MP close to tears over stories of sexual abuse

An article from the New Zealand Herald by Simon Collins

National MP Nikki Kaye was almost moved to tears when survivors of rape and sexual abuse told their stories outside her office yesterday in protest at tighter rules for ACC-funded counselling.
The 29-year-old first-term Auckland Central MP told about 30 protesters that she had people in her own life who had been affected by sexual abuse.
"So I do have some understanding, so I'm going to sit down and work out what I can do in terms of raising this with ACC and with ministers," she told them.
When West Auckland mother-of-four Yvie Stewart talked about her lifelong struggle with mental illness since she was sexually abused as a child, Ms Kaye said, "I just want to hug you". Tears welled in her eyes as the two women embraced.
The group was protesting at new ACC rules which took effect this week, restricting free counselling for sexual-abuse victims to cases where a clear link can be proved between the abuse and a subsequent "psychiatric condition".
The rules also restrict counselling to 16 weeks at a time, with reviews by independent assessors to determine whether extra sessions can be funded.
Eliana Darroch, a 19-year-old beneficiary who went on a protest hunger strike from Tuesday until yesterday outside Ms Kaye's office, said abuse victims did not necessarily have a mental illness but still needed help.
"That [mental illness] is what counselling is meant to prevent," she said.
Louise Nicholas, who went to court to challenge three policemen who she said had abused her, said the new rules would bring huge costs to society because many women would be unable to get the counselling they needed.
Mrs Stewart, 47, said her four children now aged 9 to 20 would have suffered even more than they had if she had not been able to get ACC-funded counselling on and off since 1992, and intensively for the past five years.
"I used to cut and burn myself," she said. Her arms are still scarred. "I have attempted suicide and nearly died because I couldn't get the help I needed from community mental health.
"What they do is put you on pills. You start improving. Then they close your case. The pills only work for a little while because they are only dealing with the depression and not the root cause. The root cause is the abuse."
Ms Kaye said she could not guarantee that ACC or ministers would change the new rules but she promised to pass on the women's stories to them.

http://www.nzherald.co.nz/politics/news/article.cfm?c_id=280&objectid=10606381

Counsellors support ACC review

Press release from the New Zealand Association of Counsellors

Counsellors support ACC review – but it’s not enough!
The Government is right to demand that the ACC Sensitive Claims Unit is reviewed, but this is not far enough, the new process still needs to be stopped.
Nick Smith has repeatedly followed ACC’s insistence that the new “pathway” for sexual abuse claims is a result of research undertaken by Massey University This is not the case, ACC’s management are hiding their motives behind a smokescreen of so called clinical expertise.
The New Zealand Association of Counsellors challenges ACC to properly reference the new pathway and to say which parts of the research support it.
“In general we have no issues with the “Guidelines” put out by ACC and researched by Massey University” says Eric Medcalf, NZAC Ethics Chair. “It’s the new administrative Pathway that is the problem. ACC management have chosen to selectively interpret the conclusions and use them for their own cost cutting agenda. This is a deliberate distortion of scientific research for commercial gain, at the expense of victims of crime.
“The Massey research rightly draws distinctions between the treatment needs of usually well functioning people who are sexually assaulted as adults and those who have been abused as children. Knowledge gained from brain imaging has shown that childhood experience of trauma affects brain development in ways that one- off attacks in adulthood do not. ACC is generalising from research on adult survivors and applying it to survivors of childhood abuse, and in doing so risks deterring survivors from seeking help, retraumatisation and a denial of proper and effective treatment ”.
The ACC pathway is being led by Dr Peter Jansen, a previously well respected GP and innovator in Māori health. However, his imposition of these new ACC rules appears to breach his ethical code:
“Commercial interests of an employer, health provider, or doctor must not interfere with the free exercise of clinical judgement in determining the best ways of meeting the needs of individual patients or the community, nor with the capacities of individual doctors to co-operate with other health providers in the interests of their patients, nor compromise standards of care or autonomy of patients in order to meet financial or commercial targets. (NZ Medical Association Code of Ethics, para 57)”.
NZAC urges ACC to stop the imposition of its new pathway whilst the review is under way and also to enter into meaningful dialogue with the professional associations on a fair, humane and scientifically justifiable service for the victims of sexual crimes.

http://www.scoop.co.nz/stories/PO0910/S00405.htm

Nikki Kaye picketed by sexual abuse survivors

Press release from the End Rape Culture Now! Collective

An End Rape Culture Now! Collective member today enters the third day of her hunger strike outside National MP Nikki Kaye's office. Sexual abuse survivors have been camping outside the Auckland Central MP's office since Tuesday to protest ACC cuts to sexual abuse counselling. Survivors will hold a public rally outside the MP's College Hill office at 12.00 noon this Friday 30th Oct where Louise Nicholas will speak.
The End Rape Culture Now! Collective asks that:
(1) Nikki Kaye advocates for counselling for sexual abuse and assault survivors in parliament, and discusses this with John Key.
(2) ACC supports the ACC-registered counsellors to develop a New Zealand tool to assess survivors for counselling
(3) ACC ceases to require the DSM-IV as the only diagnostic tool to assess mental injury and that a public announcement is made by ACC to this effect
Hunger Striker Eliana Darroch said "Our hunger strike is symbolic of ACC denying nourishment to survivors of sexual abuse, sexual assault and rape. To take away the counselling we need to recover, is like taking away our food. Nikki Kaye is my local MP and should advocate for survivors."
As of Tuesday, survivors have already been receiving letters from ACC stating that their applications for treatment are declined, and that required to attend a formal psychiatric assessment with a psychiatrist. "Restricting counselling access delays recovery and prolongs the trauma" says Darroch.
End Rape Culture Now! Collective are wanting answers:
With 1 in 4 women and 1 in 8 men experiencing sexual abuse in their lifetime, this is a societal problem, not a personal one, and therefore needs to be addressed by the government. “This is an issue of crave public concern. ACC and the National Party need to be held accountable for the changes they have put through. What advice would John Key give a rape survivor who was refused treatment or made to wait indefinitely? What are people to do when they can't afford counseling” said End Rape Culture Now! Auckland spokesperson Priscilla Penniket.
No funded alternative system of counselling support has been proposed to replace ACC's current system, for those who do not qualify under ACC's changes.
ACC Minister Nick Smith yesterday announced that the counselling access restrictions would be reviewed in six months. "Survivors do not have six months, they need counseling now" says Penniket. One sexual abuse survivor has already committed suicide rather than submit to a psychiatric diagnosis. "Survivors do not want a psychiatric mental illness label, it's all very well to review this pathway in six months, but these DSM-IV labels affect peoples lives in the long term" says Penniket.
DSM-IV stands for the American Diagnostic Statistical Manual. New Zealand ACC counsellors are wanting to offer alternative assessment models that are more appropriate to sexual abuse survivors.
Hunger striker Eliana Darroch is feeling physically weak but in good spirits with strong support from family and friends. It is her birthday today.
A public rally in support of sexual abuse survivors, and against the changes to ACC, will begin at 12.00 midday, Friday 30 Oct, outside Auckland Central MP Nikki Kaye's office, 82 College Hill, Auckland.
For more information,
www.stopcuts.blogspot.com
www.youtube.com/endrapeculture
www.endrapeculture.org

http://www.scoop.co.nz/stories/PO0910/S00420.htm

ACC protest delivers 4000 signatures to Parliament

An article from the Press

Opponents of ACC's new guidelines for dealing with sensitive claims have delivered a petition with 4000 signatures to Parliament in Wellington.
Petition organisers said half of the signatures came from clinical professionals.
ACC Minister Nick Smith was unavailable to meet the petition's organiser, psychotherapist Kyle MacDonald, at yesterday's rally. However, Smith sent list MPs Michael Woodhouse and Nicky Wagner to receive the petition.
MacDonald said the number of professionals who had signed the petition sent a clear message to Parliament that the guidelines were wrong.
"It should be clinicians, not politicians, directing these guidelines, but an overwhelming number of people who signed it are professionals," he said.
Wagner said it seemed strange that so many clinicians had signed the petition when the Government had undertaken more than four years of consultation with professionals before announcing the guidelines, which came into force yesterday.
Labour leader Phil Goff, who met the rally, said the protesters had his party's full support.
Labour list MP Lynne Pillay said collecting 4000 signatures in under six weeks was "incredible", and called on the Government to halt the guidelines.
Opponents are concerned that the new guidelines will reduce access to counselling for sexual abuse victims and discourage them from seeking treatment.
Smith announced yesterday that the guidelines would be reviewed after six months.

© 2009 Fairfax New Zealand Limited
http://www.stuff.co.nz/the-press/news/3004438/ACC-protest-delivers-4000-signatures-to-Parliament

Professional disagreements?

