DVRAM: messages from Northern Ireland and Barnet pilot evaluations

1. DVRAM: messages from Northern Ireland and Barnet pilot evaluations Martin C Calder Calder Training and Consultancy www.caldertrainingandconsultancy.co.uk

2. 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

3. 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?

4. INPUTS TO OUTCOMESAchieving Success in Child Protection and Domestic Violence • Local research in N.I. conducted by Patricia Nichol Programme Manager, UCHT in 2001. 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

5. First steps • Steering Groups were established to manage pilot project within SHSSB & UCHT. • Timeframe – six months SHSSB Oct 03 – Mar 04 UCHT Nov 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 Children’s 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.

6. Importing and extending the ONTARIO model

7. 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.

8. How do we measure the outcomes from this assessment? • Cardiff’s Women’s Safety Unit-15 high risk factors associated with domestic abuse • Research Home Office –Research paper 217- Domestic Violence Offenders: characteristics and offending related needs. 2003 • 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.

9. 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.

10. 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 Perpetrator’s attitude to the abuse Additional Vulnerabilities Age of victim Victim’s personal vulnerabilities-isolated- locality. Age of perpetrator Disability Issues for Victim, children and/or perpetrator Cultural Issues within family Domestic Violence Threshold Scales

11. 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

12. 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

13. 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

14. 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.

15. 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.

16. 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.

17. 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.

18. 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.

19. 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.

20. 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.

21. 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.

22. 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.

23. 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.

24. 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

25. 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.

26. 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 2007-9

27. Mid point evaluation January 2008 • Mentoring • Training • DVRAM

28. 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

29. Also provided input on engaging with perpetrator, children’s 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

30. 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 didn’t apply immediately and lacked confidence down the road

31. 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…

32. DV requires many assessments

33. Indirect tools • Centile charts • GCP • NOFT • Adult mental health • Substance misuse

34. 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

36. 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

37. CAFCASS Toolkit (versions 1&2)

38. Different risk focus (Bell, 2006)

39. Integrated risk assessment tools and focus: criminal justice • Actuarial risk tools • Numerous risk frameworks • VAI • CBI • SARA • SPECCSVO • Matrix 2000

40. DVRAM as integrative framework?

41. Differential risk focus • Risk of actual or likely significant harm? • Risk of re-offending? • Risk of relapse?

42. Common language and focus?

43. 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

44. Some evidence of downplaying of threshold scale scores • Huge coexistence of alcohol and drug issues and challenge of assessment and intervention focus/priority

45. 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)

46. 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

47. Production of an accessible flowchart for staff • Greater guidance on • Understanding the dynamics of an abusive relationship • Women’s processes of help-seeking in domestic violence • Offering case examples to help staff differentiate between the severity levels

48. 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

49. 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

50. 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