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Winston Churchill Report

 

The Programme

PLACE ORGANISATION / PROJECT MAIN CONTACT
UNITED KINGDOM    
Coventry, West Midlands NSPCC Mark Dalton
Shrewsbury, Shropshire NSPCC ASOP Colin Watt
Black Country, 
West Midlands
NSPCC 
Black Country Project
John Taylor
Coventry Register Custodian Birgitta Lundberg
Stafford NSPCC 
Stafford Project
Fiona Richards
UNITED STATES    
Denver Colorado Perpetreation Programme 
Kempe Children's Center
Gail Ryan, M.A.
Denver Colorado Foster Care Project 
Kempe Children's Home
Heather Tausig, PhD
Denver Colorado Therapeutic Pre-School 
Kempe Children's Home
Lynette Disheroon 
Head Teacher
Denver Colorado Denver Children's Home Jerry Yager, Psy.D
Denver Colorado Foster Care Inirative 
Kempe Children's Home
Margaret Tulley 
M.S.W./L.C.S.W.
Denver Colorado Child Protection Team Andy Sirotnak MD
Denver Colorado Families First Joanne Blum
Larkspur, Colorado Emily Griffith Center Tony Hodes
Denver, Colorado Early Childhood Initiative Dr. Larry Edelman
Denver, Colorado Autism Clinic Judy Reaven, PhD
St.Paul's, Minnesota Adolescent Services 
Project Pathfinder
Janis Bremer, PhD
St.Paul's, Minnesota Adolescent Services 
Project Pathfinder
Dr. Mo Smith
St.Paul's, Minnesota Adolescent Services 
Project Pathfinder
Dr. Tim Wright
St.Paul's, Minnesota Adolescent Services 
Project Pathfinder
Julie Hanna, M.A.A.T.
Minneaplois, Minnesota Illusion Theater Karen Gundlach
St.Paul's, Minnesota Stop It Now! Yvonne Cournoyer
Minneapolis, Minnesota Sensibilities Inc. Cordelia Anderson M.A.
Minneapolis, Minnesota PACER Center Jennifer Basta
St.Paul's, Minnesota Injury & Violence 
Prevention Unit 
Department of Health
Amy Okaya M.P.H.
St.Paul's, Minnesota Minnesota Center for 
Crime Victim Services
Paula Weber

 

 

Primary Prevention
I chose to visit a number of organisations in the UK and the USA, which offered a wide range of primary prevention programmes.

The NSPCC and Stop It Now! engage in primary prevention by directing energy not only towards the general community, but particularly towards potential offenders, and send out the message that child abuse is a crime. Stop It Now! uses media campaigns to urge potential sexual offenders to reach out and seek help, and provides a phone in line to help them to take the first step towards stopping their abusive behaviours.
The N.S.P.C.C - United Kingdom
The NSPCC was founded in 1884 to protect children from abuse and neglect and to support vulnerable families, and today it remains the UK's leading charity specialising in child protection and the prevention of cruelty to children.

The NSPCC believes it has a moral responsibility to bring about changes that will put an end to child abuse. The NSPCC carried out an appraisal of its services, and it believes that cruelty to children can be eliminated in the UK.
In March 1999 the NSPCC launched it's ‘Full Stop' media campaign. This invites people of the UK and Northern Ireland to support the NSPCC in its aim of ending cruelty to children. It is working to increase communities awareness of issues surrounding child abuse, and to bring about changes in attitudes and behaviour towards children. The achievement of these goals relies on involvement of Organisations and individuals across all sectors of society, co-operating in five action programmes led by the NSPCC:

Protecting the Child
Child in the Family
Child in School
Child in Community
Child in Society

Real Children Don't Bounce Back. Media Campaign.

real-children

In March 2002, the controversial media campaign ‘Real Children Don’t Bounce Back’ Television Commercial was launched, on air for 60, 30 and 10 second formats. This was backed up by leaflets, a smart card, an improved website and billboard posters depicting the theme of the campaign and placed in major towns and cities across the United Kingdom. The film depicts a father being physically abusive to his son, which is a cartoon figure. The father hits, throws, shakes and stubs out a cigarette on his cartoon son. It culminates with the father throwing the cartoon son down the stairs where he lands behind a sofa. As the camera pans round the sofa, we see a real child laying on the floor, and on screen the words ‘Real Children Don’t Bounce Back’ appears with information to get help to prevent child abuse. Cartoon music is played throughout, and unlike real children, the cartoon characters bumps and bruises magically disappear. (NSPCC, 2001).

