Department for Child Protection and Family Support

This paper draws on three studies conducted in Australia, Canada and Ireland which explore the factors influencing research utilisation in the child protection sector in each country. The paper recognises that research uptake is complicated by a number of factors. It also acknowledges critiques which cite the equally significant influence of ideologies, context, unpredictability, time constraints and political expediency. However, all three studies recognised the increasing importance of evidence‐based practice. The methods used in the three studies were not identical but the frameworks used were sufficiently similar to enable the classification of both common and dissimilar barriers and facilitators to research use. Those which they identified were categorised into four types: individual, organisational, environmental and characteristics relating to the nature of research material. Implications were identified for policy makers, service providers and research producers. The point was made that we now live in a period where unprecedented means of knowledge transfer and exchange provide unique opportunities to improve the lives of children and families. Copyright © 2013 John Wiley & Sons, Ltd. ‘All three studies recognised the increasing importance of evidence‐based practice’ Key Practitioner Messages Avail of opportunities to attend learning events. Draw on research findings when conducting assessments, writing reports, devising intervention plans, evaluating programmes and tendering for funding. Establish links with research centres. Become involved in the conduct of research. Support colleagues (champions) who display particular interest and motivation in the use of research evidence by recognising and/or rewarding effort. Avail of opportunities to undertake further study that includes a research component. ‘Establish links with research centres’

Abstract Residential group care workers are frequently required to support children with extremely challenging and aggressive behaviour. Our knowledge about the tensions that may exist for workers that manage difficult behaviour is theoretically and empirically underdeveloped. The aim of this exploratory study was to contribute to our understanding of the dynamics of behaviour management in the residential environment by identifying the worker‐reported tensions involved in the management of challenging and disruptive behaviour. Seventeen S outh A ustralian residential group care workers participated in semi‐structured interviews in which they were asked to describe their management of behaviour. These interviews were subjected to thematic analysis. The analysis revealed several dynamics that influence workers' management of challenging behaviour: the sense of parenting at a distance, the pressure for consistency, the desire for balance between control and connection, the desire for normality and the inconsistent nature of relationships. These findings contribute to our knowledge about the interpersonal context in which behaviour is addressed in the residential group home and enhance our understanding of the unique tensions that workers' experience in managing behaviour in the residential environment. The findings have implications for the development of staff training and the support of residential care workers managing challenging behaviour.

Along with major changes in mood, people living with bipolar disorder (BD) often experience recurrent hospital admissions, feelings of failure and hopelessness, social stigma, underemployment, and a loss of independence. In this study we explored the experiences of loss, coping, and recovery in a community sample of women living with BD. Ten women each participated in a semistructured interview. We used the constant comparative method to analyze the data. We identified three themes from the data: identity bound by the diagnostic label, multidimensional effects of the bipolar disorder identity, and strategies for renegotiating identity. For these women, recovery involved an ongoing process of balancing their sick self with their healthy self. The findings contribute to conceptualizations of loss, coping mechanisms for dealing with loss, and the relevance of loss in recovery for people living at the margins with BD.

Internationally, there are few studies that have trialled structured intervention programmes designed to prevent excessive weight gain or combat existing overweight/obesity for young people living in out‐of‐home care. The Healthy Eating, Active Living (HEAL) programme was designed to address this limitation and is, to our knowledge, the first programme that simultaneously encourages young people and their carers to engage in a healthy lifestyle. This is the second of two papers presenting the HEAL evaluation. The aim of this study was twofold: first, to explore the experiences and opinions of key stakeholders regarding the intervention programme; and second, to understand the key enablers and barriers to successful implementation of the HEAL programme in residential care. Seventeen carers and ten programme coordinators participated in semi‐structured interviews. Findings demonstrated that HEAL was considered a valuable adjunct to the residential care programme, and was successful in raising awareness about the importance of leading a healthy lifestyle. Positive behaviour change among the young people and carers' dietary, physical activity and sleeping habits, and the development of independent living skills were described. Barriers to implementation included leadership support and professional development of carers. Recommendations are made to improve implementation, particularly around the importance of increasing stakeholder ‘buy‐in’. Copyright © 2017 John Wiley & Sons, Ltd. Key Practitioner Messages There is a need to address the lifestyle habits of young people in residential care. Raising awareness is an important first step, but must be supplemented with supportive environmental change to enable lasting, healthy outcomes. Carer capabilities need to be strengthened so that they can effectively manage challenging behaviours, yet still address the lifestyle habits of young people in care. Stakeholder ‘buy‐in’ and a programme champion are critical to implementation of healthy lifestyle programmes in residential care. ‘The first programme that simultaneously encourages young people and their carers to engage in a healthy lifestyle’

