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Literature Review – Part 3

Responding to sexual violence: A review of literature on good practice

Commissioned by The Ministry of Women’s Affairs

Authors: Elaine Mossman, Jan Jordan, Lesley MacGibbon,Venezia Kingi, and Liz Moore

For a PDF [2.4 MB], click HERE

 

Return to Responding to sexual violence research reports

   

Contents

List of Tables
List of Boxes
Acknowledgements
Executive Summary

PART ONE: Overview of adult sexual violence and good practice
1    Introduction
2    Overview of sexual violence
3    Overview and critique of good practice

PART TWO: Summary of the literature
4    Medical system
5    Mental health system
6    Criminal justice system
7    Support services

PART THREE: Summary
8    Good practice services for adult survivors of sexual violence
8.1    New Zealand guidelines
8.2    Applicability to New Zealand context
8.3    Good practice programmes and services
8.4    Common good practice principles for delivery

Appendix: Methodology – search criteria and sources of references
References

 

PART THREE: Summary

 

8    Good practice services for adult survivors of sexual violence

 

This section brings together the findings from the four different systems (medical, criminal justice, mental health and support services). It presents:

  • New Zealand guidelines that were identified for dealing with adult victim/survivors of sexual violence
  • programmes and services identified as good practice
  • common good practice principles of service delivery.

 

Much of the good practice identified through this review has been based on overseas literature. It is important that this practice is carefully assessed for its applicability to New Zealand, particularly before any decisions are made on implementation. This section, therefore, briefly reviews some of the key characteristics and issues that impact on service provision in New Zealand.

8.1    New Zealand guidelines

Table 10 presents the New Zealand guidelines that were identified for dealing with adult victim/survivors of sexual violence. Some were developed with victim/survivors of sexual violence in mind, others are non-specific to sexual violence but have key relevance to this group.

Guidelines specific to victim/survivors of sexual violence were comprehensive, particularly the medical and mental health guidelines. However, as raised in several chapters, it is not just the content but also the implementation of the guidelines that is critical. Active monitoring of services would need to occur in order to assess this.

No guidelines were located for support services, although this may well be a reflection of their predominantly non-government organisation status.
Non-government organisations may have their own ‘in-house’ practice guideline documents that were unavailable for this review. However, national standards for these types of services were located for Australia and Europe.

Table 10: New Zealand guidelines

Guideline

Reference

System – service and sector

Specific to victim/survivors of sexual violence

The Medical Management of Sexual Assault

DSAC (2006)

Medical – forensic examination, crisis and long term medical care – adults and children

Sexual Abuse and Mental Injury: practice guidelines for Aotearoa New Zealand

ACC (2008)

Mental health – counselling – adults and children

Adult Sexual Assault Investigation Policy

New Zealand Police (1998)

Criminal justice – police – adults

Generic guidelines with relevance to victim/survivors of sexual violence

Family Violence Intervention Guidelines: child and partner abuse

Ministry of Health (2002)

Medical – primary health care – adults and children

Screening, Risk Assessment and Intervention for Family Violence Including Child Abuse and Neglect

Standards New Zealand (2006)

Medical – primary health care – adults and children

Pacific Cultural Competencies: literature review

Ministry of Health (2008)

Medical – primary health care/Pacific peoples

Prosecution Guidelines

Crown Law Office (1992)

Criminal justice – prosecution

Restorative Justice in New Zealand: best practice

Ministry of Justice (2004)

Criminal justice – restorative justice

 

8.2    Applicability to New Zealand context

New Zealand is a country with a small population from diverse cultural backgrounds. The majority of New Zealanders are of European descent, with Māori representing less than 15 percent of the population. The country has relatively few large urban centres, with most of the landscape being made up of relatively isolated rural areas. It has a centralised system of government and an adversarial justice system.

Any programmes or services identified as good practice overseas are only good practice in New Zealand if they work within this context. For example, forensic nursing has been established as good practice in many countries. While forensic nurses’ therapeutic benefits are transferable to New Zealand, their wider role may be limited through their inability to act as ‘expert’ witnesses in court cases in the New Zealand legal system. The sparsely populated rural areas also make the resourcing of specialist services to all areas difficult (e.g. Doctors for Sexual Abuse Care (DSAC) trained doctors, specialist police teams and specialist sexual offences courts).