A press release from the New Zealand Psychological Society and the New Zealand College of Clinical Psychologists

Responding to criticisms of the new ACC process for dealing with sexual abuse claims, the Minister for ACC Dr Nick Smith is reported in the media today as saying that there are “professional disagreements between psychologists and psychotherapists and counsellors about the changes to the management of sensitive claims”.
The New Zealand Psychological Society (the Society) and the New Zealand College of Clinical Psychologists (the College) is concerned by this statement because there are many serious concerns shared by psychologists, counsellors and psychotherapists about the new ACC procedures.
First, there is agreement that ACC does not appear to have been responsive to the feedback they have been given by a range of professional organisations involved in providing sensitive claims services and from the clients who use them. Some of the problems already identified in the earlier clinical pathway proposal remain in the new clinical pathway.
Second, requiring sexual abuse survivors to disclose their abuse to
more than one clinician is likely to be experienced as psychologically unsafe by many clients and may deter people from seeking help when they need it.
Third, the suggestion that sixteen sessions is sufficient to meet the needs of most sexual abuse survivors does not accurately reflect the range of experiences of sexual abuse (e.g. from one-off assaults to complex and on-going assault within familial relationships). These are likely to produce different reactions - both in terms of severity and type - requiring different treatments and different durations of treatment.
Fourth, while Psychologists endorse the use of evidence based practice, the requirement that a DSM IV1 diagnosis is needed to gain access to treatment will limit the number of people who can access care. Individuals not meeting the strict requirements of a DSM diagnosis may still be severely affected by trauma.
Fifth, the requirement for four weekly reporting is bureaucratically burdensome for clinicians and will intrude into the process of therapy, without contributing to successful outcomes.
Sixth, a pathway that limits the assessment of claims to clinical psychologists (as well as psychiatrists and those psychotherapists trained to use the DSM IV) is likely to put pressure on the available psychological workforce – already in short supply. There are many experienced counsellors and psychotherapists who have been providing initial assessments for ACC sensitive claims whose skills will be lost to the workforce as a result of this new pathway.
The Society and the College call on the Minister to listen to the shared concerns of the professional groups who work in sensitive claims and ensure that ACC processes and procedures appropriately meet the needs of claimants who require a sensitive, responsive, competent, and timely professional service.

http://www.ncwnz.org.nz/assets/Action/NZPsS-and-NZCCP-release-re-ACC-sex-abuse-claims.pdf

Implementation of ACC guidelines should stop

Press release from the New Zealand Labour Party

ACC Minister Nick Smith should admit he got it wrong on cutbacks to counselling for sexual abuse victims and scrap their implementation, says Labour’s Victims Rights Spokesperson Lynne Pillay.
“Nick Smith has today announced a clinical review of the new process, but not for six months.
“A review in six months will force victims to take part in a cruel experiment in cost cutting that will re-victimise those who have already suffered enough,“ Lynne Pillay said.
“What Nick Smith should do is admit the new process is not in the best interests of victims and scrap its implementation,” Lynne Pillay said.
“Clinicians, counsellors and victims have all said the new guidelines will potentially harm victims of sexual abuse, so why is the Minister refusing to do anything for six months?
“The current guidelines should remain in place.
“Nick Smith has conducted a shoddy and shambolic campaign of misinformation about counselling for sexual abuse victims that has caused considerable distress to people who have already suffered significantly.
“Today a petition signed by around 4000 victims, clinicians, counsellors and members of the public was delivered to Parliament asking the Minister to halt his decision to introduce cuts to counselling services.
“Unfortunately neither Minister for ACC Nick Smith or his Associate Pansy Wong could make the time to hear from those directly affected by the changes the National Government is introducing.
“I urge the Minister to start listening to clinicians today, he doesn’t need to wait six months,” Lynne Pillay said.

http://www.scoop.co.nz/stories/PA0910/S00400.htm

Review of ACC’s approach to sensitive claims

A press release from the National Government by Nick Smith

ACC Minister Nick Smith today announced that he has requested that ACC commission an independent clinical review in six months’ time of its new approach to managing sensitive claims.
The new approach, which began today, is the result of more than four years work and reflects evidence-based clinical guidelines developed by Massey University.
“The driver for these changes has always been to provide survivors of sexual abuse or sexual assault who have a mental injury with a better level of assistance, and to help them achieve a more timely and successful recovery,” Dr Smith said.
“It is important the community has full confidence in the services provided by ACC and that is why I have asked ACC to commission an independent clinical review to ensure ACC is on the right track with the changes it has made to managing sensitive claims.
“ACC has agreed to do this clinical review to make sure those who are entitled to this help are receiving the best possible assistance.”
Dr Smith said more details about the review – including who will oversee it – will be released at a later date.

http://www.scoop.co.nz/stories/PA0910/S00397.htm

Question to Minister: Sensitive claims and sexual abuse victims

LYNNE PILLAY (Labour) to the Minister for ACC: Is he satisfied new sexual abuse clinical guidelines will not further injure sexual abuse victims?
Hon Dr NICK SMITH (Minister for ACC) : Yes, because the guidelines have been put together by skilled clinicians. I have noted members’ concern, and I have invited MPs to a briefing by Dr Peter Jansen, senior medical adviser in the clinical services directorate of the Accident Compensation Corporation (ACC), to brief members on the care that ACC is taking in the sensitive claims area. I am surprised that the member who has raised these questions has not accepted my invitation to be briefed by those clinicians.
Lynne Pillay: Does the Minister realise that the majority of the 4,000 petitioners calling for a halt to the new guidelines are the professionals who provide counselling, including the researchers who took part in the Massey guidelines upon which it is claimed the new ACC sensitive claims process is based?
Hon Dr NICK SMITH: I have been hesitant to interfere in what is clinical best practice. I acknowledge that there has been some professional debate between the view of counsellors and psychotherapists, and the view of psychiatrists and psychologists. I acknowledge that difference, but, as a politician, I simply say that we should be hesitant to interfere in clinical decisions.
Michael Woodhouse: What trend has there been since 2000 in the acceptance rates by ACC of sensitive claims?
Hon Dr NICK SMITH: It is very interesting, given all the noise that has come from the Opposition, that 5 percent of sensitive claims were declined in 2000, but this figure grew in every single year that Labour was in Government, to the point where 40.5 percent of sensitive claims were declined last year. In fact, last year, 2,378 sensitive claims were rejected by the previous Government. These facts show how the Opposition has crudely used this sensitive issue for political gain.
Lynne Pillay: Can the Minister explain the blowout in the number of pending claims and the rising proportion of declined claims with regard to the sensitive claims unit—for example, in Auckland in December 2008, of 114 claims, fewer than four were awaiting a decision, and in August 2009, of 110 claims, 103 are awaiting a decision?
Hon Dr NICK SMITH: I would note that during the period from 2000 to 2008, when that member was a member of the previous Government, the number of claims that were declined grew from 5 percent to 40 percent—an eightfold increase. That is why I ask members opposite to please not make politics out of people who are the victims of sexual abuse.
Lynne Pillay: I raise a point of order, Mr Speaker. My question was very, very specific. The Minister has made no attempt whatsoever to answer it.
Mr SPEAKER: The dilemma I have with the member’s question relates to the fact that she made a very major assertion in her question. If I recollect correctly, she cited figures relating to certain cases in front of ACC that were waiting to be decided in a certain year compared with cases in another year. Strictly speaking, members cannot make that kind of assertion when they ask questions, because members are meant to ask a question. They could ask the Minister whether the figures are correct. But to make the bulk of the question an assertion like that leaves me with little opportunity to be able to ask the Minister to give any particular kind of answer, because the Minister can, if he chooses to, just dispute the figures. I do not see how I can assist the member on this occasion. I will briefly hear the member further.
Lynne Pillay: I raise a point of order, Mr Speaker. I think you may be able to assist me. I was seeking to table a response to my written question from the Minister—
Mr SPEAKER: Is the member seeking leave to table a document?
Lynne Pillay: Yes. I can quote from the document.
Mr SPEAKER: Hang on a moment. I just want to find something out. If the member is now seeking leave to table a document, I need to know what the document is.
Lynne Pillay: It is a response from the Minister to a written question, showing that the increases—
Mr SPEAKER: We get to the same difficulty. There are plenty of Speakers’ rulings that make it very clear that answers to questions for written answer are outside the kind of material that should be tabled in this House, because they are already available to all members. I presume the member wishes to seek leave to table this document to make a political point. That is not the purpose of seeking leave to table a document. The purpose is to provide information for the House that the House does not have available to it. In this case the House has that information available to it, unless the question was lodged several years ago and it was something particularly unusual. But if it was lodged in the last few months, it clearly is totally outside the Standing Orders.
Lynne Pillay: I raise a point of order, Mr Speaker. I am sorry. I may not have been clear. What I want to table is the exact figures that I have just asked in my question.
Mr SPEAKER: Forgive me. If the figures are from an answer to a written question, I will not put the seeking of leave to table that document, because it absolutely wastes the time of Parliament. Parliament has that information. If the figures are from a different source, I apologise to the member, and I will be very happy to put the leave. But if they are from information that has been provided through an answer to a written question, I will not take the time of the House for that. The House has that information. There is no way it can be within the Standing Orders to seek leave to table material that the House already has available to it.
Hon Trevor Mallard: I raise a point of order, Mr Speaker. First of all, I say “ibid.” to my previous comments as to your moving the rulings without the support of the Standing Orders Committee. I think there is an additional point in this particular case. You said you would not follow up on the question because of a lack of authentication. Now, I am a realist. I do not expect you to follow every question for written answer or to keep all those facts and figures in your head. But the figures are before the House—
Mr SPEAKER: The member will resume his seat, because he cannot use a point of order to debate that. If Ms Pillay wants to go back to the Standing Orders, she will see that I could have ruled the question out. A member cannot ask a question in that manner. The member can ask the Minister about the figures on cases and the decisions that are waiting to be made on them in a certain year and a certain other year. It is fine to ask that question, but to make an allegation of information into a question is not the purpose of question time. If the member is looking puzzled, I suggest that she reads the relevant Standing Order. It is not very difficult. It spells it out very clearly. Now, I do not normally enforce that Standing Order, because it wastes too much time of the House to do so. Where I will draw the line is where members seek leave to table documents that are answers to written questions. Members have that information. If the member is seeking leave to table information that members already have, that is out of order. That is clearly out of order, and that is why I am not putting the seeking of leave.
Hon Trevor Mallard: I raise a point of order, Mr Speaker.
Mr SPEAKER: I have made a decision on the matter. If the member wishes to challenge me, there will be consequences, but I will hear the Hon Trevor Mallard.
Hon Trevor Mallard: I can understand that you will not be happy, but I want to take you back through your argument. You ruled something out for not being authenticated. My submission to you—
Mr SPEAKER: I will not listen to—[Interruption] The member will resume his seat right now. Supplementary questions do not require authentication, because they are meant to ask questions. They should not inject new material. I do not think I can put it in any more simple words than that. The Standing Orders require supplementary questions to ask questions. They should not inject new material at all. We do allow them, but when members put in new material, they cannot object when Ministers do not answer the question in the way members might wish. Arguing that material that might be before the House—[Interruption] I can hear that the member is muttering, which he should not be doing. Arguing that material has been provided by way of written question is still no excuse for seeking to inject material into a supplementary question that is not in front of the House either as part of an answer that a Minister has given to previous supplementary questions, or contained in the original question, because the original question has been authenticated. When members seek to inject new information by way of a supplementary question, I allow it, because I do not want to be ruling members out, but members cannot be too precise about the way Ministers handle such questions. I apologise to the member, but I will not permit leave being sought to table an answer to a written question when the House has that information. That is the end of the matter.
Lynne Pillay: Given that National MPs Nicky Wagner and Michael Woodhouse have today committed on the Minister’s behalf to listen to clinicians’ concerns, will he now delay the implementation of the guidelines due to come into effect today?
Hon Dr NICK SMITH: I have made it plain to this House that I am satisfied that ACC is using the best of clinical expertise in the development of policy in this sensitive area, and that I as a politician do not intend to interfere in clinical decisions.
Michael Woodhouse: What steps has the Minister taken to reassure New Zealanders that the clinical decisions in this area are in the best interests of those who have been victims of sexual abuse?
Hon Dr NICK SMITH: I acknowledge the concern from a number of genuine professionals around the sensitive claims area and the changes being made to the scheme. For that reason I have asked ACC to consider an independent clinical review of the new policy. I am pleased to advise the House that ACC has agreed to do that, and it will be done in 6 months’ time, to ensure that what is being done in this area is putting to the forefront the needs of those people who have been victims of sexual abuse.
Lynne Pillay: I seek leave to table the copy of the petition to delay the implementation of changes to the accident compensation sensitive claims schemes, signed by 3,973 petitioners, as presented to National MPs today.
Hon Dr NICK SMITH: I raise a point of order, Mr Speaker. I seek clarification. There is a normal process for dealing with petitions that are tabled by the Clerk’s Office, which is in respect of every petition that is presented to this House. It seems to be a strange mechanism for us to be asserting that through the mechanism of tabling a document. I want clarification as to whether the process that member is adopting will usurp the normal process for dealing with a petition before the House.
Mr SPEAKER: Before I take this matter any further, I will seek advice from the Clerk as to whether this document has already been tabled in the House. We are not aware that this petition has been tabled.
Lynne Pillay: This petition is not to the House of Representatives, but to the Minister for ACC, Dr Nick Smith.
Mr SPEAKER: I understand. The member has sought leave to table this document. This is a genuine document. It is a petition. Leave is sought to table it. Is there any objection to that course of action? There is no objection.
    * Document, by leave, laid on the Table of the House.
Hon Dr NICK SMITH: I seek leave to table the official figures from ACC showing that the percentage of claims that have been declined has grown from 5 percent in 2000 to 40 percent in 2008.
Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is no objection.
    * Document, by leave, laid on the Table of the House.
Hon Trevor Mallard: I raise a point of order, Mr Speaker. When you ask members about documents they wish to table, I ask that you are consistent and that you ask Ministers as well as members on this side of the House as to whether documents are already publicly available. That document apparently was.
Mr SPEAKER: I do not need an argument on this matter. I say to members that where Ministers seek leave to be helpful by tabling official documents, or documents from officials, I believe that is helpful to the House. Now if a mistake is made and a document may already have been made public or tabled, members can object. It is perfectly within their right to object. But I believe that the whole process to table documents is to make more information available to members of this House. In respect of official documents, members normally go to a great deal of effort to try to require them under the Official Information Act. I thought it would have been helpful for members, where leave is sought, to provide those documents without that hassle.
http://www.parliament.nz/en-NZ/PB/Debates/Debates/c/2/2/49HansD_20091027_00000001-Questions-for-Oral-Answer-Questions-to-Ministers.htm

