Tier 3 – Specialist knowledge

Knowledge

In addition to Tier 1 & Tier 2 knowledge, you need to know: 

• meaning-making around child sexual abuse and trauma is influenced by cultural, religious and spiritual beliefs, and understanding these connections can significantly support healing
• ways to minimise service access costs for victims and survivors facing financial hardship, for example, help with incidental costs like parking fees or childcare
• child sexual abuse can have collective and cultural impacts on Aboriginal and Torres Strait Islander communities and can contribute to disconnection from family, community, cultural traditions and Country
• about cultural healing practices for trauma
• referral points for Aboriginal and Torres Strait Islander services.

Skills

In addition to Tier 1 & Tier 2 skills, you can: 

• privilege Aboriginal and Torres Strait Islander knowledges and culture in responses to child sexual abuse, including policy, sharing power and resources, and critical reflection to address racism
• recognise that not all models of counselling and support are appropriate or helpful for every individual
• work to reduce the power differential in the counselling relationship
• work with family, kin and supporters of the victim or survivor, where appropriate
• offer services at times preferred by Aboriginal and Torres Strait Islander victims and survivors
• seek and receive cultural supervision to continuously reflect on cultural safety
• seek cultural consultation to increase the cultural safety of interactions with victims and survivors from Aboriginal and Torres Strait Islander populations
• respectfully engage with cultural obligations and responsibilities
• incorporate Aboriginal and Torres Strait Islander healing approaches into therapeutic work with guidance from Aboriginal and Torres Strait Islander leaders
• prioritise support, such as cultural supervision, for Aboriginal and Torres Strait Islander workers.

Resource

Culturally safe responses for Aboriginal and Torres Strait Islander victims and survivors 

• The Royal Commission into Institutional Responses to Child Sexual Abuse produced A Brief Guide to the Final Report: Aboriginal and Torres Strait Islander Communities, outlining issues of particular relevance to Aboriginal and Torres Strait Islander communities.
• The Healing Foundation has produced a number of useful resources for supporting Aboriginal and Torres Strait Islander victims and survivors:
  • Coping with the impacts of trauma (a resource for victims and survivors)
  • Restoring our Spirits – Reshaping our Futures, which sets out a culturally based healing framework for understanding and responding to trauma experienced by Aboriginal and Torres Strait Islander people who as children were sexually abused within public or private institutions.
• The NSW Sexual Assault Services Cultural Safety Toolkit is another excellent resource containing many links to further information on working in a culturally safe way with Aboriginal and Torres Strait Islander peoples affected by sexual violence and abuse. 

You may also like to take a look at an evidence review by Breckenridge and Flax (2016) examining service and support needs for victims and survivors from three population groups: children and young people who were sexually abused in institutional contexts; Aboriginal and Torres Strait Islander children and young people; and people with disability.

Knowledge

In addition to Tier 1 & Tier 2 knowledge, you need to know: 

• meaning-making around child sexual abuse and trauma is influenced by cultural and religious beliefs, and unpacking these connections often forms a significant part of therapy
• exploring the unique meaning of child sexual abuse and its impacts on the life of the individual victim or survivor in the context of their culture and intersecting identities is a core part of specialist child sexual abuse counselling
• the limits of your knowledge when working with victim and survivors from different backgrounds
• victims and survivors from culturally and linguistically diverse and faith-based communities can face additional difficulties in initiating and maintaining contact with services
• ways to minimise service access costs for victims and survivors facing financial hardship, for example help with incidental costs like parking fees or childcare
• the importance of:
  • flexibility and responsiveness in how counselling services are delivered for victims and survivors from diverse backgrounds
  • implementing innovative ways to deliver services to victim and survivors
  • seeking victim and survivor input and feedback to improve services
• victims and survivors with complex needs constitute a significant proportion of the victim and survivor population.

