1. How to tell parents you are worried about their child
Dr Sandy Taylor
Named Doctor in Child Protection
From the questionnaire that you kindly sent back we know that a lot of you would really like some help in telling parents that you suspect their child may have been abused.
This is a really short introduction to give you some pointers. If you would like us to organise more in depth sessions then please put this on your feedback forms and we will see what we can do.

2. Breaking Bad News Just like breaking any bad news But more scary
Here is Sir Luke Fildes 1887 painting of “The Doctor” now hanging in Tate Briatain.
In many ways telling broaching the subject of child abuse is like breaking any bad news.
We know from palliative care, that we are the experts and the ones that get the job of starting from zero when we are giving patients information.
But of course there are many reasons why we are much more afraid of giving bad news about child abuse than some straight forward life threatening little glitch.
What I would like to ask you to do is very briefly for 2 minutes talk to the person next to you about why you, as excellent doctors with brilliant palliative care skills still dread telling a parent you think they have hit their child.
Just like breaking any bad news
But more scary

3. Why is telling parents so scary?
We may be wrong
They may get angry
Or violent
Or hate us
Or feel betrayed
Or run off with child
Or hurt child
Or disengage
What do we teach young doctors?
Feel your feelings. They are part of the diagnosis.
This isn’t you in the picture as a little scared child. This is the child.
If you are scared, with your panic button under the desk, how much more scared is the child?
Hold that thought.

4. Times when you should not tell parents
Sexual abuse
Fabricated or induced illness
Put child in danger
Put family members in danger
Put yourself in danger

5. Why should we tell parents?
They are feeling:
Anxious
Threatened
Frightened
Guilty
Ashamed
Outraged
Desperate
With all these negative emotions going round, they are going to behave badly.
With skill we can often manage the situation to make it safer and less threatening for them and they can calm down and engage with the process.
Giving them information gives them power and makes them feel safer.

6. Parents are the solution as well as the problem
Children need their parents
We need to be able to engage with them and support them in the future
Having an honest and respectful relationship is key in this

7. They don’t know what will happen next
Tell them who you are going to contact
Where they will be seen
Who they will see
What will happen then

8. Will they have their children taken away?
“I can’t give you guarantees about what will happen, but it is extremely unusual for children to be removed from their families, and only after everything else has been tried”
It is the courts and not the Social Workers that remove children.
The Law says we have to work hard to keep children and families together, but sometimes this is not the safest place for babies and children.

9. You know they love their child
“This is a very difficult situation for you, but I know you want the best for Lucy.”
“If there is any chance that she has been harmed, I know you will want me to check that out, and not take risks with her health.”

10. You heard their explanation
“I know you have explained how Davy got his bruises, but some patterns of injuries still need to be checked out further because they can have other causes.”

11. You are still there to help them It’s just procedure
“In the past doctors have missed serious things, so the rules are much tighter now.”
“In situations like this I don’t have any choice but to ask the Social Worker to arrange a medical assessment for Jason.”

12. They might not to like you but they want to trust you
“The truth”, Dumbledore sighed. “It is a beautiful and terrible thing, and should therefore be treated with great caution. However, I shall answer your questions unless I have a very good reason not to, in which case I beg you’ll forgive me. I shall not, of course, lie”.

13. I hope you come out of it ok!