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VICTIMS SERVICES

  Trauma Informed Care
OVERVIEW OF FORUM
•   Role of Victims Services
•   Key concepts in trauma informed practices
•   Impacts on victims accessing services
•   Counsellors and Authorised Report Writers
•   Managing Trauma in the Workplace
•   Trauma in the Criminal Justice System
•   Continued challenges
ROLE OF VICTIMS SERVICES

We provide support and information to victims of crime
                       in NSW.

We assist victims in their recovery and as they move
         through the criminal justice system.


      We oversee the Charter of Victims Rights.
SERVICES PROVIDED

• Victims Access Line

• Approved Counselling Scheme

• Compensation and Financial Assistance

• Restitution

• Families and Friends of Missing Persons Unit
IMPORTANCE OF UNDERSTANDING
 TRAUMA MODELS AND APPROACHES
• Trauma is a response to an event or series of events that happen to
  individuals

• Responses to trauma are understood as normal reactions rather than
  evidence of individual pathology

• Services to people who have experienced trauma such as victims of
  crime should be designed in support people in their recovery and not
  re traumatizing

• Services should be welcoming and staffed by trained workers who
  have an understanding of trauma and its impact.
KEY CONCEPTS IN TRAUMA INFORMED
            PRACTICES
• A traumatic event is one where an individual experiences,
  witnesses or been exposed to an event that involved actual or
  threatened death or serious injury to themselves or others

• Responses include intense fear, helplessness, and powerlessness

• For victims of crime, this includes people who have experienced
  child abuse, sexual abuse, interpersonal violence, and domestic
  violence as primary or secondary victims

• The impact of traumatic events maybe pervasive and impact on all
  aspects of a person‟s life and well-being
COMMON TRAUMA SYMPTOMS- WITHIN
     PTSD DIAGNOSTIC CRITERIA
Re-experiencing

• Recurrent re experiencing of the trauma, ie flashbacks, nightmares,
  intrusive thoughts and nightmares

• Intense psychological or physiological reactions to internal or external
  cues that represent some aspect of the trauma
COMMON TRAUMA SYMPTOMS- WITHIN
     PTSD DIAGNOSTIC CRITERIA (CONT)
Avoidance

•   Persistent avoidance of stimuli associated to the trauma
•    E.g. thoughts, feelings, conversations
•   Activities people and places
•   Impaired memory of aspects of the trauma
•   Reduced interest or participation in usual activities
•   Feelings or detachment /estrangement from others
•   Restricted range of affect
•   Sense of shortened lifespan
COMMON TRAUMA SYMPTOMS- WITHIN
     PTSD DIAGNOSTIC CRITERIA (CONT)
Arousal

•   Persistent feelings of intense arousal
•   Difficulty falling asleep or staying asleep
•   Frequent irritability or angry outbursts
•   Impaired concentration
•   Hypervigilance
•   Exaggerated startle response

                                                  James A. Peck Trauma-Informed Treatment Best Practices 2009
ACCESS TO SERVICES
IMPACTS ON VOC ACCESING SERVICES

How does this impact on victims of crime accessing
  services?

VICTIMS ACCESS LINE

• Information and referrals
• Emotional support
• Crisis intervention
• Provides assistance with claim processes including counselling and
  compensation
• Receives concerns about the Charter
VICTIMS ACCESS LINE –A FIRST POINT
   OF CONTACT WITH VICTIM SERVICES

How does it operate – aim, staffing, roles and
  responsibilities

• Case management and claims management

• After Hours service

• Core understanding of trauma and a client -centred approach to service
  delivery.
WHO IS ELIGIBLE TO APPLY FOR
COMPENSATION AND COUNSELLING?

A person injured by an act of violence in NSW.
They could be a:
• Primary victim
• Secondary victim
ď‚· Family victim
APPROVED COUNSELLING


• 350 Approved Counsellors in NSW

• Initial 10 hours approved

• 12 further hours can be approved

• Families of homicide victims have 20 hours approved.

