Background Families known to child protection typically require support from a range of services to meet their diverse needs. It is essential that this range of services work together to effectively support families. Parents are key stakeholders, and they must be supported to participate in these collaborations; contributing to decisions that affect their lives. Parent perspectives are critical in strengthening family member participation in service responses. Objective To explore the perspectives of parents receiving family support regarding collaborative practices between (i) practitioners involved with their family and (ii) practitioners and parents.Participants and Setting: 10 South Australian parents receiving intensive family support using a resilience practice framework as part of a differential response. Methods Semi-structured interviews were completed, recorded, transcribed, and then coded using NVivo 12 Pro. Data were interpreted using reflexive thematic analysis. Results Prioritizing positive practitioner-family relationships, transparent communication, and tailoring service responses to each family were identified as important practices for effective partnering with parents. Participants valued collaboration between services and would like it to occur more frequently. Collaboration across services and active participation of parents in service responses was found to be largely dependent upon the leadership and relational skills of family support practitioners. Conclusions To enhance access to needed support and parental participation in service responses, considerable work is required to ensure that all services prioritize relationship-centered approaches. Collaboration across services to support vulnerable families was dependent upon leadership from family support practitioners.

Trauma-focused cognitive behavioral therapy (TF-CBT) developed by Judith Cohen, Anthony Mannarino, and Esther Deblinger, is one of the most widely researched and best supported psychological treatments for posttraumatic stress in children and young people who have experienced traumatic events. However, as TF-CBT was originally developed to treat posttraumatic stress symptoms in children who had experienced sexual abuse, the literature is focused on samples experiencing trauma from child sexual abuse. A review of the effectiveness of TFCBT for trauma symptoms associated with non-sexual abuse related child maltreatment including physical abuse, emotional abuse, neglect, and domestic violence has not been specifically addressed in the literature. This review reports on the results of a systematic search of the literature for controlled and uncontrolled studies (pre-post minimum) that quantitatively examine the effectiveness or efficacy of TF-CBT for children and young people (0-18 years) who had experienced child maltreatment (>50 % of sample) where the included population was not overrepresented by sexual abuse (determined by a cut-off of <31 % of sample). Cochrane Library, Embase (via Ovid), ProQuest Central, MEDLINE (via Ovid), PsycINFO (via Ovid), and Scopus were searched in August 2021 for peer-reviewed literature. JBI checklists for RCTs and quasi-experimental studies were used to assess quality of the literature. Four randomized controlled trials (representing 446 participants) and four uncontrolled trials (representing 345 participants) were eligible for inclusion. Narrative synthesis was undertaken to present the results from this small body of literature which focuses mainly on physical abuse and domestic violence. Results suggested that TF-CBT, delivered in a variety of 'real-world' settings is an effective intervention for a range of non-sexual abuse related trauma symptoms in children and young people. The included RCTs showed that TFCBT had a positive effect on posttraumatic stress symptoms, anxiety, strengths, functional impairment, and also potentially depression and emotional and behavioral difficulties (with mixed effect). Based on the recorded trauma symptoms of the included samples, treatment effects are applicable to threat-based experiences (e.g., physical abuse and domestic violence), and cannot be generalized to deprivation-based experiences (e.g., neglect). The findings from this review suggest that a flexible approach to implementation and employing engagement strategies to minimize high attrition rates could be beneficial. Limitations of the included evidence comprise small sample sizes, self-report measures, and mixed trauma types.