This paper presents a qualitative evaluation of Operation RESET: a multi-agency child protection strategy for remote Western Australian Aboriginal communities. RESET is a proactive engagement strategy involving a mobile multi-disciplinary specialist child abuse team comprising detectives and social workers. It is underpinned by the principles that preventing and responding to child sexual abuse must be a shared responsibility, address the underlying causes and contextual issues and enhance children's safety and well-being by empowering families and communities. The evaluation procedure consisted of in-depth interviews with 64 stakeholders of various backgrounds and affiliations who lived or worked in regions where RESET had been deployed for the past 18 months. Collectively, the interviews revealed strong support for Operation RESET's implementation and outcomes. Stakeholders highlighted four elements as being valuable components of the reform: the programme's proactive outreach approach, dedication to capacity building, holistic focus and the establishment of relationships that facilitated trust. These findings are discussed within the broader literature and suggestions for further research are offered.

This study presents an evaluation of Operation RESET, a community engagement intervention designed to help remote Indigenous communities and human service agencies to uncover, respond to, and prevent child sexual abuse. The primary aim of this evaluation was to determine whether the intervention was associated with increased reporting. Data were obtained for six Western Australian regions between 2007 and 2012. Number of reports and arrests significantly increased in the intervention areas during the intervention compared with the pre-intervention time period but not in the control areas. Arrest rates significantly increased during the intervention and increased further following the intervention. There were no changes in arrest rates in regions that did not participate in the operation. This evidence suggests that the reforms led to a marked improvement in some key outcomes for Indigenous victims of child sexual abuse and supports the adoption of this collaborative approach by other jurisdictions.

OBJECTIVES: To compare the health of neonates born to women who experienced family and domestic violence (FDV) 12 months prior to birth, with the health of neonates born to women with an earlier history of FDV and women with no history of FDV. METHODS: A retrospective cohort of women who experienced FDV within 12 months of birth (antenatal FDV [AFDV]) (n = 1230) was identified using data from the Western Australia (WA) Police Force Incident Management System and WA Hospital Morbidity Data Collection. Two comparison cohorts were used, the first including women with a history of FDV (HFDV) 12-60 months prior to birth (n = 1549) and the second with no history of FDV (NFDV) recorded (n = 3690). Hospital, birth, mortality, and congenital anomaly data were used in generalized linear models to examine and compare neonatal health outcomes. RESULTS: Women in the AFDV group had higher proportions of factors associated with poor neonatal outcomes including smoking (42.4%), substance use (23.0%), and mental health disorders (34.8%). Neonates born to AFDV mothers had significantly higher odds of congenital anomalies (OR: 1.51, 95% CI: 1.18-1.94), low birth weight (1.74, 1.45-2.10), and preterm birth (1.48, 1.22-1.79) compared with neonates born to NFDV mother. Neonatal health outcomes in those born to AFDV women were not significantly different from those born to HFDV women. CONCLUSIONS: Antenatal and historical FDV were associated with poor neonatal health outcomes. Additional pregnancy and social support should be offered to women who have experienced FDV during or prior to pregnancy.

Abstract Limited research has directly sought the input of parents involved in the child protection system during pregnancy and with their infants. As the focus of these policies and practices, parents have a unique and important insight not available to others, so it is vital to obtain their input. As part of a larger Australian study, qualitative interviews were undertaken with 13 parents asking about their views and experiences. Parents predominantly became involved with child protection services during pregnancy through a prenatal report. Parents who previously had their newborn removed from their care described it as sudden and unexpected, leaving them distressed and unsupported post‐removal, with a growing list of requirements for them to see their baby or for restoration to be considered. Domestic violence was a particular issue of concern for some mothers who expressed distress that their partners, perpetrators of violence, were allowed access to their infant with fewer requirements than for them. Improvements recommended by the parents included greater communication and preparation for the removal, better recognition of improvements in their situations and increased supports to be provided to parents both pre‐ and post‐removal. Parental experiences provide an important guide to improving child protection practice with these families.

The paper reflects on developments in leaving care policy and practice in Western Australia (WA) and nationally from the mid-1990s. The review of national and some international literature suggests that current Australian policy and practice shows a ‘systems stuckness’ that requires a more potent form of annual auditing and reporting of jurisdictional leaving care outcomes. The review of mostly Australian publications focusing on leaving care and the risk of homelessness includes reflections on recent developments in leaving care services in England, which recognise and restore relationship-based services for care leavers. Finally, the history, vision and initial impact of the Living Independently for the First Time (LIFT) Project, a case study of learning by doing, is outlined. The authors and their colleagues from the Department for Child Protection and Family Support (Midland District), Swan Emergency Accommodation (now known as Indigo Junction) and the Housing Authority of WA have collaborated to design and develop the LIFT Project. This initially unfunded action-research strategy involves inter-agency policy and practice designed to prevent homelessness of vulnerable care leavers.

