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Promoting systemic thinking, and therapeutic and relationship-based approaches in Social Work

Relationship Based Practice in Child Protection: An insurmountable problem?

Richard Devine

Introduction

I walked up the short garden path of the home I visited. I held an A4-sized envelope containing a letter that I anticipated would devastate the parents to whom I delivered the letter. As I approached, my heart raced. I was tense, and every fibre in my body was telling me my anxious state would dissipate if I walked in the opposite direction. I attempted to down-regulate my heightened emotional state, but all I managed was to conceal my underlying state from visibility. I knocked on the front door. It jerked open, and the mother, Katie, quickly glanced before shouting, ‘not f—-ing today, I already told you, I don’t want you here‘. Before I uttered a word, the door slammed shut as quickly as it was opened.

I braced myself and knocked again. Katie opened the door. Her skin was clammy, her eyes puffed, and her hair unbrushed and greasy. She swayed, leaned on the door frame to steady herself, and I concluded that she was probably intoxicated. Isabelle, a 3-year-old girl with curly blonde hair and piercing blue eyes, leaned around the door frame inside the home, looked at me, coyly smiled and wandered back into the living room. Katie glanced at the letter and venomously asked, ‘what the f— is this?‘.

With trepidation, I told Katie that we had decided to enter into pre-proceedings (the final stage before court proceedings are issued and removal is sought) due to our ongoing concerns for Isabelle and the lack of progress with the child protection plan. I held up the envelope, which she snatched out of my hand, and ripped into pieces. Katie shouted threats and verbal abuse at me. I stood there for what felt like an inordinately long time. I was gripped by fear and immobilised. But I was also indecisive about how to respond.

Should I attempt to weather the storm and negotiate with her? Or shall I accept that now isn’t the right time and leave? I eventually decided on the latter. As I turned around, I saw Isabelle standing on the sofa with her forehead pressed against the window as she peered out onto the garden path. Our eyes crossed each other. She looked sad and scared. Yet, she also appeared indifferent, as if this was normal. The barrage of insults and threats continued until I stepped back into my car.

How realistic is it that I can form a therapeutic relationship in such a fraught context? How can I make sense of the gulf experienced between this encounter and the idealised concepts heavily promoted in social work literature? Ideas such as coproduction, collaboration, empowerment, and anti-discriminatory practice.

Ideas such as unconditional positive regard, genuineness, and empathy. Often, I need to act self-protectively to fulfil my statutory duties—in this instance, the inhibition and concealment of my emotional state. What pretence and mental gymnastics must I partake in to believe that I could practice, for example, in a client-centred way as advocated for by Rogers (1967, 1989). Unconditional positive regard is surely belied by the contents of the letter that stipulated if Katie did not change, she could lose her child; congruence would almost antagonise Katie and make me vulnerable to retaliation; empathy for the distress experienced by Katie would cause debilitating anguish and potentially hinder my capacity to safeguard Isabelle effectively.

Despite what I consider to be the impossibility of fully importing relationship-based, client-centred, psychotherapeutic approaches into child protection social work (Murphy, 2013; Wooten, 1959), I do not believe we should constrain our ambition and commitment to upholding the principles derived from those fields.

In this essay, I will explore how we can integrate them into what I will refer to as ‘Integrated Principle-Based Child Protection’ (IPB-CP), a new term I use to encapsulate the ideas in this piece. Integrated Principle-Based Child Protection (IPB-CP) draws upon the ideas such as those developed by Rogers (1967) and Winnicott (1971). However, it also involves confronting the reality that statutory social work is fundamentally conflictual (Barber 1991; Wilkins & Whittaker 2018; Ferguson et al., 2020). Therefore, I integrate concepts such as ‘Negotiated Case Work’ (Barber, 1991, p.48), ‘Skilful use of Authority’ (Turnell and Essex, 2006, p.45) ‘Intimate Child Protection Practice’ and ‘Good Authority’ (Ferguson, 2011, p.3), and ‘Purposeful Dialogue’ (Forrester et al., 2021, p.116). A key principle of IPB-CP is that compassion is a manifestation of understanding; therefore, I will apply this to making sense of parental difficulties and dealing with resistance or denial.

