Evaluation of the NT MOS projects
Assessment of underlying trauma in casework cases
Up to Closing the Gap: Northern Territory
Executive summary- Acronyms
- 1. Introduction
- 2. Methodology
3. Findings- 4. Analysis & recommendations
- 5. Appendices
MOS Plus staff have retrospectively categorised casework cases based on an assessment of the underlying trauma(s) or problem behaviour(s) in each case. This data was not previously captured in MOD and its collation was undertaken by reviewing the past case notes for each case.
It is important to note that assessments were made during the Interim Assessment Phase and may have changed as the case progressed. Data from the Interim Assessment Phase has been used for several reasons. Firstly, staff turnover since the beginning of the service means that, in some cases, the original counsellor for a case is not available to provide the level of insight into other trauma or problem behaviour that may have emerged over time.
Secondly, such changes were not always recorded by counsellors in case notes and therefore the assessment made in the interim Assessment Phase is the most reliable.
It should also be noted that one case may be counted in a number of categories if more than one form of abuse/problem behaviour was assessed as an underlying factor in the trauma. Over the query period there were 258 assessments made by MOS Projects' counsellors for a total of 220 cases.
In the graphs in the following section the N value has been divided by the total number of cases (rather than the total number of assessments) to provide an indication of the overall proportion of cases with a particular underlying trauma or problem behaviour. However, the N values displayed are for the total number of assessments made in a particular category, to provide an indication of numerical prevalence.
As is evident in Figure 22, sexual assault was assessed as being present in just over half of cases (57.7%), making it by far the most commonly identified underlying cause of trauma. This may, in part, reflect the specific sexual assault focus of the initial MOS service (July 2008 - November 2009) and the predominance of referrals to the service from SARCs (18.6%) and Child Protection services (21.4%).
Problem sexual behaviour was identified in less than one in six cases (13.6%), however only one client was assessed as exhibiting sexually abusive behaviour (0.5%).
Neglect was assessed as an underlying cause of trauma in approximately one in ten cases (9.1%).
In approximately one fifth of cases (20.9%) the underlying trauma or problem behaviour was 'indiscernible'.
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In the majority of cases only one abuse type or problem behaviour was identified at the Initial Assessment Phase however this result varied slightly across the Regions, with the greatest proportion of cases involving multiple abuse or problem behaviour types being recorded located in Top End (see Figure 23).
While sexual assault was by far the most commonly identified form of abuse amongst MOS Projects' clients (at the time of referral), the result varied across the Regions. Sexual assault was assessed as present in three quarters or more of cases in Barkly (77.8%) and Katherine (69.8%), compared to approximately half in Top End (53.6%), and Central Australia (50.0%) (see Figure 24).
The underlying trauma or problem behaviour was assessed as 'undiscernible' in approximately one quarter of cases in Top End (25.0%) and Central Australia (23.9%), compared with one in ten cases in Katherine (11.3%) and Barkly (11.1%) (see Figure 25).
Problem sexual behaviour was identified in approximately one in six cases overall, a result that was consistent across the Regions, with the exception of Barkly (see Figure 26).
Neglect was identified in approximately one in ten cases overall (9.1%), a result that was notably lower in Top End (5.4%), and higher in Central Australia (17.4%) (see Figure 27).
Figure 28 shows the change in the underlying abuse/problem behaviour in MOS Projects' cases over time. In 2009-2010, sexual assault was the underlying abuse type in virtually all cases. This reflects the MOS service focus until November 2009. Over 2009-10 and 2010-11 the proportion of cases with an 'other' abuse type or problem behaviour increased from 5% to 62%, which is consistent with the timeframe of the expansion of MOS Service to MOS Plus. Over the same period, the proportion of cases with sexual assault as an underlying abuse type decreased from 97% to 34%.
While the proportion of cases with sexual assault as an underlying abuse type has decreased the real number of cases involving sexual assault has remained relatively stable over the last two years. In 2009-2010 there were 32 cases where an initial assessment identified sexual assault as an underlying factor, compared with 36 cases in 2010-2011.
In 2010-11 sexual assault was still the most common underlying abuse type, and was assessed as present in one-third of cases (34%). The most commonly assessed 'other' abuse types in 2010-11 were neglect (19%), problem sexual behaviour (17%), emotional abuse (10%), and physical abuse (8%).