Multi-disciplinary case review meetings are commonly held to facilitate a holistic response to child abuse. This study set out to examine whether multi-agency case review meetings change the perceptions of members in response to series of child abuse vignettes. The study involved twelve participants from law enforcement, child protection, health, and education agencies who regularly responded to child abuse in their jurisdiction. The study replicated 'Strategy Meetings', a multi-agency meeting that occurs in Western Australia at the start of a child abuse case. The study involved a novel pre-post design, with follow-up interviews. Participants were asked to read a child abuse vignette and assess the case, participate in a 15-minute case deliberation, then complete the same individual assessment with a total of 52 pre-post assessments completed. Semi-structured interviews were conducted with nine participants a week following their session. The study found that participants generally did not change their perceptions of the case as a result of the deliberation sessions (Current Risk Scale Z = 0.173, p = 0.863, Future Risk Scale Z = 0.293, p = 0.769, & Response Scale Z =-0.161, p = 0.872). The interviews suggest that the deliberation sessions identified numerous points of difference on the cases, but these did not appear to be resolved by discussing the case in the time available. Further research on the effect of deliberation on larger samples and more diverse team structures is needed to clarify the purpose and value of holding multi-disciplinary case review meetings.

This repeated-measures study examined the effects of a hybrid of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with other therapeutic approaches at a community-based clinic in Perth Western Australia among a sample of children and young people overwhelmingly experiencing multiple forms of maltreatment and with complex family situations (i.e., family and domestic violence, parental mental health, parental substance abuse). Drawing on 1713 individual client records from between 2017 and 2020, the researchers identified 113 children and young people with viable pre-post treatment assessments including 78 on the TSCC, 36 on the TSCYC, and 12 on the CBCL. Significant improvements on most clinical scales were identified on the TSCC and TSCYC. Sub-analysis of the TSCC results found no differences across gender, age, care status, therapy funding source, and the presence of sexual abuse in the rate of improvement on trauma symptoms. Overall, the study highlights that integrating different therapy approaches for populations with multiple and complex trauma symptoms accessing community-based services can be useful for supporting the delivery of TF-CBT for difficult to treat populations.

Neurofeedback training is an established treatment for children with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder and is an increasingly accepted modality of treatment in the context of child trauma. This treatment is typically delivered as a complement to more traditional talk therapy such as trauma-focused-cognitive behavioral therapy (TF-CBT). This review examined the evidence for the effectiveness of this intervention for children with trauma through a systematic search of the literature. A targeted search across databases identified 10 eligible studies that focused on children/young people who had experienced traumatic events and/or demonstrated symptoms of trauma, and which conducted a repeated measures study at a minimum. While the included studies suggest some benefits from neurofeedback training, the available studies, including randomized trials, have to date been relatively small, involve dramatically different treatment length and intensity, and show inconsistent benefits relative to usual treatment conditions. To advance knowledge of this intervention further research is needed with a clear best practice protocol and with a clearer target group.

To improve outcomes for vulnerable children, there is a pressing need to strengthen collaboration between services that support children and families known to child protection. There is potential for shared service goals to enhance interprofessional collaboration in this field. To better understand shared service goals as an enabler of interprofessional collaboration, a scoping review was undertaken to critically explore (i) goals for children and for their parents/caregivers held by services for children and families known to child protection (ii) interpro-fessional practices underpinning these goals. Ninety-one studies met the inclusion criteria. Safety, family pres-ervation and increasing parenting capacity were identified as the most universally common goals across the range of services included in the review. Findings to enhance interprofessional collaboration are presented including: the role and value of shared goals at both the organizational and individual client level, as well as interprofessional practices that underpin the attainment of these shared goals. Recommendations for future research are made including the need to explore involvement of consumers in design and evaluation of collaborative approaches and how work to support children's wellbeing is balanced with work to improve the context in which they live.