The small size of New Zealand and its centralised system of government has helped the nation-wide implementation of new policies and service strategies such as policing strategies and health services. For example, the country has developed some innovative practices such as the national co-ordination of specialist sexual assault doctors through DSAC, state funding for rehabilitative mental health counselling for sexual abuse (Accident Compensation Corporation) and the national networking of the non-government organisation (NGO) specialised sexual violence support services (SSVSs) to develop strong and co-ordinated services and provide a voice at the national level (e.g. Te Ohaakii a Hine – National Network Ending Sexual Violence Together). The strong links New Zealand NGO SSVSs had developed with other agencies was commented on by Kelly (2005), which may mean models of service delivery advocated in other larger countries (e.g. sexual assault referral centres) may not be so applicable or necessary in New Zealand.

The lack of national networking historically has resulted in some communities developing their own models of service delivery in partnership with agencies such as the police and DSAC-affiliated doctors. This could be seen as a positive aspect enabling models to be developed that fit the local context, facilitating grassroots’ involvement. This may better meet the needs of the diverse population groups across New Zealand rather than the imposition of a single, nationally developed model of service delivery.

There are also some disadvantages to being a small country, and a major barrier in New Zealand to developing strong co-ordinated services to meet the needs of victim/survivors of sexual violence has been the lack of funding within the NGO sector (Ministry of Social Development, 2008). Although not relating specifically to services for victim/survivors of sexual violence, the Ministry of Social Development has acknowledged the inadequacy of funding for NGO services to families, children and young people. The ministry recognised that without sustainable funding there would be a decline in the level, intensity and/or quality of essential NGO services. The Government would itself need to step in to deliver these essential services. Through its Pathways to Partnership programme established in 2007, the Ministry of Social Development has begun to address issues of funding for the NGO sector (Ministry of Social Development, 2008: 3). The consistent and guaranteed resourcing of the NGOs is essential for their ongoing involvement in an integrated model of multi-agency service delivery.

Another challenge specific to New Zealand is the provision of appropriate and effective services for Māori, in particular that they have access to kaupapa Māori services (services ‘for Māori by Māori’, see Table 11). This review found that the only area where this type of service was currently available for Māori victim/survivors of sexual violence was at the community NGO level through the kaupapa SSVSs (and these were limited to the main centres). Barriers to achieving better service provision for Māori include a lack of resources for Māori to be able to develop these services and the Māori workforce needed to provide these services.

The Māori Potential Approach, the public policy framework developed by Te Puni Kōkiri (2008), provides insights into how this situation might be improved. 

The framework aims to better position Māori to build and leverage off their collective resources, knowledge, skills and leadership capability. The framework identifies three fundamental key enablers to Māori achieving full physical, psychological, emotional and spiritual well-being: mātauranga – building knowledge and skills; whakamana – strengthening leadership and decision-making; rawa – development and use of resources. While this policy framework applies to all government services, the principles and framework are also relevant to achieving effective provision of sexual violence services for Māori in New Zealand.

Clearly the unique characteristics of New Zealand mean that good practice based on overseas experience will need to be carefully assessed for its applicability to New Zealand.

8.3    Good practice programmes and services

The types of services and programmes that have been identified in this review as good practice are summarised in Table 12. Those highlighted are those for which there was either research evidence available or where they had been identified as such by experts in the field. As indicated in the table, some of those have already been incorporated in New Zealand.

8.4    Common good practice principles for delivery

In general, there was more literature and agreement over principles of delivery than particular types of service delivery. Many of those that emerged were common to a number of systems and services. The heavy reliance on international literature means their applicability to the New Zealand context will also need to be carefully considered. However, many of the principles identified appear more easily transferable to the New Zealand context, for example, for services to be culturally appropriate. Table 12 presents the overarching good practice principles for delivery that came through from the multiple types of services reviewed.

Table 11: Good practice programmes and services

Programme/service

Identified by

Evidence

(e.g. knowledge-based (victim/professional), research evidence)

Country research evidence
based on

Status

Medical

Forensic nursing (Sexual Abuse Nurse Examiners programme)

Kelly (2005)

Review of research evidence

International

Used overseas not in New Zealand

Mental health

Cognitive Behavioural Therapies (e.g. prolonged exposure treatment, stress inoculation training and cognitive processing therapy) for reducing short-term post- rape fear and anxiety symptoms

Astbury (2006)

Campbell ( 2001)

Wang and Rowley (2007)

Reviews of research evidence

International

Used overseas and in New Zealand

Criminal justice

Specialist courts

Amnesty International Australia (2008)

Kelly (2005)

Cossins (2007)

Review of research evidence

International

Used overseas not in New Zealand

Specialist prosecutors

Amnesty International Australia (2008)

Cossins (2007)

Walker and Louw (2003)

Reviews of research evidence

International

Used overseas in South Africa not in New Zealand

Specialist police investigation units

Amnesty International Australia (2008)

Brown and Heidensohn (2000)

Metropolitan Police Service (2005)