Abstract This paper adds to the limited evidence base around documentary representation of the wishes, feelings and views of children and young people involved in the child protection system. It presents the findings of a critical discourse analysis of 114 documents relating to 28 children and young people in the North of England who were the subject of a child protection conference (CPC) due to having experienced significant harm or the high likelihood of significant harm occurring. Three dominant and interlayering discourses were identified: a discourse of childhood, a discourse of participation and a discourse of professional social work practice. While some children and young people came to life in the reports and were afforded a unique identity, others were invisible and their views were marginalized. The findings support a dominant discourse of the unseen and unheard child, with participation normally mediated by power relationships between adults and children, and which marginalizes the experiences of children through a structurally constructed lens of risk and vulnerability. The findings signify the need to establish assessment practices and case reporting systems in which children are heard themselves as well as reported on by others.

TITLE: Alcohol-related harm in emergency departments: linking to subsequent hospitalizations to quantify under-reporting of presentations. AIMS: To quantify the proportion of emergency department (ED) presentations that could be identified as alcohol-related when linking to a patient's subsequent hospitalization, compared with using ED data alone, and to assess that comparison according to the change in alcohol harm rates over time and potential variations within subpopulations. DESIGN: A retrospective study using linked hospital administrative data to identify ED patients who had subsequent alcohol-related hospitalizations. SETTING: Western Australia. PARTICIPANTS: A total of 533 816 Western Australian young people (246 866 females and 286 950 males), aged 12-24 years. MEASUREMENTS: Whether or not presentations of young people to ED could be identified as alcohol-related, and for those that were not, how many had a subsequent alcohol-related hospitalization. Rates and proportions of alcohol-related harm for both methods of ascertainment were estimated by sex and Aboriginality across different age groups. FINDINGS: Alcohol-related hospitalizations that followed an initial presentation at ED allowed the identification of an additional 19 994 alcohol-related presentations (95% increase). Linking to additional hospitalization information also resulted in significant variation in alcohol-related harm trends. In particular, trends in alcohol-related ED presentations for 21-24-year-old males were stable to slightly increasing using only ED data, but decreased after linking with hospitalization data (P < 0.05). Similarly, trends among Aboriginal persons aged 21-24 shifted from increasing using only ED data to being stable in comparison to presentations using subsequent hospitalizations (P < 0.05). CONCLUSIONS: Among young people in Western Australia, twice as many emergency department presentations could be identified as being alcohol-related using diagnosis information from subsequent hospitalizations compared with emergency department data alone. When supplemented with hospitalization data, trends in alcohol-related harm presentations become significantly different within some subpopulations compared with using emergency department presentation data alone.

This study aimed to evaluate a scale to measure attitudes to child sexual abuse (CSA) in remote Australian Indigenous communities. The scale was developed to gauge attitudes that may be inhibiting the reporting of cases of CSA to police, as well as to evaluate whether interventions that focused on collaborative relationships between community members and police resulted in changes in attitudes. Participants included service providers living outside the community (58%), community members (living within the community; 9%), and service providers who were also community members (33%); 18% of participants identified as Indigenous. Principal components analysis revealed a nonintuitive six-factor solution that did not support the original four concepts. Four intuitive factors emerged from an abridged version of the scale: entrenched issues, personal understanding and knowledge, communication between community and government, and community action. The scale detected significant differences between community status and between Indigenous status groups on some factors.

• Being raised by and within ones' First Nations community, among one's mob and fully immersed in culture, is a fundamental part of the First Nations being. • Shifting towards systemic transformation through increased First Nations self-determination and control of OOHC systems and placements. • The Minintitja Care Model is an example of the power and promise that First Nations self-determination holds to deliever improved outcomes and accountability. • A Funddamental redesigning of OOHC services are delivered to First Nations children in Australia by drawing on First NAtions knowledges, traditions and values. Being raised by and within ones’ First Nations community, among one’s mob and fully immersed in culture, is a fundamental part of First Nations being. This is an aspect of First Nations being that has been disrupted through colonial practices targeting First Nations families, such as the Stolen Generations where 10–30% of all First Nations children were forcibly removed from their families in the twentieth century. It also continues in the contemporary through statutory child removals in Australia, where the continued overrepresentation of First Nations children in Australian child protection and OOHC systems has resulted in community concerns of another Stolen Generations. Shifting towards systemic transformation through increased First Nations self-determination and control of OOHC systems, this article describes an innovative model of kinship care, the ‘Minintitja Care Model’, that one First Nations community designed and delivered in rural New South Wales, Australia. The Minintitja Care Model is an example of the power and promise that First Nations self-determination holds to deliver improved outcomes for First Nations children in OOHC in Australia. We argue that it evidences the importance of fundamentally redesigning how OOHC services are delivered to First Nations children in Australia by drawing on First Nations knowledge, tradition and value. Yet redesigning a system that was not built for the benefit of First Nations children and families requires more than reform: it requires the bravery to envision new possibilities by drawing on ancient wisdom. This, we contend, is aligned with the tenets of abolition, as applied from a First Nations standpoint.