• Average of six hours per client
% Offences claimed in counselling and compensation claims lodged 2009/2010

45
                               43


40



35
                                    33
            32

30


                        25
25                 24
       23
                                                                         Counselling
                                                                         Compensation
20



15



10



 5                                             4
                                           3          3   3      3
                                                                     2
                                                                           0.4 0.4   0.6 0.6
 0
     Assault     Assault -   Domestic    Robbery   Homicide     Home     Abduction   Other
                  Sexual     Violence                         Invasion
COUNSELLING APPROAH-
            ADDRESSING TRAUMA
• Focused on the impact of the acts of violence

• Short to medium term based on counsellor‟s assessment and client‟s
  consent to participate in counselling – client driven

• Evidence based and centred on an assessment around impact of
  trauma on the person‟s wellbeing and functioning

• Recognition of “secondary” and family victims of trauma

•   Streamlining the application process
WHO ARE THE COUNSELLORS AND
  HOW ARE THEY SELECTED?

Victims Support and Rehabilitation Act 1996

• Support of Professional Bodies

• Evidence of training and experience working with a range of crime types
  and client groups

• Maintaining standards

• Role of Professional Advisory Panel
COMPENSATION PROCESS
Compensable injury to be over $7,500
Injuries include:
• Numerous physical injuries
• Psychological or psychiatric disorder
• 2 offence-based injuries – sexual assault and domestic violence
• Determined on balance of probabilities
• Requires supporting material including medical reports
• Time limit for lodging applications is 2 years
• Section 23A
• Urgent payments (interim awards)
REFORMING THE PROCESS TO MAKE IT
        MORE STREAMLINE

• Use of “Smartforms”

• Claims managers/ case managers

• More assistance „in house‟

• Increase in claims - managing the process for clients as sensitively as
  possible - telling bad news
COMPENSATION CLAIMS FOR
          PSYCHOLOGICAL INJURY

• A challenging process for applicants who have experienced trauma

• Guide for applicants

• Role of Authorised Report Writers ARWs

• Training for ARWs

• Maintaining quality of the service
FAMILIES AND FRIENDS OF
 MISSING PERSONS UNIT (FFMPU)


In NSW approximately 11,000 people per year are reported missing to
                             the Police

                          1800 227 772
                          02 8688 5423
                       9:00 am to 5:00 pm
                        Monday to Friday
              www.lawlink.nsw.gov.au/missingpersons
SERVICES PROVIDED BY FFMPU


• Crisis and ongoing counselling
• Information and referrals about searching agencies
• Advocacy and liaison with State and Federal Police
• Support and information on media and legal issues
• Support during times of reunion
• Publications, consultation and training for service providers
PROMOTING CONNECTEDNESS

A resource for service providers who find themselves working with
families and friends of missing persons in a variety of settings

Trauma informed guide to providing support – working with the
ambiguous loss experienced by this client group

Staying beside the client and the story they have about what has
happened and what they need to do in managing this liminal state of
being
MANAGING TRAUMA IN THE
                 WORKPLACE

Vicarious Trauma - July 2010 all staff participated in training
        • 51%increased awareness of VT
        • 24% increased capacity to manage VT
        • 88% felt more able to identify VT happening to them
        • 88% felt more able to manage their VT
        • 77% felt VS positively supported staff to manage VT
    – Staff had slightly elevated cognitive disruption
    – Most common VT symptoms of staff were re-experiencing, avoidance
       and arousal symptoms
MANAGING TRAUMA IN THE WORKPLACE

• Strategies:
   – Worked with EAPS to ensure they have experience and
      understanding of VT to provide appropriate counselling

   – Promotion of Well- Being Activities

   – Regular debriefing of staff

   – Development of a VT policy and management strategy
MANAGING TRAUMA IN THE WORKPLACE


• Accidental Counsellors

• Management of VT
   – Supervision
   – OHS
   – Managers Training
CRIMINAL JUSTICE SYSTEM

•   Retraumatisation

• Charter of Victims Rights

• Legal Proceedings– eg use of alternative evidence processes
CONTINUED CHALLANGES

