Conclusion and future considerations

8.1 Conclusion

The perpetrator cohort intervention trials and case management are addressing a service delivery gap for people using violence, and have contributed to delivering on recommendation 87 of the Royal Commission to “research, trial and evaluate interventions for perpetrators”.

The cohort intervention trials have provided a more tailored program design to particular cohorts of people who use violence, to better meet their needs. The analysis demonstrates that different design features work for different cohorts, for example cultural healing components for Aboriginal cohorts.

Within the cohort intervention trials there is a current service gap for people with mental illness or substance abuse, indicating a different approach may be required for engaging workforces and organisations within these sectors to design and pilot an appropriate program. Further, it will be important to consider the future delivery of the programs moving beyond a pilot stage, to ensure people who use violence have access to the tailored support programs they need, regardless of where they reside in Victoria.

Case management has also received positive feedback in terms of appropriateness of its design and implementation. In particular, providing one-on-one support that is tailored has reportedly assisted in meeting the needs of people using violence, particularly those who have more complex needs. It has also contributed to ‘group readiness’, prior to people who use violence entering into group MBCPs. Consultations with people who use violence indicate more could be done to support and provide clarity around exit planning.

Several enabling features of the cohort intervention trials and case management were identified.

• Creating trusting relationships between participants and facilitators, and among group members to encourage engagement and participation.
• Utilising both individual and group work in a complementary manner.
• Balancing accountability with a trauma informed approach to address the underlying factors contributing to violent behaviour.
• Facilitating a holistic, wrap-around approach to address contextual factors in a person’s life by connecting them to the broader service system.
• Allowing flexibility in approach for people with different levels of need and at varying stages of change.
• Providing family safety contact support to people who experience violence

Specific challenges were faced by both case management and cohort intervention trials during implementation.

• Funding uncertainty and short timeframes, which made implementation later for some cohort intervention trials and made workforce recruitment and retention challenging.
• Lack of focus on the family safety contact function, including adequate resourcing.
• Workforce capability, including challenges recruiting appropriately skilled staff and retaining them throughout the duration of the program (exacerbated by funding uncertainty).
• Data collection through IRIS was not fit-for-purpose.
• Exit planning was not always considered from the outset, and was unclear to some program participants
• Referral processes have not been systematic, often relying on intra-organisation referrals or from the courts or child protection
• Brokerage underspend due to uncertainty in how to use it appropriately
• Confusion regarding eligibility and referral pathways, particularly the mandated versus non-mandated aspect of the program.

These challenges are not uncommon for pilot programs during their establishment phase, and in light of the significant reforms occurring in Victoria in family violence. Provision of ongoing funding for case management and an additional year of funding for the cohort intervention trials provides new opportunities to overcome these challenges.

There are positive indicators of program effectiveness, including high rates of attendance, retention and engagement with the programs among people who use violence. People who use violence have also reported improving their understanding of what constitutes family violence, understanding the impact of their behaviour on others and there are examples of them self-reporting taking responsibility for their behaviour. While promising, triangulating these findings with the views of people who experience violence suggests these early indicators of progress need to be treated with caution. Ongoing monitoring particularly from the perspective of the person experiencing violence will be critical to measuring outcomes over the longer term.

8.2 Future considerations

This outcome evaluation report identifies several areas for ongoing improvement or enhancement, particularly as the programs transition from pilots to ongoing funding (case management) or providing services for an additional year (cohort trials). There are eight overarching improvement opportunities, and three that relate to cohort interventions. These are described in detail below.

