Transcript Document

ENGAGING RELUCTANT AND
RESISTANT FAMILIES
WELCOME
• Welcome to 1 day training on Engaging Reluctant
and Resistant Families
• 9.30 – 4.30
• Lunch at 12.30pm
• Housekeeping arrangements, fire, lavatories,
refreshments
TASK
• Your name, and the kind of work that you do
• What’s brought you here for this day
AIMS FOR THE DAY
• Understand the variety of ways in which families
can fail to engage and cooperate, and explore some
of the causes
• Have an increased awareness of helpful strategies
• Be clear about maintaining professional boundaries
and keeping themselves safe
• Be clear about the need to effectively assess risk
factors affecting children who are being cared for
by uncooperative adults
• Understand the importance of multi-agency
practice
• Be aware of some practical strategies for
managing the work
PROGRAMME
9.30:Welcome and Introductions
10.15: Defining Reluctant and Resistant Families
11.00: Refreshments
11.15: Assessments: Working in Partnership and Multi Agency
work
12.30: Lunch
1.30: Working with Strengths
2.00: Trigger Families
2.20: Managing Violence and Challenging Behaviour
3.15: Refreshments
3.30: Support and Systems
4.15: Ending
4.30: Close
GROUP AGREEMENT
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Phones
Timekeeping
Confidentiality
Participation
Respect
Richness of difference
Ok to be serious and to be playful
Take care of ourselves and try hard not to
make assumptions
FEELINGS ALERT
• The day will be personally challenging and
emotionally charged
• Will involve thinking about our own experiences
• Will involve thinking about personal and
professional experiences
• Will involve thinking about emotional responses as
starting point for professional responses
AINLEE LABONTE
Born 24th June 1999 Died 7th January 2002
“ The assessment of Leanne’s relationship
with her daughter….was lost in the power
struggle between Leanne and the agencies”.
“Leanne and Dennis were aggressive to all
professional staff and in turn each agency
limited the contact. Health Visitors and
Housing staff would not visit her home
because of intimidation. Leanne and Dennis
were barred from the Housing Office and
staff at clinics and hospitals would only see
them when supervised”.
AINLEE LABONTE
Born 24th June 1999 Died 7th January 2002
One by one the agencies withdrew for personal safety
issues…..….The communication between the agencies
was not constructive; the different perceptions and
failure to convey the implications of not accessing the
family were not assessed.”
AINLEE LABONTE
Born 24th June 1999 Died 7th
January
There 2002
were concerns for the welfare of the
children and attempts to make sure they received
health care, but the impact on them of the
violence of their parents was not evaluated. The
children were living in an environment that
adults were not prepared to visit.”
AINLEE LABONTE
Born 24th June 1999 Died 7th January 2002
The essential good practice issue has to be that if
the parents create the responses in professionals,
which cause them to retreat, then what
must the experience be for the
children?”
Taken from the Integrated Review into Ainlee’s death.
TASK
• Think individually about a parent or family you’ve
found difficult to engage
• DON’T choose a piece of work where there are
lots of unresolved or unhappy issues
• Write down a brief anonymous summary of your
work with them
ESSENTIALS THAT
UNDERPIN THE WORK
• Workers trained, developed and supported to carry
out the level of work expected of them.
• Clear, published statement about unacceptable
behaviour
• Risk assessment and clear structures underpinning
all Managing Violence policies.
• Culture of working with the strengths of families.
• Support in thinking about, understanding and dealing
with feelings and thoughts.
• Threats and violence never minimised -always taken
seriously.
• Equality issues key in providing good services to all
families.
• Communication, discussion, sharing good practice and
agreement underpinning all multi-disciplinary work.
TASK
• In 3 small groups, discuss:
• What are some of the kind of behaviours that
characterise difficult to engage families?
• What are the most challenging behaviours for you?
POSSIBLE REASONS FOR NOT
ENGAGING
• A refusal to acknowledge that there is a
problem
• Resentment of invasion of privacy
• Having something to hide
• Resentment of interference
• Cultural differences
• Not understanding what is expected and why
POSSIBLE REASONS
FOR NOT ENGAGING
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Poor previous experiences of involvement
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Resentment of staff changes
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Dislike or fear of authority figures
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Fear that children will be taken away
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Fear of oppressive judgements (particularly for
disabled or substance misusing parents)
POSSIBLE REASONS
FOR NOT ENGAGING
 Fear of stigmatisation
 Being overwhelmed by emotional
depression, anxiety and guilty
pain,
 Having nothing to lose, if children have
already been removed
TASK
• Turn to the person next to you, and think about
the list of possible reasons.
• Have you ever dealt with anything on the list?
• What didn’t help?
• What did help?
• Is there anything you’d add to the list?
ASSESSMENTS:THE
CHILD
Children and young people may:
• have become desensitised to violence
• have learnt to appease and minimise
• be too frightened to speak about their own
experiences
• feel guilty and anxious
• identify with the aggressor and share their
hostility and aggression
ASSESSMENTS:
THE WORKER
Am I colluding in avoiding conflict by focusing on “safe”
issues
• Am I changing my behaviour to avoid conflict?
