‘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

ContextRiskInterventions

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 CommunicationMore Information SharingMore TrainingMore ProcedureMore MonitoringMore Support

Why does it keep happening?

What can be done differently?

Perspectives on Risk

Perspectives of Interventions

Risk HierarchiesOrientation 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,

Stanford, S -British Journal of Social Work (2010) 40, 1065–1080

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.

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

l

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)

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

Local FamilyKnowledge

Professional KnowledgeNetwork and Authority

SafetyDangerComprehensive

Assessmentof Risk

Partnership and Strengths based approaches at heart of evidence-based interventions

Whole Population

Individual

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

EVIDENCE –Humphries, Moos, Wardle, White

Support and/or Service Provision

Peers and Community• Self-Help

• Recovery

EVIDENCE –Humphries, Moos, Wardle, White

•Role Models•24/7•Peer Challenge•Filling the voids•Safer socialisation

Peers and Community• Self-Help

• Recovery

EVIDENCE –Humphries, Moos, Wardle, White

•Role Models•24/7•Peer Challenge•Filling the voids•Safer socialisation

Your role•Knowledge of•Support to participate•Facilitate

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