Presentation on theme: "DVRAM: messages from Northern Ireland and Barnet pilot evaluations Martin C Calder Calder Training and Consultancy www.caldertrainingandconsultancy.co.uk."— Presentation transcript:
DVRAM: messages from Northern Ireland and Barnet pilot evaluations Martin C Calder Calder Training and Consultancy
Focus of presentation Emergence of NI model and development Focus and content of NI evaluation Parallel work in other local authorities Starting point of London work Pilot issues in Barnet Messages for the future
DVRAM: origins and initial extension How do we assess the multiple impacts of domestic violence on women and children? When we have collected the information how do we use it to analyse what it means and what to do next? How are the outcomes of any continued harm or intervention measured? How can such information inform safety planning?
INPUTS TO OUTCOMES Achieving Success in Child Protection and Domestic Violence Local research in N.I. conducted by Patricia Nichol Programme Manager, UCHT in into how domestic violence referrals from police were managed by Social Services SHSSB had identified a need in their risk assessment processes for a specific risk assessment model for domestic violence to be incorporated into the Needs Assessment Framework
First steps Steering Groups were established to manage pilot project within SHSSB & UCHT. Timeframe – six months SHSSBOct 03 – Mar 04 UCHTNov 03 – Apr 04 Barnardos provided 3 days training and 12 days mentoring to 3 social work teams within SHSSB and a similar package to 4 teams within UCHT (including SSWs and APSWs when available). Barnardos provided Childrens Services Manager, who had expertise in domestic violence and child protection work and a research officer to evaluate the projects. 50 manuals on model were provided by Barnardos.
Importing and extending the ONTARIO model
Outcome Measurement –the process of Risk Assessment Risk Assessment:- Collection of information on the situation and risk factors within a family situation using a consistent framework- Nine Assessment Areas in Domestic Violence model and a Pro-forma to collate information to support Core Assessment Framework Risk Analysis:- Use of specific threshold scales of risk factors and protective factors to measure outcomes of assessment process Risk Management:- Use of assessment and threshold scales in deciding how the case should be managed, specifically the interventions offered to family – a child protection or family support type of intervention.
How do we measure the outcomes from this assessment? Cardiffs Womens Safety Unit-15 high risk factors associated with domestic abuse Research Home Office –Research paper 217- Domestic Violence Offenders: characteristics and offending related needs Evidence based practice of Barnardos Domestic Violence Outreach Project in N.I. Pilot Research on the application of the model with N.Ireland with social work assessment teams.
Domestic Violence Threshold Scales There are five scales which rate the domestic violence from Minimum to Moderate to Severe through a range of facts that refer to the: Evidence of domestic violence, Protective factors/strengths within situation Potential vulnerabilities.
Domestic Violence Threshold Scales The above must all be considered in each case Severity of the incidences Pattern, frequency and duration of violence incidences Perpetrator 's use of the children /children caught up in the abuse Escalation of violence and use of isolation Sexual violence/abuse Perpetrators attitude to the abuse Additional Vulnerabilities Age of victim Victims personal vulnerabilities-isolated- locality. Age of perpetrator Disability Issues for Victim, children and/or perpetrator Cultural Issues within family
Additional Factors Victim has recently separated from the abuser-risk of separation violence Victim has autonomy ( taking control with support) Perpetrator wants to reconcile with woman Woman uses physical force in self-defence Children use violence-siblings/others Woman has begun new relationship
Perpetrator has history of abuse in personal relationships/woman has experiences abuse in previous relationships/childhood abuse Perpetrator will soon be released from prison The woman and children have moved to a more isolated community with or without the perpetrator Pattern of inappropriate system response. An adult victim being unable to care for the child as a result of trauma from an assault
OUTCOMES - USE OF MODEL Systematic format for the consistent recording of domestic violence in SW case files. Referral Screening, Initial, Comprehensive Assessment (Second stage assessment). Child Protection Case Conferences - information gathering, child protection planning, and intervention planning. Case planning meetings - Threshold regarding family support and child protection. Format for court reports for care orders and contact/ residence orders. In the SHSSB the model was an additional tool in the Assessment Framework
Outcomes For Staff Training and mentoring increased staff awareness and understanding of the dynamics of domestic violence. Social Work staff increased knowledge base facilitated their information gathering and confidence when dealing with domestic violence.
Outcome: Identifying the risks presented to children from domestic violence Enabled staff to examine and gather information and assisted them in identifying the risks present to children. Assessment process aided staff in rating the severity of the risks presented by domestic violence. Safety work intervention training with women and children was highlighted as extremely useful and effective.
Decision making in Case Planning - Child Protection & Family Support Threshold scales provided a consistent framework to assess and rate the level of risk. Threshold scales enabled consistent decisions on case clarification - child protection or family support. Increased awareness of risks to children and informed decision making.
Decision Making – appropriate support & interventions for children Model emphasises risks presented to children and enables staff to focus on the needs of victim, children and direct response to perpetrator. Identifies different interventions required for children, victim and perpetrator – safety/educative work and recovery work for children/victim. Maintains focus of domestic violence as main concern within the Assessment Framework but did not exclude other significant concerns.
