A therapeutic approach delivered by social workers reduces levels of trauma among children who have experienced sexual abuse, a study has shown.
The findings are from an evaluation of the NSPCC’s Letting The Future In project, which was largely delivered by social workers already experienced in direct work with children affected by sexual abuse, most of whom were then given additional training in therapeutic support.
Letting the Future In is an approach that involves providing therapeutic support to children aged between four and 17 who have experienced abuse and are living with a safe carer. Children receive four assessment sessions followed by up to 20 intervention sessions, including creative and play therapies such as painting, drawing and story-telling, and counselling. Carers are also offered up to eight sessions to help them support the child’s recovery.
Creative and play therapies
The evaluation, by Durham and Bristol universities, involved a randomised controlled trial comparing children who received the intervention immediately against those who were placed on a six-month waiting list before receiving it. The level of trauma was measured using the trauma symptoms checklist for children or young children developed by John Briere.
For children aged eight and over, the proportion experiencing the highest level of trauma fell from 73% to 46% after six months among those who received support immediately. There was no comparable drop among the group placed on the waiting list, which the report said showed the impact of the intervention.
For children aged under eight, there was little change over six months in either the intervention or waiting list groups, but there was some evidence of reduction in trauma for those who had received the intervention for a year, though this was based on a small sample size.
The majority of interventions were delivered by social workers and, for both age groups, creative therapies were the most commonly used intervention.
The average cost of the intervention per child was £2,300. This compares to an average cost of cases with a range of mental health problems seen by a multidisciplinary child and adolescent mental health service of almost £5,000 per child. An economic evaluation of the approach will be published shortly.
Largest trial of its kind
More than 240 families took part in the study across 18 NSPCC centres. It was the largest trial of its kind in the world for a sexual abuse intervention.
On average, children involved in the intervention received 16 individual sessions, with four more additional sessions involving their carers.
Jon Brown, NSPCC head of development and impact, said: “I think what this study is showing is that potentially there is a much wider range of professionals both within health and within social care who could deliver help for children, with the appropriate training and using a model like this.”
John Carpenter, lead author of the evaluation report, added: “Evidence-based therapeutic approaches are vital to help all children deal with the effects of sexual abuse. It is crucial that commissioners know what interventions work in ‘every day’ community based services to improve outcomes for children, in a cost-effective way.”