Current child pornography laws in Australia extend to cases where minors transmit sexually explicit material of themselves or others via digital communication (‘sexting’). This is the first study examining attitudes of the Australian adult public regarding criminal laws that can apply to sexting by minors. A sample of 285 Australian adults completed an online questionnaire that presented a scenario concerning adolescent sexting. Participants completed measures of perceived responsibility and deservingness of penalty for both the sext sender and recipient who, in some cases, also forwarded the sext. Overall, support for legal penalties for adolescent sexting was low, except in the case of non-consensual distribution of sexts. The results highlight the public's concern with the non-consensual forwarding of sexts, providing support for calls to distinguish between consensual and non-consensual sexting in legislation and educational and public campaigns.

INTRODUCTION: After a first alcohol-related hospitalisation in youth, subsequent hospitalisations may demonstrate an increased risk of further alcohol-related hospitalisations, but there is no existing data on this. METHODS: A retrospective longitudinal study between July 1992 and June 2017 using linked hospital administrative data identified 23 464 Western Australian young people [9009 (38.4%) females and 14 455 (61.6%) males], aged 12-24 years hospitalised for at least one alcohol-related harm (ARH) episode of care. Cox regression was used to estimate hazard ratios (HR) between risk factors and repeated alcohol-related hospitalisation after the first discharge for ARH. RESULTS: Of those admitted for an alcohol-related hospitalisation (n = 23 464), 21% (n = 4996) were readmitted for ARH. This high-risk sub-group comprised 46% (n = 16 017) of the total alcohol-related admissions (n = 34 485). After the first discharge for ARH, 16% (804) of people who experienced an alcohol-related readmission were readmitted within 1 month, and 51.8% (2589) were readmitted within 12 months. At increased risk of readmission were Aboriginal people and those with prior health service contacts occurring before their first alcohol-related hospitalisation, including illicit drug hospitalisations, mental health contacts and, in a sub-analysis, emergency department presentations. DISCUSSION AND CONCLUSIONS: The probability of a repeated ARH hospitalisation was highest in the first month after initial discharge. There is a high-risk sub-group of young people more likely to have a repeat ARH hospitalisation. This represents an opportunity to provide interventions to those most at risk of repeated ARH.

