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Social work: experiences of a longitudinal study of children living with significant harm

Social work: experiences of a longitudinal study of children living with significant harm. Dr Marian Brandon University of East Anglia m.brandon@uea.ac.uk. Stage 1 - the original study ‘Safeguarding Children with the Children Act 1989’ (1999, 2001).

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Social work: experiences of a longitudinal study of children living with significant harm

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  1. Social work: experiences of a longitudinal study of children living with significant harm Dr Marian Brandon University of East Anglia m.brandon@uea.ac.uk

  2. Stage 1 - the original study ‘Safeguarding Children with the Children Act 1989’ (1999, 2001) • Detailed picture of 105 consecutive cases (4 sites) of children (aged 0-18) newly identified as suffering or likely to suffer significant harm • Progress of children tracked over one year to see whether effective protective and supportive action for children and parents was taken • Circumstances for many children still unresolved one year on – impetus for follow up study

  3. Mechanics of Follow Up - Permission from 3:4 original Local Authorities to study SSD files • Permission from DH to access files of children who have been adopted - New sample of 77 children -39 from original ‘interview’ sample - 38 from original ‘background’ group

  4. Methods Used • Quantitative: Structured file searches of 76 cases loaded and coded on SPSS • Qualitative: Interviews: - 22 Children (semi-structured schedules adapted from Steele et al for children) with -12 Parents ( 8 birth mothers, 1 adoptive mother, 3 birth fathers), - 7 Carers (2 sets of grandparents, 1 aunt, 2 foster carers) • Standardised questionnaires Goodman SDQ, Rutter Malaise Inventory (parents/carers) Gibbons Family Problem Questionnaire)

  5. Struggles of consent, tracking - limitations • Only 3:4 original authorities agreed to participate this time (only lost 13% of original cases, but changes the profile of the 77:105 cases). • Only SSD files - limited information about other agencies. • Access via gatekeepers and public records (eg addresses) • Easier to track ‘long term’ cases. Children without problems are hard to trace - case ‘severity’ highlighted. Good/better outcome cases likely to have been missed (eg competition standard ice skater)

  6. Limitations of data contd. • SSD Files not compiled in a standardised way – variable, sometimes limited information, sometimes overwhelming quantities of information (information in 1:3 files good, 1:2 satisfactory, 1:5 seriously deficient. • Children’s own views missing in ¼ of files. • Information about parents dwindles over time – information about fathers is very sparse

  7. Nature and intensity of intervention From files • Length and pattern of involvement • Child protection status/ legal status • Child’s ‘story’ From interviews • Views about the nature and intensity of involvement (from a range of practitioners)

  8. The 77 Children 1993-4 (Time 1) In placement At home removed at birth 4 70 3 Safeguarding Process 93-01 Child Protection Family Support (57 CPR) 34court orders (20 s17) Change of carer 47 Same carer 30 Away from home, stayed away 3 Went home, left, stayed away 10 Left home, stayed away 20 Went home, stayed home 14 Stayed home throughout 30

  9. Were the children abused again? (evidence in files of CPR or orders to protect eg epo, ico, so or co) 57% of the 77 children were abused again 6 children were abused at all 3 time points

  10. Outcomes for the children

  11. Outcomes to date • A researcher rating from the range of aspects of well being (quant scales and qual information) • 72% protected (to some extent) 28% still concerns about well being /protection But qualified successes

  12. Wellbeing outcomes from file search • Overall development eg mental health (60% had long standing conduct problems) • Stability and loss – eg moves between carers, loss and death, cumulative losses • Re-abuse rates (CP plan or protective order)

  13. Outcome evaluation in child mental health treatments (Fonagy et al 2002) Developmental domains* • Absence of symptoms of mental ill health • good adaptation to the psychosocial environment • strong cognitive and emotional capacity • transactional aspects of development (ability to cope with individual and developmental changes alongside changes within the environment)

  14. Summary of outcomes of the children

  15. Reflections

  16. Change Over Time Reflections:Maltreatment over 8 years • Problems of keeping longitudinal study going - funding, access • Small sample size and large age range poses problems for methodology eg use of scales/measures and comparability • having a whole cohort (ie all maltreatment cases from all study sites) provides rigour • Problem of measuring and tracking success – if ‘success’ is a closed case.

  17. Complexity of the children’s stories and experiences can be captured by a mix of methods • Not clear whether success was linked to intervention • New learning: mental health worse for children living at home (with sig harm) than in care, return home a riskier outcome • Challenge to get routine data to tell a coherent story – but possible

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