Since the expansion of the service, the proportion of cases in which the underlying abuse or problem behaviour was 'indiscernible' has been consistent at around one-quarter to one-third of cases.
Figure 22: Overall underlying trauma/problems behaviours in MOS Projects clients
Text version of Figure 22
Overall underlying trauma/problems behaviours in MOS Projects clients:- Sexual assault (N = 127) - 57.7%
- Indiscernible (N = 46) - 20.9%
- Problem sexual behaviour (N = 30) - 13.6%
- Neglect (N = 20) - 9.1%
- Physical Abuse (N = 11) - 5.0%
- Emotional abuse (N = 11) - 5.0%
- Domestic violence (N = 9) - 4.1%
- Community violence (N = 3) - 1.4%
- Sexually abusive behaviour (N = 1) - 0.5%
Figure 23: Number of abuse types/problem behaviours per case
Text version of Figure 23
| Region | One abuse type/problem behaviour (%) | Two abuse types/problem behaviours (%) | Three or more abuse types/problem behaviours (%) |
|---|---|---|---|
| Barkly (N = 9) | 100.0 | 0.0 | 0.0 |
| Central Australia (N = 46) | 91.3 | 2.2 | 4.3 |
| Katherine (N = 53) | 88.7 | 5.7 | 5.7 |
| Top End (N = 112) | 83.9 | 12.5 | 3.6 |
| Total (N = 220) | 97.7 | 8.2 | 4.1 |
Figure 24: Abuse categories by region: sexual assault
Text version of Figure 24
Abuse categories by region: sexual assault:- Barkly (N = 7) - 77.8%
- Katherine (N = 37) - 69.8%
- Total (N = 127) - 57.7%
- Top End (N = 60) - 53.6%
- Central Australia (N = 23) - 50.0%
Figure 25: Abuse categories by region: indiscernible
Text version of Figure 25
Abuse categories by region: indiscernible:- Top End (N = 28) - 25.0%
- Central Australia (N = 11) - 23.9%
- Total (N = 46) - 20.9%
- Katherine (N = 6) - 11.3%
- Barkly (N = 1) - 11.1%
Figure 26: Abuse categories by region: problem sexual behaviour
Text versino fo Figure 26
Abuse categories by region: problem sexual behaviour:- Top End (N = 17) - 15.2%
- Katherine (N = 8) - 15.1%
- Total (N = 30) - 13.6%
- Central Australia (N = 5) - 10.9%
- Barkly (N = 0) - 0.0%
Figure 27: Abuse categories by region: neglect
Text version of Figure 27
Abuse categories by region: neglect:- Central Australia (N = 8) - 17.4%
- Katherine (N = 6) - 11.3%
- Total (N = 20) - 9.1%
- Top End (N = 6) - 5.4%
- Barkly (N = 0) - 0.0%
Figure 28: Change in underlying abuse/problem behaviour over time, as a per cent of total cases
Text version of Figure 28
Figure 28 shows the percentage change in the underlying abuse/problem behaviour type in MOS Plus cases between 2008-09 and 2010-11. In the analysis that follows, proportions of abuse/problem behaviour types total more than 100%, as more than one abuse type may be assessed as a factor in an individual case.The change in the percentage of each underlying abuse/problem behaviour type in MOS Plus cases varies over the period. In 2008-09, sexual abuse was recorded as an underlying abuse type in 97% of cases, other forms of abuse was recorded as present in 5% of cases, and no cases were assessed as 'indiscernible'. In 2010-11, sexual abuse was recorded as an underlying abuse type in 34% of cases, other forms of abuse was recorded as an underlying abuse type in 62% of cases, and in 28% of cases the underlying abuse/problem behaviour was recorded as indiscernible.
Overall in the period, sexual assault decreased as a proportion of the underlying abuse type from 97% in 2008-09, to 59% in 2009-10, to 34% in 2010-11. Other abuse was recorded as a factor in 5% of cases in 2008-09, rising to 26% in 2009-10 and rising more sharply to 62% by 2010-11. Cases in which the abuse type was recorded as indiscernible increased from 0% at the beginning of 2008-09 to 31% in 2009-10, and decreased slightly to 28% by 2010-11.