Evaluation influence is a reconceptualization of evaluation use that reflects the broad and diffuse impacts an evaluation can have on social programs and policies. This way of thinking about impact provides an opportunity to investigate how and why evaluations influence social programs and policy. Twenty participants (practitioners and managers) from two child protection programs evaluated in the previous 24 months were interviewed about the influence of these evaluations, which was complemented with the collection of internal documents about changes to the programs. A qualitative case study analysis of evaluation influence was conducted using the interviews and documents to investigate the influence of two evaluations at different stages in the dissemination process. The participants identified that the evaluations appeared to have significant high-level policy level influence; however, limited examples of influence on practices in the programs were identified. There was some suggestion that the evaluations had increased practitioner interest in working with and participating in program evaluations. The findings suggest the importance of developmental evaluation approaches and practitioner engagement in evaluation to improve the influence and adoption of new knowledge from the evaluation of social programs.

los Estados Unidos. Narrow et al., (2002) combinando datos del Programa de Área de Captación Epidemiológica (ECA) del Instituto Nacional de Salud Mental y de la Encuesta Nacional de Comorbilidad (NCS), estimaron de forma conservadora que la prevalencia en un año de cualquier trastorno de ansiedad era del 13,1% para los adultos entre 18 y 54 años. Estos trastornos tienden a ser crónicos. Las tasas de remisión a los tres años oscilan entre el 16 y el 23% para la fobia social, el trastorno de ansiedad generalizada, la agorafobia y el trastorno de pánico con agorafobia (Keller, 2000, en Barlow, 2002). En un estudio longitudinal, en los primeros 22 meses tras el inicio de un episodio, solo el 18% de los individuos diagnosticados con trastorno de pánico y agorafobia, y alrededor del 43% de los que padecían trastorno de pánico sin agorafobia, se habían recuperado, en comparación con aproximadamente el 80% de los que padecían trastorno depresivo mayor (Hirschfeld, 1996). El estado funcional de los pacientes con trastornos de ansiedad está también deteriorado, como demuestran las tasas más elevadas de dependencia económica, desempleo (p.ej., Leon et al., 1995), peor calidad de vida (Massion et al., 1993) y mayor riesgo de suicidio consumado (Allgulander, 1994)...

To improve the holistic response to child sexual abuse in Perth, Western Australia, a group consisting of government and community support agencies developed a new co-located approach that combined support services with investigations, called the Multi-agency Investigation & Support Team (MIST). The model was comparable to the prominent Children's Advocacy Centre approach, with adaptations for Australian conditions. This study evaluated the fidelity with which this new program was delivered and examined whether it resulted in improved criminal justice, child protection, and service outcomes compared to existing practice. Drawing on service data linked across participating agencies the study found MIST was delivered with reasonable fidelity to its planned procedure, but with some challenges for delivery of the program due to the relative workload for staff in the MIST condition. The service demonstrated high levels of caregiver satisfaction with the response and high rates of children's engagement with therapy. A quasi-experimental comparison between MIST (n = 126) and Practice as Usual (n = 276) found MIST was significantly faster throughout the criminal justice and child protection processes, but the conditions did not differ in the rate of arrest or child protection actions. While embedding support services within the investigation process may not have a dramatic influence on criminal justice and child protection outcomes, the high rates of uptake of therapeutic services and parental satisfaction suggest other benefits that require future exploration.

Cross-agency collaboration for responding to child abuse cases is critical for the safety and wellbeing of children. However, working effectively across organizational boundaries can be difficult, especially where there are considerable disciplinary differences. Accordingly, many jurisdictions have put in place policies and processes to support cross-agency collaboration across groups responding to severe child abuse. The aim of this scoping review was to highlight key factors that may influence the quality of cross-agency collaboration in severe child abuse cases. A systematic search comprising 57 empirical studies examining the facilitators and/or barriers to cross-agency collaboration in child abuse cases was undertaken identifying eleven factors. This review found the most commonly cited factor was the need to reconcile the different roles/mandates of workers with their roles in a cross-agency response. A clear cross-agency protocol that establishes agreed procedures was also a commonly cited factor, along with cross-agency training, and communication and information sharing practices. This scoping review highlighted the lack of high-quality evidence that could be used to assess the effectiveness of policies and processes to support cross-agency collaboration for child abuse cases, and targeted areas for future research to enhance the quality of evidence for this common type of program/intervention.