• Am I afraid to confront the family about my concerns?
• Am I keeping my anxieties and fears to myself and not
sharing them with colleagues and manager
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ASSESSMENTS:
THE WORKER
• Do I suspect the child may be keeping
itself “safe” by not telling me things?
• Do I think the child has learnt minimising
and appeasing behaviour?
• Do I feel relief when no one is in?
• Do I feel relief when I finish a visit?
ASSESSMENTS:THE WORKER
•Do I say, ask and do what I usually do when
making an assessment?
• HOW
DO I THINK THE CHILD FELT
WHEN I LEFT?
TASK
• Individually, create an Eco map to show your
relationships with other agencies.
• What are some of the positives and some of the
challenges?
• What are some of the stereotypes and fantasies
that can exist?
MULTI AGENCY WORK
Splits between agencies can result in:
• individuals and agencies blaming each other
and colluding with the family
 those who are not experiencing hostility can
find
themselves
taking
all
the
responsibility
• those who are “approved of” and “praised “
by the family may feel gratified and unable
to accept that there are problems or risks
MULTI AGENCY WORK
• those feeling under threat can feel that it is
personal
• no unified or consistent plan being made to inform
and coordinate the work
MULTI AGENCY WORK
If all agencies experience hostility, this should be
managed on an inter-agency basis. If this doesn’t
happen:
• everyone may back off, leaving the child
unprotected
• there may be a split between those who want to
appease and those who want to oppose
• everyone may collude
MULTI AGENCY WORK
When working with uncooperative, hostile or violent
parents it is ESSENTIAL that everyone:
• is aware of the impact on their own response and
on other people
• respectful of the concerns of others
• aware of the vital need to share information about
safety concerns
MULTI AGENCY WORK
• is actively supportive of each other and their
different experiences
• is open and honest when disagreeing
• is aware of the dangers of collusion
MULTI AGENCY WORK
• is open to discussing strategies if one agency is
unable to work with the family
• is aware that workers in different settings and
roles may have different thresholds of concern
and different experiences of having to confront
difficult behaviour.
TASK
• In pairs-share a time when you felt powerless
• DON’T focus on an experience where there are
lots of unresolved or unhappy issues
• How did you feel? What impact did your feelings
have on what you did?
• Repeat for a time when you felt powerful
KEY EQUALITY
ISSUES
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Particular resources
Language
Workers and family's identity
Euro-centric child development
How are men included?
Is specialist input needed?
Support and supervision
TASK
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In three small groups, think about the family.
Use a “weakness” model to think about them.
We’ll share, and then consign the model to the bin.
Return, and use a strengths model.
WHAT HELPS
• Being formal and being clear that aim of
the work is to achieve the very best for
the child
• Being clear and confident about your
authority
• Using supervision and support
• Working with the parents’ feelings and
past history
• Being clear when “enough is enough”
• Feeling fully supported by colleagues,
manager and agency
WHAT DOESN’T HELP
• Being convinced you’re incompetent and a
failure
• Seeing the situation as a battle which must
be won
• Colluding
• Focusing on personal fears and anxieties at
the expense of being alert to the child’s
needs and experiences
• Avoiding
thinking
about
negative
information
• Feeling helpless and unable to make
decisions
THREATENING BEHAVIOUR
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Deliberate silence
Written threats
E-mails and telephone calls
Intimidating or derogatory language
Racist and other oppressive remarks
Physical intimidation
Swearing
Shouting
Throwing things
Physical violence
THE IMPACT OF HOSTILITY AND
VIOLENCE
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Surprise
Embarrassment
Denial
Distress
Shock
Fear
Self doubt
THE IMPACT OF HOSTILITY AND
VIOLENCE
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Anger
Guilt
Numbness
Loss of self-esteem and confidence
Helplessness
THE IMPACT OF HOSTILITY AND
VIOLENCE
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Sleep disturbances, including nightmares
Repetitive stressful thoughts
Illness
Post traumatic stress
INCREASED IMPACT
• Previous traumatic experiences
• Regularly in threatening and violent
situations
• Threatened in their personal lives
• Male workers find it difficult to admit to
being afraid
• A culture of denying or minimising violent
episodes
• Violence and abuse directed at race,
disability, gender or sexual orientation
MAKING SENSE OF HOSTILE
RESPONSES
• Are you prepared, and supported?
• Have you aggravated the situation?
• Does the parent have a legitimate
complaint?
• Is the parent aware of the impact they are
having?
• Is the behaviour deliberately threatening
and abusive?
• Is this ordinary behaviour for this family?
TASK
• In pairs, focus on the first question.
• What has been your experience of dealing with
threats or violence?
• What do you think the “culture” about violence is,
in your work place?
• What’s positive?
• What’s challenging?