SAAIF Programme - Overview June 2012

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CONTENT Page Number

Aims of SAAIF 3

Summary of SAAIF 3

History of SAAIF 5

Programme Approach 7

Referral Process 9

Session Outline 10

Quality/Governance 11

Young People’s Voice 15

Training 15

Further Development of SAAIF 16

Costings 17

SAAIF – Stopping Aggression and Anti-social behaviour in Families2

Aims of SAAIF

To reduce violence, aggression and all forms of abuse to parents/carers.

To reduce harmful attitudes and behaviours in interpersonal relationships now and in the future.

To support positive emotional and mental resilience thus improving young people’s ability to succeed and achieve.

Through learning non-harmful ways of thinking and behaving to reduce and avoid anti-social and criminal behaviour.

As a secondary benefit through working with the young person and parent together, to reduce violence, aggression and abuse within the family environment thereby improving family stability and cohesion.

To reduce high cost services required as a consequence of social exclusion and criminal behaviour.

SUMMARYSAAIF (Stopping Aggression and Anti-Social Behaviour In Families) works with young people aged 11- 17 years who are aggressive within the family home towards parents or carers (foster/adopted/extended family member). Teenager to parent/carer abuse in the form of intimidation, aggression and violence, stealing and property damage is being increasingly recognised and reported as a widespread problem in families of different culture and class. SAAIF’s unique focus of uniting adolescent and parent/carer to focus on tackling the issue of the abuse together is a powerful approach often lost in other whole family support projects.

SAAIF aims to foster better communication and personal relationships between adolescents and parent/carer and provide them with tools for dealing with anger and aggression in themselves and others. The knock on effect of both parties learning non-harmful ways of thinking and behaving supports positive interpersonal relationships within the whole family as well as within teenage

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dating relationships. SAAIF aims also to reduce the likelihood of abusive patterns of behaviour in adulthood. Thus more positive thinking processes and behaviour support longitudinal emotional and mental well being, staying out of crime and achieving. These are at the heart of the SAAIF philosophy.

The project is an evidence based programme implemented on two levels of need and risk. Level 1 Intensive Day Workshops are offered on Saturdays (enabling working parents to attend and promoting school attendance). 8-10 teenagers come with their parent/carer with whom they are having a difficult relationship. The day is activity based with games and information giving. A non-blame approach is adopted. Issues such as lack of trust and respect are challenged and developed throughout the day. It is a preventative approach to improve teenage/parent relationships in the early/mid stages. Referrals can come from any agency or families. Additionally the workshop enables multi-agency facilitators to observe the family through a whole day to assess their type and level of problem to signpost or include in waiting list for the 14 week group programme.

Level 2 14 week programme is offered when there have been at least two incidents of Adolescent to Parent Violence or equivalent abusive behaviour. The programme runs one night a week. Parents/carers and teenagers attend the programme together. Families are visited and informed about the programme and a full assessment ensures the right level of need. It is for families where there is significant risk of harm and family breakdown.

SAAIF is led by professionals with specialist skills in parenting, child development, domestic abuse and risk management. The Programme has been highly praised in an external evaluation as beneficial to families and stakeholders alike in addressing this problem. SAAIF trains facilitators to contribute to the delivery of both levels of the programme resulting in reduced cost and enhancing the skills of the children’s workforce. SAAIF is recognised as good practice by a number of national organisations including RESPECT and the Royal College of Psychiatrists in tackling abusive thinking and behaviour patterns to improve family cohesion, interpersonal relationships, emotional and mental health, pro-social behaviour and consequently offer the chance of more positive life outcomes.

HISTORY OF SAAIF

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Over the last three years the SAAIF project has implemented 15 day workshops and 1 x 14 week programme across North East and Mid Essex.

The evaluation in 2009/2010 produced the following feedback from a young person four months after the 14 week programme ended: “I still have my folder and I look at it sometimes, I don’t need the cooling strategies now. It has made a difference, I don’t know how. Mum still shouts a lot, I don’t shout anymore. I walk away when I am angry. Mum should speak to us nicely to calm us down and not shout”. Another quote after four months: “I learnt how to treat people. It made this clearer for me. Life is very good now. College is going well and relationships at home are good. Still arguments but stroppy teenagerish now - not out of control”.

