some thoughts about what you hope it will be like for you? (Record) ............................................................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Do you have any other questions? (Record) ...................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................


Appendix 2: Participant final evaluation (v1)

Name ........................................................................................................................................................................................

Gender .....................................................................................................................................................................................

Age ............................................................................................................................................................................................

Referring ggency details ..................................................................................................................................................


Date and location of group ..............................................................................................................................................

(The questions are designed to measure any impact the group process has had on competencies across the six domains of resilience)

(Secure base)

Let us think about your time at Angel Blankets. Did you notice Angel Blanket group has been a place where you felt “comfy and safe”?



(Friendships)

Did you have fun with the other children you met in Angel Blankets?


Can you tell me more about that? .....................................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

(Social competencies)

At Angel Blanket Group did you notice yourself with the other kids being able to?

Share often sometimes occasionally never

Listen often sometimes occasionally never

Wait often sometimes occasionally never

Taking turns often sometimes occasionally never

Any other things you noticed? ............................................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................


(Positive values)

At Angel Blanket group did you notice times you were good at:

Being kind often sometimes occasionally never

Helping others often sometimes occasionally never

Staying calm often sometimes occasionally never

Can you tell me anything else you noticed about you? ................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

(Talents and interests)

In Angel Blankets did you notice times moments you were pleased with yourself and things you can do?


Can you tell me some of the things that you noticed? .................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

(Learning new skills)

Can you tell me about any new things you learnt you can do while you came to Angel blanket? ....................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Summary questions

You have made your Angel blanket. Can you describe what your Blanket means to you? ...............................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Was there anything you did not like about Angel Blankets? .......................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Can you tell me what you liked about Angel Blankets? ...............................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

What would you say to other kids who are thinking about doing an Angel Blanket Group? ..............................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Thank you


Appendix 2: Participant final evaluation (v2)

(The questions are designed to measure any impact the group process has had on competencies across the six domains of resilience)

Name ........................................................................................................................................................................................

Gender .....................................................................................................................................................................................

Age ............................................................................................................................................................................................



Date and location of group ..............................................................................................................................................

Secure base ..........................................................................................................................................................................

Let us think about your time at Angel Blankets. Did you notice Angel Blanket Group has been a place where you felt “comfy and safe”?


Friendships

Did you have fun with the other children you met in Angel Blankets?

Tell me more about that? .....................................................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Social competencies

At Angel Blanket Group did you notice yourself with the other children being able to?

Share

Listen

Wait

Take turns


Any other things you noticed? ............................................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Positive values

At Angel Blanket Group did you notice times you were good at:

Being kind

Helping others

Staying calm

Tell me anything else you noticed about you? ................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Talents and interests

In Angel Blankets did you notice times moments you were pleased with yourself and things you can do?

Tell me some of the things that you noticed? .................................................................................................................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Learning new skills

Tell me about any new things you learnt while you came to Angel blanket? ...............................................

................................................................................................................................................................

................................................................................................................................................................

Summary questions

You have made your Angel blanket. Can you describe what your Blanket means to you? ...............................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Was there anything you did not like about Angel Blankets? ...............................................................................

.................................................................................................................................................................................

.................................................................................................................................................................................


Tell me what you liked about Angel Blankets? .....................................................................................................

.................................................................................................................................................................................

.................................................................................................................................................................................

What would you say to other children who are thinking about doing an Angel Blanket Group? .......................

....................................................................................................................................................................................................

....................................................................................................................................................................................................

Thank you


Documents

Cara House Centre for Resilience and Recovery – Evaluation · Cara House Centre for Resilience and Recovery ... who facilitated the groups, and whose hard work, commitment,