Principle 14: Working collaboratively both nationally and in our local communities

A. Work in tri-partite relationship

This is about ensuring that services are all working collaboratively both nationally and in our local communities.

A coordinated psycho-social, medical and legal response is that which is most likely to best meet the needs of survivors of sexual violence.

This means that Crisis Support, Medical Forensic services and Police work together to ensure that all those affected are able to access all aspects of a coordinated response.

Such an approach offers multiple points of entry, and maximizes access to justice, medical care and support for well-being. It also supports provision of consistent and quality services through providing a vehicle for collaboration and specialisation among service providers.

This is achieved principally by two main initiatives

  1. The National Tripartite Forum on Sexual Violence

  2. Local Level Agreements (LLA) in all local areas of New Zealand

The National Tripartite Forum on Sexual Violence

This forum was set up in 2009 by agreement between Te Ohaaki a Hine – National Network Ending Sexual Violence Together (TOAH-NNEST), Rape Crisis, Doctors for Sexual Abuse Care DSAC, and the then Police Commissioner Howard Broad. It reflects the collaborative tri-partite response to sexual violence, being a medical response, a criminal justice response and a crisis support response to maximise psychological and emotional well-being of the survivor.  In 2013, Victim Support joined the national forum.

It’s main purpose is to be representative at a National Level
The Representatives are from

  • Police National,
  • TOAH-NNEST – Tauiwi Caucus,  Nga Kaitiaki Mauri
  • National Collective of Rape Crisis – Maori and non-Maori representation
  • DSAC
  • Victim Support

Local Level Agreements LLA

An LLA is the local area working model of the Tripartite approach to service delivery.
All areas of New Zealand should now have an LLA in place and those providing Police, Medical or Crisis Support services should be using the LLA to ensure there is a good working relationship….

An effective tripartite relationship-LLA:

Is based on:

  • Agreement that victim/survivor needs are paramount drivers of service and response
  • Partnership – whereby the functions of each role are considered different but equal, and where the parties hold respect for and understanding about each of the different roles
  • Local and national formal infrastructures and agreements addressing:
  • Prioritisation of victim/survivor safety and well-being, and right to informed decision-making
  • Identification of the roles and responsibilities of each party, and the tools and routes for accountability for these
    • One study investigated sexual assault nurse examiners’ perceptions of their relationships with other professionals who treat and interact with victims/survivors. Positive relationships were marked by open communications and respect shown towards the health professionals as well as victims/survivors. On the contrary, negative relationships were the result of medical practitioners perceiving the treatment of victims/survivors by other professionals (such as the police) to be poor, when advocates overstep boundaries and question medical practitioners about evidence collection or the exam, and when prosecutors fail to properly prepare them to testify during trial.[1]
  • Agreed protocols and procedures for referral and other services required by the victim
  • Transparency about possible conflicts in roles, responsibilities and accountabilities, and protocols for mitigating those conflicts and resolving disputes safely and quickly in the interests of minimising impact on service provision to victim/survivors

Protocols for ensuring good communication, including:

  • - Sharing of critical information: Meetings enable effective case co-ordination and management, information sharing and mechanisms for resolving inter-agency difficulties. Enhancing practice through sharing of ideas, clarifying role responsibilities, agreeing on basic standards for research and practice, and mitigating impacts of staff turnover can be achieved.[2]
    • Confidentiality agreements
    • Protocols for informing one another of relevant communications or initiatives being undertaken (e.g. media statements), so that each agency can respond appropriately
    • Sharing information and resources
  • Clarity and transparency regarding all decision points and potential consequences
  • Compliance with all relevant legislation and regulations
  • Agreement to advise and consult re all service initiatives or changes which could impact survivors of sexual violence and/or the tri-partite relationships.
  • Designated representatives from each party
  • Protocols to ensure information about the agreement is understood by all personnel involved in each service
    • Theory suggests multiple values in the development of protocols, such as ensuring inter-agency liaisons are professional, effective and victim-focused; reducing the likelihood of one agency being subsumed by another; and providing a written basis for monitoring service provision. An evaluation showed that existence of protocols correlated with effective relationships between law enforcement agencies and Rape Crisis advocates, but that existence of protocols did not ensure that police followed them.[3]
  • All parties agree to undertake training and create learning opportunities for each organisation to develop professionally
    • Training gains include co-ordination between organisations; collegiality; giving each organisation a stake in the others; accuracy of information, insight into the expertise and operations of other groups; common knowledge, philosophy, concern and a spirit of cooperation; development of skill, understanding, support and enthusiasm; and the development of new policies and procedures.[4]
  • Regular local and national meetings to discuss specific content of the work, and the relationship – issues arising and changes in the roles or circumstances of one party which might impact on the others
    • On-going evaluation is also theorised to have much value, in part through the collaboration to develop the evaluation procedures. Research has suggested the need for combined goal setting, agreed standards and official sanctions to encourage compliance.[5]
  •  Specialisation – supporting good service provision and development of trust and confidence between the parties.
    • Specialist police sexual assault teams have impacted on competence and confidence, development of professional and integrated services, facilitated involvement of support agencies at early stage, and have been associated with a paradigm shift to redefining policing as “protecting victims from the impacts of crime”.[6]

Is nurtured by relationship developed through:

  • Small teams, the members of which can come to know each other personally through regular work, meetings and training
  • Mutual training practices at local level (police, medical teams and support services all involved in each other’s training).