SAAIF reduces risk in families as it focuses on reducing violence and the cycle of abuse. When SAAIF was externally evaluated findings indicated the differences in the lives of family members, rediscovering that they could laugh together and be a family again (Priority Research, 2009)

A quote from a parent “We learned to become friends again. Made a big different, he’s co-operative, there’s more talking to each other. It’s lasted” . Stakeholders in the 2009 evaluation said, referring to SAAIF: “It’s a very good project which complements our own work” and “It’s given us somewhere to go – before there was nothing specific to domestic violence”. SAAIF emerged from families asking for help for this problem at the same time as child care agencies struggled to provide effective support. Adolescent to parent violence (APV) is nationally and internationally recognised. ‘Parent abuse is potentially overlooked in research as being unnatural and almost inconceivable’ (Pagani et al, 2004). ‘A veil of secrecy surrounds the topic in much the same way that other forms of family violence have been hidden in the past’ (Paterson et al, 2002).

SAAIF families and other professionals reported no one agency had the skills or resources to make change happen. .

Youth groups, youth offending teams, charities, schools, social enterprise projects and doctor’s surgeries all refer and provide facilitators to deliver SAAIF, indicating the need and support for the project and close liaison exists during the life of the programme and beyond. (Priority Research, 2009)

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SAAIF is recognised nationally as good practice in directly tackling the problem of adolescent to parent violence. SAAIF has presented its work at the 2010 RESPECT conference and that of the Royal College of Psychiatrists. Essex County Council, crime and disorder partnerships, Essex Police and the National CAMHS Forensic Service with which we work closely all support SAAIF. SAAIF has been a trail blazer in the United Kingdom in developing an evidence based programme working with both adolescents and parents to address this problem.

The British Crime Survey 1996 cited 3% domestic violence cases involving APV; whilst the Parent line Plus survey 2010 received 22,537 calls from parents regarding aggression from their children. 7,000 calls related to physical abuse.

Most importantly, families who have attended previous groups have recommended the programme to neighbours/friends (Priority Research, 2009).

What we have learnt

We believe the success of the 14 week programme has been the high level of additional attention which is given to supporting young people during and between sessions through risk assessment and risk management, mid-week telephone calls and home visits as well as talking to other partner agencies to ensure safety when necessary. SAAIF has also observed that parents sometimes lack the skills to promote positive and non-aggressive problem solving because of their own life experiences and stressors. Through a nurturing and supportive yet challenging programme of change interpersonal relationship skills should improve for both the parent and the adolescent. In 2010 the programme underwent an improvement review informed by young people, parents and facilitators.

Difficulties

In the past the project has received short term funding (1yr/18mnth) from a range of local commissioners. In one case funding was lost due to government cuts. Equally short term funding does not promote the retention of highly skilled staff which is key in delivering a high quality, effective and safe service that directly addresses the problem of adolescent to parent/carer abuse.

PROGRAMME APPROACHWho SAAIF works with

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SAAIF works with young people aged 11- 17 years who are being abusive to their parents and family regardless of class, ethnicity, or background. Through working with teenagers and parents/carers through two levels of intervention - early and intensive SAAIF - can address emerging through to significant levels of problem behaviour. SAAIF Aims

The SAAIF group programme aims to reduce and prevent violence and abuse by young people age 11-17 years to their parent or carer be that a foster carer, adoptive parent or extended family member. Many will have witnessed/experienced domestic violence. Some have specifically diagnosed conditions, e.g.: depression, ADHD or conduct disorders. Many will have combinations of these and other risk factors.

It is a group based programme working with both young people and their parent/carer together to reduce violence, aggression and abuse in family relationships. Through interactive and creative therapeutic approaches young people’s thinking patterns and behaviour are both challenged and nurtured in order to effectively learn and embed positive and non-harmful ways of dealing with interpersonal relationships and challenges in life. A secondary benefit is the reduction of violence and abuse to other family members, teenage dating partners, the family home and the community. Subsequently improved family, interpersonal and social relationships raise the likelihood of more positive outcomes as they move into adulthood. A further aim of the SAAIF programme is to reduce the likelihood or potential level of harm in adult interpersonal relationships.