"Stop it Now", United States of America
Stop it Now! is a non – profit organisation, launched by Fran Henry in 1992, with the National Office based in Haydenville, Massachusetts. Fran’s beliefs were that individuals and society can change and challenge sexually abusive behaviours towards children. It is based on the premise that to prevent child sexual abuse adults need to be responsible for prevention, rather than children.
Since its inception, Stop It Now! has been testing a social marketing approach to preventing child sexual abuse. It aims to create long term and comprehensive social change through education, policy and research, to:

Develop awareness among people who are being sexually abusive or at risk of being sexually abusive to children.
Provide mechanisms for abusers and people at risk of abusing to stop the sexual abuse and seek help.
Work with families, peers, and people regarding methods to talk with those they know who may be sexually abusing a child.
Change the social, political, and public policy climate such as that child sexual abuse will be no longer tolerated.
Stop It Now! is based on US public health campaigns which have been successful in changing attitudes and behaviours related to such issues as drink driving, safer sex etc…

The program focuses on two main areas:

Changing the way target audiences deal with sexual abuse – moving the individuals awareness and behaviour from misinformation to meaningful action.
Working with the professionals who provide services or set policy for families who have experienced child sexual abuse to create policies that will encourage adults to take responsibility for their reactions.

Vermont

Findings:

1. Abusers will call for help:
Of the 657 calls received in the first four years, some of the findings were:

15% Were from abusers
50% were from people who knew the abuser and/or victim
The remaining 35% were made by agencies and requests for information.
The fact that people who abused called for help contrasts with society’s typical view that they will not seek help.

2. An increase in adults who can talk about sexual abuse:
There was indication of changes in awareness, in that the number of Vermont residents who could explain issues related to childhood sexual abuse shifted from 44.5% in 1995 to 84.5 % in 1999.

3. Adults need to develop better skills to stop abuse:
In 1995 27.5% of Vermont residents could name at least one warning sign of an adult/young person with sexual behaviour problems; in 1999 this had risen slightly to 38%

4. Abusers stopping the abuse:
Through interviews and surveys Stop It Now! Vermont, determined that:
118 people had voluntarily sought help for sexual behaviour problems
25 people had turned themselves voluntarily into the legal system
(Stop It Now! Report #5, October 2000)

Philadelphia
Since 1998, Stop It Now! Philadelphia has partnered with the Joseph J Peters Institute to launch Stop It Now! Philadelphia, with a focus on social marketing.

Minnesota
In 2002, Stop It Now! Minnesota commenced, and I was fortunate enough to spend two days with the Programme Director, Yvonne Cournoyer.
Stop It Now! Minnesota is based at Project Pathfinder, a non-profit public benefit corporation located in down town St. Paul, Minnesota. Their vision and mission is to prevent sexual violence and abuse by intervening at the earliest possible time. Yvonne had only been employed by Project Pathfinder for six weeks, but imparted a wealth of background information to me about Stop It Now!, and gave me an excellent induction into it’s operations. The National Office provides support to Yvonne with setting programme goals, technical assistance on program related issues, the sharing of useful strategies, and the development of media materials.

media-tools

 

community-action-tools

Yvonne outlined all aspects of developing a new Stop It Now! Site, and emphasised the importance of attracting FUNDING as a first, and getting initial ‘buy in’ from Government Systems for support of the concept of Stop It Now!
Yvonne had also recently been successful in gaining a funding grant from the Centre for Disease Control and Prevention (CDC) to further the aims of Stop It Now! Minnesota. The CDC is the US Federal Agency responsible for the prevention of health problems, and has been working on issues related to violence and public health for over fifteen years.

The Kempe Children's Centre. Denver, Colorado, U.S.A

kemp-centre

The Kempe Children’s Centre is based close to down-town Denver, dramatically set against the foothills of the Rocky Mountains. It is an internationally renowned research based organisation, and a thriving legacy to Dr C. Henry Kempe, one of the founding fathers in the field of child abuse, who described the ‘battered child syndrome’ in 1962.
It’s mission states "the Kempe Children’s Centre will provide and improve direct clinical services, improve clinical services delivery systems, and provide training, education, and consultation programs to prevent and treat child abuse and neglect in Colorado and throughout the nation"...
(Annual Report, 2001).

Many of the programmes at Kempe have implications for primary prevention.