Epstein and Langenbahn (1994)

Lord and Rassel (2000)

Reviews of research evidence and individual research findings

International

Used overseas and recently introduced in New Zealand

Investigative interviewing techniques

Schollum (2005)

Reviews of research evidence

International

Used overseas and in New Zealand

Support services

Community-based, specialist sexual violence support services

Campbell and Raja (1999)

Findings of a research study

United States

Used overseas and in New Zealand

Sexual assault referral centres,  but in combination with, not instead of, community based non-government organisation specialist sexual violence support services

Kelly (2005)

Lovett, Regan and Kelly (2004)

Reviews of research evidence

International

Used overseas but not in New Zealand

 

 

Table 12: Common good practice principles of delivery

Programme/service

System applicable to – identified by

Type of evidence

Victim/survivor needs paramount

Safety of victim/survivor.

There should be informed choice and consent regarding all procedures and uptake of services to ensure victim/survivors do not feel disempowered (e.g. availability and choice regarding gender and ethnicity of service providers).

For those engaged with the criminal justice system, there must be ongoing communication and provision of information regarding case development and progression.

Victim/survivors should be treated with respect, empathy and in ways that validate their experience.

Medical – WHO (2003), DSAC (2006), Jordan (2008), Kelly and Regan (2008)

Victim/survivor perspective

Review of research evidence

Knowledge -based

Criminal justice system – Legal Aid Queensland (2007); Jordan (multiple); New Zealand Police (1998).

Knowledge -based

Mental health – ACC (2008)

Victim/survivor perspective

Knowledge-based

Support services – Rape Crisis Network Europe (2003)

Knowledge-based

Specialisation and training

Service delivery should be by appropriately trained, skilled, experienced and informed individuals and professionals. For victim/survivors’ needs to be met, the unique impacts and complexities associated with sexual violence must be understood and incorporated.

Medical – WHO (2003); Fry (2007), DSAC (2006), Jordan (2008), Kelly and Regan (2008)

Victim/survivor perspective

Review of research findings

Knowledge-based

Mental health –Jordan (1998)

Victim/survivor perspective

Criminal justice system – Amnesty International Australia (2008); Metropolitan Police Service (2005); Legal Aid Queensland (2007); Kelly (2005); Jordan (multiple); New Zealand Police (1998)

Victim/survivor perspective

Review of research findings

Knowledge-based

Research finding

Culturally appropriate

Māori victim/survivors must have access to appropriate and effective services, either run by Māori, or from non-Māori service providers who are trained in culturally appropriate protocols. These must be developed in partnership with Māori.

Services must also be adapted to meet the needs of victim/survivors from diverse ethnic groups (e.g. Pacific women, new migrants and refugees).

Specialist understanding is required to inform service delivery relevant to the needs of diverse groups of victim/survivors.

Medical – DSAC (2006), Ministry of Health (2002)

Knowledge-based

Mental health – ACC (2008)

Knowledge-based

Criminal justice system – Jordan (multiple), New Zealand Police (1998)

Victim/survivor perspective

Knowledge-based

Support services – ACSSA (2008)

Knowledge-based

Multi-agency response

Integrated service provision across multi-agencies with high levels of co-operation and co-ordinated working relationships (i.e. medical, criminal justice, mental health and specialist community support agencies).

Medical – WHO (2003)

Review of research evidence

Criminal justice system – Jordan (multiple); New Zealand Police (1998); Metropolitan Police Service (2005)

Victim/survivor perspective

Knowledge-based

Research finding

Appropriate environment

Services should be physically accessible, financially affordable, and provided in a welcoming, non-judgmental and non-intimidating manner.

Medical – WHO (2003), Astbury (2006), DSAC (2006), Jordan (2008), Kelly and Regan (2008)

Victim/survivor perspective

Review of research findings

Knowledge-based

Mental health – Jordan (1998)

Victim/survivor perspective

Criminal justice system – Amnesty International Australia (2008); Legal Aid Queensland (2007); Jordan (multiple)

Victim/survivor perspective

Review of research findings

Knowledge-based

Support services – Rape Crisis Network Europe (2003)

Knowledge-based

Accountable

There must be a commitment to ongoing evaluation of service delivery with assessment based on research evidence, practice standards and client feedback.

Mental health – ACC (2008)

Knowledge-based

Support services – ACSSA (2008)

Knowledge-based

Ensure support is available

Service providers must facilitate for victim/survivors to have access to a support person at the earliest opportunity.

