National Congress Social Workers Day August 18 th , 2010

1. National CongressSocial Workers Day August 18th, 2010

2. The Social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice and fundamental to social work. Effective and ethical social work occurs in Aotearoa New Zealand when based on the ANZASW Code of Ethics.

3. Process Diagram 1. DSM-IV diagnosis using ACC45 & ACC290 2. ACC reviews assessment/diagnosis Request more information • Gain more information by either: • Multidisciplinary Assessment Panel (MDAP),or • Initial Assessment & Recommended Treatment (IART) • Advise, plan treatment, set goals with client 1. Client referred by any provider using ACC45 & other information 9. Client may request re-entry to service via any provider. Provider will send letter to ACC MDAP may refer client directly for decision Fast stream referrals: Decision within 7 days Non-DSM IV referrals: Decision within 6 weeks End No 3. Is cover accepted? Longer-Term Cover & Treatment Lodgement & Triage Treatment Yes-Short Term Yes- Long Term 4. Short-term treatment & therapy (up to 16 sessions) 5. Treatment Completion Review & Recommendation (TCRR) End Yes 6. Is Self-management outcome reached ? No 8. Treatment for long term clinical need Yes • 7. Further treatment & either: • TCRR assessment, or • MDAP • Is self-management outcome reached? No Multidisciplinary Assessment Panel (MDAP)

4. Clinical Pathway vs. Code of Ethics • First Priority- Clients interests and welfare, social workers have to work accordingly • Clinical pathway discourages victims from seeking recovery through ACC • ACC encouraging professionals to breach the Code of Ethics by not putting the clients need first • Confidentiality- Clients information not to be disclosed, only the minimum required for the purpose should be given • Victims had to do a few assessments, diagnosed by qualified psychiatric or clinical psychologist • Diagnosis given has to meet criteria for the problem provided in the diagnostic system used • ANZASW think that it is a shocking way to rehabilitate • Tasks of social workers- Empower people to take charge of their own lives and wellbeing

5. ACC Discriminates against Maori and the Treaty of Waitangi • ACC have tried to adopt a bicultural stance • Maori are more likely to be a client for ACC subsidised counselling • Maori women experience twice the rate of sexual violence than any other women • Maori women’s needs have not been prioritised by ACC • Peter Jensen is the Senior Medical Advisor to ACC and a researcher and wants to do the right thing for Maori

6. ACC DataOctober 2009- February 2010

7. The New Zealand Herald Research October 2009- June 2010

8. ACC Costs • ACC stated that the new changes were not a cost cutting plan but in fact a better way of recovering and rehabilitating sexually abused victims • ACC have removed their online annual reports from 2008 • Inconsistent data • $ 3.5 Million spent in a year for ACC staff travel costs • Nick Smith (Minister Of ACC) proposes higher levies to cover excessive ACC costs but… • $ 1 billion profit in levies in 2008 • Contradicting outcomes and costs • If ACC cover is cut, society will pay for it somehow • Untreated injuries lead to self harm and substance abuse • Counselling leads to higher wellbeing, employed citizens and community contributors • Clinical Pathways puts pressure on NGO’s • Social Workers are feeling the burden • ACC changes is just as much our responsibility and issue as theirs, we must advocate for better policies

9. In Support of the ACC Sensitive Claims Clinical Pathway are: Hon Nick Smith Some ACC Staff

10. Those Opposed to the ACC Sensitive Claims Clinical Pathway are: Mental Health Foundation Te Whariki Tautoko Incorporated Society Specialist Sexual Violence Agencies The Massey Research Team N.Z Psychological Society National Collective of Independent Women’s Refuges Doctors for Sexual Abuse Care N.Z Association of Psychologists N.Z College of Clinical Psychologists National Council of Women of N.Z ANZASW N.Z Association of Counsellors

11. Issues and Concerns • Lack of Professionals Involved - Lack of consultation of professionals during the planning of ‘clinical pathways’ and the up and coming review. “ without effective consultation and input from expert clinicians working in the area or with patient advocacy groups” (Scoop, 2009) Lack of representation of experienced sexual abuse counsellors/ psychotherapists to assess and assist victims “The new pathway has limited the amount and availability of qualified and experienced counsellors/physiotherapists (whom were already providing initial assessments for acc sensitive claims) to assist this cliental” (The New Zealand Psychological Society, 2009).

