Evaluation of Letting the Future In
In collaboration with the Universities of Bristol and Durham, we evaluated Letting the Future In (LTFI) to see if a psychodynamic, attachment-based therapeutic approach helped sexually abused children and young people.
The evaluation included qualitative case studies and the largest multi-site randomised controlled trial (RCT) for a sexual-abuse intervention in the world.
What we learnt
Findings from the evaluation include:
- After six months of Letting the Future In, there was a significant reduction in the number of 8- to 17-year-olds with high levels of psychological and behavioural problems. There was no statistically significant change for the control group, suggesting that the intervention was responsible for improvements.
- Children under the age of 8 did not see a change in psychological and behavioural problems after six months of participating in LTFI. However, there was some evidence of improvement after 12 months. This suggests the service may take longer to have an impact on younger children.
- Children and carers both felt that LTFI had resulted in positive changes.
- The mean cost of providing LTFI was estimated as £2,300 per case. This compares to an average cost of cases seen by a multidisciplinary Child and Adolescent Mental Health Service of almost £5,000 (Curtis, 2012).
> Find out more about our evaluation of Letting the Future In
How we evaluated this service
There were three components to the evaluation of Letting the Future In.
We carried out a randomised controlled trial (RCT) including 242 cases – the largest ever RCT of a sexual-abuse therapy anywhere in the world.
Cases were allocated straight into LTFI or onto a waiting list for six months. Data were collected:
- when cases were first assessed
- after six months (which would have been at the end of the waiting period for those cases on the waiting list and after six months of the intervention for those in the intervention)
- after 12 months.
The data were collected by practitioners delivering the therapy, though the second data collection was collected by a different therapist to avoid any bias in the data.
We carried out interviews with practitioners delivering LTFI to find out their experiences of implementing the programme. We analysed case studies of children and young people who received the intervention and carried out a special study looking at the relationship between young people and their therapist.
We compared the cost and impact of LTFI with the cost and impact of any help children and young people had while they were waiting for the intervention, which could be from doctors, social workers or other services.
The evaluation used the following tools:
- Client Services Receipt Inventory
- Parental Stress Index
- Trauma Symptom Checklist for Children
- Trauma Symptom Checklist for Young Children
- Therapeutic Alliance Scale for Children.
Evaluation of LTFI for children with learning disabilities
We asked the University of Bristol to carry out a formative evaluation of Letting the Future In for children with learning disabilities (LTFI-LD). They found that practitioners who already had experience of delivering LTFI were able to deliver LTFI-LD with appropriate training and support.
> Read about our evaluation of Letting the Future In for children with learning disabilities