Medical – Fry (2007), DSAC (2006), Jordan (2008), Kelly and Regan (2003)

Victim/survivor perspective,

Review of research findings

Knowledge-based

Criminal justice system – Amnesty International Australia (2008); New Zealand Police (1998)

Review of research findings

Knowledge-based

In summary, in regards to the medical system there are comprehensive New Zealand guidelines related to the medical care of victim/survivors. The review of literature found extensive research on good practice for conducting a forensic medical examination. Forensic nursing was an initiative reviewed favourably that had been implemented successfully overseas. Its applicability to New Zealand would need to be assessed carefully, particularly in relation to the status of nurses in court as ‘ordinary witnesses’. There appears to be a paucity of literature in relation to non-specialist primary health care.

The criminal justice system in New Zealand has undergone significant reform and the legal framework continues to be reviewed. There is a police policy for the investigation of adult sexual violence offences that includes many of the good practice principles of delivery featured in Table 12. The extent to which this policy has been implemented and adhered to is less clear. Specialisation, particularly within the criminal justice system, has been recognised as good practice and the introduction of specialist adult sexual assault teams within police is clearly a positive move. However, specialisation in New Zealand is still limited within police and has not extended to the prosecution section of the criminal justice system.

There are comprehensive practice guidelines for the mental health care of victim/survivors in New Zealand that are easily accessible via the internet to all practitioners. There is very limited research internationally or in New Zealand about which types of mental health interventions are the most effective for victim/survivors.

New Zealand has a very proactive network of SSVSs with good links with other agencies. There are also a range of other non-specialist sexual violence victim support agencies. Unlike Europe and Australia there appears to be no national practice guidelines for sexual violence support services in New Zealand. It is not known if individual agencies have their own ‘in-house’ documents.

Ensuring adult victim/survivors of sexual violence have access to the optimal services to assist in their recovery and well-being is crucial, and Kelly (2005: 2) points out there is still a long way to go:

Despite three decades of research, advocacy and campaigning, even the most basic issues matter, such as ensuring that women reporting sexual violence are treated with respect and dignity, cannot be guaranteed even in high resource contexts.

However, this review has identified a variety of good practice programmes and principles of delivery for adult victim/survivors of sexual violence. Providing we critically assess who has identified these practices, on what outcomes and what criteria, and ensure that the needs of victim/survivors remain paramount, then we are making a promising start.


Appendix: Methodology – search criteria and sources of references

 

Search criteria
The search was conducted by the Ministry of Women’s Affairs’ Information Services and by the business information specialist at Wellington City Libraries. It focused on material published in English, primarily since 2000, from New Zealand, Australia, Canada, the United Kingdom, the United States and South Africa.

Key words

  • Victim(s), victim support, survivors.
  • Sexual violence, sexual assault, rape, attack, sex*offending.
  • Best practice, guidelines, models.
  • Medical, emotional, mental health, community, criminal justice, police, prosecut*, court.
  • New Zealand, Australia, Canada, United Kingdom, United States, South Africa.


Databases and other reference sources

  • Ministry of Women’s Affairs in-house library.
  • Te Puna – National Library of New Zealand Database.
  • Internet.
  • Google scholar http://scholar.google.co.nz.
  • New Zealand Family Violence Clearing House.
  • National Resource Center on Domestic Violence http://new.vawnet.org/.
  • Contemporary Women’s issues.
  • Masterfile Premier.
  • The Australia/New Zealand Reference Centre.
  • Gale’s General OneFile.
  • Innz (Index to New Zealand periodicals).
  • Australian Centre for the Study of Sexual Assault.
  • References traced from articles and books.

 

The Ministry of Women’s Affairs’ research manager scanned the final list and decided which literature should be included or excluded. Given the volume of international practice guidelines for different types of agencies and systems, the final list contained a selection of guidelines for the different systems, rather than all available references. This was considered sufficient for the purpose of extracting high-level best practice principles. The list also contained some references published before 2000, where these were regarded as key references or where there was little other information available (e.g. in relation to specific population groups). Also included were diverse newspaper articles from New Zealand and journal articles from Journal of Interpersonal Violence and Violence against Women.


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Disclaimer

This report was commissioned by the Ministry of Women’s Affairs. The views, opinions and conclusions expressed in the report are intended to inform and stimulate wider debate. They do not represent government policy.
 

Published in October 2009
by the Ministry of Women’s Affairs | Minitatanga Mō Ngā Wāhine
PO Box 10 049, Wellington, 6143, New Zealand
Phone: 0064 4 915 7112
Fax: 0064 4 916 1604
Email: mwa@mwa.govt.nz
Website: www.mwa.govt.nz

ISBN 978-0-478252-43-9 (Print)
ISBN 978-0-478252-44-6 (Digital)

Last modified: Nov. 13, 2009 9:49 am