Tier 2 – Additional knowledge

Knowledge

In addition to Tier 1 knowledge, you need to know: 

• victims and survivors of all ages may manage their emotional and psychological response to child sexual abuse with a range of coping strategies
• grooming can be used to manipulate and control the child or young person, their family, kin or other supporters
• the specific service needs and referral options for the following key priority groups: children and young people and their support networks; victims and survivors of child sexual abuse; Aboriginal and Torres Strait Islander peoples; people from culturally and linguistically diverse and faith-based communities; people with disability; LGBTQIA+ people; and people living in rural and remote communities.

Skills

In addition to Tier 1 skills, you can: 

• use a trauma-informed approach to engage with victims and survivors
• provide online, face-to-face, telephone and/or written responses appropriate to the victim and survivor’s needs, as relevant to your role
• help victims and survivors to make connections between their current concerns and their history of child sexual abuse
• use strengths-based approaches to explain that coping strategies are understandable responses to their traumatic experiences
• provide victims and survivors with culturally and developmentally and age-appropriate educational resources about the traumatic impacts of child sexual abuse, and referral options for support and healing
• involve victims and survivors of all ages in decisions about referrals
• work with victims and survivors, and their family, kin and supporters, to contact and access services through ‘warm referrals’, if referrals are needed/wanted.

Did you know?

Coping strategies

When people experience trauma, they cope as best they can. Coping strategies help a victim and survivor to manage their distress and reduce their feelings of being overwhelmed, helpless and powerless.

While coping strategies are often protective at first, they can become less helpful over time. Some coping strategies can even pose risks to health and wellbeing. A person may not even be aware of using them. It is important to acknowledge the purpose of coping strategies and respect the role they play. 

Sometimes the coping strategies used by victims and survivors are framed as difficulties or challenging behaviour, rather than being understood as a means of coping with unsafe situations or their distress. A trauma-informed, strengths-based lens focuses on what has happened to the person rather than framing their behaviour as the problem.

You might like to review this Blue Knot Foundation Coping Strategies Resource for more detailed information. 

Referrals

All referrals should be made in consultation with the victim and survivor, and with families, kin and supporters where relevant, and with the victim or survivor’s informed consent (where this is safe, possible and practical).

Referrals are likely to be more effective when the victim and survivor is involved in deciding which service is most appropriate for them. You can provide information about a range of options and let the victim and survivor decide which services they want to use. 

Providing a victim and survivor with verbal or written information about other services can be helpful, but do not assume that the person will follow up on the information and make contact. 

If appropriate to your role, you might like to check at a later time if they have made contact and, if not, support them with and offer a warm or facilitated referral to help overcome any barriers. 

A warm referral involves contacting a service for or with the victim and survivor, rather than just providing contact information and recommending that they contact the service directly. In addition, the worker and victim and survivor could make the phone call to the service together to make introductions and share information. 

Section 6 of this Guide provides you with a comprehensive list of culturally, age and ability-appropriate referrals that you can support victims and survivors to access.

Resource

Disability and trauma-informed responses 

These resources can help you provide trauma-informed responses when working with people with disability: 

• 1800RESPECT has a Disability Support Toolkit
• Blue Knot Foundation has developed a free guide, Guidelines for Trauma Informed Practice: Supporting people with disability who have experienced complex trauma (2021). 

Knowledge

In addition to Tier 1 knowledge, you need to know: 

• the many complex and interconnected factors influencing the severity or types of impacts experienced by victims and survivors
• physical and mental health concerns may be trauma-related
• victims and survivors may seek help for trauma-related impacts from a range of organisations, for example, schools, alcohol and other drug services, mental health services, relationship counselling, general practitioners and legal services
• the needs of victims and survivors may change over their life
• victims and survivors will have points of strength and resilience.

Skills

In addition to Tier 1 skills, you can: 

• actively consider whether any emotional and psychological issues raised with you might relate to a history of child sexual abuse
• discuss current coping strategies with victims and survivors and any alternatives they may find helpful
• actively connect with a range of service providers to ensure a coordinated and seamless response to the traumatic impacts for victims and survivors of all ages
• involve families, kin and supporters where appropriate
• recognise every interaction with a victim and survivor as an opportunity to emphasise points of strength and resilience.

