Transcript Safeguarding in the 21st century – where to now?

Safeguarding in the 21st
century – where to now?
Bournemouth and Poole
September 2010
Susannah Bowyer
All presentation content credited to Jane
Barlow (2010) and Barlow and Scott
(2010)
The Safeguarding review is the best thing
we’ve seen for a decade or two in this area.
The proposed model is comprehensive,
subtle, wide-ranging and thoroughly
evidence-based in the proper sense of that
term. Professional judgement is positioned
at the heart of the framework but
systematically linked to research and policy
considerations. This is the publication that
should drive government and professional
body thinking in the coming period.
Professor Andrew Cooper (UEL & Tavistock
Clinic)
In this presentation:
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What we know about emotional abuse/neglect
and child development
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Relationship-based practice
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Assessment
New Evidence about early
Development
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The early environment plays a major role in
shaping children’s development
Most important is the relationship that a child has
with their early caregivers
The key aspects of the interaction is the role this
plays in regulating the infants’ affect and arousal
via the attachment system
Early Development and Later
Wellbeing
Parenting
Self-esteem
Behaviour
Infants’
brain
Emotional
Regulation
Relationships
Emotional regulation
via attachment
Empathy
Learning
Smoking/drugs
Promiscuity
School failure
Delinquency
Obesity
etc…
The infant’s brain-softwiring
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Unique wiring of individual brain determines how
we behave, think, feel, memories etc and our
sense of ‘self’
Wiring takes place during prenatal period to
school-entry – important first two years
Rapid proliferation and overproduction of
synapses followed by loss (pruning)
‘Use it or lose it’ – lost if not functionally
confirmed
For example…
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Looks and smiles help the brain to grow
Baby looks at mother; sees dilated pupils
(evidence that sympathetic nervous system
aroused and happy); own nervous system is
aroused - heart rate increases
Lead to a biochemical response - pleasure
neuropeptides (betaendorphin and dopamine)
released into brain and helps neurons grow
Families doting looks help brain to grow
Negative looks trigger a different biochemical
response (cortisol) stops these hormones and
related growth (Gerhardt, 2004)
Early experiences of persistent neglect
and trauma
Need for Core Developmental
Model
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In maltreating families parent-child interaction is
characterised by hostility; low levels of
reciprocity, engagement and synchrony,
unpredictability (ignoring plus intrusive hostility)
Around 80% of children who are abused have a
‘disorganised attachment’
Disorganised attachment predicts a range of
poor outcomes
Practice MUST recognise the importance of
attachment
All assessments should
include evaluation of:
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Parent-child interaction informed by specialist
training
Parents’ capacity to change: should include use
of standardised tests and observations
Parenting capacity: motivation and capacity to
acquire parenting skills should be assessed over
4-6 months
Cycles of abusive parenting
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Abusive parents have mostly been exposed to
early parenting that did not meet their own
developmental needs
They find their children’s needs and fears
overwhelming and profoundly evocative
Respond by withdrawing, or being intrusive and
hostile
The early representational and relationship
patterns that are developed as a response to
poor parenting and/or trauma are re-enacted
throughout the individual’s life
What works?
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long-term ‘relationship-based practice’
Some evidence about the effectiveness of
manualised programmes
effective intervention during the first four years
of life involves dyadic interventions
The team around the child model appears to
offer benefits in terms of both families and
professionals
Relationship-based practice
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a supportive therapeutic stance based on
principles of acceptance, empathy and trust
giving parents an opportunity to reflect on the
parenting they are providing in the light of their
own experiences
The relationship as an intervention
- emotionally restorative experience
- a model for other relationships
- Underpinned by partnership model of practice
‘Bringing about change’ in
parent-child relationship
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Expectations are currently far too low
We aren’t working effectively because our
services/interventions are not often
underpinned by:
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Evidence-based models of change
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Developmental models with regard to children
Conclusion
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Need for new conceptual model to underpin 21st
century safeguarding
Need for new ways of working with regard to
assessment and intervention
- Relationship-based and reflective practice
- Evidence-based attachment and dyadic
interventions
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Need for better organisational structures to
support such practice