How we deliver SAAIF to reach young people and families

The programme uses an assertive engagement approach and a rolling waiting list to engage any teenager and their family, including self-referrals. SAAIF has two levels of group programme intervention. Assertive engagement is the foundation for buying into the programme for young people and families with the highest need and lowest levels of motivation to change. The ethos of SAAIF is to be both flexible and assertive in our approach. SAAIF operates a non-judgemental ethos supporting change, not blame. SAAIF maintains close links and targeted marketing with agencies working with very troubled young people and their families, e.g. Police, Housing, Refuges, Youth Offending Teams.

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SAAIF offers two levels of intervention, the Intensive Day Workshop is used both as an engagement, assessment and treatment approach, with referral on to the 14 week programme, or signposting to other agencies if in discussion with facilitators and families a higher or different level of intervention is required. Thus SAAIF ensures right families receive the right approach

Level 1 is the SAAIF Intensive Day Workshop for young people and their parent. This is held on a Saturday from 10 am to 4.00 pm with intensive activities to enable families to think positively and learn new skills to help their relationship. For some families the Workshop sorts out their problems. For all families it allows facilitators to determine their level of need, refer on to other agencies, or refer to a waiting list for Level 2, the SAAIF 14 week programme.

The SAAIF 14 week programme is aimed at families where there is significant violence and/or abuse from the young person to their parent, or the family home. The police or Youth Offending Service may already be involved. The young person and the parent attend together two hour weekly sessions for a period of 14 weeks plus community and telephone support. There is comprehensive risk assessment before and after the intervention.

There is a lead co-ordinator with a Social Work or other Professional Child/Health Care qualification and Group Skills Training who has been involved in developing, delivering and monitoring the SAAIF programme. Both programmes have five facilitators at each session, a minimum of three having both professional and group skills qualifications and who work for other child care partners. The 14 week programme has the requirement for individual, group and sessional supervision from a qualified child care professional with experience in managing domestic abuse and violent behaviour.

How many children and young people SAAIF aims to work with?

Each Level 1 Workshop: 8 -10 young people and 8-10 parent/carers.

Each Level 2 Group Programme: 8 young people and 8 parent/carers.Improved family relationships will also have a positive impact on other children in the family. Improved interpersonal and non-abusive relational skills will also reduce the likelihood of abusive teenage and adult relationships.

REFERRAL PROCESS

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Referral Process

Any initial route of referral acceptable e.g. telephone, face to face, to enable self-referrals. Then information transferred to referral form for data collection. Referrals from professionals via referral form.

Types of Referrals

To date services in North East and Mid Essex we have worked with and taken referrals from include; Self-referral (e.g. via info at police station), Schools, CAMHS, TASCC, Education Welfare, Social Care, Children Centres , Swan, Early Intervention Psychosis Team, Women’s Refuge, PCT’s, MIND, TACMEP and GP’s .

About the young people targeted in SAAIF

Young people attending either of the SAAIF programmes are almost always known to at least one child care agency for extra support for poor emotional wellbeing, challenging behaviour, risk of family breakdown or exclusion from school. Young people referred onto the 14 week programme are highly likely to experience a combination of these disadvantages from information from colleagues in Social Care, Child and Adolescent Mental Health, the Police and Youth Justice System.

One of the geographical areas covered by SAAIF experiences the highest level of multiple deprivation factors in England (The English Indices of Deprivation 2010).

Aggressive behaviour can be linked to higher incidences of involvement with the youth justice system, gang and weapon carrying, smoking, anti-social behaviour and children wanting to leave home. (Parentline Plus 2010) thus putting these young people at even higher risks of disadvantage into their adult lives.

