Training in the
Childhood Experience of Care and Abuse (CECA) Interview

Contact: lifespantraining@mdx.ac.uk

Training courses are offered in the CECA research interview into neglect and abuse in childhood by the Centre for Abuse and Trauma Studies - CATS (fomerly Lifespan Research Group) at Middlesex University London.

Childhood Experience of Care and Abuse (CECA) Interview
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 (eg the team at CATS) to investigate lifetime risk factors for psychological disorder. It has been used by a number of teams in the UK and internationally and is available in other languages ) It has 2 formats and training procedures. There is also a questionnaire version (CECA.Q).


I. CECA for Forensic & Clinical Psychologists

As an interview it 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 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.

The interview has been translated into different languages, and used in research in Portugal, France and Italy as well as in Canada and USA.

2-day trainings for Forensic and Clinical Psychologists and researchers are available. For enquiries or to reserve a place contact lifespantraining@mdx.ac.uk.

Reference
1Bifulco 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. 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 new 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 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..

One-day workshops are available to Safeguarding teams on:

1. Neglect/ antipathy
2. Physical abuse & domestic violence
3. Psychological abuse

The workshops will outline definitions, recent research, assessment of severity threshold and discuss practice implications and report writing.

Download CECA workshops flier for details.

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.

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 (full report available on request).

 

The Questionnaire: CECA.Q2

A brief self-report version has been validated against the interview. This assesses loss of parents, neglect, antipathy from main carers and physical and sexual abuse. Support in childhood is also included. The measure shows acceptable sensitivity and specificity against the interview measure, and published cut-off scores are available. The CECA.Q has been translated into a number of languages (eg Italian, German, Spanish, Portuguese, Chinese) and has been used in Europe, USA, Canada, South America and the Far East. The measure is significantly associated with both the Parental Bonding Instrument and the Childhood Trauma Questionnaire3, but has wider coverage of maltreatment, shows a dose-response effect in relation to lifetime clinical depression and has improved improved prediction of disorder.

Download CECA Questionnaire here.

CECA.Q3 offers additional sections of psychological abuse and role reversal. These are included in the later version because of their key relationship to later depression and self-harm behaviour in adolescents. Download CECA Questionnaire - with Psychological Abuse and Role Reversal (CECA.Q3) here.

Download CECA Questionnaire Scoring Guide here.

References:

2Bifulco 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.

3Fisher HL, Barber R, & Morgan C (under review). Concurrent validity of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and the Childhood Trauma Questionnaire (CTQ). British Journal of Clinical Psychology.