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9.06 - Final Report

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

  1. be trauma-informed and have an understanding of institutional child sexual abuse
  2. be collaborative, available, accessible, acceptable and high quality
  3. use collaborative community development approaches
  4. provide staff with supervision and professional development.

The functions outlined in this recommendation are currently fulfilled by existing services.

In accordance with the Women’s and Children’s Health Network (WCHN) Service Level Agreement the WCHN provides state - wide services including.

  • Yarrow Place Rape and Sexual Assault Service for people 16 years and above provides specialist therapeutic treatment for victims and survivors across South Australia, including victims and survivors of institutional child sexual abuse as long as they were 16 years or older at the time of the assault. The service provides advocacy, education; training and sector development to develop a state-wide trauma aware workforce. Building community capacity to respond to and prevent sexual assault through training and education.
  • Child and Adolescent Mental Health Service (CAMHS) provide specialist mental health assessment and therapeutic services across South Australia, utilising a bio-psychosocial, developmental and family oriented framework. To infants, children and young people between the ages of 0-18 including children under Guardianship and mothers in the perinatal period, and their families. CAMHS values, respects and undertakes its work within the cultural context of its clients and families.  CAMHS recognises the significant behavioural and emotional impact that complex developmental trauma has upon infants, children and young people. Specialised CAMHS clinicians deliver evidence informed therapeutic interventions to the child, their care environment and the wider systems in the most complex cases. CAMHS also provides early intervention and prevention through consultation and education within the wider community.

The SA Health Child Protection Services (CPS) provide tertiary child protection services within three Local Health Networks: Women’s and Children’s Health Network (WCHN); Northern Adelaide Local Health Network (NALHN) and the Southern Adelaide Local Health Network (SALHN). The three CPS’s are dedicated tertiary trauma specialist services for children, young people and their families who have been referred by the Department for Child Protection (DCP); South Australia Police (SAPOL) and others following suspected or confirmed child abuse and neglect.  The CPSs provide services for all country areas as well as the metropolitan area.

  • The three CPS undertake forensic medical, psychosocial and parenting assessments for children and young people 0-18 where there have been allegations or confirmation of abuse or neglect.
  • The three CPS are comprised of multi-disciplinary teams, including doctors, social workers and psychologists who have specialist knowledge and expertise in trauma, child development and the impact of abuse and neglect on children and young people.  The CPS are underpinned by robust clinical governance structures that involve comprehensive supervision, support and ongoing training/ professional development for staff.
  • The WCHN CPS provides a range of evidenced based therapeutic services to children/young people, in relation to their experiences of abuse, trauma and neglect and has dedicated services to children and young people under Guardianship.
  • From January 2020 the NALHN CPS will provide a range of evidenced based therapeutic services to children and young people, in relation to their experiences of abuse, trauma and neglect inclusive of sexual abuse/assault; physical and/or emotional abuse.
  • The SALHN CPS operates as an acute forensic service offering therapy is in relation to reunification with children and parents in regards to physical abuse/neglect. The SALHN CPS provides a therapeutic reunification service for infants and young children under the age of 5 years and their family by referral where the children are under current Guardianship Orders.

The three CPS recognise and respond to the varying impact of trauma on children, caregivers and those who have contact with the child protection system and utilise this knowledge and skill to help influence and improve organisational culture and assist in the development of policies and practices to ensure they are trauma informed.

Government response: For further consideration
Lead agency: Department for Health and Wellbeing
Recommendation progress status: Planning

9.8 - Final Report

The Australian Government and state and territory government agencies responsible for the delivery of human services should ensure relevant policy frameworks and strategies recognise the needs of victims and survivors and the benefits of implementing trauma informed approaches.

SA Health’s relevant current policy frameworks and strategies align with this recommendation.

The South Australian perinatal practice guidelines are state-wide clinical guidelines published by SA Health that assist perinatal service providers and have been developed in consideration of best available research. The South Australian Perinatal Practice Guideline Trauma Informed Care is intended for use in the identification and support of women who have experienced childhood sexual abuse and who are pregnant, giving birth and in the postnatal period.

The Central Adelaide Local Health Network Community Mental Health (CMH) Model of Care (ages 16 – 65) 2019, is a strategic document providing a framework for service delivery. A priority area within the Model of Care (MOC) is for service delivery based on trauma informed approaches to practice. The MOC defines a wide range of events that can potentially cause childhood trauma such as abuse and loss.

Trauma informed care is an integral part of the recovery oriented practices of SA Health mental health services. These services are committed to the training of staff in trauma informed care, delivering evidence based models and to incorporate the principles of safety; trustworthiness; choice, collaboration; empowerment and least restrictive practices as supported by the Mental Health Act 2009 (SA), which form the essential foundation to the trauma informed approach in services.

