1. Coventry Safeguarding Children Board Workshop Keeping the Child at the Centre Managing resistant and uncooperative parents / carers Shirley Heath & Amy Weir

2. Coventry Safeguarding Children Board Safeguarding Disabled Children Conference February 27 th 2012

3. 3 Well evidenced that Disabled Children are more vulnerable to abuse and neglect Recent high profile child protection cases nationally have raised concern about ‘resistant’ families who do not change despite intervention Coventry LSCB management review has highlighted this as an area for practice improvement particularly for disabled children Why is this a focus for practice?

4. 4 "They become very clever at diverting attention away from what has happened to the child. Therefore people who work in this field - whether health visitors, police officers, social workers, whatever – have to recognise this in their evidence gathering. They have to be sceptical; they have to be streetwise; they have to be courageous.“ Lord Laming 2008

5. 5 What is resistance? Denial/AvoidanceAmbivalence Unresponsiveness to treatment Violence/Hostility

6. Research on effectiveness Positive relationships with practitioners Parental involvementPractical help and social support for families Services that help to build skills and empower families For children, stable relationships with committed carers

7. 7 Practitioners are able to describe behaviours and circumstances that pose challenges to their practice including: –Inability to contact parents –Families’ lack of motivation/commitment –Families that are in constant crisis –Threats of and fear of Violence –Focus on parents’ need for support to care for disabled child –Lack of expertise to comunicate with disabled child But, they lacked confidence distinguishing between families’ active engagement in treatment vs. false compliance Challenges related to families

8. Challenges related to working with Disabled Children Communication needs may not be appreciated Parent may seek to speak for the child Illness or developmental difficulties may be ascribed wrongly to the disability rather than to parental / carer abuse or neglect Expectations of outcomes for disabled child may be too low 8

9. 9 Practitioners involved in complex cases may lose focus on children when: –Parents’ needs eclipse needs of children –Parents turn the focus away from maltreatment allegations –Parents make it difficult for practitioners to see children alone –Practitioners do not have sufficient experience/training to help parents understand how their behaviour is harmful to children Men, grandparents and siblings are often left out of equation Challenges related to practitioners

10. 10 False dichotomy between ‘in need’ and ‘at risk’ categories – and the threshold between them Practitioners feel pressured to close cases quickly and balance heavy caseloads Practitioners frustrated with long waits for or lack of available specialist services Poor quality (and fragmented) assessments – leading to flawed decision-making Challenges related to agencies

11. 11Implications Practitioners may need further training on how to differentiate engagement from compliance Practitioners need to ensure that they do not lose sight of the child in complex cases Practitioners need adequate time to offer targeted services Practitioners need to find the middle ground and not be either collusive or confrontational Overcoming challenges

12. 12 Importance of good, in-depth assessments cannot be overestimated Regular and clear Inter-agency Communication and Information sharing Assessments should not be ‘one-off’ snapshots of families’ behaviours and should include: –Observations – particularly, parent-child interactions –Understanding of families’ histories –Inclusion of the whole family unit –Information from all agencies Assessments should be sustained to ensure cases do not lose momentum Effective Assessments

13. Effective Interventions 13 Focused, long-term plans and services appear to achieve better outcomes for children than episodic intervention. Services that seem to be effective include practical help for families, families’ involvement in their treatment and social support. Agencies and practitioners may display resistance of their own, and strategies need to be in place to detect and overcome this. The attitudes and behaviour of individual practitioners have a major effect on whether families engage or not and more attention needs to be paid to the ways in which they interact.

14. 14 Most evidence mentions the importance of management and supervision to safeguarding practice, but few lessons on what works Circumstances where good supervision is essential include when practitioners: –Are overwhelmed/lacking confidence –Experience violence –Are acting out their own strong emotions –Have less experience of particular needs such as disability Effective supervision

15. 15 Implications for practice In-depth assessments Observe parent-child interactions Talk to children Balance empathy with scepticism Coordinate information across agencies

16. Collaborative learning It is important therefore that a wider range of learning mechanisms are developed. Munro 2011 a clear understanding that protection of children is a shared responsibility between agencies and professionals; recognition that all workers in all agencies need to be supported by strong leadership making decisions underpinned by full and unambiguous rationale; the development and examination of decision-making processes in full partnership with each other; the value of sharing potential indicators of abuse or neglect and sharing such observations at the earliest stage; regularly reviewing the outcomes of actions or information with partners as part of the shared responsibility; 16