Provides detailed information on which to base decision making. Enabled clarity regarding the level and type of intervention needed. Evidence–based practice of Barnardos Domestic Violence Outreach Project- safety work for women and children.
Compatibility with current practice and policies Initial assessment teams used the safety and domestic violence education during their work and found this extremely useful. Once model used a detailed case record can be maintained in file - this will be significant if case later entered the child protection or/and court arena.
Adjustments to Threshold Scales Data collected during the pilot confirmed that the threshold scales were accurate in rating cases into family support and/or child protection. Additional risk factors were added to threshold scales during the pilot which expands the risk factors. Work was undertaken to adapt the scales so they could be used directly with service users to discuss risk factors to children.
Mentoring Sessions Sessions provided support to implement model and without the focus and support of sessions, staff would have struggled to implement this into their practice. Mentoring facilitated practice, consultation, learning, reflection on practice, provided research information. Use of team approach: SSW attendance at sessions was crucial as they are responsible for decision-making for case management and support to their SW staff.
Usefulness of the model to different social work teams Initial Response/Assessment Teams – Model useful for structuring initial information. Model readily identified gaps in information. Provided tangible record of all instances of domestic violence. In new cases not all information readily available. Children & Families Teams - Initial assessment using the framework at IRT assisted in longer term case planning. Provided consistent clear record of decision making.
Future Use of Model Consideration to be given to multi- agency use of threshold scales in determining risk and appropriate referral to Social Services. Consideration of piloting the threshold scales with Police Service NI Consideration to be given to aligning training in domestic violence risk factors and threshold scales with existing child protection training.
Calder Comments Consistent thinking with RASSAMM Model allows for information collection and analysis and helps measure outcomes It is an initial assessment and core assessment tool and could be a screening tool It informs the Needs Led Assessment Framework Need to balance risk and assets in threshold scales Model is actuarially informed-based on research and professional knowledge It considers stable, static and dynamic risk factors
Recommendations of Martin Calder It is an holistic assessment model which could benefit from a re-ordering of the threshold scales-this has been completed. Users perspective on the impact of the assessment tool would be beneficial. Threshold scales of risk factors provides an accurate analysis of risk - this could be improved with gravity scoring used in the Graded Care Profile and AIM.
Step 2 In June 2005 the NI Regional Steering Group agreed to fund the mentoring component of the implementation of the model. The training component would be paid for by individual Trusts and the mentoring component by the Regional Steering Group Evaluation of mentoring by me
Mid point evaluation January 2008 Mentoring Training DVRAM
Mentoring Predominantly for social care although parallel processes for health and occasionally multi-agency Provided support and practical guidance on applying model to cases (excused supervisors from familiarity with the model) thus consolidating the training Attendance often precluded by caseload pressures so should be mandatory and linked to professional development hours
Also provided input on engaging with perpetrator, childrens resilience and female perpetrators etc. Staff found themselves mentoring colleagues and managers Unrealistic for one person, no matter how committed Shift mentoring within newly developed Principal Practitioner Posts
Training Well received and competently delivered Should be mandatory Needs to be compulsory to first line managers Refresher training needs to be considered as many staff didnt apply immediately and lacked confidence down the road
DVRAM Extremely accessible and easy to use Provided roadmap of complicated territory Legitimises questioning of gut feelings Confusion about linkage with UNOCINI Anxiety that it will identify more work Variable use if case not initially referred as DV DVRAM as core assessment tool or one of a number? It is not an end in itself…
Refinement of vocabulary Greater guidance on differentiation between severity levels One threshold scale per child? Requires clear mandate of adoption and application Instils confidence in staff: offering structure, clarifies roles and responsibilities and is usable with families
Integrated risk assessment tools and focus: child care Strengths-loaded Risk adverse Safeguarding predominates Expansion of harm General not specific Time-limited Evidence-based practice Use of professional judgement
CAFCASS Toolkit (versions 1&2)
Different risk focus (Bell, 2006)
Integrated risk assessment tools and focus: criminal justice Actuarial risk tools Numerous risk frameworks VAI CBI SARA SPECCSVO Matrix 2000
DVRAM as integrative framework?
Differential risk focus Risk of actual or likely significant harm? Risk of re-offending? Risk of relapse?