Presentation of Petition to Parliament:Delay implementation of any changes to the Sensitive Claims Scheme

Press release from Kyle MacDonald, NZAP

Over the course of the last six weeks nearly four thousand concerned professionals, clients and members of the general public have signed the online petition : Urgent Action: Delay implementation of any changes to the Sensitive Claims Scheme hosted at http://www.petitiononlinecom/ACC0909/ which asks ACC and the Minister for ACC the Hon. Dr. Nick Smith to delay implementation of the new treatment pathway until adequate consultation can take place.
Despite this ACC has continued to push for implementation of a new pathway which focuses on short treatment, limits treatment to sixteen sessions, and requires a mandatory diagnosis of a DSM-IV mental illness.
ACC claim to have allowed adequate time for consultation on this matter; they have not. ACC claim to have followed a recent research report “The Massey Guidelines” to develop best practice treatment; they have not.
Clients will still be required to see more than one treatment provider before treatment is approved unless they see an “appropriately trained clinician” which excludes counsellors, social workers and many psychotherapists; professions that have competently provided treatment to this vulnerable client group for many years.
Tomorrow, Tuesday the 27th of October a rally has been organized on the Parliamentary Forecourt at Parliament Buildings to present the Hon. Dr. Nick Smith with the petition. The National government and ACC must be held to account.
Throughout this process the Minister has repeatedly said that this decision will be made “by clinicians, not politicians” yet the pathway is not supported by the professional bodies, or individual clinicians who provide this treatment, and this petition reflects that. We invite the Minister to hear what clinicians really think of this proposed change by ACC.

http://www.scoop.co.nz/stories/PO0910/S00376.htm

Unethical new ACC Sensitive Claims Pathway

Press release from Kyle MacDonald, NZAP

The Northern Branch of the New Zealand Association of Psychotherapists (NZAP) would like to publicly state their opposition to the new treatment pathway for sensitive claims clients released on Monday the 19th of October and due for immediate implementation on the 27th of October.
The new pathway claims to be amended to reflect the concerns and feedback of the professional community and continues to insist that the changes are to provide “clients with the most effective treatment possible to enable them to achieve timely return to everyday life…”
ACC has failed to hear the loud and clear voices of protest from the skilled clinicians who provide this treatment and they have chosen to ignore the vociferous protests in the streets of our nation on Monday.
Clients will still be required to see more than one treatment provider before treatment is approved unless they see an “appropriately trained clinician” which excludes counsellors, social workers and many psychotherapists; professions that have competently provided treatment to this vulnerable client group for many years.
The focus on short treatment, limited to sixteen sessions, and a mandatory requirement for a DSM-IV diagnosis of a mental illness remain.
Psychotherapists in the Northern Region believe that the Massey Guidelines have been misrepresented to justify less treatment, despite ongoing claims by ACC and the Minister for ACC, the Hon. Dr Nick Smith that this new pathway is “best practice.” Already many clinicians are withdrawing their services stating that these new guidelines are in breach of their professional code of ethics.

http://www.scoop.co.nz/stories/PO0910/S00372.htm

Claims are not skyrocketing, victims are not paramount – it’s privatisation time, baby

A blog entry from LudditeJourno

Now we understand why ACC has been pushing a clinical framework for providing counselling to survivors of sexual abuse which counsellors, survivors, and advocates working in the sexual violence sector say is unethical.
Why now?
The National government admits their plans investigate explicitly the privatisation of ACC.  Despite there being no economic need according to, well, economists.

Read the rest of this entry at http://ludditejourno.wordpress.com/2009/10/26/claims-are-not-skyrocketing-victims-are-not-paramount-its-privatisation-time-baby/

ACC sexual abuse counselling cuts could compromise rural women

A press release from Rural Women New Zealand

Proposed cuts to ACC sexual abuse counselling will badly impact women living in a rural setting, says Rural Women New Zealand (RWNZ).
The ACC changes to sexual abuse counselling are due to be implemented next week.
Under the current system, rural women already face extra hurdles in accessing support and counselling. These include a lack of local services and the greater difficulty ensuring confidentiality in smaller communities.
As stated in the recently released Ministry of Women’s Affairs report, Responding to sexual violence: Environmental scan of New Zealand agencies (September 2009):
“There was a risk of family members finding out when victim/survivors did not want them to know, or service providers being related or known to the victim/survivor or perpetrator. It is also important to recognise that rural areas require additional staff to compensate for the travel time required to cover wide geographical areas in order to see clients.”
Maori and migrant women living in rural areas also experience greater access problems due to the lack of providers who are able to understand different cultural needs.
“We want clarification from ACC on how it will provide an efficient, accessible service to rural women when there is already a lack of available services under the current system,” says RWNZ National President Margaret Chapman.
“We also question the feasibility of the three required ACC therapist checks - an expansion to the checking system - given the current lack of services.”

http://www.scoop.co.nz/stories/PO0910/S00359.htm

Abuse victims beg Government to drop ACC plan

An article from the Waikato Times by Maryanne Twentyman

Harrowing accounts of violent sexual abuse have been revealed as victims plead with the Government not to cut their ACC entitlements.
The Waikato Times has been inundated with calls from victims who can't be identified but who say the proposed new criteria for sexual abuse cases will cost lives.
Under the new criteria, survivors will be eligible for counselling paid for by ACC only if they have been diagnosed as having a strictly defined mental injury.
One Waikato woman who was abused between the age of 4 and 15 by eight different men, mostly family members, said it was hard enough for people to seek help without being challenged about it.
"The only reason I'm still here today is that I got the help I needed through counselling," she said. "The Government needs to prevent victims getting to that point with fast intervention, not wait till they are so desperate that they are mentally ill and trying to kill themselves."
The woman, now in her 40s, fell pregnant through abuse when she was 14.
"I didn't know I was pregnant until I was six months on.
"I had the baby which was then abused at the hands of my own attackers. I was powerless to stop it as it was the only life I knew and back then it was bloody hard to get the help I desperately needed."
Years of shame, abuse, prostitution and self-harm followed as the woman struggled to "deal with her demons".
"It's incredible that ACC are now making it harder to get help. A rugby player makes a choice to play the game and if they get injured then ACC help them every step of the way ... do they think I `chose' to be abused," she questioned.
The woman has shared her story along with more than 20 others in a book to be released next year by the Child Abuse Prevention Agency.
Under the working title Hidden In Front Of Us, the book aims to educate others to recognise signs of abuse.
In another case, a Waikato father of two said his family faced constant fear and pain and he was outraged over ACC's plan to change the criteria for covering the cost of counselling for victims of sexual abuse. It had been 10 years since his daughter was a victim of serious sexual abuse and just three weeks since she last attempted suicide, prompting the man to speak out about the changes. "ACC wants the victims to be diagnosed as having a mental disorder before they will pay for counselling.
"If we didn't have that counselling I don't know where we would be," he said.
He was upset that future sexual abuse victims may fall victim again – this time at the hands of ACC.
His concerns were echoed by Male Survivors of Sexual Abuse Waikato co-ordinator Mike Holloway who said victims needed support and time, not a one-off assessment.
"It can take up to six sessions with experts just to scratch the surface. There is no way victims can be assessed and labelled mentally ill when they have been through such an ordeal," Mr Holloway said.
Mr Holloway was a victim of sexual abuse for three years from the age of 9.
"I now work with victims of sexual abuse and they can trust me because I have been there and know what they go through. They can't be expected to open up to a complete stranger let alone expect to be diagnosed with a mental injury." Mr Holloway said the new criteria undermined all the work he was trying to do around education and prevention of abuse.