Kempe Perpetration Programme

gail-ryan

My time at the Kempe Centre was based with Gail Ryan, M.A., Director of the Kempe Perpetration Programme. This programme not only works with young people who have sexually abused other children, but also continuously studies the dynamics associated with abusive behaviours, and factors that increase or reduce the risk of a young person going on to commit sexual offences as an adult. The programme is also the lead agency in the National Adolescent Perpetration Network, which facilitates communication between those people who work in this challenging field sharing knowledge and providing support.
During my two weeks at the Kempe Centre I worked with Gail to be accredited to provide three of her training curriculum. The first of these, ‘Understanding and Responding to the Sexual Behaviours of Children’ can be used with parents, professionals, and all those who have direct contact with children. It aims ‘to promote adult understanding of children’s sexual behaviour and to teach appropriate adult responses in order to be more aware and intervene earlier in the development of sexually abusive patterns’ (Ryan et al, 1988). The training promotes the development of healthy sexuality in children and young people, and offers an excellent model for primary prevention.

Kempe Community Caring Programme
One of the most well known primary prevention programmes is the home visitation programme, nurtured and developed by such visionaries as Dr Henry Kempe, and Dr David Olds, at the Kempe Children’s Centre. The original programme focussed on the use of universal home visitation programmes to help new families, and to provide support and education. Out of this has grown the Kempe Community Caring Programme. This has included providing home visitation to first time mums and their infants in Denver City, and provides education within the community to ensure the development of healthy mother-child relationships.

Families First
The Director of Families First is the inspiring Joanne Blum, who also had worked at the Kempe Children’s Centre. Families First is a Non-Government Organisation, based in the outskirts of Denver. The organisation aims to provide services that ‘strengthen family relationships before problems occur, before parents resort to terror and violence, before abuse and neglect’.
(Annual Report, 2001).

Some of the strategies used to reach these aims include:

Infant Massage Classes
Parent support and education groups. Workshops
A Family Support phone-in Line.
Structured Groups for Children
Families First also provides secondary and tertiary prevention within their Children’s Centre, a residential service for children in need of out of home care for intensive therapy.

Educating children, young people and adults about sexual violence, and how to respond to it is the most usual primary prevention strategy. The most common education programmes for children and young people are provided within public and private schools, and teach such skills as assertiveness, self-defence and saying ‘no!’ Many place the responsibility on the child, who is expected to protect themselves from bigger, more powerful young people and adults who are more cognitively skilled. They usually have a familiar relationship with the older person, who would be entrusted with their care.

I am concerned that prevention and education programmes for children and young people do not place the onus of responsibility for stopping abuse on the child or young person, but educate them about issues of abuse, and help increase their safety levels using exciting mediums to get messages across, rather than lectures and discussion based programmes. I was interested in programmes that would help children retain knowledge by being offered over time, rather than ‘one-offs’ and would also suit their differing developmental levels.

The Pacer Center, Minneapolis
The Parent Advocacy Coalition for Educational Rights Centre was founded in 1977 by parents of children and young people with disabilities to help other parents and families facing similar challenges. One of the ways they do this is by helping students, teachers and other educational professionals create accepting environments for students with disabilities.

The ‘Count Me In’ puppet show was developed for preschool and elementary aged school children to foster positive attitudes and acceptance of children with disabilities in their schools and communities. Such was the success of the programme that they developed the ‘Let’s Prevent Abuse’ Puppet shows in 1984 for children, their parents and professionals to create awareness and develop skills to prevent sexual, emotional and physical abuse. Since that time the puppet shows have been presented to over 80,000 students with excellent responses.

jennifer-basta

I was able to attend a puppet show with Jennifer Basta, the Puppet Co-ordinator during my time in Minnesota. Jennifer and two puppet volunteers presented the show to approximately 50 children. I was surprised by the puppets, which were the size of a five year old child. They are very cute multi-cultural puppets, with one girl puppet having a physical disability and requiring the aid of a wheel chair. The children loved the puppets, were very attentive, and interacted throughout the show with the puppets and the Jennifer, who was the show convenor.

The puppet shows:

Defined physical, sexual and emotional abuse
Discussed feeling of isolation and shame associated with abuse
Discuss how to talk about abuse, and
Looked at who children could tell (and tell) if they were abused.
Disclosures of abuse occur during and after the shows, and this did occur at the show I attended; there is a lot of pre and post show preparation by teachers, and also teachers and the School social worker are present at the shows if this occurs. Further action is then taken as appropriate.

illusion-theatre

The Illusion Theatre was founded in 1974 by Michael Robins, and aims to use the power of theatre, to facilitate personal and social change. It supports artists in their goal of producing new work that reflects a variety of cultural perspectives.

