Transcript Building relationships to strength networks – the evidence

‘Building relationships to strengthen networks –
the evidence for moving away from a deficit-based
and problem-focused approach to child protection
work with alcohol and drugs’
Wulf Livingston,
Senior Lecturer in Social Work, Glyndwr University
Conwy & Denbighshire LSCB Annual Conference - March 2013 - 9.00am till 4.00pm
Theme : The interface between safeguarding children, alcohol and substance misuse
Context
Risk
Interventions
Kelly and Gary
Why are we here?
Harm is not up for debate (huge evidence trail) –
(we know this and this is not the focus of this presentation)
but….
How many more – Inquiries?
•
Fisher (Colwell) 1974
•
Butler-Sloss (Cleveland) 1998
•
Laming (Climbie) 2003 (Baby P) 2009
•
Francis (Mid-Staffs) 2012
•
Hughes 2006 –Canada
•
Woods Commission 2008 -Australia
More Communication
More Information Sharing
More Training
More Procedure
More Monitoring
More Support
More Communication
More Information Sharing
More Training
More Procedure
More Monitoring
More Support
Why does it keep happening?
What can be done differently?
Perspectives on Risk
Perspectives of Interventions
Risk Hierarchies
Orientation affects perspectives/approaches
•
Organisation
•
Managers
•
Employees
•
Service Users
•
Carers
•
Public
Risky Business
•
A Control Management (with) Professional
Judgment
-There are increasing (evidence-based) calls for
front-line professionals to be supported in and
empowered to take informed risks – risk taking
is necessary in the promotion of growth
(for service users and professionals)
•
EVIDENCE - Barry, Bonat, Bytheway, Littlechild, Monroe, Stanford,
The rhetoric of risk is used within neo-liberal risk society
to mobilise fear as an emotive, defensive and strategic
medium for advancing the values of safety and security.
In this context it is argued that risk, driven by the politics
of fear, has re-oriented (social work) practice towards
managing and securing against risk as opposed to
genuine attempts to respond meaningfully to need.
According to this discourse (social) workers are fearful we fear for our physical and mental well-being; we fear
that we will be blamed when things go wrong; and we
fear the loss of the integrity of our profession.
Stanford, S -British Journal of Social Work (2010) 40, 1065–1080
Risky Business
•
A Control and Management
•
B Deficits and Strengths
•
-From Paternalism to PARTNERSHIP
•
•
-Department for Health's 1995 "Child
Protection; Messages for Research“
-Honest Use of Power
Signs of SAFETY
(Yes) – Identify the harms but also consider
•Positions towards abuse (these are
multiple)
•Exceptions (when it does not happen)
•Family strengths and resources
•Willingness, Capacity and Confidence (in
change)
l
Evidence - Turnell
Why has Mickey not been to school this Friday?
How have you succeeded in getting Mickey to
school four days this week?
both HARM and SAFETY in our considerations
• Factors which make the child or young person more vulnerable to harm or
safer from harm
•
Pattern and history of harm and safety - for the child or young person; in the
parents’ care of children
• Factors in the beliefs and relationship between the child/young person and
parents/ carers which may increase the likelihood of harm or of safety
• Characteristics of the parents/carers and their lifestyle which effect their
capacity to protect and care for their children
• Family and community supports and services which assist in protection and
care - isolation to engagement
• Factors which increase the opportunity for harm or of safety for the child or
young person
Partnership and Strengths based approaches at heart of
evidence-based interventions
• Childre
n
Whole Population
• HARM
• Protection
• Minimisation
• Prevention
Individual
• Alcohol and
other drugs
Jenny and (John)
Interventions –
Key evidence for 3 levels/areas
Service user/s and worker relationship
•
Families and not individuals
•
Peer and community support
•
Apply – Alcohol, Drugs, Mental Health and in some contexts
Domestic Abuse
•
Common Qualities
• An emphasis on relationship building
• Empathy
• Excellent communication skills, including active
listening and reflection
• An empowering attitude and approach
• Non-judgemental attitudes
EVIDENCE – Livingston and Galvani
Relationships supported by
• Advice and Brief Interventions
• Motivational Interviewing
-Providing information
-Helping folk to consider change
-Identifying choices and supporting decision
making
Evidence –Alcohol Learning Centre, Lundhal et al, Miller and Rollnick
Family Interventions
How much more evidence do we need?
before
we truly implement The Children's Act
1989?
Interventions that seek to work in
partnership with families, using the critical
moment of their children’s referral to social
care as an opportunity to support parents
in accentuating the positive reasons for
changing their behaviours (including
alcohol and other drugs) and, at the same
time, highlighting the existing strengths
they have.
Family Interventions
•Home Builders (strengths)
•Option 2 (critical and crisis)
•IFSS
•SBNT (extending support for users)
•‘5 Step Model’ (supporting other family
members)
•CRAFT
•DARRT
EVIDENCE - Copello, Orford, Templeton, Velleman
Family Interventions
• They help not only the user (problem) but the
other family members who are the strength
(safeguard)
• Impact is beyond just substance use or mental
health – into family functioning
• Use in conjunction with ‘signs of safety’
approaches
• The impossibility of assessment
For Families, Peers and Communities we need to
think beyond……
Peers and Community
• Self-Help
• AA and NA
• SMART, INTUITIVE
• Recovery
• COSA
Support and/or
Service Provision
EVIDENCE –Humphries, Moos, Wardle, White
Peers and Community
•
Self-Help
•
Recovery
•Role Models
•24/7
•Peer Challenge
•Filling the voids
•Safer socialisation
EVIDENCE –Humphries, Moos, Wardle, White
Peers and Community
•
Self-Help
•
Recovery
•Role Models
•24/7
•Peer Challenge
•Filling the voids
•Safer socialisation
Your role
• Knowledge of
• Support to participate
• Facilitate
EVIDENCE –Humphries, Moos, Wardle, White
Concluding Thoughts
• Alcohol, Drugs, Mental Health and Violence – does
harm children
• Safeguarding – needs to be protection plus
prevention , if not prevention plus protection
• New frameworks of risk – trusting you
• There are effective interventions and change is very
much possible (knowledge and belief)
• Relationships and Families (communities) are the
solution
• Who is missing –here in the room if these
conversations are to meet these aspirations?
Thank you for listening
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