• Recruiting experience counsellors and ARW‟s

• The Criminal Justice Systems understanding of trauma responses

• Reducing retraumatisiation in CJS

• Research on what works for victims
Mandy Young
               Director
           (02) 8688 8056
        Mandy_young@agd.nsw.gov.au

           Lynn Mitchell
A/Manger Policy and Service Delivery

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Trauma-Informed Victim Services

  • 1. VICTIMS SERVICES Trauma Informed Care
  • 2. OVERVIEW OF FORUM • Role of Victims Services • Key concepts in trauma informed practices • Impacts on victims accessing services • Counsellors and Authorised Report Writers • Managing Trauma in the Workplace • Trauma in the Criminal Justice System • Continued challenges
  • 3. ROLE OF VICTIMS SERVICES We provide support and information to victims of crime in NSW. We assist victims in their recovery and as they move through the criminal justice system. We oversee the Charter of Victims Rights.
  • 4. SERVICES PROVIDED • Victims Access Line • Approved Counselling Scheme • Compensation and Financial Assistance • Restitution • Families and Friends of Missing Persons Unit
  • 5. IMPORTANCE OF UNDERSTANDING TRAUMA MODELS AND APPROACHES • Trauma is a response to an event or series of events that happen to individuals • Responses to trauma are understood as normal reactions rather than evidence of individual pathology • Services to people who have experienced trauma such as victims of crime should be designed in support people in their recovery and not re traumatizing • Services should be welcoming and staffed by trained workers who have an understanding of trauma and its impact.
  • 6. KEY CONCEPTS IN TRAUMA INFORMED PRACTICES • A traumatic event is one where an individual experiences, witnesses or been exposed to an event that involved actual or threatened death or serious injury to themselves or others • Responses include intense fear, helplessness, and powerlessness • For victims of crime, this includes people who have experienced child abuse, sexual abuse, interpersonal violence, and domestic violence as primary or secondary victims • The impact of traumatic events maybe pervasive and impact on all aspects of a person‟s life and well-being
  • 7. COMMON TRAUMA SYMPTOMS- WITHIN PTSD DIAGNOSTIC CRITERIA Re-experiencing • Recurrent re experiencing of the trauma, ie flashbacks, nightmares, intrusive thoughts and nightmares • Intense psychological or physiological reactions to internal or external cues that represent some aspect of the trauma
  • 8. COMMON TRAUMA SYMPTOMS- WITHIN PTSD DIAGNOSTIC CRITERIA (CONT) Avoidance • Persistent avoidance of stimuli associated to the trauma • E.g. thoughts, feelings, conversations • Activities people and places • Impaired memory of aspects of the trauma • Reduced interest or participation in usual activities • Feelings or detachment /estrangement from others • Restricted range of affect • Sense of shortened lifespan
  • 9. COMMON TRAUMA SYMPTOMS- WITHIN PTSD DIAGNOSTIC CRITERIA (CONT) Arousal • Persistent feelings of intense arousal • Difficulty falling asleep or staying asleep • Frequent irritability or angry outbursts • Impaired concentration • Hypervigilance • Exaggerated startle response James A. Peck Trauma-Informed Treatment Best Practices 2009
  • 11. IMPACTS ON VOC ACCESING SERVICES How does this impact on victims of crime accessing services? VICTIMS ACCESS LINE • Information and referrals • Emotional support • Crisis intervention • Provides assistance with claim processes including counselling and compensation • Receives concerns about the Charter
  • 12. VICTIMS ACCESS LINE –A FIRST POINT OF CONTACT WITH VICTIM SERVICES How does it operate – aim, staffing, roles and responsibilities • Case management and claims management • After Hours service • Core understanding of trauma and a client -centred approach to service delivery.
  • 13. WHO IS ELIGIBLE TO APPLY FOR COMPENSATION AND COUNSELLING? A person injured by an act of violence in NSW. They could be a: • Primary victim • Secondary victim ď‚· Family victim
  • 14. APPROVED COUNSELLING • 350 Approved Counsellors in NSW • Initial 10 hours approved • 12 further hours can be approved • Families of homicide victims have 20 hours approved. • Average of six hours per client