In 1977 the Hennepin County Attorney’s Child Sexual Abuse Prevention Programme and the Illusion Theatre collaborated to produce a nationally acclaimed sexual abuse prevention play. Since then the Illusion Theatre has developed an Education/Prevention Programme that works within society to address difficult issues, using theatre as an educational vehicle. The Illusion Theatre educational messages have reached an audience of over 3 million people world wide by incorporating the use of video and commercial television. I met Karen Gundlach, the Education Director, at the beautiful old theatre, to explore what the education programme could offer.

Their most exciting programme was the innovative TRUST Peer Education Programme. (Teaching Reaching Using Students and Theatre). This gives organisations the right to perform the Illusion Theatre’s educational plays within their own communities. Sites receive training, scripts, and direction from the Theatre Staff to enable High School Students to perform the plays for primary and high school students. Of particular interest were the four plays which focussed on sexual abuse and violence prevention.

Although primary prevention is often the area that receives the least funding, it is evident that there are numerous programmes that have been established, or are presently being researched, that offer great promise in this much neglected area of prevention.

Secondary Prevention
When we translate public health secondary prevention methods to sexual violence, then we begin to focus on interventions with individuals at risk. We want to detect and intervene early enough to minimise harmful effects, and provide support and therapy if required, when sexual abuse has already occurred. This would include improving the responses of adults to reports of disclosure by children and young people, whether they are parents, carers, or professionals.

Secondary sexual violence prevention must address the needs of those children and young people who are at risk of developing sexualised behaviours due to all forms of child abuse, those who have been in sexualised environments, and those who have been exposed to sexualised models of compensation. These groups of children and young people are usually over-represented in therapy programmes and foster care (Ryan,1997).

From a secondary prevention perspective, it also makes sense that if those people at risk of committing sexual offences can be identified before offending commences, and there is an understanding of what factors could motivate or influence someone to commit a sexual offence, then programmes that work towards alleviating these factors could be developed.

Identified risk factors include:

Child maltreatment and abuse, including witnessing domestic violence and sexualised environments
Being in out of home care.
Poor attachment with parents or other caregivers.
Violence condoned by society, for example, in the media.
The Kempe Theurapetic Pre-School
One of the most exciting secondary prevention programmes I visited was the Kempe Therapeutic Pre-school, which I was fortunate enough to participate in under the wings of Lynnette Disheroon, the Head Teacher. The Pre-school is based on the site of the Kempe Childrens Centre, and is a highly specialised therapy programme which works with disturbed three to six year old children who have been abused and neglected. The Pre-school offers a range of services, which supports children’s return or transition into regular pre-schools. The staff provide a safe, predictable environment that allows the children to develop trusting relationships, positive self-esteem and acceptable social interactions. Children who attend the pre-school may have a psychiatric diagnosis, but many do not.

The Pre-school runs for five days a week from 8:00a.m. – 12:00noon, and provides a healthy breakfast and lunch for the children. The average length of attendance at the Pre-school is three to seven months, and in the ten years of the Pre-school they have rarely had children return for further attendance. The children have daily sessions that focus on developing cognitive skills and feelings and managing conflict. They also receive therapy twice a week from the ‘Meeting Girls’, who are usually Psychologists on placement in the Pre-school. They focus on assessment and therapy, usually non-directive play therapy and cognitive behavioural therapy.

Kempe Infants in Fosterand Kinship Care
Another intervention which offers sound secondary prevention is the focus that Kempe has on providing services to children and young people in foster and kinship care, and supporting foster and kinship carers. I spent time with several professionals involved specifically in this area, where three main projects are being developed.

Dr Rob Clyman was passionate about the need to give foster children a voice on the policy table. He stated approximately 750,000 children were in foster care in the USA, 45% being infants and children. Millions of dollars have been spent on programmes that have been demonstrated not to work.

The Infants in Foster and Kinship Care holds great promise, and is a longitudinal research study. It offers services to every infant and child who enters foster care in Denver. It aims to have a demonstrated positive impact on the child’s developmental and mental health issues, reducing the need for interventions at a later stage and therefore easing psychological and emotional suffering, and the cost of expensive therapies at a later stage. I spent time with Margaret Tulley, M.S.W., who stated that their team was working with between one hundred and one hundred and twenty infants per year from age birth to eighteen months. Therapy was home based, and would be provided for the infant and carer, and if appropriate for the birth mother and baby.

Margaret also discussed a new project which has been funded initially for three years. This is a mental health project which places four clinicians in the District Health Service. They are available for consultation by case workers who are involved with children aged birth to five years, who are at risk. They may be at home, or in foster care. Training is also provided for foster parents, professionals, Judges and Attorneys, in fact anyone who might be involved with children at risk.