http://www.stuff.co.nz/waikato-times/news/2989419/Abuse-victims-beg-Govt-to-drop-ACC-plan

Speech at the release of Ministry of Women's Affairs' sexual violence research project

A speech by Pansy Wong from the National Party

Good evening everyone, it is a pleasure to be here as we gather to acknowledge the release of this significant research project.
First of all, I would like to thank the Ministry of Women's Affairs who led the two-year project, ‘Strong and Safe Communities - Effective Interventions for Adult Victim/Survivors of Sexual Violence', and to your project partners, the Ministry of Justice and the New Zealand Police.
Thank you also to the researchers from the Crime and Justice Research Centre at Victoria University for your skill, dedication, and absolute professionalism.
Above all, we must express our deep gratitude to the survivors who participated in the research. Without their strength and courage we would not be here tonight.
Thank you to all of you who had involvement in this research. The result is an outstanding example of a collaborative effort across many sectors.
This research is the result of a lot of hard work on the part of community agencies, researchers, service providers, and government agencies.
It is the first comprehensive piece of research to be conducted on adult sexual violation in New Zealand in the past three decades and it reaffirms our nation's international reputation of being a fair, caring and innovative country.
Through face-to-face interviews with survivors and surveys completed by them, we have gained a real insight into how the system caters to people who have been through the harrowing ordeal of a violent sexual attack.
Professionals like yourselves and decision makers like myself have long understood that many of the thoughts and perceptions surrounding sexual violence are myths.
For example, there is a common misconception that most attacks are committed by strangers.
Now, for the first time, this comprehensive two-year research project is able to dispel such myths with authority and provide us with a platform to change attitudes.
In fact, the research revealed that sexual violence cases involving a stranger have the highest success rate for prosecution, and that the victims of such incidents are more likely to report them to police.
The majority of sexual attacks involve someone the victim knows. The first hurdle is to convince these victims to report the crime and then comes the hurdle for them to jump over the justice bar.
The Minister of Justice has introduced a raft of legislative changes to lower the hurdles in the justice system for the victims of sexual violence, such as the removal of provocation as defence and launching a Law Commission review to consider alternative justice procedures for the victims of sexual violence.
This review includes looking at changing our approach from being an adversarial system to an inquisitorial system, which would see the judge becoming involved in collecting and determining the facts of the case.
Sexual violation is the most costly crime in New Zealand, with the social cost estimated to be at about $1.2 billion per year, but it is also the most significantly under-reported crimes.
The research has highlighted many reasons for this under-reporting, including shame, self-blame and the fear of not being believed.
This shows that one of the most useful tools we can have as a nation is to have the people around victims understand the importance of giving support and showing trust.
Unfortunately the research tells us this is not always the case, with some survivors saying their disclosures were met with disbelief, blame, and ostracism for bringing shame on the family.
Hence, it is important for us to work towards providing an environment that nurtures and caters for victims to come forward to report these dreadful crimes.
Often, a victim's first cry for help is through medical, mental health and social services - with them often seeking help for related issues such as drink or drug addiction, gambling or other problems that have arisen from their ordeal.
This is expected since specialist services for the victims of sexual violence are still in their development stages. Therefore it is important these frontline services are equipped to detect signs of sexual violence and refer the victims to other agencies to receive the specialised help they need.
Tomorrow, Hon Power will be releasing the Sexual Violence Taskforce report. The Government's responses to this report will be forthcoming.
Your good work has helped us to debunk the myths surrounding sexual violence and has armed us with facts and evidence to change society's attitude towards sexual violence.
This research has provided a good base from which we can look at the services available and determine how we can help victims and how the justice system can better cater to their needs.
This Government is committed to utilising this significant piece of research to reduce the impact sexual violence has on the victims - with one interviewee describing the feeling as having her soul stolen.
As Minister of Women's Affairs, I will do my best to restore the many souls that have been stolen through sexual violence.

http://beehive.govt.nz/speech/speech+release+ministry+women039s+affairs039+sexual+violence+research+project

Compo scheme can still work without breaking the bank

An article from the New Zealand Herald by Tim Hazledine

How foolish is the kerfuffle about the alleged blowout in our Accident Compensation Corporation liabilities? This is how foolish.
Suppose you and your spouse are in charge of a family of, say, three young children. That means you are legally responsible for bringing them up to school leaving age and morally responsible for helping them in further training or education after that.
So how much is this going to cost you? A lot. Let's say $10,000 per child per year through their school years; possibly more later at polytech or university. You'd better also allow for some inflation of education costs, just to be on the safe side - and this is all about your children. You do want to be on the safe side, right? And then those unforeseeable contingencies - need a prudent margin there, too.
It all adds up to many hundreds of thousands of dollars of expenditures. And just how are you planning to pay for this?
Well, you have a job, you say. And your spouse will be back in the workforce in a few years after the kids all get into school.
But that's simply not good enough. You can't guarantee you won't lose your job, can you? And as for your spouse's posited future contribution - well, how do you know present skills won't be outdated when the time comes, requiring further expensive retraining? No, you have these locked-in cast-iron financial commitments.
You must match them with equally solid and secure income-earning assets.
You need to be able to show unencumbered funds of at least half a million dollars right now to guarantee the future income stream necessary to meet your obligations to your children.
And you haven't got that, have you? You've got about $20,000 in KiwiSaver accounts. You've a bit of equity in your house, but, hey, you can't bring up your children in a tent, can you? Let's face it. Strictly speaking, you are broke; busted; bankrupt. And so are several hundred thousand other New Zealand families just like you - billions of dollars of unfunded liabilities, in total.
It's the "biggest loss of any entity, public or private, in New Zealand history", to slightly paraphrase Dr Nick Smith on the $4.8 billion "loss" recorded last year by the ACC. If you think this is silly, then the ACC fracas is truly dumb. It's basically the same story writ large - the idea that future accident compensation payments are rigid "obligations" which have to be "pre-funded", as they say, along with some jiggery pokery with the projections of payouts and expenses. It's dumber because, of course, the Government's ability to raise revenue when needed is much more secure than any individual's future income, and also because, on the payment side, our ACC obligations are in fact rather more fluid than are the parents' obligations to do the best for their children.
So let's all be sensible about this. To me, the best thing about Sir Owen Woodhouse's great accident compensation scheme is the no-fault part - the removal, in most circumstances, of the right to sue for damages.
In America, in contrast, they've basically privatised the welfare state, with every man and his lawyer against every other man and his lawyer, in a contest for compensation from which the only long-term winners are the lawyers. We don't have that here now, thanks to ACC, and that's really good. We do have some problems with claims growth exceeding population growth. But we can deal with this if we aren't too squeamish about adjusting claim payouts to fit a total budget, which itself can be adjusted from year to year according to macroeconomic conditions.
We can have a pay-as-you go "Vote ACC" just as we have pay-as-you-go Vote Education and Vote Health in each year's budget. The key is to accept that accident compensation can only ever be a palliative, not a panacea.
Dr Smith's suggestion that a terminally ill person might choose to kill themselves to get the compo for their family may have been a bit tactless, but he actually has a point. ACC funds some things; not others. If accidents and suicides, why not illness? Why not compensation for marriage split-ups, which are apparently one of the most traumatic of all personal tragedies - possibly worse than losing a limb. No, enough already. The state can't compensate people in cash for all life's misadventures and it shouldn't try. We can help, but we can't make people whole again.
There are problems with ACC, but they very much depend on how the issues are framed. Truly, New Zealand can have a decent, efficient, state-run accident compensation system without breaking the bank.
Don't fret about it. Get back to figuring out how you are going to pay for bringing up those kids.

http://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466&objectid=10604155&pnum=0

