Quality statement 5: Therapeutic interventions

Quality statement

Children and young people who have experienced abuse or neglect are offered therapeutic interventions based on a detailed assessment of therapeutic needs.

Rationale

There are many ways in which children and young people can be affected by abuse and neglect. In order to offer effective therapeutic interventions, practitioners need to identify each child or young person's therapeutic needs using a detailed assessment. They can then discuss the options with them and their parents and carers (if appropriate) and make a joint decision about the therapy. Some children and young people may not be ready or may not want the therapy at that point. This should be their choice.

Quality measures

Structure

a) Evidence of local arrangements to ensure that children and young people who have experienced abuse or neglect have a detailed assessment of therapeutic needs.

Data source: Local data collection, for example, audit of service specification or protocols.

b) Evidence of local arrangements to ensure that children and young people who have experienced abuse or neglect are offered therapeutic interventions based on a detailed assessment of therapeutic need.

Data source: Local data collection, for example, audit of service specification or protocols.

Process

a) Proportion of children and young people who have experienced abuse or neglect who had a detailed assessment of therapeutic needs.

Numerator – the number in the denominator who had a detailed assessment of therapeutic needs.

Denominator – the number of children and young people who have experienced abuse or neglect.

Data source:  Statistics: children in need and child protection, Department for Education and local data collection, for example, audit of individual case records.

b) Proportion of children and young people who have experienced abuse or neglect who were offered therapeutic interventions based on a detailed assessment of therapeutic needs.

Numerator – the number in the denominator offered therapeutic interventions based on identified therapeutic needs.

Denominator – the number of children and young people who have experienced abuse or neglect and had a detailed assessment of therapeutic needs.

Data source:  Statistics: children in need and child protection, Department for Education and local data collection, for example, audit of individual case records.

c) Proportion of children and young people who received a therapeutic intervention after experiencing abuse or neglect who had a review of how effective the therapeutic intervention was.

Numerator – the number in the denominator who had a review of how effective the therapeutic intervention was.

Denominator – the number of children and young people who received a therapeutic intervention after experiencing abuse or neglect.

Data source:  Statistics: children in need and child protection, Department for Education and local data collection, for example, audit of individual case records.

Outcome

a) Acceptability of therapeutic interventions offered to children and young people who experienced abuse and neglect.

Data source: Local data collection, for example, feedback from children and young people supported by children's services.

b) Health and wellbeing of children and young people who experienced abuse or neglect.

Data source: Local data collection, for example, feedback from children and young people supported by children's services.

What the quality statement means for different audiences

Service providers (such social services, sexual health services, drug and alcohol services, child and adolescent mental health services, youth offending services and primary and secondary care services) ensure that members of staff who support children and young people who have experienced abuse or neglect are trained to carry out an effective detailed assessment of therapeutic needs. This is to establish the most appropriate therapeutic interventions, make referrals or to deliver these interventions, and to evaluate their effectiveness. They are also trained to discuss the interventions with children and young people in a way that helps shared decision making.

Practitioners (such as social workers, mental health professionals, specialist drug services professionals, health visitors, GPs, community nurses, youth workers and probation officers) ensure that they offer the most appropriate therapeutic interventions to children and young people who have experienced abuse or neglect based on a detailed assessment of their therapeutic needs. They also ensure that children and young people understand their choices and that if they decide to start the therapeutic intervention, they discuss throughout how effective it is.

Commissioners (such as local authorities, clinical commissioning groups and NHS England) commission services in which children and young people who have experienced abuse or neglect have access to the most suitable and effective therapeutic interventions.

Children and young people who have experienced abuse or neglect are offered therapeutic interventions that are seen as the most suitable for their circumstances. They have an opportunity to discuss their options, and get an explanation from their practitioner about what the interventions are and what they involve. They have a choice to participate in the interventions or not if they do not feel ready at that point.

Source guidance

Child abuse and neglect (2017) NICE guideline NG76, recommendations 1.7.1, 1.7.2 and 1.7.3

Definitions of terms used in this quality statement

Children and young people who have experienced abuse or neglect

Includes those assessed as 'in need', likely to suffer significant harm or suffering significant harm.

[NICE's guideline on child abuse and neglect, section 1.6]

Equality and diversity considerations

Children and young people who need to communicate with practitioners about abuse or neglect may have problems with communication, for example because they are very young (pre-verbal) or because of disability or speech or language problems. The support may be in the form of more frequent visits, involving family members who know the child or young person well (where they are not implicated in the abuse or neglect) and any specialists who can help with the communication such as speech and language therapists or interpreters.