Coastal Child and Adult Therapeutic Services

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On 30 November 2017, CCATS held its fourth conference “Moving Forward – Working with young people: Research and innovation” in Manchester. The event showcased the research of the CCATS team to practitioners working with young people and reflected their evidence-based approach towards the application of knowledge in clinical practice. This can have real impact for the people we support.

During the event, presentations covered a range of topics that reflected the diversity of interests and skills in the CCATS team, including secondary trauma, child sexual exploitation, aggression, institutional abuse, self-injury and posttraumatic growth. All presentations addressed areas of research that are lacking in the wider literature, thus demonstrating innovation and promoting the latest knowledge.

Dr. Carol Ireland presented her systematic review on secondary trauma in professionals working with traumatised children, co-authored with intern Sonia Huxley, which has now been accepted for publication in the Journal of Forensic Practice (congratulations!) This review draws attention to the idea that working with traumatised children can be potentially traumatising to professionals, an area often overlooked. The presentation identified key themes of the secondary trauma experience, and made recommendations to support professionals in their practice.
Kirsty Alderson discussed her PhD research on child sexual exploitation. She identified factors that should be considered when assessing the impact of CSE on a young person’s development. An individualised needs assessment was key to supporting young people, which considers both risk and resilience factors.

In her presentation, Professor Jane Ireland provided an introduction to the aggression literature. There was a need to acknowledge the motivations for aggressive behaviours, including assessing a range of emotions, thoughts and beliefs, environmental factors and instances of non-aggression, rather than focusing on typologies. Together, these could be combined to provide a more holistic formulation of behaviour.

The afternoon presentations began with a talk from Rebecca Ozanne on institutional abuse. Currently in the early stages of her PhD, Rebecca outlined the results of her systematic review on factors that promoted negative symptoms and strength among those who have experienced in-care or institutional abuse. There was a need to dispel myths that all people who are institutionally abused go on to abuse others, and to help individuals to recognise strengths and talents, thereby enhancing well-being.

Charlotte Caton, who is in the latter stages of her PhD, presented her research on self-injury. Charlotte presented her own model of self-injury to help understand the reasons why people engage in self-injurious behaviour. She encouraged practitioners working with young people who self-injure to focus on their strengths and consider the various reasons why people may engage in this behaviour.

Finally, Matt Brooks (University of Central Lancashire), who is in the final stages of his PhD, presented his research on posttraumatic growth. He introduced the idea some people can also report positive changes following traumatic experiences, shifting the sole focus away from the negative symptoms. Matt discussed the impact of childhood trauma on adults and the PTG research on children. The presentation recommended practitioners focus on promoting positive thought processes and the social environment to encourage growth in young traumatised children.

The event was well-received. Here are some comments from attendees:

“Presentations were thorough and well-presented, demonstrating key knowledge and experience.”

“Good overview of the varied specialisms within CCATS.”

“There was a clear application to practice.”

“I was able to relate to behaviours displayed by young people within my care, and have new ideas on how to challenge and manage these more effectively.”

All that is left to be said is a big thank you to all of the speakers and CCATS staff involved in putting this event together and making it a success!

Vulnerability. It is a universal term increasingly adopted by practitioners and academics in clinical work and literature, often associated with risk, contrasted with resilience, or serving as a justification for intervention and support. Yet in doing so, we have perhaps never fully considered what ‘vulnerability’ actually means, or encapsulates. Consider a victim of repeated sexual abuse from a caregiver, an offender with a traumatic upbringing and a lack of appropriate coping strategies, or a household in which domestic violence occurs. Does vulnerability lie with the victim, the offender, or the situation? This was the interesting question posed at a recent conference.

If we take a step back, the whole notion of vulnerability is rather complex. Various definitions of vulnerability emerged: “risk factors”, “situations that expose people to high or elevated risk”, “reasons why the same people are constantly revictimised”, “we should instead consider needs, not vulnerabilities”, “everyone is vulnerable, but it is the exploitation of that vulnerability that is criminalised”.

Given the diversity of views, it is tempting to consider whether vulnerability can add anything to our understanding of a person, as the term can miss marginalised groups and people with multiple vulnerabilities. A number of statistics were presented: 61% of children who are in care are so due to abuse and neglect. In addition, 68% of all adverse events are suffered by repeat victims. The debate is often centred on who is vulnerable, and in doing so, we end up placing victims into subgroups according to their gender, age, ethnicity and so on – which is not always helpful.

Perhaps we should focus less on which particular demographic is vulnerable, and instead consider the situation in which individuals find themselves in. More broadly, wider structures such as the criminal justice or residential child care systems can also unintentionally maintain vulnerability. In these environments, decisions are often made for or on behalf of ‘vulnerable’ individuals, such as those with mental health needs or young people. This can be challenging, as some may argue this takes away the autonomy of the individual.