Question to Minister: Accident Compensation—Counselling

RAHUI KATENE (Māori Party—Te Tai Tonga)  to the Minister for ACC: What evidence does he have that victims of sexual abuse suffer from clinical mental disorders; and why is he insisting that victims of sexual abuse will have to be diagnosed with a clinical mental disorder from the American Diagnostic and Statistical Manual, version four, before their claims for ACC-funded counselling are accepted?
Hon Dr NICK SMITH (Minister for ACC) : The law requires that the Accident Compensation Corporation (ACC) can only accept sensitive claims from those diagnosed with a mental injury. This Government has made no changes, nor does it intend to make any changes in this regard. The changes that are raising controversy in this area arise from the implementation of new clinical guidelines based on comprehensive research from Massey University on the right care for sensitive claimants. I remain of the view that clinicians and not politicians should decide on appropriate treatments.
Rahui Katene: What was his response to the 200 protestors who marched on Parliament yesterday stating that the added stigma of a mental disorder would put off people seeking help; and what support will be available for sexual abuse victims who will require counselling that is not related to clinical mental disorders?
Hon Dr NICK SMITH: I would say to them, as I would say to all members of the House, that they should read the Injury Prevention, Rehabilitation, and Compensation Act, which requires a mental injury to have occurred for there to be a valid claim. I quote section 27, which states: “Mental injury means a clinically significant behavioural, cognitive, or psychological dysfunction.” [Interruption] Members opposite say that that is wrong; that is the law that stood in place for the entire time of the Act that they passed in 2001.
Lynne Pillay: What does the Minister say to the hundreds of counsellors who marched in the streets yesterday who say the new accident compensation guidelines are not best practice; is he saying that they are not qualified and not expert?
Hon Dr NICK SMITH: Firstly, I can say, as the Minister, that this Government has made no decisions in respect of dealing with sensitive claims. The changes arise from a piece of work by Massey University that occurred under the previous Government. The decisions have been made by clinicians on the basis of what is thought to be the best standard of practice, and as a Minister I am very hesitant to overrule the decisions of skilled clinicians.
Rahui Katene: What response does he have to the situation described in today’s New Zealand Herald by an Auckland mother of three, who states that the psychiatric test set to be imposed on sexual abuse victims as a requirement for ACC support almost killed her?
Hon Dr NICK SMITH: I note that the person referred to was actually assessed last year under the previous Government. This reinforces the fact that the legal test for a valid claim has not changed. I have confidence that psychiatrists can professionally do their assessments without putting people’s lives at risk. I stress again that we as politicians should leave clinical decisions to clinicians.

http://www.parliament.nz/en-NZ/PB/Debates/Debates/0/9/b/49HansD_20091020_00000052-Questions-for-Oral-Answer-Questions-to-Ministers.htm

Question to Minister: ACC - Child sexual abuse victims

Hon ANNETTE KING (Deputy Leader—Labour) to the Minister for ACC: What protocols and procedures, if any, are in place within ACC for children who have been sexually abused?
Hon Dr NICK SMITH (Minister for ACC) : The Accident Compensation Corporation (ACC) has protocols and procedures in place to refer cases to the Department of Child, Youth and Family Services. It has a dedicated child specialist in the Sensitive Claims Unit, and the corporation endeavours to ensure that it has access to expert clinicians with the required specialist skills to deal with those who have suffered from child sex abuse.
Hon Annette King: Is he aware that since July 2009 his instructions to ACC have led to well over 420 sexual abuse cases being held up—an increase of over 500 percent—as ACC waits for the new assessment tool to come into effect, and that 24 counsellors in his own electorate say they will stop doing accident compensation counselling because the changes will actually harm their clients; and how many counsellors around New Zealand will be available to do accident compensation work?
Hon Dr NICK SMITH: There are many questions within the member’s supplementary question. I will answer just a couple of those. Firstly, I have given absolutely no instructions to ACC, except to say that this is a very sensitive area in which I have no expectations of savings, and that decisions need to be made based on what is in people’s best clinical interests. Secondly, I met with 18 of those counsellors in my own area at the weekend, and had a very constructive meeting with them.
Hon Annette King: If he believes politicians should listen to clinicians when it comes to assessment of sexual abuse claims for accident compensation, as he states, why does he not take his own advice and listen to the New Zealand Psychological Society and the New Zealand Association of Child and Adolescent Psychotherapists who have written to him saying that ACC has misinterpreted the Massey guidelines to justify reduced treatment, and the new assessment tool is clinically unsound and not best clinical practice?
Hon Dr NICK SMITH: The first point I make is that the law in this area was passed in 2001 by the members opposite, and that it makes it absolutely plain that for people to be eligible for accident compensation they need to have suffered a mental injury. The second point I will make is that the decisions made by ACC have been led by a group of very skilled clinicians, including psychiatrists and psychologists, and, in my view, the group is making decisions that are in the best interests of those who have suffered abuse.
Hon Annette King: When he said last week there had been no change to clinical guidelines to date for the counselling of people who had been sexually abused, why did he not tell the public that the new assessment tool, which starts being used next week, is the reason many cases have been deferred and declined, including the case of the two little boys in Taranaki who were injured and sexually abused, and had their counselling stopped by ACC; and can he not see that the veracity of his statements is causing concern and confusion to very vulnerable people?
Hon Dr NICK SMITH: In respect of the individual case that the member has raised, the decisions in that case were made by a clinical psychologist. I, as Minister, will not override decisions made by clinicians. As I pointed out earlier in the week, as a consequence of representations from the MP for New Plymouth, counselling is being provided for that child, quite appropriately, through Child, Youth and Family.
http://www.parliament.nz/en-NZ/PB/Debates/Debates/0/2/0/49HansD_20091021_00000540-Questions-for-Oral-Answer-Questions-to-Ministers.htm

ACC clarifies assistance for mental injury

Press release from ACC

ACC is today sending information to counsellors and other health professionals about new procedures for managing claims for mental injury arising from sexual abuse.
ACC understands that this is an area of great concern and sensitivity. We would like to provide the following points of clarification, which can be attributed to Denise Cosgrove, General Manager.

• ACC’s legislation is very specific in requiring us to concentrate only on those who suffer a diagnosed mental injury as a result of sexual abuse.
• If a client meets these requirements, there is no limit to the amount of counselling available.
• This has always been the case and has not changed.
• The changes initially apply only to new claims. They are:

1. Ensuring a clinical diagnosis of mental injury actually happens, as soon as possible.
2. Using this information to ensure appropriate treatment from the start.

Treatment to be based on practical steps back to the clients’ normal life, and monitored more closely for progress.

• This is not about saving money. It’s about providing the best treatment possible to those who are entitled to it by law.
• These changes are the culmination of four years of work with academics and professionals.

The information provided to counsellors and others will be available shortly on the ACC website.

http://www.scoop.co.nz/stories/GE0910/S00084.htm

ACC cutbacks to counselling spark fight back

Press release from the New Zealand Labour Party

New Zealanders today began their fight back against uncaring cutbacks to counselling services for victims of sexual abuse Labour’s Victims Rights Spokesperson Lynne Pillay said.
“Thousands of people from around the country today protested at the cutbacks that have seen delays in the ability of people to access counselling, reductions in eligibility and cut backs to services,” Lynne Pillay said.
“Victims of molestation, rape and sexual assault have suffered enough, they should not be forced to endure an uncaring National Party philosophy on ACC entitlements in addition to what they have already been through.
“National campaigned in the lead-up to the election that it cared about victims of crime, yet its actions in denying victims of sexual assault counselling are uncaring and simply re-victimise those who have suffered.
“Labour is opposed to these cutbacks that attack the vulnerable for the sake of petty cost cutting.
“ACC Minister Nick Smith has repeatedly and cynically tried to mislead the public on this issue, claiming clinicians continue make the decisions on counselling.
“What he has repeatedly failed to mention that decisions on the length of counselling needed are not being made by those counsellors who are in contact with victims, they are being made by people sitting in Wellington who have never even met the victims, who have placed their trust in ACC.
“Nick Smith’s handling of his ACC portfolio can only be described as shambolic, uncaring and incompetent and sadly it is some of New Zealand’s most vulnerable who are suffering as a result.
“New Zealanders have had enough and are clearly rejecting the changes being made by Nick Smith, we can only hope he listens,” Lynne Pillay said.

http://www.scoop.co.nz/stories/PA0910/S00247.htm

Day of action against ACC cuts

Press release from Young Labour

Today Young Labour will attend marches around the country to oppose changes to the ACC sensitive claims criteria that will allow only those diagnosed as having a mental disorder access to ACC funded sexual abuse counseling, says Young Labour President Patrick Leyland.
“ACC exists to help survivors, not to marginalise or traumatise them further. Denying survivors of sexual abuse the help they need because they refuse to be labeled as mentally ill is a disturbing move and we are calling on the Minister for ACC to reconsider this decision,” says Leyland.
“Being diagnosed with a mental illness can have a large impact on the life of a survivor, as many situations, such as job interviews, can often require the disclosure of such information.
“For many people counseling provides a critical lifeline in overcoming horrific sexual abuses and it is necessary for ACC to help these individuals. However, it appears that there is no commitment to helping abuse survivors and instead these changes make it more difficult for them to receive this much needed assistance,“ added Leyland
“Young Labour wants to see a society that opposes the culture of silence around sexual abuse, and gives survivors the opportunity to be heard. These changes will make it harder for survivors to take the brave step to speak up.
“Since the announcement of these changes, over 4000 people have signed an online petition calling for a stop to the proposed changes to sexual abuse counseling. In addition, many will march around the country today calling on the Government to reverse these changes, “ Leyland concluded.
Marchers will gather on Monday 19 October at the Albert Park Band Rotunda in Auckland at 12 noon; at the Cenotaph in Wellington at 12.30pm; at the Speakers’ Corner, Cathedral Square in Christchurch at 12.30pm; and at the ACC offices on the corner of Maclaggan and Clark Streets in Dunedin at 3pm.

http://www.scoop.co.nz/stories/PO0910/S00281.htm

Stop ACC Cuts march

A video from the End Rape Culture Now! Collective




http://www.youtube.com/watch?v=Oczdxkujikg

Louise Nicholas at the hunger strike rally

A video from the End Rape Culture Now! Collective



http://www.youtube.com/watch?v=-TfSFYPlGhM

Enhancing ACC support for survivors of sexual abuse with a mental injury

Press release from ACC

• Changes reflect four years’ work aimed at improving client outcomes
• ACC committed to working with sector to implement, review and refine changes
• New approach reflects evidence-based, best practice

From 27 October 2009, ACC will introduce some changes to enhance the way it manages sensitive claims – that is, claims for mental injury resulting from sexual abuse or sexual assault.
“The changes will initially apply to new claims only, and are designed to build on the level of care, understanding and support we currently provide to all clients who have survived the trauma of sexual abuse or assault but have a resulting mental injury,” says ACC’s Chief Executive, Dr Jan White.
The changes will:

• reduce the time it takes ACC to make claim decisions, so treatment and support can be started more promptly
• enable diagnosis of a client’s specific condition and needs earlier in the assessment phase, to enable the appropriate support to be identified
• provide greater focus on working towards clearly defined recovery goals, to enable clients to recover sooner and more successfully.