8.2.1 Overarching opportunities

Building focus on the role of the family safety contact. The family safety contact role has not been a focus of the programs to date. As outlined in Section 4.7, the family safety contact function has either been ad hoc and unexpected and/or created barriers to access through the involvement of the person who used violence with the same service provider. This role is currently being aligned to the MARAM framework. Communities of practice for the family safety contact function and their supervisors is now occurring, delivered by No to Violence. Several steps can be taken to ensure the intention of the role is understood and embedded within the programs going forward:

• Funding agreements and/or submissions should allocate specific funding to this role, over and above what may currently be provided by the service provider. The purpose of this is to overcome existing family safety contact workers being used for these programs without additional resourcing. Service providers and funding submissions should factor in resources for this role in their budgets.
• FSV utilise the newly initiated training and communities of practice for the family safety contact function to better understand the roles, their function and broader system integration implications.
• FSV can provide additional guidance material to service providers on how the person experiencing violence can be appropriately connected to ongoing support, where this is preferred to contact with the family safety contact worker. Particular requests were made by people who experienced violence for financial support, referral to programs, and on-going involvement in support groups or counselling. A few participants also identified that there could have been greater support provided for their children, such as access to a child psychologist.

It is advised this opportunity is prioritised, as it directly affects the safety of the person experiencing violence.

Strengthening the referral pathway by raising awareness of the programs within the service system. As outlined in Section 7.3 there is a need for a more sophisticated approach to referrals that encourages and leverages system connectivity. Raising awareness of the programs, and providing guidance on when and how to refer to the programs, is an initial step to improve the referral pathway. Capacity building within the broader service system connectivity is particularly important to avoid misidentification of the primary aggressor. To strengthen the referral pathway, it is advised that:

• FSV actively work with the Orange Door implementation teams to ensure that as they are rolled out, there is a process for knowing which cohort intervention trials and case management programs are available within the DHHS area.
• Guidance material is provided on client eligibility, to avoid confusion regarding whether or not the programs are mandated. This material could be developed for different audiences, including service providers, so they understand what the process is for accepting someone if they are on a CCO, clients, and major referrers including Magistrates and Child Protection.

Contributing to building workforce capability. Recognising the challenges associated with recruiting an appropriately skilled workforce, there may be a role for FSV to play in ensuring there is sufficient representation of, and training to develop, the perpetrator workforce, including those from a diverse background. This should align with implementation of Building from Strength: 10-year industry Plan for Family Violence Prevention and Response. This plan identified a high desire among the family violence workforce for training in working with people who use violence, and that immediate actions included ‘funding the development and delivery of training to meet immediate upskilling needs’ and specifically identified working with people who use violence as an example of this. As such, the Industry Plan represents an opportunity for the FSV project team to share their knowledge on working with people who use violence, and articulate why this is important to promote safety among people experiencing violence. While this may be beyond the initial scope of the project team’s work, it is nonetheless a critical input into the success and sustainability of the programs it funds.

Improving accountability, governance and reporting of the programs through FSV. During the pilot stage, the FSV project team was appropriately focused on major project establishment activities, including developing operational guidelines, assessing and awarding submissions for funding, establishing governance arrangements and providing ongoing implementation support. Given the ongoing funding for case management and an additional year of funding for the cohort intervention trials, there is now a need to develop stronger monitoring and accountability mechanisms in future.

Specifically, this includes establishing or improving existing data collection systems for outcome reporting, including ensuring a consistent approach is adopted across providers. This would build on the work undertaken through this evaluation. This should clearly cover reliable and consistent methods for understanding how many participants have accessed the programs, demographics of the program participants, and referral pathways. Where service providers have not met agreed performance measures, this needs to be actively managed by FSV and APSS, and transparently reported. Clear role delineation between FSV and all of the APSS is required to support this process.

Currently, the data collection tool developed by the evaluators as part of this evaluation has filled a gap by collecting outcome measures and data where it may not be reliably collected via IRIS. Sustainable outcome data collection methods need to be established beyond the life of the evaluation. These recommendations are necessary for overall accountability purposes, particularly where providers are not meeting their service obligations.

Providing improved exit planning for case management participants. Service providers need to ensure exit planning is included within their services, and that this is clearly communicated to program participants. This opportunity relates specifically to the case management program, since the cohort trial participants had a clearly defined program end date. Setting boundaries between the case worker and participant upfront may assist in managing this process. Additional training or guidance to service providers on how to support exit planning may also contribute to improved exit planning, as would opportunities for ongoing supervision.

