Appendix A — Evidence Base, Outcomes and Detailed Findings
Detailed service evidence, outcomes, methodology and limitations.
Detailed three-year service evidence: growth, need and impact, 2023–2026
Restitute provides high-intensity support to non-abusing parents, carers, partners, siblings and other family members affected by sexual abuse, sexual violence, domestic abuse and other serious violence. The service is independent of support offered to the primary victim. It works with family members who are often left trying to manage risk, police and court processes, safeguarding, school or work disruption, financial and practical pressure, and the wider impact of trauma on family life.
This appendix brings together three years of evidence to show the reach, profile and outcomes of Restitute’s work. It looks at who received support, the recurring patterns of harm and need behind that support, and whether the quality and impact of the service held up as the number of people supported increased.
A1. Scale and profile
Across the three-year period, Restitute supported more people while working with a broadly consistent pattern of harm, need and family impact. The client group remained recognisable and the main crime profile stayed stable.
Growing reach, consistent client group
The age profile was stable, with the largest groups in the 35–44 and 45–54 age bands, reflecting that 73% of clients were parents caring for someone under 18.
The ethnic profile remained mainly White, with White British the largest group in each year. This partly reflects where Restitute began, as the service started in East Anglia. When the work expanded into more diverse areas, the number of Black and Asian clients supported increased. The available outcomes data did not show a clear difference between recorded ethnic groups, although numbers in some groups were small.
Most clients identified as heterosexual, with smaller numbers identifying as lesbian, gay, bisexual or another sexuality. This profile is shaped by the cases coming into the service. Much of Restitute’s work involves children harmed by fathers, stepfathers or other adult male carers. Many clients are therefore mothers who were in heterosexual relationships with the perpetrator.
The client group changed little across the three years.
A2. Nature of harm and family need
Clients usually arrived with several pressures at once. A legal problem could sit alongside school, caring, health, money, safeguarding and immediate crisis.
Relationship-based harm
Family members were the largest perpetrator group in every year. Other perpetrator categories included adult partners or ex-partners, children or peers, other known people, and unknown people or strangers.
Most of Restitute’s work was therefore dealing with harm inside families or other close relationships, not mainly harm from strangers.
Gendered pattern of harm and family support
Across all three years, clients were mainly female, making up 85.3% of the total three-year cohort. Most were non-abusing parents and carers supporting a primary victim who was also female.
Perpetrators were overwhelmingly male. Among perpetrators with recorded gender, fewer than ten were female across the full three-year period.
Crime affecting loved ones
Across the three years, the largest category concerned harm to children by adults. Other recurring categories included domestic abuse, harmful behaviour between children, sexual violence affecting adults, online offences and other serious violence.
The overall pattern remained broadly consistent from year to year.
Overlapping needs and pressures
Many clients were dealing with more than one issue at once. A substantial number were victims of crime themselves. Some were also living with disability. In some cases, the same perpetrator had harmed both the client and the person they were caring for.
Consistent systemic challenges
Parents and carers often had to deal with safeguarding, school, criminal justice processes, conflict inside the home, relatives siding with the perpetrator, other children in the family struggling with what had happened, and severe financial hardship after disclosure or separation.
In some families, siblings believed the primary victim. In others, they did not, or blamed the primary victim for changes in contact or family life.
The recorded need themes show the same pattern. Legal processes, education, parenting and caring, health, emotional wellbeing, finance, safeguarding and crisis appeared across all three years with very little movement. Clients rarely came with one clean issue. Most were trying to hold several pressures at once.
A3. What Restitute provided
From the start, Restitute was built around what lived experience told us would help and what families said they needed.
Everyone who came into the service received a one-to-one support worker. Some also needed direct practical help to make life safer or more manageable, and a smaller group received support from an independent therapeutic provider.
One-to-one support worker
Everyone who worked with Restitute had an assigned one-to-one support worker. Support was proactive and based on planned appointments, not on clients having to keep asking for help or start again each time something changed. Over time, the support worker got to know the client and their family situation, so they did not have to tell the whole story in one go or repeat themselves to different people. They could say more as trust built and as and when they were ready.
Clients were often overwhelmed at the point support began and did not know what to do first. The support worker helped them work out what was urgent, what could wait and what they needed to do next. This could include police interviews, court hearings, child protection meetings, school meetings, social care involvement, housing problems or financial pressure. It could also mean helping a client hold the line when relatives sided with the perpetrator, or helping them manage what was happening inside the home when other children were angry, confused or blaming the primary victim for what had changed.
