Therapy The One in Four psychotherapy programme provides specialised individual and group therapy to men and women who have been sexually abused in childhood and to their families. We understand that sexual abuse does not happen in isolation. The child, their family, their community and the wider society are all impacted, and any effective intervention must take account of this. The client’s first point of contact is an individual assessment meeting with a therapist. This facilitates a broad exploration of the impact of sexual abuse on the person’s life and to tentatively establish what the client might need. Child protection is also discussed. Following this meeting the client may be offered a place on the 20 week Initial Stage Therapy programme or may be referred to another specialist service, for example if there are addiction issues. The client meets a therapist weekly following a structured evidence based programme exploring their family of origin, their current life situation, their coping strategies and their relational style. Child protection concerns are addressed and notifications are made to the Child and Family Agency. At the end of this programme the client and therapist work together to decide the specific pathway that is required to repair the harm done. This may include longer term individual or group therapy or the client may decide they have achieved what they needed. If the decision is to move into longer term therapy, a therapeutic needs plan is developed jointly which will inform the direction therapy will take. One of the significant themes that continue to emerge is the realisation for clients that they need the understanding and support of family members.We believe that focussing on the impacts of childhood sexual abuse is an essential element in a holistic approach to support individuals to move from surviving to living. Psychotherapy at One in Four is based on an attachment –based trauma model of working with adult survivors. The majority of clients who enter long term therapy remain with the service for 2 – 3 years. Fewer than 10% of clients remain in therapy for over 4 years. Theories: Finkelhor and Browne (1988): Trauma as " an experience that alters a child's cognitive or emotional orientation to the world" Briere (1992): Long Term effects of Child abuse Family Support Over 40% of One in Four Psychotherapy clients have been sexually abused by a family member. The disclosure of abuse has an enormous impact on the entire family system: victim, offender and the non-offending family members. Typically family members are torn between loyalty to the offender, fear of the societal response and concern for the victim. Families are often terrified of the consequences of a disclosure within the community and fear being ostracised. Some families enter total denial and ostracise the victim while others have a more ambivalent response. Families in this situation need an enormous amount of assistance both to support the victim and to ensure that other children in the family are safe. One in Four offers a psycho-educative family support programme. Initially families are met for an individual session to assess their needs and impact on them, and to explore their response to the disclosure. Families tell us of the shame and guilt they feel that sexual abuse has occurred on their watch’. Families can be very split in relation to the disclosure and each individual’s voice needs to be heard. Individuals then join a group with people from other families who have had similar experiences. For more information on The Family Support Programme click here. The Phoenix Programme The Phoenix Programme is seen at One in Four as a core child protection strategy. We work with the sex offenders, their families and the statutory services to help offenders confront the harm that they have caused and to support them in living lives that are free from sexually harmful behaviour. The programme is underpinned by the Good lives Model and risk management principles to reduce recidivism. It is one of the very few programmes available for non-convicted offenders in Ireland. Last year we worked with 52 individuals. Sex offenders are referred to the programme by Tusla, the Gardaí, the Courts and by their families. The programme is delivered from a Good Lives, Risk Needs (RNM) Relapse Prevention and Systemic theoretical pathways model. The individual will only begin the Pathways Model following their meeting with a Social Worker from TUSLA. Once the individual has engaged with TUSLA this begins the Multi Agency Risk Management meetings. Multi Agency Risk Management meetings will take place throughout the duration of the individual and family (if available) engagement with the programmes. The risk needs will be gathered initially in the one to one screening meetings which will include the SA07 (STATIC and STABLE 2007) the MATRIX 2000 and the Armadillo 2013, the SCJT (Structured Clinical Judgement Gathering Tool) gathering tools which will inform in the risk management case formulation. There are also specific gathering tools to deal with Child Sexual Abuse material (C.S.A.M) The case plan is used to understand the motivation and pathways that led to the individual offending and to inform treatment. One in Four does not undertake risk assessments. The treatment programme is delivered over 18 months in a group setting. Three modules focus on early life history, offence specific details and relapse prevention. Tusla child protection services and the Gardaí are informed when an offender engages with the Phoenix Programme. One in Four staff psychotherapists take part in multi-agency meetings on a regular basis, with a view to managing the offenders in the community. Following treatment the offender attends an intervention maintenance group which supports and reinforces relapse prevention. An increasing number of young offenders aged 18– 29 attended the programme in 2018, comprising 36% of total participants. Research suggests that, without intervention, this age group has the highest recidivism rate. From a child protection perspective, it is vital to intervene with this group. In 2018 offenders travelled from all over the country to attend the Phoenix Programme, with 65% of individuals coming from outside Dublin. This highlights the need for this type of community intervention programme throughout the country. Family Support is a key aspect of the Phoenix Programme has always been the involvement of non-offending family members. Family members, usually the wife/partner or parent of the offender, are invited to attend a psycho-educative support group which allows them to learn about characteristics of individuals who offend, offending behaviour and the pathways that led to the offending behaviour. For more information on The Phoenix Programme click here. For more information on The Family Programme for The Phoenix Programme click here.