SESSION OUTLINE

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Session 1 READY FOR CHANGE ‘Introductory session’

Session 2 READY FOR CHANGE ‘Abuse and Violence in relationships’

Session 3 READY FOR CHANGE ‘Domestic Abuse’

Session 4 READY FOR CHANGE ‘ Moving from Childhood’

Session 5 REDUCING AGGRESSION ‘ Triggers and Personal Responsibility

Session 6 REDUCING AGGRESSION ‘Managing Conflict and Anger – Body Changes and De-escalation’

Session 7 REDUCING AGGRESSION ‘Managing Conflict and Anger – Positive Problem Solving’

Session 8 BUILDING RELATIONSHIPS ‘Working together to share personal

feelings’

Session 9 BUILDING RELATIONSHIPS ‘Working together to build relationships’

Session 10 BUILDING RELATIONSHIPS ‘Effective listening and communication’

Session 11 BUILDING RELATIONSHIPS ‘A positive sense of self’

Session 12 SAAIF FUTURES ‘Responsible and respectful relationships’

Session 13 SAAIF FUTURES ‘Sex, drugs and health lifestyles’

Session 14 SAAIF FUTURES ‘ Moving on Together’

PROGRAMME QUALITY/GOVERNANCEPerformance Measures

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Level 1 – Early Intervention - Day Workshop Number of attendees; collected by attendance records to show

engagement

End of workshop evaluation sheets assessing the usefulness of session content and any improvements.

Following the workshop a 3 month follow up call/visit is made to enquire whether things continue to improve. Anecdotal feedback from stake holders and referrers is also requested.

Level 2 – Specialist Intervention - 14 Week Group Programme Weekly discussion with participants. Following each feedback session

comments are reviewed by facilitators and notes taken to consider how amendments could be made for the delivery of the next programme.

Pre and Post Strengths and Difficulties Questionnaires (SDQ’s) The SDQ is a brief teenage/parent behavioural screening questionnaire composed by Goodman et al. (Goodman, Meltzer & Bailey, 1998) taken from SAAIF 2010 evaluation.

Self-assessment aggression Scales (A1) will be used to measure the frequency of self-reported aggressive behaviours (e.g., hitting, pushing, name-calling, threatening) to assess level of need

Score 15 – Family Functioning outcome measure used before and after 14 week intervention.

Facilitators record observations between parent/adolescent after each session of the 14 week programme. Staff note whether interactions and behaviours improve/become more respectful/increase in frequency without staff direction or encouragement. Any negative interactions are also noted and any Safeguarding issues agreed and responsibility for action identified.

SAAIF workshop/group venues

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SAAIF recognises the importance of providing a safe environment in which to deliver the programme. Experience and feedback from parents supports use of non-stigmatising voluntary and community based venues

Programme facilitators are all experienced professionals who possess effective group management skills and an understanding of mental health, antisocial and aggressive behaviour in young people and adults and the impact this has within a family and the wider society. This enables professionals to keep flexible but tight boundaries and agree a contract of acceptable behaviour and consequences with attendees.

Facilitators come from a variety of backgrounds enabling rapid access to services, which ensures that the needs of the young people can be individually considered, whether that is from a mental health, or youth justice perspective. All facilitators will have undergone required statutory safety checks.

Choosing a venue that is emotionally safe as well as a physically safe space is vital.

All venues will aim to offer safe and free parking and be on a bus route

Disabled access

Facilitation

All the trainers in the company are trained to degree level in a variety of professions including education, health promotion and nursing

All facilitators employed by the company are trained in the chosen programme and all have undertaken, group skills and child protection training

All groups are videotaped from supervision purposes (only exception will be if a parent does not consent to videotaping, in this case a director of the company would undertake a group session observation)

All groups and workshops are evaluated pre and post group, original copies of evaluation sent if requested to agency

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Full evaluation report prepared and sent, if requested, to agency

We have regular team meetings which includes time for on-going professional development, supervision and reflective practice.

Our Facilitators

All the groups and workshops will be delivered by trained group facilitators, whose purpose is to facilitate the group, by building up a reciprocal relationship, equally using their own knowledge and the group’s strengths and perceptions. By doing this the group facilitator will build an environment of trust, enabling parents in the group to feel safe and confident which will enable them to experiment with the strategies and techniques offered. All the Ministry of Parenting (CIC) facilitators have a background in working with families, have group facilitation training, have excellent interpersonal skills along with an understanding in social learning theory and good listening skills. The group facilitators are all CRB checked and have training in Safeguarding, Domestic Violence, CAF processes and work within the polices and procedures of the Ministry of Parenting (CIC).