Statutory social work and conflict

A primary source of conflict arises from the fact that most parents whom social workers are involved with do not wish to have a social worker. Ferguson et al. (2020) consider this ‘one of the most difficult, important and yet under analysed dilemmas in social work’ (p.2). The conflict of interest arises because the state intends to intrude upon private family matters, yet the parents do not wish for the intrusion to occur. The state justifies intrusion under the auspices of safeguarding the child; however, there is often a dispute about the legitimacy of the concerns held by the Local Authority about the child.

Because of the legal duties bestowed upon Local Authorities and administered by social workers, parents find the involvement of social workers threatening. Anxiety, mistrust, and fear cause tension and friction and breed hostile ground for building relationships. As observed by Lade Hale (2019),

‘the aspiration of developing a partnership between children’s services and families with children in need proved very difficult to achieve… The trouble is that, if efforts to work with families run into difficulties, the local authority can always resort to care proceedings and the families know that.” (p.11).

In addition to being feared by many families, social workers are considerably bound by time. This deprives the relationship of two key ingredients: psychological safety and time (Perry and Szalavitz, 2017; Porges, 2017). How much could I realistically achieve therapeutically with Katie when she vehemently opposed the reasons for social work involvement and was frightened by what I represented? Or when I could only visit, at most, weekly? If I were to measure my competence as a social worker based on the degree to which I built a therapeutic relationship with Katie, I would quickly feel demoralized and disillusioned.

Parent’s difficulties, denial, and resistance

In addition to recognizing that conflict is built-in to the relationship, it is also crucial to understand how a parent has come to experience the difficulties that warrant statutory involvement, as well as explore the rationale behind resistance and denial. Otherwise, social workers run the risk of blaming parents for their difficulties, paternalistically telling parents what needs to change under the misguided belief that once this is pointed out, they will change (Forrester et al., 2021) and taking it personally when a parent is evasive or dishonest (Ferguson et al., 2022).

Conceptualising parent’s difficulties

How can social workers make sense of the actions of those who cause harm to children in a way that does not negate their harmful behaviour yet facilitates compassion? First, I think we have to admit that the division between ‘us’ and ‘them’ is an illusion or a false construct. Suppose we had been brought up at the same time, in the same place and the same family. In that case, there is an inevitable probability that we would function in the exact same way. Spiritual teacher Eckhart Tolle (2003) captures what has otherwise been described from a neuroscientific perspective by Eagleman (2011), Mate (2017) and Sapolsky (2017).

‘If her past were your past, her pain your pain, her level of consciousness your level of consciousness, then you would think and act exactly as she does. With this realisation comes forgiveness, compassion, peace’ (p.92)

Extending compassion to those that harm children, intentionally or unintentionally, can be challenging because it feels like we are making the behaviour acceptable or devaluing another person’s perspective (Crittenden, 2016). In other words, it can feel like we are overlooking the harm done to children. Therefore, this requires professional maturity, one of the ingredients of IPB-CP.

This approach requires another ingredient to IPB-CP, humility. I have to accept that under the right conditions, I have the capacity for malice and harmful behaviour. I recognise that if I had Katie’s experience and found myself in her position, I would be hurling abuse at the social worker standing in front of me. I would also struggle with an alcohol addiction to deal with the unbearable psychological distress associated with traumatic childhood memories and the lack of familial and social support.

Denial and Resistance

There are two types of denial, which I will refer to as ‘situational’ and ‘psychological’. Many parents are highly fearful of social work intervention. They often overestimate the powers available to social workers causing them to believe that their children can easily be removed. In other cases, where the children are subject to a child protection plan or pre-proceedings, the potential for care proceedings will often feel like a real possibility. In both instances, the families can easily conclude that sharing concerns and/or requesting help will be used unfavourably against them. This can result in disputes whereby the parents vehemently deny or minimise the issue, and social workers can find themselves spending a lot of time trying to prove and demonstrate how a parent is incorrect (Turnell and Essex, 2006). This is ‘situational denial’.

