Transcript Document

Respecting Family Strengths
Damian Griffiths
Driving from A to B…
• This is one of the lowest ebbs of your life
• You are terrified of losing your children…
• You get a report which is 20 pages long which you can’t make head
nor tail of and seems to be mostly empty boxes
• Attached to the report is a chronology, which is a list of all the worst
stuff that has ever happened to you or you have done
• You go to a formal meeting in a room full of people, half of whom
you do not know
• They talk in a language you can’t really understand
• If you disagree they say you are ‘in denial’
• They make a decision which tells you ‘you’re a bad parent – it’s
official’ and then, whist you are still crying, they expect you to agree
to a load of stuff to do, half of which you don’t know what it is
Partnership With Parents
• An idea in search of practice…
• Someone worth doing business with
• ‘I’m OK, you’re OK”
• A common language
Supporting Family
Participation
Family Dominated
Professionally Dominated
Stages of Change
Biestek's Principles of Social Casework
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Recognition that every client is unique
Client’s need to freely express feeling
Controlled emotional involvement
Acceptance
Non-judgemental attitude
Client self-determination
Confidentiality
Good Performance - Human Needs
Empowerment
Initiative
Choice
Frustration
Resentment
High morale
Respect
& Appreciation
Low morale
Absenteism
Adapted from Human Needs at Work, University of Nottingham
Motivators
Confidence
Enthusiasm
Communication &
Clear objectives
Anxiety
Confusion
Comprehensive Risk Assessment
Family Knowledge
Network and Culture
Danger
Balanced
Assessment
of Risk
Safety
Professional Knowledge
Network and Authority
©2000Andrew Turnell PO Box 56 Burswood WA 6100 Australia,
[email protected]
Partnership in practice – the social
discipline window
(Wachtel & McCold)
Control (limit-setting, discipline)
High
Low
TO
WITH
Punitive
Restorative
Neglectful
NOT
Permissive
FOR
Support (encouragement, nurture)
High
Research on Child Protection
Conferences
Key Messages:
Professionally dominated
Parents passive and ‘tested’ for co-operation
Insufficient time spent on planning
Plans of poor quality and no feasibility
discussion
Reviews – little reappraisal of earlier decisions
WHY?
Review of what works in family support interventions:
Identifies 4 common factors that influence the effectiveness of all therapeutic
interventions
% of Variance in Outcome Explained
15%
30%
15%
Therapeutic
Technique
Client Hopefulness
Client Characteristics
& Social Support
Relationship between
client and therapist
40%
Kieran McKeowan (Dublin, 2000)
WHY?
Factors
Future Significant Harm More Likely
Future Significant Harm less likely
Abuse
Severe inc burns / scalds
Neglect
Severe growth failure
Mixed abuse
Previous maltreatment
Long duration penetrative csa
Fabricated / induced illness
Sadistic abuse
Less severe forms of abuse
Child
Dev. delay with special needs
Mental health problems
Very young requiring rapid parental change
Healthy child
Attributions in csa
Later age of onset
One good corrective relationship
Parent
Personality – antisocial / sadistic / aggressive
Lack of compliance
Denial of problems
LD plus mental illness
Substance abuse
Paranoid psychosis
Abuse in childhood, not recognised
Non – abusive partner
Willingness to engage with services
Recognition of problem
Responsibility taken
Mental disorder – responsive to treatment
Adaptation to childhood abuse
Parent & Child
interaction
Disordered attachment
Lack of empathy for the child & own needs first
Poor parenting competency
Normal attachment
Empathy for the child
Competence in some areas
Family
Interparental conflict and violence
Family stress
Power problems: poor negotiation, autonomy and
affect expression
Absence of domestic abuse
Non abusive partner
Capacity for change
Supportive extended family
Professional
Lack of resources
Ineptitude
Therapeutic relationship with the child
Outreach to family
Partnership with parents
Social setting
Social isolation and lack of social support
Violent, unsupportive neighbourhood
Social support
More local child care facilities
If severe, yet compliance and lack of denial, success still
possible
Motivating for Partnership
• Start where the person is
• Collaboration (vs. confrontation)
• Evocation – drawing out rather than imposing
ideas
• Autonomy and skilful use of authority
• Express empathy
• Support self-efficacy
• “Roll” with resistance – dancing not wrestling
Research & best practice suggests
conferences should …
• Have a greater focus on planning & outcomes
• Better enable families to present their views
• Ensure professional views, risk assessment and
decisions are grounded in evidence
• Place a strong emphasis on relationships
• Reduce power inequalities
• Identify and build on strengths and family
resources
• Keep a better focus on reviewing danger
• Try to motivate and create some hope
WHY?
Child Protection Conferences
- Towards Partnership & Collaboration
• Incident Based
• Retrospective
• Problem focused
• Ecological
• Paternalistic
• Prospective
• Adversarial
• Needs based,
building on
strengths
• Partnership
• Collaborative
Building Effective Group Dynamics
Change
challenge
trust
openness
safety
HOW?
Family Tree
Lily
?
Jack
Alfie
Beattie
Den
Marge
Caz
Mark
Maggie
Alf
Muriel
Strengthening Families Framework
Danger/Harm
Safety
ℴ Detail re: incident(s)
Bringing the family to
the attention of the
agency.
ℴ Strengths demonstrated as
protection over time
ℴ Pattern/history of exceptions
ℴ Pattern/history
(Grey Area)
Complicating Factors
Strengths/Protective
Factors
ℴ Condition/behaviors
that contribute to
greater difficulty for
the family
ℴ Assets, resources,
capacities within family,
individual/community
ℴ Presence of research
based risk factors
ℴ Presence of research
based protective factors
Child & Family Services/(Lohrbach)
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Risk Statement
Safety Goals
Safety Measures
What are professionals
worried will happen to
Harry and Meera if things
carry on as they are?
When all these problems
are fixed enough for
professionals to stop
worrying, what will life be
like for Meera and Harry?
When the safety goals are
being achieved – what will
professionals see which
shows that?
How will we know when it
is ‘fixed’?
If things don’t change,
then Harry and Meera are
likely to see or hear their
dad threaten, punch and
kick their mum at least
once a month
• Child specific
• Get a picture
• Judicious use of risk
loaded language
Meera and Harry will live
in a house where
disagreements are
resolved peacefully, there
are no threats or violence
and very little shouting
• Describes the child’s
experience
• Get a picture
No neighbour reports to
police; parents and
professionals’ reports;
Harry less aggressive;
Meera less withdrawn
• Focus mostly on
adults’ behaviours,
parenting, lifestyle
• Get a picture
• Beware of process
measures
What would Munro say?
• It’s a good idea
• Socio-technical rather than technocratic
• Ripple effects – attention to how the process builds
more safety or more danger
• Requisite variety in planning
• Single and double loop learning – did we do what we
planned and did it make any difference?
A Questioning Approach…Key Skills
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OARS & EARS
Shit sandwich / herringboning
Digging for facts and detail – evidence
Cutting away extraneous detail – ‘distilling’
Focus on child impact
Respectful and appreciative rather than
interrogative – the questions must be as
useful to the questioned as the questioner
What This is Not About…
• Pulling punches
• Allowing Family to dominate
• Move from rule of pessimism to rule of
optimism
• Colluding with abuse
• Quietening professional concerns
Questions…