Family and domestic violence (FDV) has increasingly been recognised as a major societal issue globally (World Health Organisation, 2021). As research continues to highlight the nature and extent of FDV, growing attention has turned to the impact of FDV on children and young people's safety and wellbeing, highlighting that those exposed to FDV experience a multitude of long-term internalising, externalising and trauma symptoms (Evans et al., 2008; Jenney & Alaggia, 2018). It is estimated that between 133 to 275 million children globally are exposed to at least one incident of FDV each year (Pinheiro, 2006). More recent localised estimates suggest that in the US 17.3 per cent of children had witnessed assault between parents/caregivers in their lifetime (Finkelhor et al., 2013), while across low-income and lower-middle-income countries children's exposure to intimate partner violence was estimated to be 29 per cent (Kieselbach et al., 2022). Considering this, global changes have been enacted to improve child protection policy and legislation and better reflect children and young people exposed to FDV as at risk and in need of protection (Australian Institute of Health & Welfare [AIHW], 2021a; Black et al., 2008). In many Australian states and territories, exposure to FDV is formally recognised in legislative definitions as grounds for a child in need of protection. However, exposure to FDV is not always represented as its own category of harm in data. For example, Australian population-level statistics report four harm types including emotional abuse, physical abuse, sexual abuse and neglect (AIHW, 2021a). Exposure to FDV is commonly incorporated within the definition of emotional or psychological abuse (AIHW, 2021a; Australian Institute of Family Studies [AIFS], 2019). Australian child protection population-level statistics therefore report on emotional abuse broadly, inclusive of children exposed to FDV (AIHW, 2021a). Researchers have examined children's exposure specifically to FDV using fixed-field child protection administrative data at the jurisdictional level. These data are recorded as structured, readily extractable pre-set fields (called fixed fields) in an administrative child protection system. For example, Shlonsky et al. (2019) found that 16 per cent of reports to child protection in New South Wales, Victoria, and Western Australian between 2010/11 and 2014/15 related to FDV, with an increase of 25 per cent across that time. Similar rates have been found in prenatal reports to child protection in the Australian Capital Territory, where FDV was the reason for 13.4 per cent of reports (Taplin, 2017). While fixed-field data provide an indication of the extent of children's exposure to FDV, relying on these high-level operational data is limited for two key reasons. First, operational data are not primarily collected for research purposes. Instead, the information is collected and recorded, typically by social workers, as a part of the day-to-day operation and service delivery of child protection departments. In requesting fixed-field data from data custodians within child protection departments, researchers select the relevant data from an established list of available fields used in client management systems. Due to the availability of information routinely recorded about harm type in fixed-field data, using these data researchers typically can only report on one (primary) or two (primary and secondary) types of harm. However, it is the norm for children known to child protection to experience multiple forms of harm (Moore et al., 2015; Price-Robertson et al., 2013). While relevant child protection authorities can access the nuanced report details to understand the (potential) multiple harm types, researchers using fixed-field data cannot sufficiently capture a complete picture of the child's experiences. Secondly, the recording of a primary and secondary harm type often requires a report to be ‘screened in’ for a child protection response (i.e. those meeting the threshold for abuse and neglect), meaning that ‘screened out’ reports are not examined. By definition, screened-out notifications should not contain abuse or neglect. However, the 2016 South Australian Child Protection Systems Royal Commission assessed a small selection of notifications screened out as notifier-only concerns (i.e. the notification is insufficient or vague, the notifier lacks credibility or the notification does not meet the definition of abuse or neglect), including some that contained concerns relating to children's exposure to FDV. The Child Protection Systems Royal Commission (2016) found that only two of the 20 examined reports would not have required a response from the department. Hence, FDV may be significantly underestimated in studies that use fixed-field information from screened in reports alone. In recognition of these limitations, research has started to examine the narrative information recorded in child protection reports, further highlighting the potential underestimation of risk. For example, in a recent study in Australia by Meiksans et al. (2021), a much higher level of intimate partner violence (70 per cent) was identified when examining prenatal child protection report narratives compared to that found in previous research using fixed-field data (13.4 per cent; Taplin, 2017). While such a considerable discrepancy between rates of similarly sized Australian samples points to the restrictive nature of fixed-field data, these samples are not directly comparable because they are from different Australian jurisdictions. However, considering the increased reporting of FDV (Shlonsky et al., 2019) this potential underestimation of child exposure to FDV warrants further investigation. This study was approved by the Aboriginal Health Council of South Australia, Aboriginal Health Research Ethics Committee (Protocol #04–17-718) and the University of South Australia Human Research Ethics Committee (ID: 0000036590). Due to the over-representation of Australian Aboriginal and Torres Strait Islander children and families within child protection systems, the research was governed by an Aboriginal Leadership Group who provided cultural oversight and guidance in research design, coding and interpretation of findings. This study utilised data extracted for a broader program of research exploring the characteristics of, and concerns reported to child protection for, children and families (Octoman et al., 2022). Two types of child protection data were utilised including fixed-field and narrative. Unit record (report-level) fixed-field data were extracted by the child protection department and provided to the research team. The current study data included child ID, report date, age and harm type, including ‘primary screening ground’ and ‘primary harm type’, as recorded by the child protection department. The ‘primary screening ground’ category relates to detailed screening criteria about the reason/type of harm or likelihood of harm as determined at intake. ‘Primary screening ground’ was utilised in this study to explore the extent of FDV which included ‘significant risk of emotional abuse – domestic violence’ and ‘significant risk of physical abuse – domestic violence’. ‘Primary harm type’ relates to the high-level category of harm/risk and includes: physical abuse, sexual abuse, emotional abuse and neglect. While not the focus of the current study, for comparison purposes with previous research, emotional abuse as a ‘primary harm type’ was also explored in supplementary analyses. FDV as a ‘primary screening ground’ and emotional abuse as a ‘primary harm type’ are mutually exclusive variables. Narrative data included child protection intake reports which were extracted on site by the research team from the child protection departments. Intake reports were de-identified, with all identifying information including surname, address and service use removed, and given names were replaced by pseudonyms. Information included in child protection intake reports is collected via telephone or an online reporting system and recorded in the electronic case management system. For the current study, information relating to the child/ren being reported, the date of the report and narrative details about the current allegations/concerns were considered. The sample was identified using a three-stage process. First, 17 postcodes within a discrete metropolitan region were selected, ranging from the 4th to 80th percentile on the Index of Relative Socio-economic Advantage and Disadvantage (Australian Bureau of Statistics, 2018). Second, the unique child ID within the statutory child protection database was used to identify all children within the selected postcodes who were reported to child protection between 1 July and 31 December 2016. Third, 20 per cent of the children fitting the stage two criteria were randomly selected using IBM SPSS version 24 and the narrative reports for this sample were extracted. Of the 540 reports identified, 47 report narratives were unable to be reliably matched to the fixed-field data due to incomplete data. These reports were therefore excluded from analysis. Figure 1 depicts the sample selection and screening process. A child present (e.g., seeing, hearing, being directly involved such as attempting to intervene, or experiencing the aftermath) when a family member is threatening, controlling and abusive toward another family member including a) adults in a family such as partners or spouses, between adult children and parents or between extended family members; and b) adults who used to be in the family (between former partners or spouses). Types of FDV may include physical, sexual, verbal, emotional, or psychological abuse (Council of Australian Governments, 2011; Raising Children Network, 2021). One hundred per cent of the randomly selected files were independently coded by at least two coders. The presence or absence of exposure to FDV were coded from the current concern in the report narrative when information fitting the predetermined definition of FDV were identified. The coding was assessed by examining all codes and checking for agreement. Where a disagreement was identified between coders, this disagreement was discussed amongst the coders until 100 per cent consensus was reached for all reports. Frequency and descriptive analysis were undertaken using IBM SPSS version 24 to examine the characteristics of children and the proportion of reports that include FDV using fixed-field and narrative data. Table 1 displays the characteristics of children and the number of child protection reports received within the six-month study period. At the time of the first report to child protection during the study period, children and young people were a median of 7.9 years of age and had between one and five reports to child protection during the six months. Using fixed-field data, child exposure to FDV was identified in 8.9 per cent (n = 44) of all 493 reports recorded by the child protection department for the sample within the six-month study period. This included 35 reports which had a screening ground of’ ‘significant risk of emotional abuse – domestic violence’ and nine reports with screening ground relating to ‘significant risk of physical abuse – domestic violence’. Coding narrative data relating to current concerns within intake reports, child exposure to FDV was identified in 28.2 per cent (n = 139) of all 493 reports for this sample within the six-month study period. Of the 139 reports where exposure to FDV was coded from the narrative data, almost a quarter also had FDV recorded in the fixed-field data, just over one-fifth had a screening ground other than FDV recorded and over half had no harm type recorded in the fixed-field data (see Table 2). While not a focus of this study, to allow comparison with previous research and population-level statistics relating to FDV exposure, emotional abuse as a primary harm type was examined. Seventy of the 493 reports (14.2 per cent) were reported to have a primary harm type of emotional abuse using fixed-field data. This short report examined the extent of children's exposure to FDV in child protection reports using both fixed-field and narrative data. Results from examination of the narrative data revealed that children's reported current exposure to FDV could be two to three times higher than fixed-field data suggest. In the current study, analyses also showed that over half of all reports to child protection did not have a primary harm type recorded (i.e. the reports were ‘screened out’). A quarter of these included details of child exposure to FDV in the narrative. The implications for these findings are substantial. Underestimating risk is likely to lead to a significant underestimation in the need for services and interventions specifically relating to FDV for families involved in child protection, for example, parenting post-violence and child trauma responses incorporating exposure to violence. Based on the results of the current study, efforts need to be focused on ensuring adequate services are available to support children and families known to child protection who have experienced FDV. While this study looked specifically at child exposure to FDV, the results may have implications for other types of harm commonly seen in child protection cases, which may be underestimated using fixed-field administrative data. This is an important consideration given that reports of fixed-field data, such as population-level child protection reporting (AIHW, 2021a), are limited to one primary, and sometimes a primary and secondary harm type, despite increasing evidence that experiences and types of abuse or neglect are often multiple, interrelated and co-occur (Moore et al., 2015; Price-Robertson et al., 2013). When exploring harm type in child protection cases utilising fixed field data, consideration should be given to the limitation that it may not capture all types of harm and rather primary harm type typically includes the most serious type of abuse or neglect identified in the case. Future studies should look to investigate data from narrative child protection cases to determine the extent of other factors such as these, particularly where multiple abuse types are present for the child and family. Narrative data within child protection reports are a rich source of information that in the current study has generated important insights about the extent of child exposure to FDV. Despite this, the methods required (e.g. manual review and coding) take considerable resources, meaning feasibility at a population level and timeliness of contemporary results are limited. Consideration should therefore be given to the use of innovative methods to allow narrative reports to be efficiently examined. Recent advances in data science (e.g. text mining), can automate the processes of reading and coding narrative data, bringing coding to scale and assisting with fast population-level insights to inform research, and assist with decision making for policy and practice. For example, feasibility studies in the US have used text mining and machine learning to identify domestic violence and substance-related concerns in narrative child welfare reports (Perron et al., 2019; Victor et al., 2021). Alternatively, if fixed-field data are to be reliably used in research to inform risk within child protection cases, then recording practices will need to be reformed to include all harm types reported, not just the primary and secondary harm types. This study was strengthened by the direct comparison of fixed-field and narrative data within the same jurisdiction and enhanced by dual person coding that reached consensus. However, due to the nature of narrative data, for practicality, this study utilised a small sample from within a discrete metropolitan region of a single jurisdiction, which limits generalisability of the results. Further, while narrative-level data can provide rich information regarding child protection concerns, the data are limited to what has been reported by notifiers and therefore may not fully represent a child's or family's situation nor capture all occurrences of child abuse and neglect. In addition, analysis was undertaken at the child level which does not consider the complexity of the family situation. Further, while the purpose of this paper was not to compare harm types and exposure to FDV for specific populations within the broader child protection population, given that Australian Aboriginal and Torres Strait Islander children are significantly over-represented in Australia's child protection systems (AIHW, 2021b), future research could focus on comparing Aboriginal and non-Aboriginal children. Relying on fixed-field data underestimates the extent of risk and harm to which children are exposed. Fixed-field child protection data are important for efficiently understanding children's contact with the child protection system at a population-level. This paper however demonstrates the limitation of such an approach when it comes to understanding the concerns that are being reported to child protection. Understanding the extent of exposure to risk and harm has implications for demand modelling and service delivery for children and families. Narrative data contained in electronic child protection systems include a wealth of information; utilising innovative approaches to efficiently examine these data is important to understand these concerns. The authors would like to acknowledge Christine Gibson, Dr Kerry Lewig and Dr Mary Salveron who extracted the data for this programme of research, and Dr Samantha Finan and Dr Martine Hawkes who coded data for this programme of research, for their contribution. The authors would also like to acknowledge the guidance and contribution by the Aboriginal Leadership Group. Open access publishing facilitated by University of South Australia, as part of the Wiley - University of South Australia agreement via the Council of Australian University Librarians. We have no conflicts of interests to declare. This study was approved by the Aboriginal Health Council of South Australia, Aboriginal Health Research Ethics Committee (Protocol #04–17-718) and the University of South Australia Human Research Ethics Committee (ID: 0000036590).