‘Psychological denial’ functions self-protectively to conceal from ‘the self’ aspects of functioning that often cause shame. For example, a parent (like Katie) who misuses alcohol might experience many difficulties looking after their child. They might also find it to be the most effective (and only available) solution to cope with loneliness and/or emotional distress related to past experiences. The pain of recognizing the harmful effects alcohol use might have on their functioning, parenting, and children can sometimes be too much to tolerate. To deal with this, some parents try to minimize or deny its effects on themselves and others. There are also many aspects of our functioning that is unconscious, such as being emotionally disconnected, anxious, or relationally coercive. We develop ways of coping in our childhood, and because these strategies develop early on, they become habituated and psychologically embedded. Consequently, we can be completely unaware of them (Crittenden, 2016).

These two types of denial can be compounded by a parent’s experiences of past abuse and trauma that compromise their capacity to trust, regulate their emotions under stress and communicate effectively (Mason et al., 2020).

Therefore, we have to recognise that there are many intense psychological and ‘social and interactional pressures that make denial a compelling response’ (Turnell and Essex, 2006, p.26). A parent who attempts to deceive, minimise, or deny concerns, therefore, often has a logical basis, even if it undermines the development of a trusting relationship. Acknowledging the underlying reasons is critical because if social workers feel personally hurt or let down by this, then they might unconsciously channel those negative feelings unhelpfully into the relationship (Ferguson et al., 2020).

Integrated Principle-Based Child Protection (IPB-CP)

Relationships in statutory child protection are often fraught with conflict and are often emotionally demanding, provoking a range of negative emotions. The challenge is to show compassion when for reasons pertaining to their own situation, a parent acts in a way that causes a social worker to feel frightened, anxious, or incompetent. It is easy and arguably quite obvious to state that social workers must be compassionate towards parents. When a parent approaches social workers for help, this can be more straightforwardly achieved. However, this is more challenging when a parent is involved on an involuntary basis and is resistant or abusive in highly personalised ways. I believe it is possible, but it requires that we dispense with the idea that social workers can function as quasi-therapists.

As pointed out by Barber (1994),

In place of a ‘helping’ [or ‘therapeutic’] relationship, then, the foundation of social casework with involuntary clients is a ‘working’ relationship wherein client and worker are prepared to work towards a speedy resolution of the problem and reinstatement of the client’s liberty’ (p.48).

I suggest we confront the reality that conflict is an inevitable feature of child protection social work, and from that position, consider how under these conditions, we can support parents to improve their lives for themselves and their children.

To this effect, I will summarise several principles of IPB-CP here:

  1. A commitment to ‘enter into the internal world of others feelings and personal meanings so completely’ that we lose ‘all desire to evaluate and judge it?‘ (Rogers, 1967, p.53). We are genuinely curious about the reasons for their difficulties (e.g., I might ask Katie, ‘what relief do you find in alcohol?‘ or ‘How does alcohol help you cope?‘) and the reasons for their dissatisfaction with social work involvement. We ‘seek first to understand, then to be understood’ (Covey 2004, p.237).

 Social workers do not need to agree with a parent to validate their perspective. Often, but not always, this interpersonal act lessens a parent’s fear, softens the parent’s denial, and creates an openness to discussing their problems. It is important to note that resistance is not just a product of the person but is also influenced largely by the relationship between the person and the worker (Forrester et al., 2021).

  1. Holding onto multiple perspectives. Returning to Katie and her daughter, Isabelle, this would involve; a) compassion towards the mother’s behaviour, attempting to appreciate that her anger might be motivated by a profound fear of needing to change or losing her child (a parent can be frightened and frightening); b) a recognition of the harm experienced by Isabelle being cared for by a mother dependant on alcohol, and behaving aggressively towards a social worker; c) acknowledging the feelings experienced due to Katie’s aggressive behaviour and using appropriate outlets to share emotions such as supervision so as not to allow them to influence the relationship negatively.

Empathy for a parent and their difficulties does not need to be traded off with a focus on the child (Wilkins and Whittaker, 2018). In my experience, what separates a perpetrator of child abuse from a victim of child abuse is the passage of time. Put simply, ‘today’s parents are yesterday’s children’ (Crittenden, 2016, p.12).