  • 15. % Offences claimed in counselling and compensation claims lodged 2009/2010 45 43 40 35 33 32 30 25 25 24 23 Counselling Compensation 20 15 10 5 4 3 3 3 3 2 0.4 0.4 0.6 0.6 0 Assault Assault - Domestic Robbery Homicide Home Abduction Other Sexual Violence Invasion
  • 16. COUNSELLING APPROAH- ADDRESSING TRAUMA • Focused on the impact of the acts of violence • Short to medium term based on counsellor‟s assessment and client‟s consent to participate in counselling – client driven • Evidence based and centred on an assessment around impact of trauma on the person‟s wellbeing and functioning • Recognition of “secondary” and family victims of trauma • Streamlining the application process
  • 17. WHO ARE THE COUNSELLORS AND HOW ARE THEY SELECTED? Victims Support and Rehabilitation Act 1996 • Support of Professional Bodies • Evidence of training and experience working with a range of crime types and client groups • Maintaining standards • Role of Professional Advisory Panel
  • 18. COMPENSATION PROCESS Compensable injury to be over $7,500 Injuries include: • Numerous physical injuries • Psychological or psychiatric disorder • 2 offence-based injuries – sexual assault and domestic violence • Determined on balance of probabilities • Requires supporting material including medical reports • Time limit for lodging applications is 2 years • Section 23A • Urgent payments (interim awards)
  • 19. REFORMING THE PROCESS TO MAKE IT MORE STREAMLINE • Use of “Smartforms” • Claims managers/ case managers • More assistance „in house‟ • Increase in claims - managing the process for clients as sensitively as possible - telling bad news
  • 20. COMPENSATION CLAIMS FOR PSYCHOLOGICAL INJURY • A challenging process for applicants who have experienced trauma • Guide for applicants • Role of Authorised Report Writers ARWs • Training for ARWs • Maintaining quality of the service
  • 21. FAMILIES AND FRIENDS OF MISSING PERSONS UNIT (FFMPU) In NSW approximately 11,000 people per year are reported missing to the Police 1800 227 772 02 8688 5423 9:00 am to 5:00 pm Monday to Friday www.lawlink.nsw.gov.au/missingpersons
  • 22. SERVICES PROVIDED BY FFMPU • Crisis and ongoing counselling • Information and referrals about searching agencies • Advocacy and liaison with State and Federal Police • Support and information on media and legal issues • Support during times of reunion • Publications, consultation and training for service providers
  • 23. PROMOTING CONNECTEDNESS A resource for service providers who find themselves working with families and friends of missing persons in a variety of settings Trauma informed guide to providing support – working with the ambiguous loss experienced by this client group Staying beside the client and the story they have about what has happened and what they need to do in managing this liminal state of being
  • 24. MANAGING TRAUMA IN THE WORKPLACE Vicarious Trauma - July 2010 all staff participated in training • 51%increased awareness of VT • 24% increased capacity to manage VT • 88% felt more able to identify VT happening to them • 88% felt more able to manage their VT • 77% felt VS positively supported staff to manage VT – Staff had slightly elevated cognitive disruption – Most common VT symptoms of staff were re-experiencing, avoidance and arousal symptoms
  • 25. MANAGING TRAUMA IN THE WORKPLACE • Strategies: – Worked with EAPS to ensure they have experience and understanding of VT to provide appropriate counselling – Promotion of Well- Being Activities – Regular debriefing of staff – Development of a VT policy and management strategy
  • 26. MANAGING TRAUMA IN THE WORKPLACE • Accidental Counsellors • Management of VT – Supervision – OHS – Managers Training
  • 27. CRIMINAL JUSTICE SYSTEM • Retraumatisation • Charter of Victims Rights • Legal Proceedings– eg use of alternative evidence processes
  • 28. CONTINUED CHALLANGES • Recruiting experience counsellors and ARW‟s • The Criminal Justice Systems understanding of trauma responses • Reducing retraumatisiation in CJS • Research on what works for victims
  • 29. Mandy Young Director (02) 8688 8056 Mandy_young@agd.nsw.gov.au Lynn Mitchell A/Manger Policy and Service Delivery