Some clients were trying to hold things together while the primary victim was in acute distress, struggling with their mental health, self-harming, refusing school or showing behaviour that was hard to manage. Some were also dealing with intimidation, isolation and family fallout. The support worker stayed with them, knew the detail and helped them deal with what was in front of them. They also provided encouragement, reminded clients of what had been achieved and celebrated successes, large and small.
Practical help
Some clients needed practical help to make life safer or simply keep things going. In some cases, that meant security equipment after threats, stalking or intimidation. In others, it meant replacing basic household items, dealing with the state of the home after the perpetrator had gone, or helping a family manage when faced with financial crisis following the removal or arrest of a main earner in the household.
Across the three-year period, Restitute made 468 practical support grants worth just over £29,000. This included 101 grants for food, fuel and electricity, alongside security items, beds, bedding and household essentials. Spend was highest in 2023–24, when cost-of-living pressure was at its worst in the UK. Many families were already trying to absorb the financial consequences of the crime committed against their child or loved one, with very little room to absorb another crisis.
Some items were not only about practicality, and flowers were one example. For clients who often felt blamed, isolated or ashamed, receiving flowers showed care and respect. Christmas hampers mattered in a similar way. They helped some families materially, but they also showed care at a difficult and stressful time of year.
Therapeutic intervention
Only a minority of clients were referred for therapeutic intervention: 11.6% in 2023–24, 8.6% in 2024–25 and 9.2% in 2025–26. The proportion stayed fairly steady across the three years.
11.6%
8.6%
9.2%
Therapy remained a selective part of the wider model rather than the default response.
Clients may have been deeply distressed by what had happened, but distress is not the same as needing clinical therapy. Clients worked first with a one-to-one support worker, and discussion about a possible referral came later. For many, the immediate need was to regain some control over routines, what happened next and how they cared for their loved one. Being able to challenge decisions, ask for explanations and hold professionals to account helped many re-establish themselves as the adult in the family.
Where a client wanted to explore therapy, Restitute could support a referral to an independent therapeutic provider. Decisions about clinical need, suitability, therapeutic approach and treatment rested with the qualified provider.
The University of Suffolk evaluation supports the wider approach. Clients who received therapy showed the same overall pattern of improvement in wellbeing as those who did not. This suggests that therapy was being used selectively as part of the wider model, rather than becoming the default response for every distressed client.
A4. Outcomes and durability of change
Despite increasing numbers of clients, the quality of Restitute’s work has remained strong, showing significantly improved outcomes for parents, carers and families.
Changes during support
Restitute uses outcome measures to understand change in the areas most closely connected to the model: wellbeing, carer confidence and physical health. The measures are completed at the beginning of support, at review points and at exit.
Across the three-year period, clients showed a consistent pattern of improvement in all three areas. The independent University of Suffolk evaluation also found improvements from clients’ first to final engagement in wellbeing, physical health, carer confidence and satisfaction with the services supporting their loved one.
The greatest improvements were often seen among clients who began support with the poorest wellbeing, health and carer-confidence scores. Longer engagement with Restitute was associated with greater improvement in wellbeing and physical health.
Restitute’s outcome measures were developed with clients and staff because generic tools did not fully capture the practical, emotional and caring impact experienced by the people the service supports. They are not validated clinical scales and should not be presented as such. Their value lies in showing whether clients become steadier, healthier and more confident in their ability to care, make decisions and manage the pressures surrounding their family.
Long-term outcomes
Restitute’s long-term follow-up asks whether improvements made during support are still present six months or more after active support has ended.
In the current long-term follow-up cohort:
The vertical marker represents 100% maintenance. A result above 100% means that, on average, the improvement continued after active support ended.
Carer-confidence gains did not merely hold. On average, they continued to increase after support ended. This is particularly important because the model aims to help clients regain the confidence and capacity to make decisions, manage systems, hold boundaries and support their family without becoming permanently dependent on a support worker.
The findings suggest that Restitute’s impact is not limited to short-term crisis relief. Most of the gains in wellbeing remained, and clients continued to report substantially greater confidence in their caring role after they had left active support.
The long-term dataset is still developing and should be interpreted carefully. It is smaller than the main service dataset and includes only former clients who consented to and completed follow-up. It nevertheless provides important emerging evidence that the changes made during Restitute support can last beyond the intervention itself.
A5. Evidence sources and limitations
The evidence base for the Restitute Model comes from four main sources: evaluated evidence, practice evidence, lived-experience evidence and developing economic evidence. Each source does a different job. Evaluation tests outcomes and experience more formally. Practice evidence shows what happens in real delivery. Lived-experience evidence keeps the model grounded in what families and loved ones actually carry. Economic evidence is still developing, but it is important because the model may reduce pressure on other services by helping families earlier, more practically and more consistently.