  1. Principles that support compassionate and ethical practice. A commitment to understanding the parents’ perspective, a focus on the child and a desire to act ethically irrespective of the conditions are critical ingredients. In addition to professional maturity and compassion, the following can be considered:
  • It takes tremendous courage, tenacity, and fortitude to undertake the task of statutory social work. For example, courage to knock on a family’s door for the first time; speak to a child about abuse or harm; explain to a parent why we are concerned; return to a visit when a parent has been abusive, etc. It requires fortitude and a strong focus on the purpose of social work involvement.
  • Wisdom involves knowing the degree to which we can influence outcomes for children and families. It sounds obvious to state, but we can’t make a parent change, and knowing where and how we can influence is an important skill to develop.
  • Humility for what is achievable. There is no ‘perfect practice and ideal solutions’ (Turnell, 2006, p.96). Further, a social worker can never eradicate risk (Munro, 2020) and to believe so is to place an insurmountable expectation and burden upon ourselves. Instead, a social worker’s job is to lessen risk sufficient enough to enable the child not to be exposed to excessively high levels of harm. That is an important distinction to make.
  1. Social workers are always working in a legal context. Parents need clear explanations about the process under which social workers are working with them, as well as expectations regarding change and what will happen if change does not occur.

Davies (1994) asks whether it is feasible for a social worker to implement statutory processes andgain the family’s confidence…convey the personal warmth and genuineness implicit in her professional’s role?‘. He answers unambiguously, ‘it has to be done; and the evidence suggests it is by no means impossible to achieve – provided the social worker is crystal clear about the nature of her job and duality of roles’ (p.100).

I wholeheartedly agree. Indeed, a failure to provide this is received unfavourably by parents (Davies, 1994; Forrester et al., 2020; van Nijnatten et al., 2001).

  1. Safeguarding children depends on effective support for parents to resolve their difficulties. In my opinion, practical casework is the most effective way of achieving this. Social Workers are limited in their ability to intervene with a parent therapeutically, but we can assist them in accessing services and provide them with practical support. In addition to helping parents change, we can also look to change the context as a way of improving the life of a child, especially if a parent is not ready to change. Suppose Katie wasn’t ready to address her alcohol use. In that case, I could look at ways to support the family or professional network to lessen the risks associated with her substance misuse (i.e., FGC and extra-curricular activities for Isabelle).

I have not detailed all the principles, for example, I think the intensity of support should be matched to the intensity of need, and we should focus on the critical cause of concern and change. I have also not considered the role of the organization in providing emotional containment and support for social workers. Suffice it to say; this is paramount. Nevertheless, I hope it provides a flavour of the principled and relational approach being advocated.

Conclusion

In this essay, I have sought to outline how we can practice statutory social work with transparency, compassion, professional maturity, humility, courage, and wisdom. I think case management, instead of being devalued, should be elevated as an ethically sound and effective way of helping children and families. It involves integrating different approaches, adopting a principled approach, and ensuring that parents are provided with relationships and support that maximize the chance of change so that children can reside, with enough safety, in their parent’s care, healthy and happy.

References

Barber, J.G. (1991). Beyond Case Work. Basingstoke. Macmillan.

Covey, S. R. (2004). The 7 habits of highly effective people: Restoring the character ethic ([Rev. ed.].). Free Press.

Crittenden, P.M. (2016) Raising Parents: Attachment, Representation and Treatment,(2nd ed.) Abingdon, Oxon: Routledge

Davies, M (1994). The Essential Social Worker (3rd edition). London, Routledge.

Eagleman, D (2011) Incognito. The Secret Lives of the Brain. London, Canongate books.

