20 August 2009

ACC targets sexual abuse counseling amidst concerns about safety of new clinical framework

Press release from the New Zealand Association of Counsellors, the New Zealand Association of Psychotherapists and the Aotearoa New Zealand Association of Social Workers
Specialists in the provision of counselling and psychotherapy for sexual abuse are joining together to challenge ACC’s drive to push down operating costs at the expense of the current options available to their clients.
Treatment providers throughout New Zealand – including approximately 750 counsellors – have been informed by ACC that a push is being made to find areas of “innovation” within the treatment of sensitive claims clients – primarily by creating an assessor/provider ‘split’ more commonly found in the insurance business. ACC has also stated that a new approach is being taken to “streamline the service to ensure we will return to acceptable operating parameters in the near future”.
“The Sensitive Claims Unit of ACC has declared that it is changing the way it works in response to difficult times, but it seems to have overlooked the fact that the clients involved in receiving our services are some of the most traumatised members of society,” says Susan Hawthorne of the NZ Association of Psychotherapists.
Under a new Clinical Framework about to be implemented for ACC’s Sensitive Claims Unit an acceptance that a client’s circumstances will affect the duration, intensity and type of counselling needed is limited to “exceptional circumstances”. Counsellors who have been informed about the Framework are critical of plans to devote more resources to the role of clinical psychologists in the overall process and have other concerns such as the lack of reference to cultural competency, an emphasis on artificially curtailing the number of counselling sessions and assumptions that psychologists alone can provide the specialist knowledge required to work successfully in this field.
“Putting in place a top-down treatment approach to manage a growing volume of need downwards will, we believe, put the wellbeing of clients in jeopardy. It ignores the scale of sexual abuse and the injuries caused to affected people and our ethical response to that,”says Susan Hawthorne.
Sean Manning, President-elect of the NZ Association of Psychotherapists, adds that “ACC is in the business of addressing the effects of trauma, but the proposed process where a victim of sexual abuse will have to tell their story to three people before getting help, will actually be damaging. If you want to put people off asking for help, this is a good way to do it. It is a shocking way to deliver a supposedly rehabilitative service.”
“Other than an implied criticism that there are clients who are receiving ‘too much’ counselling we have yet to hear clearly from ACC what it is they believe isn’t working under the current system. Instead we’re seeing a set of changes hurriedly imposed that we predict will impact negatively on clients who are already distressed by experiencing difficulties with getting cover, unreasonable delays and the impacts this has on safe practice,” says Adrienne Dale of the NZ Association of Counsellors.
“Private practitioners who belong to the Aotearoa New Zealand Association of Social Workers will always put our clients’ needs first. We are concerned that ACC appears to have undertaken an ill thought out re-gearing of the system towards pathways that dumb down our specialist skills without any real consultation, and that claim to be ‘best practice’ when that may not be the case. The risk is that ACC will end up by turning therapy into a factory line that assumes that everyone will recover from sexual abuse in a predetermined way,” says Cathy McPherson, convenor of ANZASW’s Private Practitioners Interest Group.
The counselling community have also expressed concern that any dollar gains envisaged by ACC from its stated goal of streamlining the current system are minimal, whereas the pain of changes to the system for sexual abuse clients could be huge.
According to information published by ACC’s Senstive Claims Unit as many as 5,000 clients access counselling every month, and on average the Unit receives about 550 new claims related to mental injury caused by sexual abuse, including trauma caused by incest, each month.
http://www.scoop.co.nz/stories/PO0908/S00246.htm

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