“As always, we will continue to match clients with the most appropriate health professional for their needs,” says Dr White. “Where possible, we’ll offer clients a choice of suitable practitioners in their region.
“ACC appreciates that sensitive claims need to be handled with the utmost care and sensitivity,” says Dr White. “Every effort will therefore be made to minimise the number of health professionals that a client needs to see during their assessment and treatment. However, this will be balanced against ensuring clients receive the assistance they need to make a successful recovery.”
An important feature of the changes is that they will focus on providing clinically-based treatment over a shorter timeframe (typically around 16 treatment sessions).
“This is because research shows this achieves the best outcomes for clients,” says Dr White. She stresses, however, that “There is no treatment cap, and clients needing longer-term support will continue to have access to this.
“ACC is committed to working with health professionals and the wider sector to review its new approach, and keep improving the service it provides to clients with a sensitive claim. We’re also about to start work on enhancing specific treatment and support processes for Maori, children and those with an intellectual disability.”
The enhancements planned from 27 October 2009 are underpinned by new guidelines developed by Massey University.
“These guidelines represent a significant landmark in the treatment of mental injury resulting from sexual abuse,” says Dr White, “because they’re developed by New Zealanders for New Zealanders; are evidence-based; and the product of four years’ extensive research and consultation.”
To ensure health professionals are fully informed about the changes, ACC will supply them with information packs.
By law, ACC can only accept sensitive claims from those diagnosed with a mental injury resulting from the sexual abuse they’ve suffered. Other agencies are available to assist sexual abuse survivors who have not developed a diagnosed mental injury.
Concerned clients or victims of sexual assault or abuse, or their family or friends, can contact ACC directly on a freephone number (0508 222 233) or by email (sensitiveclaims@acc.co.nz). ACC will run a series of advertisements in metropolitan and regional newspapers this weekend (17 and 18 October 2009) to alert people to these details.

http://www.scoop.co.nz/stories/GE0910/S00076.htm

Sexual abuse victims set to suffer from ACC cuts

An article from Te Waha Nui by Alice Tollestrup

Cuts to ACC could have a lasting effect on survivors of sexual abuse as counselling support criteria are tightened. The new regulations will be coming into place from 27 October.
Under the proposed changes a sexual assault victim must now talk with three separate ACC therapists before they are eligible for counselling support. Prior to the ACC cuts, victims were only required to talk with one therapist for evaluation.
End Rape Culture spokesperson Miriam Sessa says it usually takes a bit of safety building to know what you are thinking is not going to be fired back at you.
“Many victims will be put off if they feel as though they are simply being shipped from one person to another.”
Director of Rape Prevention Education Dr Kim McGregor says many people do not realise for some survivors of severe interpersonal trauma such as child sexual abuse, their counsellor may be their lifeline.
“If their connection to their counsellor is threatened, then for some their very life feels under threat,” she said.
A second major change to the ACC rules is in the eligibility requirements for victims. Those wishing to get support will only be eligible for help if they can claim the abuse has lead to ‘mental injury’. This ‘mental injury’ will then be listed on the individual’s permanent record – meaning the victim will have to declare the mental injury when applying for jobs, benefits and education.
Sexual abuse psychotherapist Marylyn Tait said she had heard of a client who had been diagnosed with post traumatic stress after a sexual abuse incident. Years after the incident, when the client applied for life insurance they were denied due to the fact they were more likely to commit suicide.
Groups opposed to the changes are arguing that labelling a victim with a mental injury shifts the onus away from the perpetrator, labeling the victim as ‘crazy’.
An example was highlighted in the Taranaki Daily News last week about a grandmother who had received a letter from the ACC regarding her grandson who had been sexually abused. The letter declined the boy cover, stating ACC had found no clinically mental injury arising from the events described.
“An ACC psychologist believes one of the boy’s mood swings, tearfulness and sitting alone sucking his thumb could be due to settling into schools and a new environment rather than the sexual abuse events,” it said.
Counselling hours are also under question and the amount a victim can receive will be cut. The hours needed are to be determined by ACC with each individual client and they are able to cut them off at any given time.
A spokesman for ACC Minister Nick Smith said this was a clinical matter for ACC and the minister had no more intention of intervening over eligibility than he did in other areas of medical treatment.
“The origins of the guidelines go back to 2004, when concerns were raised about the effectiveness of sexual abuse counselling. That resulted in an $800,000 comprehensive research programme by Massey University, which led to the new guidelines being produced last year. There has been extensive consultation on those guidelines,” the spokesman says.
A group of ACC counsellors in Nelson have made a stand, saying they will not take on any new ACC clients as they believe it is against their ethics and unsafe for the clients.
“We as a group are ethically opposed to the changes as they are not safe for the client. We are not going to work under the conditions,” says Tait. The decision has not been made lightly, with Tait losing about 50 per cent of her workload by taking this stand. She says some counsellors will be losing 100 per cent of their work as a result. “We believe so strongly in this. It’s just not fair and we believe it is our responsibility to be responsible for the clients and make them feel safe.”
Tait said the group of counsellors are still awaiting some kind of recognition to their stand from the ACC, which has not acknowledged their move. “We are making an ethical stand and we are expecting a response,” she said.
The group said in a statement that they were not withdrawing their counselling services from current clients. “Of course we will continue to work with anyone to whom we have already made a therapeutic commitment.”
Dr Kim McGregor gave Te Waha Nui details of a letter written to ACC from an individual who had been violently raped by an extended family member at age seven. The individual stated: “I am absolutely certain that without the help of a counsellor, the pain and disability that I experienced due to the abuse I suffered as a child would have driven me to suicide.
“If my counsellor had told me I needed to see ACC’s shrink three times and be diagnosed with a mental condition before I could go to counselling, I would never have gone back,” the person said in the letter.
Sessa believes the long term impacts of these cuts will be huge for New Zealand. “Even if you look at it economically, it will cost the country more in the long run to be paying out for mental illness benefits as opposed to working on prevention,” she says.
A national day of action will be happening around the country in the main centres with Auckland protestors marching to ACC from the Albert Park band rotunda at 12pm, October 19.

http://www.tewahanui.info/wordpress2/?p=2535

Survivors outraged at ACC's proposed guideline changes

An article from Voxy

Widespread dissent at the proposed changes to ACC's funding criteria for help for sexual abuse and assault survivors can be felt throughout New Zealand with a national day of action against the changes planned for Monday 19 October.
Marches will take place in Auckland, Wellington, Christchurch and Dunedin.
"People up and down New Zealand are outraged", said Felicity Perry, spokesperson for the Wellington group that has formed to challenge ACC's proposed guidelines. Rape Crisis New Zealand estimates that one in four women and one in eight men are survivors of sexual abuse and assault.
"All New Zealanders know someone who is affected by sexual abuse and assault. ACC should be supporting them, not abandoning survivors when they need help most", Perry said.
The proposed changes mean that in order to get ACC support survivors must be diagnosed with an illness from the American Diagnostic and Statistical Manual, version four.
"Having to be diagnosed with a mental illness in order to receive treatment will further traumatize abuse survivors", said Perry.
Such survivors will have this diagnosis on their medical records for the rest of their lives and will be required to declare it if asked by insurance companies, banks and prospective employers, to name a few.
"It already takes on average 16 years for survivors of abuse to summon the courage to seek help. The proposed changes will mean that less and less survivors will ask for the help that they need," Perry said.
"It is hard enough living with the stigma of being an abuse survivor, let alone having the added stigma of being declared mentally ill," said Perry.
The effects of such stigma have already been witnessed with the recent suicide of a woman who was told by ACC that she needed a psychiatric report before they would approve further counselling.
The Injury, Prevention and Rehabilitation Act 2001 states that ACC is to reduce the incidence and severity of personal injury and minimise both the overall incidence of injury in the community, and the impact of injury on the community (including economic, social, and personal costs).
"According to its governing legislation, ACC should be helping survivors, not marginalizing them. Denying survivors who refuse to be labeled as mentally ill the help they need means that everyone suffers," Perry said.
"For most people ACC is the only agency to turn to in their time of need. Other agencies are underfunded and in short supply. If ACC is shirking from its responsibility to society, it needs to fund other counselling agencies," said Perry. "Instead ACC has shown that it is not committed to helping abuse survivors by creating obstacles for survivors to get help and cutting its funding of the Auckland Sexual Abuse Help Foundation's 24-hour crisis line and call-out service," said Perry.
Marchers will gather on Monday 19 October at the Albert Park Band Rotunda in Auckland at 12 noon; at the Cenotaph in Wellington at 12.30pm; at the Speakers' Corner, Cathedral Square in Christchurch at 12.30pm; and at the ACC offices on the corner of Maclaggan and Clark Streets in Dunedin at 3pm.

http://www.voxy.co.nz/national/survivors-outraged-acc039s-proposed-guideline-changes/5/27493

Sexual abuse victims now victims of ACC cutbacks

Press release from the New Zealand Labour Party

The tragic case of two young boys from Taranaki who were brutally sodomised and abused but who have been denied sexual abuse counselling by ACC is horrifying, says Labour’s Victims Rights Spokesperson Lynne Pillay.
“I understand that these young boys will now receive counselling through Child Youth and Family after their story was made public, but their family should not have had to take their story public in order to receive government help,” Lynne Pillay said.
“Counsellors have been warning for months that proposed changes by ACC that would limit or prevent victims of sexual abuse from accessing counselling would be disastrous but Nick Smith has blithely continued to push these.
“Mr Smith’s claims that he was not making decisions about changing access to sexual abuse counselling funded by ACC that it was clinicians making the decisions is simply untrue.
“In the case of the two young boys from Taranaki a counsellor and the police supported their need for ACC funded counselling and they were still told no.
“What Nick Smith is failing to mention when he says clinicians are making the decisions on counselling need is that the clinicians he is talking about are sitting in ACC offices in Wellington and have never met or even spoken with the victims.
“How can they be clinical decisions if those making the decisions are simply just sitting in an office in Wellington rubber stamping the cut backs initiated by the National Government?
“It seems in order to qualify for counselling victims of molestation and rape will now have to tell their stories to the media before the Government will listen and deliver them the help they need.
“Withholding much needed and deserved support from those who have suffered horrendously at the hands of criminals is a disgrace,” Lynne Pillay said.