Ferguson, H (2011) Child Protection Practice. Basingstoke: Palgrave Macmillan

Ferguson, H. (2016) What social workers do in performing child protection work: evidence from research into face‐to‐face practice. Child & Family Social Work, 21(3), 283-294

Ferguson, H., Disney, T., Warwick, L., Leigh, J., Singh Cooner, T & Beddoe, L (2020): Hostile relationships in social work practice: anxiety, hate and conflict in long-term work with involuntary service users, Journal of Social Work Practice, DOI: 10.1080/02650533.2020.1834371

Ferguson, F., Warwick, L., Disney, T., Leigh, J., Singh Cooner, T & Beddoe, L (2022) Relationship-based practice and the creation of therapeutic change in long-term work: social work as a holding relationship, Social Work Education, 41:2, 209-227, DOI: 10.1080/02615479.2020.1837105

Forrester, D., Westlake, D., and Glynn, G. (2012). Parental resistance and social worker skills: Towards a theory of motivational social work. Child & Family Social Work, 17(2), 118– 29. https://doi.org/10.1111/j.1365-2206.2012.00837.x

Forrester, D., Killian, M., Westlake, D. and Sheehan, L. (2020). Patterns of practice: an exploratory factor analysis of child and family social worker skills. Child and Family Social Work 25 (1),pp. 108-117.

Forrester, D., Wilkins, D. & Whittaker, C. (2021). Motivational Interviewing For Working with Children and Families: A Practical Guide for Early Intervention and Child Protection. London. Jessica Kingsley Publishers.

Hale, B. (2019). 30 Years of the Children Act 1989—Scarman Lecture 2019, Law Commission, London— Lady Hale. https://www.supremecourt.uk/docs/speech-191113.pdf

Mason, C., Taggart, D., and Broadhurst K. Parental Non-Engagement within Child Protection Services—How Can Understandings of Complex Trauma and Epistemic Trust Help? Societies. 2020; 10(4):93. https://doi.org/10.3390/soc10040093

Mate, G (2018). In the Realm of Hungry Ghosts. Close Encounters with Addiction. London, Vermilion.

Murphy, D., Duggan, M., and Joseph,S. Relationship-Based Social Work and Its Compatibility with the Person-Centred Approach: Principled versus Instrumental Perspectives, The British Journal of Social Work, Volume 43, Issue 4, June 2013, Pages 703–719, https://doi.org/10.1093/bjsw/bcs003

Munro, E (2020). Effective Child Protection (3rd Edition). London, Sage Publications Ltd.

Porges, S (2017) The Pocket Guide to The Polyvagal Theory: The Transformative Power of Feeling Safe. New York. W.W. Norton and Company

Perry, B, and Szalavitz, M (2017, 3rd Edition) The Boy who was Raised as a Dog: And Other Stories from a Child Psychiatrist’s Notebook : what Traumatized Children Can Teach Us about Loss, Love, and Healing.  Basic Books.

Rogers, C. (1967) On Becoming a Person. A therapists view of psychotherapy. London. Constable and Robins.

Rogers, C. R. (1989). The Carl Rogers reader. (H. Kirschenbaum & V. L. Henderson, Eds.). Houghton, Mifflin and Company.

Sapolsky, R (2017) Behave: The Biology of Humans at Our Best and Worst. Penguin Press.

Tolle, E. (2003) Stillness Speaks. Hodder and Stoughton, Great Britain.

Tuck, V. (2013) Resistant Parents and Child Protection: Knowledge Base, Pointers for Practice and Implications for Policy. Child Abuse Review. 22, 5–19.

Turnell, A. (2006) Enacting the Interpretive Turn: Narrative Means Toward Transformational Practice in Child Protection Social Work. Thesis presented for the degree of Doctor of Philosophy of Curtin University of Technology

Turnell, A. & Essex, S. (2006). Working With Denied Child Abuse: The Resolutions Approach. Berkshire. Open University Press.

van Nijnatten, C., Hoogsteder, M, and Suurmond, J. Communication in Care and Coercion: Institutional Interactions between Family Supervisors and Parents, The British Journal of Social Work, Volume 31, Issue 5, 1 October 2001, Pages 705–720

Wilkins, D and Whittaker, C. (2018) Doing Child-Protection Social Work with Parents: What Are the Barriers in Practice?, The British Journal of Social Work, Volume 48, Issue 7, Pages 2003–2019, https://doi.org/10.1093/bjsw/bcx139

Winnicott, D. (1971). Playing and Reality. London and New York, Routledge.

Wooton, B. (1959) Social Science and Social Pathology. London: George Allen and Unwin

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