• TF-CBT is effective for non-sexual abuse-related child maltreatment PTSD symptoms. • TF-CBT is also likely effective for a range of other key trauma symptoms. • Results are applicable to threat-based child maltreatment experiences. • Further research is needed to determine generalizability of results to neglect. • Integrating TF-CBT within existing services is possible, but flexibility is required. Trauma-focused cognitive behavioral therapy (TF-CBT) developed by Judith Cohen, Anthony Mannarino, and Esther Deblinger, is one of the most widely researched and best supported psychological treatments for posttraumatic stress in children and young people who have experienced traumatic events. However, as TF-CBT was originally developed to treat posttraumatic stress symptoms in children who had experienced sexual abuse, the literature is focused on samples experiencing trauma from child sexual abuse. A review of the effectiveness of TF-CBT for trauma symptoms associated with non-sexual abuse related child maltreatment including physical abuse, emotional abuse, neglect, and domestic violence has not been specifically addressed in the literature. This review reports on the results of a systematic search of the literature for controlled and uncontrolled studies (pre-post minimum) that quantitatively examine the effectiveness or efficacy of TF-CBT for children and young people (0–18 years) who had experienced child maltreatment (>50 % of sample) where the included population was not overrepresented by sexual abuse (determined by a cut-off of <31 % of sample). Cochrane Library, Embase (via Ovid), ProQuest Central, MEDLINE (via Ovid), PsycINFO (via Ovid), and Scopus were searched in August 2021 for peer-reviewed literature. JBI checklists for RCTs and quasi-experimental studies were used to assess quality of the literature. Four randomized controlled trials (representing 446 participants) and four uncontrolled trials (representing 345 participants) were eligible for inclusion. Narrative synthesis was undertaken to present the results from this small body of literature which focuses mainly on physical abuse and domestic violence. Results suggested that TF-CBT, delivered in a variety of ‘real-world’ settings is an effective intervention for a range of non-sexual abuse related trauma symptoms in children and young people. The included RCTs showed that TF-CBT had a positive effect on posttraumatic stress symptoms, anxiety, strengths, functional impairment, and also potentially depression and emotional and behavioral difficulties (with mixed effect). Based on the recorded trauma symptoms of the included samples, treatment effects are applicable to threat-based experiences (e.g., physical abuse and domestic violence), and cannot be generalized to deprivation-based experiences (e.g., neglect). The findings from this review suggest that a flexible approach to implementation and employing engagement strategies to minimize high attrition rates could be beneficial. Limitations of the included evidence comprise small sample sizes, self-report measures, and mixed trauma types.