Effective Risk Management

Many of the young people referred to SAAIF have witnessed or experienced domestic violence; for some, nowhere feels safe. The safety of young people is paramount. A comprehensive assessment is carried out where the adolescent feels comfortable, for each family referred to the 14 week programme. SAAIF recognises the importance of providing a safe environment in which to deliver the programme. Programme facilitators are all experienced professionals who possess effective group management skills and an understanding of mental health, antisocial and aggressive behaviour in young people and adults and the impact this has within a family and the wider society. This enables professionals to keep flexible but tight boundaries and agree a contract of acceptable behaviour and consequences with attendees.

SAAIF uses 5 facilitators for 16 attendees (adolescent and parents/carers) which allows a ‘floater facilitator’. This enables the floater to respond to either group should upset occur. Our aim is to have 3 facilitators with the adolescences and 2 with the adults, but this is flexible between the two groups. Risk assessments are carried out through the programme using validated screening tools for

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adolescents with aggressive behaviour i.e. Structured Assessment of Violence Risk in Youth (SAVRY).

The SAAIF programme uses a range of methods that research shows works for this type of problem, having the best chance of helping and encouraging young people to change their behaviour e.g. Family Systems based framework (Functional Family Therapy), cognitive, dialectical and solution based therapeutic approaches, positive role modelling and praise. This approaches are flexible and accessible giving young people a better chance of making positive changes to their thinking and behaviour, thus improving their chances of achieving their potential for a successful life.

Quality Assurance Process

Facilitators adhere to individual Codes of Professional Conduct, e.g. nursing, psychology and policies and protocols in place within individual agencies including clinical/managerial supervision, safeguarding, yearly professional appraisals. Quality of service delivery is ensured verbal and written audit after each programme session and within the group/individual supervision processes. Weekly feedback from users ensures relativity of material to need. There is a final evaluation from users and facilitators including review of new ‘what works’ evidence from research.

Quality assurance process; to ensure that the right children and young people with relevant needs are receiving SAAIF

Literature with clear information regarding programme criteria is available to all with telephone support. Information is widely available in the community, police stations, schools etc. Comprehensive joint assessments with two professionals use a screening tool to determine level of need/type of problem behaviours. Screening tool and supporting information from a variety of partners is taken to multi-disciplinary SAAIF meetings to determine suitability for day/14 week programme or signposting.

THE YOUNG PERSON’S VOICE IN SAAIF

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One of the strengths of the programme is its adaptability to a wide range of participants. Flexibility is built into the programme as we recognise that the needs of young people vary enormously. A parent from our 14 week programme is now a volunteer and provides valuable feedback and support to young people and their families.

Following the last SAAIF 14 week programme young people said they wanted more activity based exercises to engage them and keep their attention. Art and role play are now a big part in the programme at their request, the programme leaders carefully adapting the programme, achieving the same result but making it easier and more interesting to learn new ways of thinking and behaving. Additionally facilitators held a day workshop to review and improve programme content guided by the young people’s participation.

The method of delivery has developed following evaluation from the young people involved thus far. This has come from verbal feedback and also the more formal written evaluations. Additionally one of SAAIF’s partner organisations has a youth advisory board that has helped voice young people’s views and needs.

STRUCTURED TRAINING/DEVELOPMENT PROGRAMME Facilitating and Delivery SAAIF

Currently SAAIF is coordinated and delivered by child care professionals who have been involved in development of the programme who all have a professional qualification in a relevant field of child care and group skills training. New facilitators introduced to the programme train via participation in the group programme as additional facilitators. Robust clinical supervision is in place from a forensic clinical nurse specialist and a national parenting specialist. A programme manual is in the final stages of production to assist training.

Level 1 SAAIF Intensive Day Workshop: Training through participation would be given to locality child care staff (voluntary/statutory sector) to run Intensive Day Programmes in local community settings.

