1. Project description Key benefits What’s next? How does this work demonstrate integration of care? Music Therapy with children exposed to domestic violence: Oxleas Music Therapy Service in partnership with Greenwich Domestic Violence and Abuse Services (Housing for Women) and CAMHS Early Intervention Team (November 2012-March 2015) Service evaluation – Quantitative data + interview data (service users and professionals) Literature review update Case study presentation - British Association of Music therapy conference in April 2015. Publication in peer-reviewed journal, such as the British Journal of Music Therapy. Research design - Putting together a bid for more substantial research funding. Seek funding for further clinical work using this model. Children exposed to domestic violence are faced with a variety of challenges. As well as the direct psychological impact of witnessing violence they can also be affected indirectly by the problems their parent/carer might face in the aftermath of a violent relationship. Music therapists work with the child in the here-and-now, allowing space for difficult emotions to arise when the child feels ready to address them, while CAMHS EIT therapists support the parent/carer in their understanding of the challenges faced by the child. For children exposed to domestic violence, music therapy may be helpful in addressing: Traumatic stress Affect regulation Attachment difficulties Interpersonal relationships Low self-esteem/confidence Referrals from Housing for Women to Music Therapy/CAMHS EIT: 3 teams working together in direct contact with families. 10 session blocks of individual music therapy alongside CAMHS consultation model (3 sessions). Child placed at the centre of the work. Recent NICE guidelines on domestic violence* support various aspects of this work. There is clear emphasis on the “wide range of ill-effects that exposure to domestic violence and abuse can have on children and young people” (4.9) and on ‘the importance of working concurrently with both the non-abusive parent or carer and child’ (4.10). We are planning to explore a number of new avenues, developing the work already completed. Economic rationale The indications from parental feedback and from the key workers and clinicians involved were that the project had a positive impact in the majority of cases. Furthermore current NICE guidelines state that “The cost [of domestic violence], in both human and economic terms, is so significant that even marginally effective interventions are cost effective” and that “even using conservative assumptions, it seems likely that the interventions will be cost-effective in the long term by stopping the violence and improving the mental health of all those involved”, thus providing an economic as well as a clinical rationale for the project. There were two parts to this project. 1 - Collaborative work between Housing for Women, CAMHS EIT and Oxleas Music Therapy Service, in which individual music therapy for children took place alongside systemic work with the family from CAMHS EIT. Housing for Women support workers provided the referrals and were closely involved in ongoing work at every stage. Housing for Women Referral Music Therapy Group Music Therapy Core Service Discharge CAMHS EIT+ Music Therapy Discharge or referral on Housing for Women support CAMHS family consultation Individual music therapy (Child) 2 – A slow-open music therapy group in a children’s centre, again with referrals coming from Housing for Women. The sessions took place once a week for 45 minutes and the personnel of the group evolved over time, with new members being added when other group members ended their period of treatment. *http://www.nice.org.uk/guidance/ph50/chapter/introduction (February 2014)