Did you know?

Dynamics of child sexual abuse 

Many complex and interconnected factors, often referred to as the dynamics of child sexual abuse, influence the severity or types of impacts experienced by victims and survivors. These factors include: 

• the nature of the abuse (for example, the type, duration, and frequency)
• the relationship of the perpetrator to the child
• the social, historical, and institutional contexts of the abuse
• the victim or survivor’s characteristics, including whether they have faced additional discrimination or barriers
• the victim or survivor’s circumstances and experiences, such as prior maltreatment, financial circumstances and experiences of disclosure
• how the victim or survivor makes sense of the abuse, and the narrative the victim or survivor develops about why they were targeted.

Practice tip

Noticing resilience and strength 

It is important to recognise the sources of strength and resilience for victims and survivors of all ages. These can include strong relationships and support from family, peers, and significant others, including friends, advocates, and support networks; access to counselling/therapy; education; work and leisure activities; spirituality; and cultural connection.

Working with children in out-of-home care 

Children in out-of-home care have often experienced childhood trauma, including child sexual abuse. The Take Two Practice Guide from Berry Street, a service for children and young people in Victoria, provides practical steps about how to understand and respond to children and young people who are displaying concerning behaviours or distrust, and engage them in therapeutic services.

Trauma-informed responses to young people 

The guide to trauma-informed care by Orygen (The National Centre of Excellence in Youth Mental Health) supports people working with young people in health contexts, but can be applied to other settings.

The National Child Traumatic Stress Network 

The National Child Traumatic Stress Network has useful fact sheets about child trauma.

Considerations for asking about child sexual abuse 

Sometimes, knowing that a child, young person or adult has experienced child sexual abuse is important as it helps you make sense of any difficulties they may be experiencing and may guide the way you interact with them, as well as the responses you offer. However, there are times when asking direct questions about the experience of child sexual abuse is inappropriate. Consider: 

• What protocols does your organisation or service have in place regarding engagement, including building rapport and trust, with children, young people and adults who may have experienced child sexual abuse or other trauma? Are there certain tools you are required to use?
• Be mindful of the limitations of your role. Discussing details of trauma should only occur as part of ongoing counselling, for the safety of victims and survivors as well as your own wellbeing. Do not ask for detail you do not need.
• An important part of being trauma-informed is limiting the number of times a person is asked to tell their story. It may be more helpful to focus on what help the person is seeking and assisting them to find the right support. 

If you determine that asking about child sexual abuse is appropriate, consider the following: 

• Can you provide a safe environment to ask questions?
• Does your job role allow you to offer victims and survivors the opportunity to talk to you about their experience of child sexual abuse if they choose to?
• Does your job role allow you to provide a response that is consistent with the principles of trauma-informed care? 

You may be concerned that you will say the wrong thing and make the person feel worse. However, this is unlikely if your response is supportive, respectful, and consistent with the principles of trauma-informed care.

Knowledge

In addition to Tier 1 knowledge, you need to know: 

• victims and survivors of all ages may experience a range of reactions and flashbacks which can be triggered by seemingly unrelated events, sensations or sensory cues
• every victim and survivor is unique. People may be triggered by a range of abusive experiences, including Stolen Generations, displacement, war, institutionalisation, past experiences of personal care, and medical interventions
• an individual who is very overwhelmed may look very distressed or, alternatively, disconnected or blank
• ‘grounding techniques’ can be a useful mechanism for calming a victim or survivor who is triggered and re-experiencing distress related to events from the past.

Skills

In addition to Tier 1 skills, you can: 

• identify the types of procedures and situations that can trigger memories of the trauma and associated feelings
• assist a person who is very overwhelmed to focus on the purpose of your interaction with them by using grounding techniques
• recognise where the experience of trauma is having an effect on a person’s relationship with you or your service and adapt your practice accordingly.

Did you know?

Trauma, triggers and flashbacks 

When we experience trauma, and particularly repeated trauma, or when we are in danger (or feel that we are), our biological survival or stress response stays turned on. This means that we are unable to return to a feeling of calm. 