Government response: Accepted in principle
Lead agency: Department for Health and Wellbeing
Recommendation progress status: Not yet commenced

9.09 - Final Report

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

The national centre’s functions should be to:

  1. raise community awareness and promote destigmatising messages about the impacts of child sexual abuse
  2. increase practitioners’ knowledge and competence in responding to child and adult victims and survivors by translating knowledge about the impacts of child sexual abuse and the evidence on effective responses into practice and policy. This should include activities to:
    1. identify, translate and promote research in easily available and accessible formats for advocacy and support and therapeutic treatment practitioners
    2. produce national training materials and best practice clinical resources
    3. partner with training organisations to conduct training and workforce development programs
    4. influence national tertiary curricula to incorporate child sexual abuse and trauma-informed care
    5. inform government policy making
  3. lead the development of better service models and interventions through coordinating a national research agenda and conducting high-quality program evaluation.

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

The South Australian Government will engage with other states and territories around this recommendation at the national level.

Government response: For further consideration
Lead agency: Department for Health and Wellbeing
Recommendation progress status: For further consideration

10.1 - Final Report

The Australian Government and state and territory governments should ensure the issue of children’s harmful sexual behaviours is included in the national strategy to prevent child sexual abuse that we have recommended (see Recommendations 6.1 to 6.3).

Harmful sexual behaviours by children should be addressed through each of the following:

  1. primary prevention strategies to educate family, community members, carers and professionals (including mandatory reporters) about preventing harmful sexual behaviours
  2. secondary prevention strategies to ensure early intervention when harmful sexual behaviours are developing
  3. tertiary intervention strategies to address harmful sexual behaviours.

The Commonwealth National Office for Child Safety (Department of the Prime Minister and Cabinet) and the NSW Ministry of Health will co-chair the Inter-Jurisdictional Working Group on Therapeutic Responses for Children with Problematic and Harmful Sexual Behaviours (P&HSB).

SA Health will be represented on the Working Group to progress the Royal Commission into Institutional Responses to Child Sexual Abuse’s recommendations relating to therapeutic responses for children with P&HSB.

Government response: Accepted in principle
Lead agency: Department for Health and Wellbeing
Recommendation progress status: Not yet commenced

10.02 - Final Report

The Australian Government and state and territory governments should ensure timely expert assessment is available for individual children with problematic and harmful sexual behaviours, so they receive appropriate responses, including therapeutic interventions, which match their particular circumstances.

SA Health Child and Adolescent Mental Health Services (CAMHS) and the SA Health Child Protection Service (CPS) Units provide specialist services through the CAMHS Adolescent Sexual Assault Prevention Program (ASAPP) and the Women’s and Children’s Health Network (WCHN) Sexualised Behaviour Treatment service to ensure timely expert assessment; therapeutic interventions and clear established referral pathways are available for individual children with problematic and harmful sexual behaviours, to ensure they receive appropriate individual responses.

CAMHS also provides priority clinical assessment and therapeutic services on the APY Lands for the identified clinical issues of self-harming and suicidal behaviours, sexualised behaviour, sexual assault; the impact of trauma and abuse; parenting; substance abuse.

The WCHN CPS Sexualised Behaviour Treatment service provides therapy to children 2-12 years of age and their families or carers where the major concern is problematic sexual behaviour and where recent sexual abuse has not been confirmed.

Government response: Accepted
Lead agency: Department for Health and Wellbeing
Recommendation progress status: Complete

10.03 - Final Report

The Australian Government and state and territory governments should adequately fund therapeutic interventions to meet the needs of all children with harmful sexual behaviours. These should be delivered through a network of specialist and generalist therapeutic services. Specialist services should also be adequately resourced to provide expert support to generalist services.

The Commonwealth National Office for Child Safety (Department of the Prime Minister and Cabinet) and the NSW Ministry of Health will co-chair the Inter-Jurisdictional Working Group on Therapeutic Responses for Children with Problematic and Harmful Sexual Behaviours (P&HSB).

SA Health will be represented on the Working Group to progress the Royal Commission into Institutional Responses to Child Sexual Abuse’s recommendations relating to therapeutic responses for children with P&HSB.

Government response: For further consideration
Lead agency: Department for Health and Wellbeing
Recommendation progress status: For further consideration

10.04 - Final Report

State and territory governments should ensure that there are clear referral pathways for children with harmful sexual behaviours to access expert assessment and therapeutic intervention, regardless of whether the child is engaging voluntarily, on the advice of an institution or through their involvement with the child protection or criminal justice systems.

SA Health continues to work with the Department for Child Protection, the Youth Justice system, Disability Services SA and SAPOL in addressing the needs of children with problematic and harmful sexual behaviour so they receive appropriate responses.

Child and Adolescent Mental Health Service (CAMHS) Adolescent Sexual Assault Prevention Program (ASAPP) is a child protection/ crime prevention strategy for preventing child sexual abuse in the community.

ASAPP accepts referrals of adolescents who have sexually abused or offended. Attendance may be voluntary or mandated by court or statutory authority or as part of a formal undertaking in a Family Conference.

