{"id":2392,"date":"2023-09-06T19:27:42","date_gmt":"2023-09-06T19:27:42","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjsrh\/?p=2392"},"modified":"2023-09-06T19:30:30","modified_gmt":"2023-09-06T19:30:30","slug":"capturing-clouds-listening-to-young-survivors","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjsrh\/2023\/09\/06\/capturing-clouds-listening-to-young-survivors\/","title":{"rendered":"Capturing Clouds: Listening to young survivors in the design of their journey through Paediatric Sexual Abuse Referral Centre services"},"content":{"rendered":"<p style=\"text-align: right\"><span data-ccp-props=\"{}\">\u00a0<\/span><i><span data-contrast=\"auto\">By Jane Meyrick, Michelle Cutland and Rae Adams<\/span><\/i><span data-ccp-props=\"{&quot;335559685&quot;:2160,&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Childhood Sexual Abuse (CSA) is increasingly recognised and the impact often <\/span><a href=\"https:\/\/www.iicsa.org.uk\/final-report.html\"><span data-contrast=\"none\">lifelong<\/span><\/a><span data-contrast=\"auto\">.\u00a0 With at least 15% of girls\/young women and 5% of boys\/young men experiencing some form of sexual abuse before the age of <\/span><a href=\"https:\/\/www.csacentre.org.uk\/documents\/scale-nature-review-evidence-0621\/\"><span data-contrast=\"none\">16 years<\/span><\/a><span data-contrast=\"auto\"> the role of sexual health is crucial.\u00a0 Sexual Health Follow-up (SHFU) is offered by paediatric Sexual Abuse Referral Centres (SARC) but an audit by the clinical team at <\/span><a href=\"https:\/\/www.thebridgecanhelp.org.uk\/\"><span data-contrast=\"none\">the Bridge<\/span><\/a><span data-contrast=\"auto\">, University Hospitals Bristol and Weston NHS Foundation Trust showed we could be doing better.1 in 5 were lost to follow up and young survivors and their carers found visits potentially anxiety-provoking or re-traumatising.\u00a0 Referring teams struggled to find an appropriate provider, especially for survivors aged under 13 who cannot attend standard sexual health clinics. Providers themselves reported feeling these consultations went beyond their day-to-day competencies.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><span data-contrast=\"auto\">Our paper describes how members of the clinical team supported the \u2018voice group\u2019 of survivors at the <\/span><a href=\"https:\/\/the-green-house.org.uk\/\"><span data-contrast=\"none\">Greenhouse<\/span><\/a><span data-contrast=\"auto\"> CSA support service<\/span><span data-contrast=\"auto\">,<\/span><span data-contrast=\"auto\"> to re-design a pathway that would better meet their needs, with guidance from a health psychologist.\u00a0 This work was funded by research capability funding from the NHS Trust.\u00a0 The work did this in a way that paid attention to power dynamics \u2013 we did not invite patients into healthcare structures and processes that hoard power but went to them. We did not and start\u00a0<\/span> <span data-contrast=\"auto\">a \u2018one-off\u2019 project-based group but found the organisations that had already built a safe space for supported \/safeguarded survivors.\u00a0 The work was transformational<\/span><span data-contrast=\"auto\">, <\/span><span data-contrast=\"auto\">not because of what we did but how we did it, focusing on restoring voice and agency to young survivors whose experiences had robbed them of both.\u00a0 The pictures below illustrate the trauma informed and survivor centred passport through sexual health follow up we developed (which included links to short \u2018this is what it is\u2019 videos).\u00a0 We designed this through arts<\/span><span data-contrast=\"auto\">&#8211;<\/span> <span data-contrast=\"auto\">based, creative workshops that used <\/span><a href=\"https:\/\/www.our-voices.org.uk\/assets\/images\/IC-CYP-participation-ethical-working-paper.pdf\"><span data-contrast=\"none\">evidence-based tools<\/span><\/a><span data-contrast=\"auto\"> allowing distancing techniques for survivors to safely talk about what others might need. Data from the groups, parents and a wide range of staff was thematically analysed.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/options.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-2393\" src=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/options-257x300.jpg\" alt=\"\" width=\"291\" height=\"340\" srcset=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/options-257x300.jpg 257w, https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/options.jpg 438w\" sizes=\"auto, (max-width: 291px) 100vw, 291px\" \/><\/a> <a href=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/map.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-2394\" src=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/map-234x300.jpg\" alt=\"\" width=\"234\" height=\"300\" srcset=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/map-234x300.jpg 234w, https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/map.jpg 417w\" sizes=\"auto, (max-width: 234px) 100vw, 234px\" \/><\/a> <a href=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/Picture1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-2395\" src=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/Picture1-300x225.jpg\" alt=\"\" width=\"355\" height=\"266\" srcset=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/Picture1-300x225.jpg 300w, https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/Picture1-1024x768.jpg 1024w, https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/Picture1-768x576.jpg 