The range of potential childhood trauma triggers is vast. Things known to serve as triggers for many children, young people and adults include: 

• specific smells, sounds, sights, tastes, or forms of touch
• particular places or people
• specific times of day or times of year
• situations or scenarios that resemble past traumas
• exposure to certain kinds of movies or other media
• specific emotional states
• certain words or topics of conversation
• certain items and symbols 

For more information, please see this resource on traumas, triggers and flashbacks from the Blue Knot Foundation.

Practice tip

Grounding techniques – helping victims and survivors focus on the here and now

There are some techniques that can help you support a victim or survivor to calm themselves if they are triggered and re-experiencing distress related to events from the past. These are sometimes called ‘grounding techniques’. Assisting a person with lived or living experience of child sexual abuse to focus on the here and now can help them feel less overwhelmed. Some grounding techniques include: 

• helping the person to become aware of their surroundings and reminding them that they’re safe
  Some examples of what you might say are: “You might be experiencing strong emotions related to what happened in the past. Right now, you’re in a safe situation. Let’s focus on the present. Take a slow breath, and notice your feet on the floor, the feeling of the chair underneath you …”
• clenching fists, holding them, then releasing
• using the senses – for example: name three things you can see, three things you can hear, three things you can touch. 

The Seedling Group is a group of Aboriginal and Torres Strait Islander professionals committed to working with Indigenous communities on projects to build capacity and hope. They have developed an Interactive Safety Plan template which includes grounding techniques.

Hints for healing from trauma

The NSW-based Service for Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS) provides useful Hints for Healing webinars, factsheets and blogs that may assist you to respond to victims and survivors who have experienced war, civil conflict and displacement.

Resource

Grounding techniques 

The following resources provide age-appropriate grounding techniques, including self-soothing strategies: 

• For children: Calming strategies for children who have experienced trauma
• For children and young people: Grounding: a calming exercise for children and teenagers
• For adults: Self-soothing strategies for survivors of child sexual abuse.

Knowledge

In addition to Tier 1 knowledge, you need to know: 

• it is essential for victims and survivors to consider you and your service as trustworthy
• safety must be continuously monitored, and child protection and reporting obligations must be kept at the forefront of your mind
• when someone makes a disclosure, your role is to offer support so that they feel safe
• children and young people may feel safer with a support person present
• there is potential for victims and survivors to experience re-traumatisation
• victims and survivors from some population groups may not feel safe accessing mainstream services, for example, LGBTQIA+ people, people with disabilities, people from culturally and linguistically diverse and faith-based communities, Aboriginal and Torres Strait Islander people. 

Skills

In addition to Tier 1 skills, you can: 

• build a trusting relationship with victims and survivors and demonstrate your reliability and predictability
• involve adult victims and survivors in decision-making about their care
• draw on your knowledge of the continuum of sexual behaviours displayed by children and young people
• support children and young people to make decisions appropriate for their age and developmental stage and in consultation with their parents/carers/guardians
• support victims and survivors with practical goals (for example, finding secure housing, decreasing reliance on drugs and alcohol, managing mental or physical health conditions)
• recognise where a child, young person or adult victim or survivor may be at ongoing risk of harm, and link with support services and relevant interagency investigation teams, including child protection services, police and health services
• support the person (and in the case of children and young people, their parents/caregivers) to minimise risk as far as possible
• recognise when new information becomes available that may require you to make initial or further reports to child protection services.

Practice tip

Trauma-informed ways of writing about a young person 

The Innovate Project at the University of Sussex has developed a useful infographic about trauma-informed ways of writing about a young person. 

Using your existing skills to support a child who has been sexually abused 

The Emerging Minds Making use of practitioners’ skills to support a child who has been sexually abused resource allows you to recognise how your current skills can be enhanced to respond to children who have been sexually abused.

Resource

Engaging safely 

Useful resources include: 

• NASASV National Standards of Practice Manual (3rd edition) – Standard 2 ‘Valuing client experience at the service’
• Blue Knot Foundation Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery
• National Health and Medical Research Council Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Post-traumatic Stress Disorder and Complex PTSD Specific Populations and Trauma Types – Chapter 9: Sexual Assault.