Common language and focus? Criminal Justice Probation, police and prison inc MAPPA Risk of re-offending (no timeframe indicated and restricted to index offence) Criminal Justice (MARAC) High risk victims in need of protection Social careRisk of actual or likely significant harm
Case file analysis – highlighted areas The displacement of responsibility on to the mother Little evidence of perpetrator work to reduce the risk and hold him accountable for his behaviour Evidence of a high level of co-existence of physical abuse, neglect and emotional abuse of children Evidence of high levels of maternal mental health problems yet not in the perpetrator Scores of 4 did not always initiate a core assessment Staff changes and lack of continuity/ training linked to above
Some evidence of downplaying of threshold scale scores Huge coexistence of alcohol and drug issues and challenge of assessment and intervention focus/priority
Coventry Commission How to develop specific DVRAM factors for their growing ethnic population Principally South Asian, Portuguese, Arabic and Refugee/Asylum seekers The Silent minority literature review (Calder, 2007)
London pilots Benefited from prior evaluations and parallel commissions Adopted and testing ethnic threshold scales Threshold scales refined to match CAF levels and brought forward within identification and intervention process Updating of model with emerging evidence- base
Production of an accessible flowchart for staff Greater guidance on Understanding the dynamics of an abusive relationship Womens processes of help-seeking in domestic violence Offering case examples to help staff differentiate between the severity levels
Broader suggested usage e.g. education and prevention Revised DVRAM for core assessment More detailed and identified evidence-based materials How domestic violence affects the parenting of perpetrators Greater details relating to the risks to children from contact with the perpetrator
Areas not resolved Differentiation of static, stable and dynamic risk factors Supporting modules for female perpetrators, same sex, domestic violence from young people Inclusion of risk profile for adult victims of domestic violence
Areas for debate Boundaries of the model e.g. when is a specialist assessment indicated and what format should that take? DVRAM as integrative model to unify social care and criminal justice models and processes Use when victims are not mothers
4-pronged model Multi-agency DV threshold scale Social Care Initial Assessment Social Care Core Assessment Safety intervention with children and mothers
Barnet evaluation Briefing (half-day to 200 staff) Training (2 days on initial and core assessments and 1 day on safety planning interventions) Mentoring (3/4 sessions on monthly basis for 5/6 staff) DVRAM
Briefing Awareness raising of DVRAM and threshold scales Variability of ownership of CAF completion and knowledge regarding DV Challenges the practice of couple work and mediation in DV Useful but not sufficiently bedded down to evaluate potential
Threshold scales clear and accessible – providing a useful compass and map Supports more informed referral (using CAF) Can help bring CAF alive and populate social care systems Doesnt necessarily dovetail with other agency positions – in relation to contact with the perpetrator
Training Staff felt multi-agency audience would have been better to promote greater clarity of roles and responsibilities Manager training key to supporting staff in case application Training clear and delivery encouraged motivation and reflection
Mentoring Positive when able to attend: able to elicit direction and apply to cases immediately Focus on case application as well as areas not well served by the model – same sex violence etc. Need it to continue for some time until model embedded and they feel safe flying solo Felt stretched mentoring managers and colleagues in a new model if they hadnt attended the training
DVRAM Provides great structure and focus Provides new information and confidence Captures and organises complexity into accessible tool Workload pressures may preclude such in-depth assessments Greater clarity about fit with CAF and ICS needed: little evidence of use to date Confusion about relationship with MERLIN
MERLIN will use SPECCSVO MARAC now measuring whether DVRAM has been completed and if so at what level
Very useful in working with adult victims – you can see the penny dropping as you work through the materials… Shortened version (prompt card) suggested Not seen as a stand-alone tool but as part of a pick n mix portfolio Challenged practice immediately in relation to babies/younger children Not yet tested in courts but advance notification of its status would help workers DVRAM and safety planning – links with local resources allows work to be transferred
Threshold weighting correlated with professional experience and thus some evidence of differential interpretation Little evidence of shifting practice toward greater engagement of perpetrators Staff frustrated about limited time to work through the model with mothers
Messages from Barnet Rolling programme of training required and useful to embrace adult-orientated services such as mental health, substance misuse etc. and link into existing Safeguarding Board Training Use application of DVRAM to identify deficits in resource provision Re-emphasizing focus on safety work with children and young people Link DVRAM explicitly with CAF, ICS and preventive strategy Building resilience, supporting independence Map possible portfolio of assessment tools to use in conjunction with DVRAM
Cross-pilot site contacts to share information and good practice and avoid duplication Examine how ongoing mentoring can be achieved Consider case analysis to examine whether outcomes are more focused attained
Future work Conceptual and practice refinement of DVRAM Development of supporting modules Linkage with other assessment tools and processes Clear positioning and adoption of DVRAM Training and mentoring support package
References Calder MC (2007) The silent minority: domestic abuse perpetrated within ethnic communities: A review of the literature with recommendations for risk assessment. Leigh: Calder Training and Consultancy Calder MC (2007b) Domestic violence and child protection: challenges for professional practice. Context 84: Calder MC (2008) Evaluation of domestic violence training and mentoring programme in Northern Ireland: Mid-point summary analysis. Leigh: Calder Training and Consultancy Calder MC with Harold G and Howarth E (2004) Children living with domestic violence: Toward a framework for assessment and intervention. Dorset: Russell House Publishing. WOMAN ABUSE: Increasing Safety for Abused Women and Their Children (CAS/VAW JOINT TRAINING - FACILITATOR MANUAL Ontario Ministry of Community and Social Services Ontario, CANADA, JULY 2001