768w, https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/Picture1-1536x1152.jpg 1536w, https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/Picture1-2048x1536.jpg 2048w, https:\/\/blogs.bmj.com\/bmjsrh\/files\/2023\/09\/Picture1-640x480.jpg 640w\" sizes=\"auto, (max-width: 355px) 100vw, 355px\" \/><\/a><\/p>\n<p><em>The \u2018My Healthy Journey\u2019 map produced by Dr Rachel Adams and Hope Barraclough from the Bridge, is for service users and their carers but also for clinical staff to clearly understand the pathway with a parallel professional map. \u00a0<\/em><\/p>\n<p><span data-contrast=\"auto\">The impact for those involved was <\/span><i><span data-contrast=\"auto\">\u201camazing\u2019.. really proud\u201d <\/span><\/i><span data-contrast=\"auto\">and<\/span><i><span data-contrast=\"auto\"> &#8220;the group were really pleased with the outcomes\u2026especially the way that what they had said got taken in and fed back\u2026they have repeatedly said is what makes being part of the group worthwhile&#8221;<\/span><\/i><span data-contrast=\"auto\"> (Voice facilitator).\u00a0 We are currently formally evaluating the work but focusing on the principles of survivors as experts by experience, we have started by asking survivors how they would measure their own outcomes: as the Bridge Paediatric Clinical Director, Dr Michelle Cutland wisely described it, \u2018capturing clouds\u2019.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><span data-contrast=\"auto\">The theme of World Sexual Health Day this week is consent. This reminds sexual health of their pivotal contribution to identifying and supporting survivors of a range of violence and abuse.\u00a0 That means moving beyond the limited domestic violence\/safeguarding framework that can dominate.\u00a0 Parallel work around sexual abuse is taking place with BASHH\u2019s Sexual Violence interest group.\u00a0 Results from a national survey of how sexual health asks about sexual and domestic violence is currently being prepared for publication, watch this space.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/srh.bmj.com\/content\/early\/2023\/07\/03\/bmjsrh-2023-201866\"><span data-contrast=\"none\">Read the BMJ SRH paper here<\/span><\/a><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><em><strong>About the authors\u00a0<\/strong><\/em><\/p>\n<p><span data-contrast=\"auto\">Associate Professor of Health Psychology Dr Jane Meyrick specialises in sexual health and sexual violence\/abuse.\u00a0 She recently published an accessible overview of sexual violence in her research translation <\/span><a href=\"https:\/\/www.routledge.com\/MeToo-for-Women-and-Men-Understanding-Power-through-Sexual-Harassment\/Meyrick\/p\/book\/9780367767976\"><span data-contrast=\"none\">book #MeToo for Women and Men<\/span><\/a><span data-contrast=\"auto\">. Her work\u00a0 particularly focuses on the lived experience of marginalised communities in sexual health.\u00a0\u00a0<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Dr Michelle Cutland is the Clinical Director of the Paediatric SARC at the Bridge.\u202f\u202fShe is a consultant paediatrician and recent co-clinical lead for the Royal College of Paediatrics &amp; Child Health (RCPCH) systematic review \u2018The physical signs of child sexual abuse\u2019.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Dr Rachel Adams is a senior community and reproductive health trainee in the South West.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00a0By Jane Meyrick, Michelle Cutland and Rae Adams\u00a0 Childhood Sexual Abuse (CSA) is increasingly recognised and the impact often lifelong.\u00a0 With at least 15% of girls\/young women and 5% of boys\/young men experiencing some form of sexual abuse before the age of 16 years the role of sexual health is crucial.\u00a0 Sexual Health Follow-up (SHFU) [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmjsrh\/2023\/09\/06\/capturing-clouds-listening-to-young-survivors\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":472,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7420,2601,15160],"tags":[],"class_list":["post-2392","post","type-post","status-publish","format-standard","hentry","category-clinical-practice","category-latest-research","category-patient-co-production"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Capturing Clouds: Listening to young survivors in the design of their journey through Paediatric Sexual Abuse Referral Centre services - BMJ Sexual &amp; Reproductive Health blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmjsrh\/2023\/09\/06\/capturing-clouds-listening-to-young-survivors\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Capturing Clouds: Listening to young survivors in the design of their journey through Paediatric Sexual Abuse Referral Centre services - BMJ Sexual &amp; Reproductive Health blog\" \/>\n<meta property=\"og:description\" content=\"\u00a0By Jane Meyrick, Michelle Cutland and Rae Adams\u00a0 Childhood Sexual Abuse (CSA) is increasingly recognised and the impact often lifelong.\u00a0 With at least 15% of girls\/young women and 5% of boys\/young men experiencing some form of sexual abuse before the age of 16 years the role of sexual health is crucial.\u00a0 Sexual Health Follow-up (SHFU) [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmjsrh\/2023\/09\/06\/capturing-clouds-listening-to-young-survivors\/\" \/>\n<meta property=\"og:site_name\" content=\"BMJ Sexual &amp; 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