An effective tripartite relationship is nurtured by relationship developed through:

  • Small teams, the members of which can come to know each other personally through regular work, meetings and training.
  • Mutual training practices at local level (police, medical teams and support services all involved in each other’s training).
  • There remains debate about the value of a move to physically integrated services.  Referring to the evaluations of Britain’s SARCs, Beckett suggests sharing premises as “an important step”. However, she also points out that these were developed at the exclusion of Rape Crisis centres and that this is a concern as “the therapeutic necessity for victim empowerment is more likely to be understood, integral, and lasting if underpinned by a feminist perspective”.[7] [8]

Research supports the tri-partite approach.

In the US, the collaboration of legal, medical and mental health resources using an ecological conception of person-environment fit as the criteria for a “good” outcome was investigated. The question explored “Did the system respond in a manner consistent with victims’ needs?” (p.360). Survivors who lived in areas with co-ordinated approaches were more likely to have positive experiences with the systems involved, and to be able to obtain services which were considered to be consistent with their needs. [9]

In another study, communities considered to be highly co-ordinated regarding services for sexual violence were compared with communities considered to have low co-ordination. In communities considered to be highly co-ordinated, three types of multi-agency programmes existed: co-ordinated service programmes, interagency training programmes and community-level reform groups. Common features of multi-agency service programmes, whether co-ordination was formal or informal, were that they involved staff from multiple agencies, and focused on improving service delivery for victims. In contrast, in communities with low co-ordination, interagency training was the only kind of multi-agency programme. There were also differences between the nature of the training between communities with high service co-ordination and those with low service co-ordination. For the former, training was short but frequent, had goals of both relationship building and on-going learning, and was reciprocal. For the latter, training tended to be mandated, infrequent, long, and restricted to established service providers only. [10]

In a review of four communities, a number of factors were identified as practices that enhanced the provision of care to survivors of sexual assault, and led to increased successful prosecution of sexual assault cases. These included:

  1. Inter-agency task forces and networks
  2. Joint interviewing with victims
  3. Cross-training between agencies
  4. Referral services [11]

B. LOCAL CONFIGURATIONS FOR LOCAL NEED

The natures of our communities vary widely in ethnic make-up, socio-demographic profile, and availability of other resources. Therefore, services need to be tailored to take into account local contexts, needs and service constraints. A one-size-fits-all approach to crisis support services provision is unlikely to be effective for victim/survivors.

PRACTICE EXAMPLES

  1. Mid North Women’s Support and Youth Services -  in response to the local needs of the Kerikeri community, this group have at times provided extra services such as  budgeting and youth services.

  2. In the Kaipara area, following a drop in funding for the women’s centre, Rape Crisis picked up the function of providing emergency housing and associated advocacy to women and children in situations of violence.

C. Good relationships with other local services (non-tri-partite)

Sexual violence happens to a person in the context of the rest of their life and their other needs. Any pre-existing difficulties can hamper recovery, and the period of disorganisation which can occur following sexual assault can mean that survivors might need assistance with issues that they previously managed well themselves. Therefore, crisis support workers might need to engage a number of other services for a victim/survivor to be optimally supported following an assault.

For example, one study found hotline and advocacy workers linked survivors (on average) to at least two additional community resources.[12]

Stigma attached to sexual assault also attaches to those agencies which work with survivors of sexual assault. This can contribute - along with shame, doubt, lack of trust, and a belief that they can manage on their own - to many survivors not seeking help directly from sexual assault services.

Good community relationships mean that other services who receive disclosures of sexual violence are able to assist survivors to access sexual assault services.

For example, in a review of four communities, it was found that coordination between sexual assault victim advocates and organisations assisting underserved populations, led to better provision of translation, technical assistance, training and funding by and for some advocacy groups.[13]

Sexual violence can seem like society’s ‘dirty secret’, as if there is an alternate reality that only survivors, you, and your colleagues are aware of. This can feel isolating. To be widely active in community relationships and talking about sexual violence exposes the secret and the isolation it engenders. This is both good for the mental health of service providers and assists communities to alter their attitudes to sexual violence and its victims.

The ‘Blowing the secret’ study, based in the USA, found that agencies in communities which were co-ordinated in their responses to sexual violence, were involved in community-level reform, such as interagency task forces, women’s action groups e.g. court watch, t-shirts carrying survivor voices.[14]

PRACTICE EXAMPLES    

  1. Collaborative work with school counselors can lead to provision of specialist counseling and crisis support services to youth in schools.  This both improves young people’s access to service and improves awareness of sexual violence and its effects in the school community.