The Multi-agency Investigation & Support Team (MIST) was a new approach to abuse investigations that aimed to minimize the distress and uncertainty experienced by children and non-abusive caregivers in dealing with the many agencies typically involved in a case post-disclosure, while also attempting to improve the accessibility of supportive and therapeutic services. As part of a broader evaluation, this study examined worker perceptions early in the implementation of this new approach. Thirty-three (33) interviews were conducted with workers affected by this new pilot. The interviews identified almost exclusively positive perceptions of the changes relative to practice as usual, particularly in terms of improvements to collaboration and communication across agencies, and the benefits of providing support alongside the investigation process. Some areas of difficulty and areas for improvement were identified, particularly the need for stronger governance of the cross-agency protocol and improved connection to some of the groups involved in the response that were not co-located. The study suggests professionals working in the MIST model consider the model beneficial to the quality of the response to severe child abuse while highlighting that the process of change into this new way of working was challenging at times.

The recommendations of the Royal Commission into Institutional Responses to Child Sexual Abuse were substantially informed by the evidence of the many thousands of victim/survivors (While acknowledging that different preferences exist in the use of the terms victim/survivors, we have adopted the terminology used in the Royal Commission, which is "'victim' when referring to a person who has experienced child sexual abuse at the time the abuse occurred. We use the term 'survivor' when referring to a person who has experienced child sexual abuse after the abuse occurred, such as when they are sharing their story or accessing support" (Royal Commission into Institutional Responses to Child Sexual Abuse, 2017a, p. 328).) who participated in 'private sessions'. This change to the usual format of public evidence giving in Royal Commissions reflected the need to provide a trauma-informed and survivor-led approach to giving evidence about institutional child sexual abuse. The large volume of participants who provided evidence to the commission presents an opportunity to reflect on the state of the research evidence on the impacts of institutional child sexual abuse, which was synthesised by the authors in a review completed for the Royal Commission. The combination of evidence from the private sessions and preexisting research, each with their own methodological advantages, provides a clearer picture of the pervasive effects of institutional child sexual abuse across all facets of life. Across sources, the direct impacts of abuse were identified, particularly in terms of immediate mental health impacts and the effects of long-term trauma on education, employment, and relationships. The private sessions add new insights to how these effects may continue to manifest in later life including parenting, grandparenting, and entering aged care. The private sessions also shed further light on how abuse interacts with personal characteristics, engagement with the institution in which abuse was perpetrated, and the role of support of caregivers, family, and local communities in influencing the impacts of abuse. While not necessarily a representative sample, the survivors that provided evidence to the Royal Commission have made an important contribution to the research evidence by highlighting the pernicious and complex effects of abuse over the life-course. Advancing knowledge of the full range of impacts can help advance support services and sensitise other services to the multifaceted needs of victims and survivors.

The physical and sexual abuse of children is a complex social issue that often requires a multi-disciplinary response; an alliance between police, child welfare authorities, mental health, medical examiners, and advocates for children and their non-abusive caregivers. Previously published reviews have identified deficits in the rationale for multi-disciplinary approaches to child abuse; a mismatch between the intention of systems to address the wellbeing of children post-disclosure, and their design which overwhelmingly focuses on the needs of the criminal justice system. This article aims to present a collective program logic from models identified in the research literature, reflecting the collective rationale in use among multi-disciplinary teams responding to child abuse. The logic highlights that the rationale for multi-disciplinary teams relies heavily on referral to external services and programs to improve the wellbeing of children and families affected by abuse. This article will add to the conceptual development, planning and evaluation of multi-disciplinary teams by elucidating common assumptions about the connection between mechanisms and outcomes across approaches. Articulating the assumptions underlying this common approach will assist program developers with designing interventions that are appropriately targeted and result in meaningful improvements to multi-disciplinary approaches and suggests critical areas for further research to improve understanding of the effects of multi-agency components.