Level 2 SAAIF 14 week Programme: specialist training by lead co-ordinator and established facilitators to other workers with both a professional child care qualification and groups skills training. Some may be paid as independent facilitators due to time commitment and resources within other agencies.

A delivery and training manual is in the final stages of production.

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FURTHER DEVELOPMENT OF SAAIFFuture Plans for SAAIF Currently we have a working party which meets regularly to explore funding and developments of SAAIF. Our aim is to obtain funding for a full time SAAIF co-ordinator; who would work across the county supporting other professionals to train and deliver the Day Programme. The co-ordinator would also manage the implementation of the 14 week programme across the county taking referrals from both the independently run Day Programmes and direct from higher tariff agencies such as CAMHS T3/4, YJ, Police, Social Care etc. This role would also aid the training arm of SAAIF and the further developments of the SAAIF manual.

While we as a working group are seeking funding grants we also are offering SAAIF as a service to be commissioned below are the costs of delivery (2012 prices).

Geographical Replication Aims

Geographical replication aim to other Local Authority quadrants, currently delivered in Colchester and Tendring, roll out to Central and West Essex. The goal is for a lead SAIF co-ordinator to be funded to facilitate referrals through network of child care agencies and training as follows:

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COSTINGSCostings for delivery of Level 1 SAAIF day workshop (6-8 teenagers plus parent/carer)

£ 2,972.60 if The Ministry of Parenting (CIC) provide all resources.£ 2,380.60 if delivered in partnership with another service which would provide two members of staff trained in the programme, venue and support with marketing and recruitment of parents.

Equates to £250 - £350 per family attending Day Workshop (for 8 – 10 families depending on variations of numbers attending and costs of facilitators/venue etc).

Cost for delivery of Level 2 SAAIF parenting group 6-8 teenagers plus parent/carer)£ 15,255.00 if The Ministry of Parenting (CIC) provide all resources£ 8,647.00 if delivered in partnership with another service which would provide two members of staff trained in the programme, venue and support with marketing and recruitment of parent.

Equates to £1500 - £2000 per family attending 14 Week Programme per family depending on variations of numbers attending and costs of facilitators/venue etc).

Cost breakdown in more detail - SAAIF day workshop

Time factors Staffing Requirements Cost Day (Saturday) group 6 hour workshop

5 Venue : 2 large rooms approx. £192 per session Facilitation ; £35 per facilitator per hour; 6 hours per session (£200 for the session) 200 x 5 Marketing (leaflets, Posters etc.) £180 Hand-outs; Cost 10p per hand-out sheet;Per session approx.; 6 sheets , Per parent, hand-outs for all sessions £3.60 A management/administration fee of £150Refreshments £100 (includes lunches)Certificates £1 per parent and child (£12)End parent gift £5 per parent and child (£30)Evaluation report £50 Family taxi/child care

192

1000180

3.60

150100123050100

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Pre-planning 2 home visiting (2 staff) 12 hours (£ 35 per hour) pre-set up, professional meetings and planning sessions 6 hours (£ 35 per hour) Telephone engagement 3 hours (£ 35 per hour)

840210

105 Total 2972.60

SAAIF group programme

Time factors Staffing Requirements Cost Evening group 2 hours 14 weeks (8 families)

5 Venue : 2 large rooms approx. £192 per session x 14 (2688)Facilitation ; £35 per facilitator per hour; 4 hours per session (£140 for the session x14 £1960 ) x5 £9800Marketing (leaflets, Posters etc.) £180 Hand-outs; Cost 10p per hand-out sheet;Per session approx.; 6 sheets , Per parent, hand-outs for all sessions £3.60 x 14 A management/administration fee of £350Refreshments £20 x 14 Certificates £1 per parent and child (£18)End parent gift £5 per parent and child (£40)Evaluation report £90 Family taxi/child care

2688

98001803.60

50.40350280184090600

Pre-planning 2 home visiting (2 staff) 12 hours (£ 35 per hour) pre-set up, professional meetings and planning sessions 6 hours (£ 35 per hour) Telephone engagement 3 hours (£ 35 per hour)

840210

105 Total 15255

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