Providing clarity around funding. Lack of notice regarding future funding was a major impediment to successful implementation of the programs (see Section 7.4). Noting the additional funding provided 2019/2020, it is advised that:

• DHHS, through FSV, release and confirm funding amounts for the case-management service providers as soon as practicable.
• DHHS, through FSV, provide clarity to cohort service providers regarding the future of their funding at least one quarter prior to funding ceasing.

While this is at times outset the control of the FSV project team, it is important to pursue this recommendation where possible, given the impact it can have on the sustainability and effectiveness of the programs.

Adopting a systems approach by creating alignment with the justice perpetrator programs. The intention of this opportunity is to ensure there is clear guidance and pathways for when people who use violence should be referred to the justice programs versus the cohort intervention trials or case management. Avoiding duplication between these programs contributes to a more efficient service system. This could be achieved by using the existing program governance frameworks that incorporate members from both the justice and cohort intervention trials, but focus discussion on how the programs can complement each other.

Long-term research and evaluation. The cohort intervention trials were designed to be pilots and thus this evaluation only captured the short-term outcomes of the interventions. Further, the process of behaviour change occurs over a long time period, often involving multiple interventions through the web of accountability. As such, this evaluation was unable to show the effect of the programs over a longer time period. Further, evaluation of MBCPs has not occurred in a systematic way in Victoria, and this evaluation has not analysed the MBCP group work element (this was out of scope). For this reason, it is recommended further monitoring and evaluation occurs both for mainstream MBCPs, and the programs within scope of this evaluation. This will assist in better understanding the sequencing of interventions across community and justice settings.

8.2.2 Cohort specific

Tailoring implementation and reporting targets for Aboriginal cohorts. As outlined in Section 5.4, service providers for Aboriginal cohorts may take additional time to implement and deliver programs for a range of reasons, including to establish strong partnerships with other agencies, to build community trust of the program to facilitate word-of-mouth referrals, and so program content can incorporate cultural healing. To ensure program funding and reporting supports Aboriginal cohort providers and recognises these differences, it is suggested that:

• Consideration be given to tailoring funding agreements with Aboriginal providers to reflect these differences, particularly in relation to expected numbers of program participants within particular timeframes. Reviewing the effectiveness of these programs in the same timeframes as other service providers may lead to misleading conclusions being drawn, if it is implementation features (such as strong partnerships) that are still in development rather than the program itself that is not effective.
• Funding agreements should also allow support for cultural healing. This may include compensation for Elder involvement, transportation costs to sites of cultural importance, or longer program timeframes to create time for healing from past trauma.

Building capability within the mental health and AOD workforces to encourage the design of suitable programs for these cohorts. There remains a service need for this cohort. To ensure the Recommendations of the Royal Commission are fulfilled, and more importantly to ensure programs are delivered to cohorts where there is a clear need, it is important programs are designed and delivered for people with mental illness and/or substance abuse. Given the lack of appropriate responses in the initial funding round, this may require a different approach driven by FSV.

Future work would need to be done in the context of the Industry Plan and work already being undertaken by FSV to build the capacity of the existing mental health and AOD workforce. It is understood that FSV have already embarked on this process through the Specialist Family Violence Capacity Building Program in AOD and mental health workforces, and provision of funding for No To Violence and Domestic Violence Victoria for a coordination function. Given this may be a significant undertaking, some work in this area may fall outside the mandate of the immediate FSV project team.

There is also a need to build capacity in other mainstream services, to support these cohort over the longer term and as they engage with other support services such as housing. These mainstream services need to be equipped and capable of responding to diversity.

Consider opportunities to scale the programs. The programs were intended to be pilots in their initial year. During their second year of funding, consideration should be given to the ongoing future of the programs, and opportunities for state-wide scaling. Given the intensity of the programs, this needs to consider whether adaptations are made to existing MBCPs adopting enabling features of the trials, or adopting other means to improve access to these same cohorts located in other parts of the State. Given there is need for the programs within select areas of the State where they are currently being piloted, it is likely this need would extend state-wide. A needs analysis and feasibility assessment would need to be conducted initially to determine which programs and where to target them, recognising the resource intensity involved in scaling. At a minimum, this evaluation has identified six practice features that should be visibly incorporated into any future iteration of the programs.