Multi-Disciplinary teams (MDTs) have often been presented as the key to dealing with a number of intractable problems associated with responding to allegations of physical and sexual child abuse. While these approaches have proliferated internationally, researchers have complained of the lack of a specific evidence base identifying the processes and structures supporting multi-disciplinary work and how these contribute to high-level outcomes. This systematic search of the literature aims to synthesize the existing state of knowledge on the effectiveness of MDTs. This review found that overall there is reasonable evidence to support the idea that MDTs are effective in improving criminal justice and mental health responses compared to standard agency practices. The next step toward developing a viable evidence base to inform these types of approaches seems to be to more clearly identify the mechanisms associated with effective MDTs in order to better inform how they are planned and implemented.

This article considers how the concept of edgework can help to understand the work of staff members within juvenile justice centres – individuals who voluntarily engage in risk and negotiate boundaries to: respond to institutional routines, and/or express the institutional and cultural constraints of the emerging social order. The article describes edgework and its use in occupational settings, including criminal justice. It then presents data from an Australian study to demonstrate the stressful and sometimes dangerous conditions that staff members within juvenile justice centres experience. With reference to these data, the article argues that edgework can reveal essential paradoxes in juvenile justice work. This in turn can help to understand workers’ motivation(s) and what might be needed to recruit, support, and retain juvenile justice workers.

Child Advocacy Centers (CAC) emphasize developing effective cross-agency collaborations between workers involved in serious abuse investigations to foster improvements in agency outcomes, and to minimize distress, confusion and uncertainty for children and families. This study examined the characteristics of CACs, whether models in practice match the predominant model presented in the research literature. Directors of CACs in the United States that were members of the National Children’s Alliance (NCA) mailing list (n = 361) completed an online survey in 2016. While some core characteristics were ubiquitous across CACs, the data suggests that different types of CACs exist defined by characteristics that are not prescribed under NCA principles, but which are arguably relevant to the quality of the response. From the results of a cluster analysis, the researchers propose a typology of CACs that reflects the development and integration of centers: (a) core CAC services (i.e. interviewing & cross-agency case review); (b) an aggregator of external services, and (c) a more centralized full-service CAC. Further research is needed to understand how these variations may impact practice and outcomes; this is particularly important considering many CACs do not match the full-service models most commonly examined in the research literature, which limits the degree to which these findings apply to CACs generally. This article proposes further research framed by the need to better understand how different parts of the response impact on outcomes for children and families affected by abuse.

While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.

The Child Advocacy Center (CAC) model has been presented as the solution to many of the problems inherent in responses by authorities to child sexual abuse. The lack of referral to therapeutic services and support, procedurally flawed and potentially traumatic investigation practices, and conflict between the different statutory agencies involved are all thought to contribute to low conviction rates for abuse and poor outcomes for children. The CAC model aims to address these problems through a combination of multidisciplinary teams, joint investigations, and services, all provided in a single child friendly environment. Using a systematic search strategy, this research aimed to identify and review all studies that have evaluated the effectiveness of the approach as a whole, recognizing that a separate evidence base exists for parts of the approach (e.g., victim advocacy and therapeutic responses). The review found that while the criminal justice outcomes of the model have been well studied, there was a lack of research on the effect of the model on child and family outcomes. Although some modest outcomes were clear, the lack of empirical research, and overreliance on measuring program outputs, rather than outcomes, suggests that some clarification of the goals of the CAC model is needed.

While human service practice improvement is acknowledged as an important outcome of program evaluation, much evaluation is narrowly focused on accountability requirements. This type of evaluation often has limited use and relevance to human service practitioners. In exploring forms of evaluation that do have practice relevance, this article presents the experiences and perceptions of human service practitioners subject to evaluations that set out to foster learning. Across the cases participants expressed concerns about data quality and credibility, the relevance of evaluation data to the program context, the invasiveness of the evaluation, management of the process (particularly limited consultation with practitioners), and the lack of effective dissemination. These cases illustrate the challenges for evaluation to be useful to practice, and to foster meaningful improvements to services.