Skills

In addition to Tier 1 & Tier 2 skills, you can: 

• discuss and consider the needs and preferences of victims and survivors when engaging a qualified interpreter
• debrief the interpreter after counselling sessions
• explore complexities, experiences and meaning-making for victims and survivors of child sexual abuse
• modify and adapt usual clinical and counselling practice when working with victims and survivors with specific communication needs
• access supervision or additional professional development to increase skills and knowledge when working with diversity
• seek and access cultural consultations when working with victims and survivors from diverse cultural backgrounds
• recognise when intersecting identities create barriers to help-seeking and accessing services, and advocate to overcome these barriers
• take a proactive approach to engaging and following up with victims and survivors, being persistent and adaptive but respectful
• inform victims and survivors about any costs associated with using the service and schemes for reducing costs, and advocate for victims and survivors when incidental costs are identified
• where possible and where resourcing is available, identify groups in the community that are not represented in the service population and develop plans for engaging these groups
• where appropriate, welcome victims and survivors with complex trauma histories and provide the longer-term support, case management and advocacy that they need for their recovery and healing.

Did you know?

Working with victims and survivors from culturally and linguistically diverse and faith-based communities 

Research related to service provision for victims and survivors from culturally and linguistically diverse and faith-based communities suggests that the following elements are helpful when designing and delivering culturally safe services: 

• Know how to work with interpreters trained in matters to do with child sexual abuse and sexual violence generally. Organisations could provide training to interpreters or brief them prior to an interview, to minimise risk of escalated harm from the use of untrained interpreters.
• Ensure an ethnically and culturally diverse workforce, including in management positions, to offer choice to victims and survivors about culturally, linguistically and religiously matched service providers and increase decision-making power to implement policies that promote the decolonisation of knowledge and practice.
• Provide regular ‘cultural safety training’ to address staff turnover and respond to new and emerging communities.
• Use ‘a multicultural framework’ to demonstrate the service values cultural difference.
• Collect data to monitor who is and is not accessing the services from the local community.

Practice tip

Intersectionality 

‘Failure to investigate multiple forms of identities and marginalisation can damage relationships with clients. Similarly, imposing one’s own understanding and knowledge can also skew the practitioner–client interactions, with clients feeling that psychologists are more interested in imposing their own values instead of honouring the client’s rich, unique lived experiences.’ 
– Excerpt from a research article on intersectionality in psychology by Tang et al. (2020)

Resource

Using interpreters in therapy 

This research article by Hanft-Robert et al. (2023) examines how interpreters affect the therapeutic alliance in psychotherapy with trauma-affected refugees.

Knowledge

In addition to Tier 1 & Tier 2 knowledge, you need to know: 

• consistency, predictability, reliability and flexibility can help the victim or survivor feel safe. You need to understand:
  • the value a therapeutic relationship can have for some victims and survivors to promote recovery and healing following trauma
  • how boundaries can assist victims and survivors to feel safe and in control
  • it can be challenging to establish and maintain effective boundaries with victims and survivors of child sexual abuse
  • it can be beneficial to discuss in advance what you will do if you see each other outside the service
  • the importance of safely preparing the victim or survivor for the point that therapeutic contact will end, recognising the loss this can represent.

Skills

In addition to Tier 1 & Tier 2 skills, you can: 

• demonstrate self-awareness and understanding of cultural safety
• appropriately pace the sessions with victims and survivors to allow rapport to develop
• be mindful of preferences and needs of victims or survivors when allocating a counsellor
• collaboratively develop a plan for managing any encounters outside of counselling. This is particularly important if the worker and the victim or survivor live in a rural or regional area or belong to the same religious or cultural community
• provide secure counselling/yarning spaces where victims and survivors can’t be overheard, and where they have a choice of seating
• where possible, offer alternative counselling/ yarning spaces (such as outdoor areas)
• acknowledge and help the individual to cope with the end of the relationship in advance of finishing contact
• use supervision to reflect on professional boundaries and clinical practice.

Did you know?

Building trust

According to a research article by Lefevre et al. (2017), engagement in therapeutic interventions is most likely to occur ‘… in the context of a trusted professional relationship where [victims and survivors] feel supported and emotionally close to the worker.’ 

‘The core experiences of psychological trauma are disempowerment and disconnection from others. Recovery, therefore, is based on the empowerment of the survivors and the creations of new connections.’ 

– Excerpt from a research article by Judith Herman (2002)

The NASASV National Standards of Practice Manual for Services provides more information on building trust (p 76) and establishing boundaries (p 97).