Independent evaluation
The evaluated evidence includes the independent mixed-method evaluation undertaken by the University of Suffolk between 2023 and 2025. It combined qualitative analysis of case records and interviews with former clients with quantitative analysis of outcome measures completed at different points in support. It found that the casework service offered significant benefits, with clients reporting improvements across the main outcome areas. The evaluation also examined outcomes for clients who accessed therapy alongside casework, using validated measures of anxiety and depression. This evidence is important because it shows that the model is not only valued by clients, but is associated with measurable improvements in how clients are coping, functioning and experiencing their role.
Practice evidence
Restitute’s evidence base is not only formal evaluation data. It also includes practice evidence built through case studies, supervision, audit learning, delivery experience, case recording, client feedback, Home Office reporting and annual reporting. This material matters because it shows how the model works in real situations: what families ask for, what workers actually do, where risk or safeguarding issues arise, what practical support is needed, and how support changes as families move through crisis, stabilisation, ongoing work and closure. This evidence is not a substitute for independent evaluation, but it is an important part of understanding, testing and refining the model.
Lived-experience evidence
Lived-experience evidence is also central to the Restitute Model. Restitute works with co-production principles, which means that the experiences of clients, former clients and people with lived experience help shape the way support is understood, delivered and improved. Lived experience within the staff team also matters. It can help workers recognise patterns, build trust and understand why families may feel ashamed, frightened, blamed, angry or unsure what help they are allowed to ask for. The University of Suffolk evaluation identified lived experience as one of the factors that helped clients feel understood. But lived experience is carefully bounded within the model. It does not replace training, supervision, safeguarding, recording or professional judgement, and it must always be used in a way that keeps the client’s needs at the centre.
Developing economic evidence
Restitute is also developing its economic evidence. The University of Suffolk evaluation identified that further cost-benefit analysis is needed, particularly because the casework service, its range of work and its positive impact may be diverting clients away from other services. University of Bristol / VISION work is helping to strengthen this part of the evidence base. At this stage, the economic case should be treated as developing evidence, not final proof of cost-effectiveness. The strongest current position is that the model has credible reasons to expect wider system value, but the full cost-benefit evidence is still being built.
How the evidence is maintained and interpreted
The evidence base continues to grow through routine delivery, outcome tracking, follow-up and clear reporting of its limits.
Routine evidence collection
Restitute has collected evidence in different forms since the service began, with outcome information recorded more systematically from 2021. This has included Restitute’s own client outcome measures, case recording, client feedback, case studies, practical-support records and wider service data. Where clients accessed therapy through an independent therapeutic provider, validated clinical scales were also used as part of the therapy evaluation. This means the evidence base has developed through both routine service delivery and more formal evaluation activity, rather than being created only for one report or funding requirement.
Client outcome measures
Restitute uses client outcome measures during casework to understand change in the areas most relevant to the model. The measures focus on wellbeing, carer confidence and health. They were developed with clients and staff because existing generic tools did not fully capture the practical, emotional and caring impact experienced by the people Restitute supports. The measures are not national or internationally validated clinical scales, and they should not be presented as if they are. Their value is different. They help Restitute track whether clients are feeling steadier, more confident, healthier and more able to manage their caring role as support progresses.
Long-term follow-up
Long-term follow-up is an important developing part of the evidence base. The University of Suffolk evaluation recommended that Restitute should have mechanisms for assessing longer-term outcomes after clients have left the service. Restitute is building this evidence so it can understand whether the gains made during support are maintained after the intervention has ended. This matters because the model is not only interested in whether clients feel better at closure. It also needs to understand whether clients remain steadier, more confident and more able to manage family life, systems and future high-stress points after active support has ended. The long-term follow-up dataset is still developing, so it should be used carefully, but it is an important part of testing whether the model has lasting value.
Honest limits
The evidence base is strong enough to define, explain and transfer the Restitute Model, but it should still be presented honestly. The current evidence shows that clients value the service and report improvements in wellbeing, carer confidence and health. For clients who accessed therapy through an independent therapeutic provider, evaluation evidence also showed reductions in anxiety and depression. The economic evidence is promising but still developing. Restitute has credible reasons to believe that practical, relational and structured support may reduce pressure on other services by helping families earlier and more effectively, but the full cost-benefit case is still being built. This distinction matters. The model does not need inflated claims; it needs clear evidence, honest limits and a commitment to keep testing what works.