  2. While some survivors wish to control the use of their personal and health information, others are happy for mental health services and crisis support services to work together to develop complementary plans for counselling and support.

  3. Dunedin has a good relationship with Shakti for the benefit of clients of both services. 

D. NATIONAL CO-ORDINATION

As a network of predominantly small organisations, working collaboratively can achieve sharing of resources and development of strategic planning and relationships, in order to achieve the goals of provision of appropriate services and ending sexual violence.

PRACTICE EXAMPLES

  1. Both of the following networks support agencies providing specialist services in response to sexual violence:
    • Nga Whiitiiki Whanau  Ahuru Mowai o Aotearoa/ National Collective of Rape Crisis and Related Groups of Aotearoa Inc. 
    • Te Ohaaki a Hine – National Network Ending Sexual Violence Together.
  2. Co-ordination by Nga Whiitiiki Whanau  Ahuru Mowai o Aotearoa/ National Collective of Rape Crisis and Related Groups of Aotearoa Inc for Rape Awareness Week allows a national theme which increases the power to bring public attention to the issue.
  3. Nga Whiitiiki Whanau  Ahuru Mowai o Aotearoa/ National Collective of Rape Crisis and Related Groups of Aotearoa Inc also coordinate standardised education resources and standardised worker training for volunteers and staff on a national level to reduce the duplication by local agencies.  This process enhances the National Resources by gaining multiple women's input. 
  1.  Maier, S. (2012). Sexual assault nurse examiners’ perceptions of their relationship with doctors, rape victim advocates, police and prosecutors. Journal of Interpersonal Violence 27(7), 1314-1340.
  2. Beckett, L. L. (2007). Care in collaboration: Preventing secondary victimization through a holistic approach to pre-court sexual violence interventions. Unpublished doctoral dissertation, Victoria, University of Wellington. Wellington, NZ.
  3. Beckett, L. L. (2007). Care in collaboration: Preventing secondary victimization through a holistic approach to pre-court sexual violence interventions. Unpublished doctoral dissertation, Victoria, University of Wellington. Wellington, NZ.
  4. Beckett, L. L. (2007). Care in collaboration: Preventing secondary victimization through a holistic approach to pre-court sexual violence interventions. Unpublished doctoral dissertation, Victoria, University of Wellington. Wellington, NZ.
  5. Beckett, L. L. (2007). Care in collaboration: Preventing secondary victimization through a holistic approach to pre-court sexual violence interventions. Unpublished doctoral dissertation, Victoria, University of Wellington. Wellington, NZ.
  6. Beckett, L. L. (2007). Care in collaboration: Preventing secondary victimization through a holistic approach to pre-court sexual violence interventions. Unpublished doctoral dissertation, Victoria, University of Wellington. Wellington, NZ, p.29.
  7.  Beckett, L. L. (2007). Care in collaboration: Preventing secondary victimization through a holistic approach to pre-court sexual violence interventions. Unpublished doctoral dissertation, Victoria, University of Wellington. Wellington, NZ, p.40
  8.  Such exclusion has also occurred in New Zealand’s first attempt to develop an integrated service, Puawaitahi in Auckland. In spite of full participation throughout the initial years of service planning and development, community crisis support services were excluded from the final set up.
  9.  Campbell, R. (1998). The community response to rape: Victims’ experiences with the legal, medical and mental health systems. American Journal of Community Psychology, 26, 355- 379.
  10.  Campbell,R., Sefl, T., Barnes, H., Ahrens, C., Wasco, S., & Zaragoza-Diesfeld, Y. (1999). Community services for rape survivors: Enhancing psychological well-being or increasing trauma? Journal of Consulting and Clinical Psychology, 67, 847-858.
  11.  Epstein & Langenbahn (1994), cited in Decker, S.E., & Naugle, A. F. (2009). Immediate intervention for sexual assault: A review with recommendations and implications for practitioners. Journal of Aggression, Maltreatment and Trauma, 18, 419-441.
  12.  Wasco, S., Campbell, R., Howard, A., Mason, G., Staggs, S., Schewe, P., & Riger, S. (2004). A statewide evaluation of services provided to rape survivors. Journal of Interpersonal Violence, 19, 252-263.
  13.  Epstein & Langenbahn (1994), cited in Decker, S.E., & Naugle, A. F. (2009). Immediate intervention for sexual assault: A review with recommendations and implications for practitioners. Journal of Aggression, Maltreatment and Trauma, 18, 419-441.

  14.  Campbell,R., Sefl, T., Barnes, H., Ahrens, C., Wasco, S., & Zaragoza-Diesfeld, Y. (1999). Community services for rape survivors: Enhancing psychological well-being or increasing trauma? Journal of Consulting and Clinical Psychology, 67, 847-858.