The safeguarding body, which is starting its third year of work, is headed up by Boston Cardinal Sean O'Malley and holds its next plenary meeting at the beginning of February.
"We do work in our working groups in between these big plenary meetings. A lot of it is done electronically. We're working all the time. It is busy and quite stressful," said Collins.
Collins, who brought the priest who abused her as a sick child in a Dublin hospital in the 1960s to justice in 1997, warned that "there is still resistance" within the church to safeguarding protocols and that is why the commission's work is "essential."
In some countries, there is still an attitude that clerical child sexual abuse "is not a problem and never will be problem, or that it is a Western problem or a problem within English-speaking countries, or it is being exaggerated, or that it would never happen in our country because of our culture," she said.
"It is very difficult to convince people to put safety measures in place if they think it is never going to happen. They can't see the point," Collins commented.
On the other hand, in countries where the church is tackling the issue, she detects an attitude of " 'When will this be all over and we can stop having to put all of these provisions and policies in place? When can we go back to being the way we were?' You have to try to get through that and say you can never go back to where you were."
Collins believes that it will be survivors of abuse in Africa and Asia who will force the church there to implement change. To date, in countries where abuse has been uncovered and better safeguarding practices have been implemented, it has been a survivor-led movement.
"It is not that the church wanted to listen, it is they were made to listen by survivors and I don't think anything will change in that respect," Collins said.
In places like Ireland, the U.S., U.K. and Germany, "the best thing the church could have done is to have admitted all their mistakes and done some research into why the cover-ups occurred and the systemic response was as it was," Collins said. "I don't think there is still any appetite at all to look at the 'whys.' "
Admitting she may sound "very negative," she added, "You have got to work with the reality. You can't think that because the church has put in place a commission, suddenly everything is going to change. If I felt that this was the case, it would be wonderful, but I don't."
The woman who took on Irish church leadership over its mishandling of clerical sexual abuse admits she would never have envisaged herself on a Vatican commission in the past. It is an indication of just how far the church has moved in recognizing its culpability instead of shunning victims.
"Knowing the attitudes that were being directed towards me and others like me, being told by various people in the diocese how I should basically go away and forget about it, I would obviously never have seen myself in the position I am in now."
She recalls how in the 1990s, when her story of clerical abuse was emerging in the Irish media, a priest in her own Dublin parish told the congregation not to believe a word of it.
"What is important is the work and trying to make children safe in the future. We are there to do a job," she said.
The stress involved in working for the commission "is not much different" from when she was persona non grata within the church. You are still dealing with some people in the church -- I am not saying everybody -- who have those defensive attitudes that survivors exaggerate, are looking for money, or they are trying to destroy the church," Collins said.
In recent months, the Association of Catholic Priests in Ireland has been highlighting the obligation that bishops have to priests who are accused of child sexual abuse. At its November annual meeting, the group criticized bishops who too often presume accused priests are guilty and cut them adrift.
But in Collins' opinion, the bishops "have to balance their duties towards their members against the duty towards children or minors in their care."
Referring to the paramountcy principle, which would require people to put the welfare of the child first, she told NCR, "If you always make your decisions on that basis, then you are much clearer about what the priority is: The priority is that children or young people must be kept safe. So it is not a question of balancing equal rights, and I think that is a point that is missed a lot."
However, she also acknowledged, "A perpetrator or somebody who is out of ministry has rights and has to be cared for. But if it comes to a situation where you are thinking about their rights and the rights of children, you have to put the safety of the child first."
Under Pope Francis, she believes, the Catholic church has been a less judgmental church.
"It is wonderful that we have a more humble church, because my problem with the leadership has always been the arrogance and putting themselves up on pedestals."
Despite or perhaps because of everything Collins has been through, her faith remains strong.
"I have always retained my belief in God. The difficulties I have are with the institutional church and whether I really want to be or need to be part of that institution to continue to be a believer. I did have a lot of struggles and there were times when I just wanted to walk away. I still struggle," she acknowledged.
2016 is a milestone year for Collins. It is a year for "taking stock" she told NCR. She and her husband "are 40 years married this year, and I have a landmark birthday" -- she'll be turning 70.
"I have got to see what I want to do with the rest of my days," she said. "I want to enjoy my family. I have my husband, Ray; my brother, Harry; and my son, Peter, and his wife. I spent many years when I was unwell when I was unable to really interact or be part of anything that was going on."
She was referring to the years in the late 1970s to the early '90s, when she was hospitalized with depression and agoraphobia. Throughout that time, her husband "had to be mother and father" to their son and run the house. Only much later did he learn of her abuse by a priest.
"Since I've had therapy, we've really enjoyed our older years," Collins said. "That is why our 40th will be special. It is a time to reassess where my life is."
Sarah Mac Donald is a journalist based in Dublin