http://www.scoop.co.nz/stories/PA0910/S00188.htm

Question to Minister: ACC - Counselling

LYNNE PILLAY (Labour) to the Minister for ACC: Does he agree ACC should tighten procedures to limit access to counselling for those injured through serious crime?
Hon Dr NICK SMITH (Minister for ACC) : The Government is not making any changes to the accident compensation legislation in respect of when people get counselling for sensitive claims arising from crime. The issue here is best practice. A substantive research project initiated and concluded during the last Government by Massey University recommended new guidelines to ensure better service for clients. The Accident Compensation Corporation (ACC) is implementing those changes, and I am very reluctant to interfere in decisions on clinical best practice in this area, or, frankly, any other.
Lynne Pillay: Why, then, did two young boys from Taranaki, who were sodomised and thrown out of a window, and whose case for counselling was supported by their counsellor and the police, have to resort to their stories being told in the media because ACC had declined the counselling they so clearly needed, in order to have someone from the Government listen?
Hon Dr NICK SMITH: The member for New Plymouth raised that specific and sensitive case with me—
Hon Annette King: Belatedly.
Hon Dr NICK SMITH: —actually, before the Opposition did, and raised it publicly. I have asked ACC officials to look into the specifics of the case. I ask the member and others in the House not to substitute themselves for clinical psychologists who appropriately make the judgment of whether people are eligible for accident compensation, and judge the appropriateness of the particular counselling or other care that is provided.
Lynne Pillay: Does this Taranaki example show that victims of horrendous sexual crimes now have to tell their terrible and personal stories publicly in order for them to get the help they need, and will he now guarantee that ACC will fund the counselling?
Hon Dr NICK SMITH: I think it is important for the House to note that there has been no change in the clinical guidelines, to date.
Hon Annette King: Oh yes, there has.
Hon Dr NICK SMITH: No, there has not. I have just answered a large number of written questions on this matter, and the answers show that the number of cases that have been turned down in recent months is no different from what it was a year ago—no different, according to those statistics. So I say to the member opposite that this case, tragic as it is, cannot be a consequence of any changes in practice, because those changes have not yet been made.
Sandra Goudie: Has the Minister or his associate Minister at any time since his appointment asked ACC to make savings in the area of counselling?
Hon Dr NICK SMITH: No, I have not. The changes regarding counselling for sensitive claims were well under way before my appointment. My only direction to ACC is to be cautious in this sensitive area, because I do recognise how vulnerable victims of sexual abuse are.
I seek leave of the House to table Sexual Abuse and Mental Injury: Practice Guidelines for Aotearoa New Zealand, dated March 2008.
Mr SPEAKER: Leave is sought to table that document. [Interruption] Order! The seeking of leave is being dealt with. Members need only reflect on who was interjecting while that was happening. Leave is sought. Is there any objection to that course of action? There is no objection.
    * Document, by leave, laid on the Table of the House.
Lynne Pillay: Why has the Minister claimed that decisions to limit counselling are clinical decisions, when the decision to cancel and decline counselling for people who have been raped and molested is being made by people in Wellington who have never met, or even spoken with, these victims and who are simply rubber-stamping cost-cutting initiatives being put in place by this Government?
Hon Dr NICK SMITH: The first thing I would point out, for the member, is that in the example she has given, and arising from the representations that have been made by the member for New Plymouth, Child, Youth and Family has appropriately decided to fund counselling for the boys who are affected. In respect of the member’s claims that people in Wellington are making decisions about such counselling, I assure the member that those decisions are being made by properly qualified psychiatrists and others who have the clinical skills to make them.
Hon David Parker: I raise a point of order, Mr Speaker. Given that the Government does not have numbers for the reduction in scope—
Mr SPEAKER: I am listening for the point of order and there is nothing—
Hon David Parker: I seek leave to table—
Mr SPEAKER: I am on my feet. There is nothing that I can perceive to do with the order of the House that has anything to do with Government numbers for anything. I ask the member to come to his point of order.
Hon David Parker: I seek leave for my member’s bill, the Injury Prevention, Rehabilitation and Compensation (Change of Date for Full Funding) Amendment Bill, which extends by 5 years the deadline for funding of the accident compensation tail, to be put on the Order Paper.
Mr SPEAKER: Leave is sought for that member’s bill to be put on the Order Paper. Is there any objection to that course of action? There is objection.
Hon Lianne Dalziel: I seek leave to table the document that ACC prepared showing its new guidelines for victims of sexual violence, which do not bear resemblance—
Mr SPEAKER: Leave is sought to table a further ACC document on guidelines. Is there any objection to that course of action? There is objection.
Hon Trevor Mallard: In light of the Minister’s reply to the last supplementary question—that Child, Youth and Family is funding counselling for young boys—what is the system now for counselling older, female rape victims?
Hon Dr NICK SMITH: A member asked a specific question about a case in New Plymouth that had been drawn to my attention by the member for New Plymouth, and I appropriately drew to the House’s attention the fact that counselling has been provided by Child, Youth and Family. In respect of ACC’s support for victims of sexual abuse, ACC will continue to provide support as per the clinical guidelines that were developed during the time of the previous Government, of which that member was part—and they were launched by the Hon Steve Maharey, I would note.
http://www.parliament.nz/en-NZ/PB/Debates/Debates/1/e/d/49HansD_20091015_00000029-Questions-for-Oral-Answer-Questions-to-Ministers.htm

Sensitive Claims Unit changes raise concern

An editorial from the Otago Daily Times by Sandra Buchanan

Today, ACC minister Nick Smith is expected to announce that levies will rise and entitlements will be cut. Sandra Buchanan takes a critical look at the proposed reduction in counselling through the Sensitive Claims Unit.
Since 1972, children, women and men who have been mentally injured, as a result of sexual abuse, have been able to access counselling funded by ACC's Sensitive Claims Unit. ACC has recently announced policies to change and substantially limit this - their new Clinical Framework.
Today, ACC Minister Nick Smith is expected to reveal about 20 areas across ACC's purview where it is looking to cut back entitlements.
As a registered psychotherapist and ACC-registered counsellor, I have grave concerns about the proposed Sensitive Claims Unit changes. These concerns are shared by the majority of the providers of services, both clinicians and NGOs.
Since the changes were first proposed by ACC in early August, we have been providing thorough, research-based evidence to support our claim that these changes are poorly conceived and potentially dangerous to clients. Professional associations are united in their opposition to the plans.
ACC has denied the changes have anything to do with cost-cutting and in fact the greater report-writing and external assessments being proposed will have higher administrative costs. It is already the case that for every $19 million spent annually on administrating the Sensitive Claims Unit, only $2 million actually goes to counselling.
Some minor changes have been made to the new framework since it was first proposed. One such change means there will no longer be a categorical divide between the clinician assessing the client and the clinician providing the treatment - such a separation could have meant that a client saw up to three health professionals (including first disclosing to a GP) before any actual treatment began.
It appears ACC is also backtracking on providing two sessions only for the therapist and client to produce a report which determines cover. Four sessions has been the norm till now but even that was quite limited. It is not simple for someone to disclose very personal and traumatic information that they may not have spoken of previously at all.
Of most concern however, and there seems no sign of ACC rethinking on this, is that most clients will receive 16 sessions only, with any further treatment needing to be approved by an external assessor or internal ACC multi-disciplinary panel. ACC note in their latest document that it is unlikely there will be many clients in this group.
ACC says it is basing these changes on research undertaken for them by Massey University last year, the so-called Massey Guidelines, although many of their conclusions cannot be drawn from this work. ACC states that best clinical outcomes for the majority of clients can be achieved through shorter-term programmes of focused intervention.
Clinicians and other experts in the field take issue with this statement. Sixteen sessions of brief, focused psychotherapy may well assist previously functional adults who have sustained a one-off sexual assault, to recover their lives. It is totally insufficient for the clients that I typically work with, as a psychotherapist.
Individuals unfortunate enough to face childhood sexual abuse (particularly that which has occurred frequently and at the hands of a trusted family member or friend) will typically have experienced such profound assaults on their sense of trust, that their ability to form an attachment with others will be impaired.
In such a situation it may take the full 16 sessions and many more for the client to form the necessary therapeutic relationship for any treatment of the trauma to occur.
It is also of great concern that ACC is demanding that every client now have a psychiatric diagnosis to be eligible for ACC-funded counselling.
Many sexual abuse survivors do, of course, struggle hugely with depression, anxiety or post-traumatic stress disorder, which are psychiatric diagnoses - some, however, require assistance to reclaim their lives and do not have symptoms such that they would meet the criteria for such a diagnosis.
In general, therapists prefer a more holistic approach that sees the person, with their strengths and struggles, rather than a diagnosis.
At present, ACC typically requires progress reports after every 20 sessions or so, and an external assessment after about 50 sessions.
This system, to my mind, has generally worked well for years. It is now proposed that reports be done every four weeks and external assessments much more frequently. It feels as if those of us in the field are not being trusted to make our own decisions, regarding our clients' treatment.
All counsellors belonging to reputable professional bodies already have regular clinical supervision where assessment of our treatment plans for sensitive claims clients could be reviewed.
It is already the case that there are insufficient ACC-registered counsellors, particularly in specialist areas such as working with children or Maori/Pacific Islanders. There is also scarce provision outside of the major urban centres.
Therapists are so concerned about the possible dangers to clients of these changes that discussion has been given to whether it will actually be ethical to continue this work at all.
It is highly likely some counsellors will no longer provide services to ACC under these circumstances, making it even harder for clients to access therapy. (It is important to stress however that no-one is suggesting treatment of existing clients will be affected.)
The new system depends either on NGOs, such as Rape Crisis, or the public mental health services, being able to step in to provide safety for clients during extensive delays while decisions are made by the Sensitive Claims Unit.
Both NGOs and public services are already extremely stretched, as we well know. A client has to be very psychiatrically unwell to meet the criteria for services within the public mental health system, whose brief is to cover the 3% of the population with moderate to severe psychiatric disorders.
We hear a lot in the news about limited provision of services to victims of crime as opposed to offenders. ACC's system of providing counselling to those who have been victims of sexual offending was a fantastic example of actually providing some help before the ambulance at the bottom of the cliff.
It did mean assistance for victims and was about empowering individuals to recover their lives after abuse. It is also clearly minimally expensive compared with the costs of keeping offenders, many of whom have suffered their own childhood abuse, in prison for years.
None of these arguments has made any difference to the policy makers at ACC or the Government, which has been very quiet on the issue. This is a real concern for democracy.

http://www.odt.co.nz/opinion/opinion/77958/sensitive-claims-unit-changes-raise-concern

Is The Blood On ACC's Hands?