Women’s and Children’s Health Network (WCHN) Child Protection Service (CPS) unit Sexualised Behaviour Treatment service provides expert assessment and therapeutic services to children 2-12 years of age and their families or carers where the major concern is problematic sexual behaviour and where recent sexual abuse has not been confirmed.

SA Health Child and Adolescent Mental Health Services (CAMHS) and the SA Health Child Protection Service (CPS) Units provide specialist services through the CAMHS Adolescent Sexual Assault Prevention Program (ASAPP) and the Women’s and Children’s health Network (WCHN) Sexualised Behaviour Treatment service to ensure timely expert assessment; therapeutic interventions and clear established referral pathways are available for individual children with problematic and harmful sexual behaviours, to ensure they receive appropriate individual responses.

Government response: Accepted
Lead agency: Department for Health and Wellbeing
Recommendation progress status: Complete

10.05 - Final Report

Therapeutic intervention for children with harmful sexual behaviours should be based on the following principles:

  1. a contextual and systemic approach should be used
  2. family and carers should be involved
  3. safety should be established
  4. there should be accountability and responsibility for the harmful sexual behaviours
  5. there should be a focus on behaviour change
  6. developmentally and cognitively appropriate interventions should be used
  7. the care provided should be trauma-informed
  8. therapeutic services and interventions should be culturally safe
  9. therapeutic interventions should be accessible to all children with harmful sexual behaviours.

The Commonwealth National Office for Child Safety (Department of the Prime Minister and Cabinet) and the NSW Ministry of Health will co-chair the Inter-Jurisdictional Working Group on Therapeutic Responses for Children with Problematic and Harmful Sexual Behaviours (P&HSB).

SA Health will be represented on the Working Group to progress the Royal Commission into Institutional Responses to Child Sexual Abuse recommendations relating to therapeutic responses for children with P&HSB.

Current practice in South Australia is consistent with this recommendation.

Child and Adolescent Mental Health Service (CAMHS) is a state-wide service of the Women’s and Children’s Health Network (WCHN), SA Health.

CAMHS Adolescent Sexual Assault Prevention Program (ASAPP) follows the 2010 National Standards for Mental Health Services which align with this recommendation.

The CAMHS KATU (Kunpungku Atunymankunytjaku Tjitji Uwarkara) provides therapeutic interventions on the APY Lands to children, young people, families and communities to respond to complex emotional, behavioural and mental health difficulties, and also responds to problem sexualised behaviour, sexual abuse and sexually abusive behaviours.

The three SA Health Child Protection Services undertake forensic medical, psychosocial and parenting assessments for children and young people 0-18 years where there have been allegations or confirmation of abuse or neglect.

The WCHN Child Protection Service (CPS) Sexualised Behaviour Treatment Program provides therapy to children under 12 who display problematic sexualised behaviour and their carers/parents. This therapeutic work involves schools, child care centres, DCP residential care facilities and other relevant services. The Sexualised Behaviour Treatment program provides consultation and training to health professionals, DCP workers, schools and other relevant agencies.

WCHN CPS provides a forensic psycho-social assessment and therapeutic service for children less than 12 years of age and their families on the APY lands who are displaying severe problematic sexualised behaviour. CPS provides a fly in-fly out service to undertake this work.

Government response: Accepted
Lead agency: Department for Health and Wellbeing
Recommendation progress status: Implementing

10.06 - Final Report

The Australian Government and state and territory governments should ensure that all services funded to provide therapeutic intervention for children with harmful sexual behaviours provide professional training and clinical supervision for their staff.

The Women’s and Children’s Health Network (WCHN), Child Protection Service (CPS) unit’s Sexualised Behaviour Treatment service and Child and Adolescent Mental Health Service’s (CAMHS) Adolescent Sexual Assault Prevention Program (ASAPP) and services to the APY Lands services provide robust systems of clinical accountability, within trauma informed approaches through supervision within and across disciplines, provided by experienced and approved practitioners.

Formal multidisciplinary case reviews are undertaken to assess care plans, formulations, address risk, and progress quality assurance.

These services are provided with professional training in the provision of therapeutic interventions for children with harmful sexual behaviours.

Government response: Accepted
Lead agency: Department for Health and Wellbeing
Recommendation progress status: Complete

10.07 - Final Report

The Australian Government and state and territory governments should fund and support evaluation of services providing therapeutic interventions for problematic and harmful sexual behaviours by children.

The Commonwealth National Office for Child Safety (Department of the Prime Minister and Cabinet) and the NSW Ministry of Health will co-chair the Inter-Jurisdictional Working Group on Therapeutic Responses for Children with Problematic and Harmful Sexual Behaviours (P&HSB).

SA Health is in the process of nominating representatives to join the Working Group to progress the Royal Commission into Institutional Responses to Child Sexual Abuse recommendations relating to therapeutic responses for children with P&HSB.

Government response: For further consideration
Lead agency: Department for Health and Wellbeing
Recommendation progress status: Planning

Page last updated: 5 December 2019