BACKGROUND: Young people who were in out-of-home care (OHC) face an accelerated transition to independent adulthood. Current evidence on outcomes for Australian care-leavers is scant. OBJECTIVE: This study aims to develop a better understanding of the outcomes for young people leaving care. PARTICIPANTS AND SETTING: A birth cohort of children and young people born in Western Australia (WA) from 1993 to 2008. Three groups were identified and compared: young people with care-experience (OHC Cohort), those with child protection involvement but not care experience (CP Contact Cohort), and peers in the general population (No Contact Cohort). METHODS: This is a retrospective, population-based study utilising de-identified, linked administrative records provided by the WA state government agencies. Data from the three cohorts were compared through descriptive statistics, independent samples t-tests, and logistic regression modelling. RESULTS: The birth cohort contained records for 414,266 individuals. The smallest comparison group in this study was the OHC Cohort (n = 6526), followed by the CP Contact Cohort (n = 78,095), and the No Contact Cohort (n = 329,645). Care-experienced young people in WA fared significantly worse than their peers across the domains of health (physical and mental), disability, education, social housing and criminal justice involvement. CONCLUSIONS: Those who have had child protection involvement, but have not been placed in care, had better outcomes than those who had been in care. However, their outcomes were still poorer than the population cohort with no child protection contact.