12. Issues and Concerns • New Procedures and Processes Deemed Harmful – • Long waiting for and during assessments Victims having to disclose their case to too many various people will cause more trauma. High priority list does not include ‘suicidal people’ TangataWhenua and children procedures regarding ‘clinical pathways’ were not consulted or planned for first “We'll contact you shortly about developing specific processes for Maori and children” (ACC, 2009) • Stigma Associated with the Status ‘Mental Injury/Illness’ - Long term effects for future livelihood such as employment and finances. “If you undergo a DSM IV assessment by a psychologist or psychiatrist, it will be determined that you have experienced mental illness as a result of trauma. This will have implications in the future when seeking assistance in terms of his/her mortgage, access to insurances, and opportunities for employment”(The National Council Women of New Zealand, n.d) Affects the client’s well-being and rehabilitation

13. Discrimination • Discriminations – Women “Indirect discrimination occurs when an action or policy that appears to treat everyone the same way actually has a discriminatory effect on a person or group of people because of a characteristic of that person or group that is covered by the grounds of discrimination in the act” (Human Rights Commssion,2008 ) Tangata Whenua Victims living in rural areas People whom have had some form of dysfunction through childhood or in their present lives Prisoners seeking help “The Human Rights Commission works for a fair, safe and just society, where diversity is valued, human rights are respected, and everyone is able to live free from prejudice and discrimination” (Human Rights Commission, n.d)

14. Possible Solutions • Awareness & education to social workers and the public • Organise a conference/formal meeting with government and policy makers • Write submissions to parliament • Organise a rally and/or protest • Remove revenue all together from ACC and create a new government agency specific to sexual abuse • Force a independent clinical review to the minister of ACC (Nick Smith) or refer your concerns onto the independent clinical review panel (Dr Barbara Disley)

15. References • ACC. (2009). New Clinical Pathway for Sensitive Claims Clients. Retrieved from http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_communications/documents/reference_tools/prd_ctrb118366.pdf • ACC. (2009). Sensitive claims- provider newsletter. Retrieved from http://www.acc.co.nz • Action Against ACC Funding Cuts For Counselling. (2010). Retrieved from http://gfrerichs.typepad.com/my_weblog/2010/03/action-against-acc-funding-cuts-for-counselling.html • Aotearoa New Zealand Association of Social Workers. (2008). Code of ethics =: Kote tauākī tikanga. Christchurch, N.Z: ANZASW • Aotearoa New Zealand Association of Social Workers. (2010). Retrieved from http://anzasw.org.nz • Aotearoa New Zealand Association of Social Workers. (2010). Submission to the Independent clinical review of the ACC claims clinical pathway. Retrieved from http://www.anzasw.org.nz/user/file/609/ANZASW%20submission%20to%20independent%20review%20June%202010.pdf • Beynen, M. (2010, January 8). Review of ACC sexual-abuse claims. The Press. Retrieved from http://www.stuff.co.nz • Collins, S. (2010, April 27). Denied help for sexual Abuse, dead days later. The New Zealand Herald. Retrieved from http://www.nzherald.co.nz • Collins, S. (2010, June 18). ACC failing to help most sex abuse victims. The New Zealand Herald. Retrieved from http://www.nzherald.co.nz • Frerichs, G. (2010). Action Against ACC Funding Cuts For Counselling. Retrieved July 12, 2010 from http://gfrerichs.typepad.com/my_weblog/2010/03/action-against-acc-funding-cuts-for-counselling.html • Human Rights Commission. (2008). Fact sheet #01 [handout]. Auckland New Zealand: Human Rights Commission.

16. References Cont. • Human Rights Commission. (n.d). What is the Human Rights Commission? [Brochure]. Auckland, New Zealand: Human Rights Commission. • Miller, J. (2004). The impact of specific third-party funding on what counts in New Zealand counselling. Retrieved July 12, 2010 from http://ir.canterbury.ac.nz/bitstream/10092/2795/1/12595171_The%20impact%20of%20funding.pdf • NCWNZ Submission to the ACC review Panel. (2010, June). ACC changes to sexual abuse counselling. Retrieved from http://www.ncwnz.org.nz • Scoop. (2009). ACC sexual abuse counselling cuts. Retrieved from http://www.scoop.co.nz/stories/PO0910/SOO359.htm • Scoop. (2009). DSAC Concerns Over New Clinical Pathway. Retrieved from http://www.scoop.co.nz/stories/PO0911/SOO270.htm • Sensitive claims Clinical Pathway for new claims. (2009, 19th October). Retrieve from http://www.psychotherapy.org.nz/uploads/SCU%20Clinical%20Pathway.pdf • Sensitive Claims Unit (SCU). (n.d). Clinical pathway- Frequently asked questions. Retrieved from http://www.psychotherapy.org.nz/uploads/ProviderFAQs(FINAL).pdf • The National Council of Women of New Zealand. (n.d.). ACC changes to sexual abuse counselling. Retrieved from http://www.ncwnz.org.nz • The New Zealand Psychological Society. (2009). Media release. Retrieved from http://www.parliament.nz/NR/rdonlyres/8F1FBF10-95B5-42DC-8A67-B42576445253/142254/49SCTIR_EVI_00DBHOH_BILL9637_1_A28520_NewZealandAs.pdf • The swamp report. (2009). Acc changes discriminate against Maori women. Retrieved from http://theswampreport.blogspot.com/search/label/Maori • TVNZ Te Karere Maori News. (2009, December 8). ACC accused of discriminating against Maori women. Retrieved from http://youtube.com