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Childhood Experience of Care and Abuse (CECA) Interview training

The CECA is a measure of childhood and adolescent experience of neglect and abuse, developed and used over a 20 year period. It original use was by researchers to investigate lifetime risk factors for psychological disorder.

We now offer 2 types of CECA training: a 2-day generic training, suitable for psychologist, psychiatrists, psychotherapists and related professionals who need to assess childhood experience retrospectively in relation to practice; as well as 1-day training courses around specific CECA-related issues such as Neglect, Physical and Psychological Abuse, suitable for Safeguarding professionals.

1. CECA for Forensic & Clinical Psychologists, Psychiatrists, Psychotherapists and related professionals

As an interview CECA can establish retrospective accounts of childhood from young people and adults. It identifies etiological factors important in common mental health disorders such as depression and anxiety and encompasses both psychosocial risk and resilience factors. The CECA 2-day training is designed for researchers and practitioners in clinical, forensic and children and family services, related professionals who need to assess childhood experience retrospectively in relation to practice. The method can also be used for summarising case material.

The CECA takes the form of a semi-structured interview, which aims to reflect objective features of early life experience with probing questions to ascertain details of context and time-sequence of experience. The CECA takes the form of a semi-structured interview, which aims to reflect objective features of early life experience with probing questions to ascertain details of context and time-sequence of experience. The interview takes an average of 1.5 hours or so to administer for a medium risk case and around three times as long to transcribe and score. The length of the interview is variable depending on the complexity of the childhood circumstances.

The interview assesses lack of care (neglect, antipathy), physical abuse, sexual abuse and psychological abuse, all of which are shown to relate to adolescent and adult psychological disorder. These form the Core CECA. Additional scales which can be utilized assess loss of parent, family arrangements, discord in the home, violence between parents, supervision and control of children, role reversal and childhood helplessness. Positive scales assess support, closeness to parents, coping and being the parents’ favourite child. A brief measure reflecting circumstances of leaving home is also included. Demographic measures such as parental social class, sibling position and details of parental loss are also included.

The interview measure has high levels of reliability and validity. Since the measure is used retrospectively, questioning about childhood attempts to enhance recall by (i) allowing the respondent time to talk at length by using a number of general open questions in addition to detailed ones and (ii) dealing with childhood experience chronologically and in detail in order to further trigger memory. The adolescent measure can be used from age 13.

Trainees are required to become familiar with definitions, rating thresholds and interview techniques for dealing with issues of reporting style and overcoming biases in recall. Training is through use of video-taped and transcribed interviews, reference to a rating manual and rating of case studies. Discussion is held throughout on analysis of the CECA and its adaptation to different samples and outcome variables. The training pack consists of the interview questions and rating schedules (printed copies can be ordered for those who are trained in the measure).

Training sessions are held at our campus in Hendon, North London, but special training sessions can be held for teams on site if required, including those held outside the UK. Additional consultancy can be provided after training for rating reliability, analysis and on research design.

(i) Bifulco A & Moran P (1998) Wednesday’s Child: Research into wormen’s experience of neglect and abuse in childhood and adult depression. Routledge, London, New York.
(ii) Bifulco A, Bernazzani O, Moran PM & Jacobs C (2005) Childhood Experience of Care and Abuse Questionnaire (CECA.Q) Validation in a community series. British Journal of Clinical Psychology, 44: 563-581.

2. CECA for for Safeguarding – reports and chronologies

There is increasing need for standardised means of assessing abuse in families to help with Safeguarding services. This is particularly highlighted by the Public Law Outline (PLO) which requires reduction in delays for applications for care or supervisions from ‘application to disposal’. Tools that can aid with assessing and analysing the range and severity of abuse or negative parenting experiences can therefore aid best practice in the interest of children and families. Such tools are also useful in the Integrated Children’s System to summarise or quantify characteristics of abuse for the Core Assessment. The CECA rating scales and definitions can be useful for such purposes as well as for aiding assessment in Parenting Support programmes.

CECA measure has recently been successfully introduced to the Safeguarding and ‘Looked After’ Services to help social workers in their assessments of children and families at risk. Workers receive training in rating CECA experience in neglect, role reversal, physical, psychological abuse and related experience. CECA can then be used to inform ongoing cases in Child Protection, Child in Need and Looked After Services, enhancing the assessments of complex cases by providing benchmarked severity ratings and clarity of definitions. This can help the social workers and courts to decide on, or confirm, care planning.

Example of CECA use in practice: An evaluation was carried out on the use of the CECA in Royal Borough of Kingston’s Child Safeguarding Services. The study trained 8 social workers in the CECA and examined how it can be used to inform chronologies for court proceedings and the categorization of maltreatment and severity ratings for care planning. The ‘Childhood Experience of Care and Abuse Interview’ for Child Safeguarding practitioners: An evaluation in RB Kingston Safeguarding Services‘, by Professor Antonia Bifulco & Catherine Jacobs, 2010. Read project executive summary report here (full report available on request).

CECA scoring and benchmarked rating system can be used in practice contexts to systematise case record material, and inform categorisation of information collected from varied sources (child, family, witnesses etc). The scales are scored according to a set of definitions, rating rules and precedent ‘benchmark’ examples. The training here is modularised into one day training courses. Each day will provide training in the reliable use of the topics covered. The workshops outline definitions, recent research, assessment of severity threshold and discuss practice implications and report writing.

One-day workshops are available to Safeguarding teams on:

  • Neglect/ antipathy
  • Physical abuse & domestic violence
  • Psychological abuse

Download CECA workshops flier for full details.

Team briefings can be provided to agencies on the use of CECA in Safeguarding. Team training can be arranged on site or at our North London training venue.