Recovering from a first episode of mental illness entails unique challenges and often includes experiencing unmet needs. The availability of a formal, structured and valid means of assessing the needs of individuals recovering from a first episode of mental illness may improve mental health service delivery. This article describes the development of a new needs assessment tool, the Needs in Recovery Assessment (NiRA), and presents the results of processes used to validate the tool. The NiRA was developed using data collected in a previous literature review and focus groups with mental health service users. It contains three sections for the identification, prioritization, planning and re-evaluation of a broad array of needs. It was presented in two workshops, where mental health service users and clinicians evaluated its validity, acceptability and usability. Items of need and the format of the NiRA were evaluated using Likert-scale questions, open-ended short answer and closed questions. Each item of need was evaluated for its validity by a panel of experts via an online survey. Descriptive statistics were used to analyse data, including means, percentages and the Content Validity Index (CVI).Streiner and Kottner's scale development and testing guidelines were used in the reporting of this study. 48 items of need were evaluated as valid by mental health service users, clinicians and academics. Most items received an I-CVI of greater than .93. The scale CVI/Avg was .96. The NiRA is perceived as a valid and acceptable tool for assessing the needs of people recovering from a first episode of mental illness.

AIM: To investigate childhood (0-18 years) hospitalisation and emergency department (ED) contacts for epilepsy in Western Australian (WA) children exposed to family and domestic violence (FDV) pre 5 years of age compared to children with no FDV exposure. METHODS: A retrospective, population-based cohort study included children born 1987-2010 who were identified as being exposed to FDV (n = 7018) from two sources: WA Police Information Management System and WA Hospital Morbidity Data Collection (HMDC) and a non-exposed comparison group (n = 41 996). Epilepsy contact was identified in HMDC and ED Data Collection records. Cox regression was used to estimate the adjusted and unadjusted hazard ratio and 95% confidence interval (CI) for epilepsy contact; adjustment was made for a range of demographic characteristics known to impact health outcomes. Analyses were stratified by Aboriginal and Torres Strait Islander status to account for higher rates of FDV and epilepsy hospital admissions in Aboriginal and Torres Strait Islander children. RESULTS: Children exposed to FDV had a 62% (HR 1.62, 95% CI: 1.33-1.98) increased risk of epilepsy contact than non-exposed counterparts. Furthermore, the children exposed to FDV had a 50% longer average hospital stay for epilepsy than non-exposed children (4.7 days vs. 3 days, P = 0.006). When stratified by Aboriginal status, we found that Aboriginal children exposed to FDV stayed (on average) 2 days longer in hospital for epilepsy than their non-exposed counterparts (5.1 days vs. 3.1 days, P = 0.018). CONCLUSIONS: FDV exposure in early childhood is associated with increased risk of requiring secondary health care and longer hospital stays for childhood epilepsy.