The focus then shifts as to how we can intervene or mitigate the impact of situations that make individuals vulnerable. This may involve steps to reduce harm against a person, changing situations that generate vulnerability by identifying underlying causes for the behaviour, and reforming systems in society to promote greater autonomy.

Clearly, there is a need to refine our perceptions of vulnerability. This will not be an easy task, but it has the potential for a major shift in our understanding of this vitally important topic, with implications for both theory and clinical practice.

The following is a reflection of thoughts on the ‘Tackling Child Sexual Exploitation & Abuse’ conference by Lancashire Constabulary on 9 November 2016. This was a well-attended conference, with representatives from the police, local authorities, practitioners, support services and academia.

Three main themes quickly became apparent. First, the prevalence of child sexual exploitation (CSE) is greater than originally thought. In one 48-hour period, one police force received four reports of arson, six reports of theft, and 16 reports of CSE. This is just one example of the growing problem of CSE and the challenges it presents to professionals working in this area.

The most moving presentation came from a survivor of significant abuse and CSE in childhood. Her personal talk gave an outline of the mental health difficulties she continues to experience to this day as a result of her early experiences. Very often, procedures put in place to protect survivors from themselves (such as detention or arrest and transport to hospital for assessment) only served to reignite traumatic memories of the initial abuse.

Throughout the conference, there was a clear message that professionals should appreciate circumstances from the survivor’s perspective to really understand their thoughts and behaviours. In essence, the voice of the victim should be heard in the criminal justice system, from reporting, assessment and possible treatment by secondary services. Clearly, a trauma-informed approach is needed from professionals when dealing with those exposed to CSE and other traumatic events.

The second major focus of the conference addressed diversity issues in CSE. It was clear that there was a real gap in the literature in respect of the experiences of boys exposed to CSE, as many studies to date have framed CSE as a female victim and male perpetrator issue. There is also a general lack of knowledge as to how CSE is experienced by children in BME communities and in those with learning disabilities. Individuals may respond differently to CSE, shaped by their understanding of the world and wider social and cultural context. Again, these voices need to be heard through research and engagement.

The presentations contained many interesting debates that warrant consideration. Notably, victim services questioned whether there had been appropriate attempts to reach specific populations traditionally regarded as ‘hard to reach’ (such as BME communities and children with learning needs), in order to fully engage with CSE survivors from these backgrounds. Another service called for further research into how CSE can be appropriately recognised and risk assessed, given that these factors vary considerably from person to person and some CSE survivors may not display any typical signs of exploitation at all. That said, even with limited findings in these populations, it is important to recognise these individuals as children, first and foremost, in the way we approach this sensitive issue.

The conference was extremely informative and outlined current initiatives to deal with CSE. It is encouraging that awareness of CSE is increasing, which will promote more child-centred, holistic and innovate ways to support and engage with survivors. When the voice of the victim is heard, it can only have a positive effect on outcomes for survivors of CSE moving forward.

Coastal Child and Adult Therapeutic Services (CCATS) has extensive experience and a successful track record of providing psychological assessment and treatment services for children, young people, adults and families. We work throughout the north of England, covering a wide area including Lancashire, Manchester, Cheshire, Yorkshire and beyond. We work in partnership with many organisations including the NHS, social care, Youth Offending Teams, GPs and schools. Specialist services for looked after children are provided in partnership with carefully selected children’s residential care providers. We work with legal practices, acting in accordance with instructions from the Courts. Self-referrals are also accepted.

We are pleased to announce that two members of our team, Prof. Jane Ireland and Dr. Carol Ireland, along with Dr. Philip Birch, have released the second edition of their book, “Violent and Sexual Offenders: Assessment, Treatment and Management”.

This second edition covers the latest developments in the area, such as female offenders, Internet offenders, terrorists, young people involved in harmful sexual behaviour, and protective factors for aggression. The book will be of interest to practitioners, academics and students engaged with understanding and/or treating violence and aggression, sexual offending, and the assessment, treatment and management of offenders.

To order a copy, and for more information, visit the publisher Routledge’s website. A 20% discount is available using SOC19 at the checkout.

Back in September the team at CCATS received their standard Investors in People accreditation – a fantastic achievement. But following an outstanding assessment in November, CCATS are proud to announce they have received the IIP Gold Accreditation!

Investors in People is a framework by which companies are assessed on their performance in terms of people management and working environments to achieve success. An IIP Accreditation is an internationally recognised mark of excellence.

The report has now come through showing that CCATS has managed to achieve above and beyond minimum requirements and reads that ‘the Assessor was satisfied beyond any doubt that CCATS meets the requirements of Investors in People Gold Accreditation.’

All the staff are responsible for this wonderful achievement as the assessor wrote that it was indeed a ‘great privilege’ to visit CCATS, ‘not least because of the shared dedication and commitment to delivering a high quality service which was evident throughout interviews.’

The whole team at CCATS are hugely grateful for this endorsement and look forward to a fruitful 2016!