An article from Voxy

A few weeks ago a male survivor, a professional young man who said he had been "violently raped" at the age of 7 years by member of his extended family warned the heads of the ACC Sensitive Claims Unit (SCU) that the "blood will be on your hands" if the new Clinical Pathway to access therapy for survivors of sexual abuse was implemented. In his view if he had to face the Clinical Pathway that the ACC SCU was proposing to implement on 27th October he would probably not have got the counselling help he needed as a student in his 20s. In a letter he told the heads of ACC and the Minister of ACC:
"I am absolutely certain that without the help of a counsellor, the pain and disability that I experienced due to the abuse I suffered as a child would have driven me to suicide. I would not be here today. At the time when I went to see my counsellor, I barely had the confidence or strength to tell him about the existence of the abuse. If my counsellor had told me I needed to see ACC's shrink three times and be diagnosed with a mental condition before I could go to counselling, I would never have gone back. The bottom line is that many young New Zealanders will not let themselves be diagnosed as crazy, and nor should they have to, to receive sex abuse counselling. Other than ACC counselling, many of those youngsters will never have an opportunity to receive counselling to deal with the consequences of child sexual abuse. Some of those individuals will commit suicide. When people start committing suicide as a result of the ACC's new policy, the blood will be on your hands. If this new policy is implemented, I hope that you like awake every night thinking about the talented, innocent young New Zealanders who have died because of the changes you have made".
Could the following case be the first example of the "blood on their hands" even before the Clinical Pathway is implemented?
A woman took years in the mental health system before she finally felt able to disclose that she had experienced many years of extreme sexually abuse by a member of her family as a child.
While in the mental health system she had been labelled with a particularly stigmatising psychiatric diagnosis because of her self-harming behaviours and suicide attempts. She reported feeling "judged", not taken seriously but instead felt "dismissed" by those in the mental health system.
Once she disclosed the sexual abuse she was referred for ACC subsidised counselling.
She completed ACC counselling several years ago and had stablised her life sufficiently to hold down a steady job and develop a secure ongoing relationship.
Recently she was extremely distressed at work when she came across a child who had been sexually abused at the same age as when the sexual abuse began for her. Distress about this child's case meant that the woman could not return to her job.
At her own costs she went to see a private psychiatrist to assess her for medication - she did not want to see a psychiatrist in the mental health system because of her previous experiences.
To help her deal with symptom of flashbacks, nightmares, sleeping difficulties, and difficulties concentrating at her work, she sought further ACC subsidised counselling support.
ACC accepted her claim to return to counselling and allocated her a number of sessions. Over a few weeks she became more stable. She was contacted by ACC and told that in order to be allocated further counselling sessions she needed to be assessed by an ACC psychiatrist. She was told that the ACC psychiatrist would assess her self-harming behaviours and also which of her issues should be covered by ACC and which issues she should be referred back to the mental health system for. The client was concerned that ACC would insist on her returning back to the mental health system.
When the client then read in the media about the new ACC SCU Clinical Pathway she asked her counsellor how the implementation of this pathway could affect her. She clearly had the impression from ACC that they were assessing how much of her issues were to do with the sexual abuse. Her counsellor helped her consider what options she had if ACC would no longer fund her therapy. The client was concerned that she would not be able to afford to pay for counselling if ACC stopped subsidising her sessions. She had had to leave her job as a result of being triggered to remember her child sexual abuse experiences, had costs associated with paying to see a psychiatrist privately to avoid going back into the mental health system and therefore had built up some debt.
The woman's counsellor said when she next saw the client and the woman was worried about how her partner was being affected by her trauma-related depression and worried that the relationship may not last. She reported feeling "weighted down" by how difficult her life was becoming - financial difficulties, being off work, worrying about her relationship, worrying about how she would be able to pay for therapy if ACC stopped funding her counselling and insisted that she return for help back to the mental health system. She reported "nothing feels stable".
She committed suicide two days later.
Her counsellor was understandably distraught and reviewed the last few sessions several times in supervision.
The counsellor has been left with uncertainty and states that although her client was suicidal she "might have been able to have been more supported if she had been confident that ongoing therapy would continue" and "also if she had not dreaded yet another psychiatric assessment where she was scared of some negative assessment that would impact on her". "I recognise that even if either of those two things had been changed she still may have decided to suicide but ... "
Many people do not realise that for some survivors of severe interpersonal trauma such as child sexual abuse, their counsellor may be their lifeline. If their connection to their counsellor is threatened (in this case by having to see a psychiatrist for an assessment in order to decide whether ACC will continue to cover further counselling sessions), for some their very life feels under threat.
Therapists who work with survivors of sexual abuse as well as survivors themselves have advised ACC of this fact. They have told the Minister of ACC Nick Smith, the Associate Minister of ACC Pansy Wong and the ACC Sensitive Claims Unit hierarchy continuously that their new processes are not safe and clients' lives are at stake.
ACC does not appear to be listening to survivors of sexual violence or to the experts who work with them.
ACC will not be moved on insisting that to have a claim for therapy accepted in the first one or two sessions: 1) a psychiatric diagnosis is required and 2) 'a clear causal link' between the abuse and the current effects is proven.
This means that in the first one or two sessions a survivor of sexual violence would not only have to disclose the abuse (that they may have taken 20 years to find the courage to see a counsellor about) but they would ALSO need to provide sufficient information to enable the psychologist to give a psychiatric diagnosis from the American Diagnostic and Statistical Manual of Mental Disorders (DSMIV) AND provide a 'clear causal link' between the sexual violence and the effects now.
In the first one or two sessions the survivor will also be required to sign release forms so that all of her or his medical records and employment records could be collected.
A cynic may conclude that ACC could review these records and find alternative explanations for the current effects (eg if the survivor of abuse is suffering depression that the survivor said was related to a rape or child sexual abuse years earlier - it would be easy for ACC to point to other issues in the survivor's life such as current relationship difficulties or job stress that could be the cause of the current depression).
A recent example may be found in an article reported by the Taranaki Daily News last week about a letter from ACC to a grandmother whose grandsons had been sexually abused, declining cover. The letter stated ACC "found no clinically significant mental injury arising from the events described". The newspaper went on to state: "An ACC psychologist believes one of the boy's mood swings, tearfulness and sitting alone sucking his thumb could be due to settling into school and a new environment rather than the sexual abuse events". According to the newspaper the letter from ACC stated: "The best practice may be not to treat this child for sexual abuse unless further problems which were clearly related to the abuse later became evident".
The requirement of 1) a person's symptoms fitting the criteria of a psychiatric diagnosis and 2) being able to 'prove' a clear causal link between the abuse and the current effects on a person's life, will mean that it will be almost impossible for survivors of sexual violence to have any ACC subsidized therapy allocated.
In the Auckland area alone in the last 9 months over 470 survivors of sexual violence have had their claims for counselling declined. There are more than a 100 waiting for approval.
There are endless cases of survivors of sexual violence around the country waiting 2-4 months for psychiatric assessments so that ACC can decide whether it believes they are entitled to counselling support.
As I was about to send this Press Release out I received an email from a colleague stating:
"I have just seen a client who told me that her friend has decided not to proceed with filing a claim for counselling, as she received a letter from ACC Sensitive Claims telling her that she'd get 4 sessions with the counsellor to write the report and then she'd have to see someone else to determine whether that counsellor is the best person for her to have counselling with. She'd already completed 3 sessions with the counsellor and just can't face the idea of having to see anyone else. It has taken her YEARS to work up the courage to talk to anyone about her history of abuse.
It seems that the new pathways are already being implemented, despite the start date being deferred".
To keep some survivors of sexual abuse alive it is vital that they are able to access specialist counselling support when they need it and to know that this support it is available to them for as long as they need.
The government needs to take all necessary steps to make sure that survivors of sexual violence get this support.
In recent months since the shock announcement by ACC to counsellors who work with survivors of sexual violence there has been a huge amount of professional outrage, letters to Ministers and a petition with over 3000 signatures calling for ACC to stop its Clinical Pathway.
I have been a therapist registered with ACC since 1986. I wrote the first set of ACC therapy guidelines for therapists working with survivors of child sexual abuse published in 2001.
If this Pathway is implemented I and many other therapists particularly Maori therapists have said they will resign as ACC registered therapists. We will not put our clients through this cruel assessment process.
All we ask is that ACC stop the implementation of this pathway and work with the professionals who work with survivors of sexual violence to sort out what ever it is that ACC is trying to fix.
We want to work 'with' ACC to find a solution but we do not know why ACC is changing the current system with such haste and without the experts' help to ensure that any changes to the current clinical pathway is safe.
I and many of my colleagues believe that the proposed ACC Clinical Pathway is unethical and many professionals and survivors believe that lives will be lost because of it.

http://www.voxy.co.nz/national/blood-acc039s-hands/5/27048