Working with Resistance and Disguised Compliance

1. Working with Resistance and Disguised Compliance Jane Wiffin

2. Where does my knowledge come from? • Work as a social worker • User of services as a carer • Serious case review author – largely children, but some adults • Researcher/Dissemination of research • Training

3. Why do I tell you this? • One of the biggest issues emerging in SCRs is the importance of professionals not relying on one source of information in important circumstances/decisions/assessments/understanding poor engagement or hostility • Not relying on self report – looking for the clues or discrepancies • Intuitive & Analytical thinking • Major issue in resistance and disguised compliance – making and trusting our professional judgements

4. Intuitive & Analytical thinking • Recognise the impact of Intuitive and Analytical reasoning (Munro Review) • Intuitive: unconscious process that occurs automatically and integrates wide range of data to produce quick judgement. Makes use of emotions (sometimes referred to as “gut feelings” • Analytical: conscious and controlled – using formal reasoning and explicit data – often not using data from emotions – ruling them out • Each have their benefits and drawbacks • But: • Need to draw on both to make sense of complex situations • Need to recognise when one dominates

5. What different forms does resistance take? Ambivalence not sure of need to change or when people are ‘stuck’ at a certain point Denial/Avoidance not willing to acknowledge problem and/or purposely avoid practitioners Violence/Hostility Disguised Compliance

6. Disguised Compliance • Disguised Compliance is a phrase coined by Reder, Duncan & Gray in 1993 in ‘Beyond Blame – child abuse tragedies revisited’. • They described It as a patterns of interaction between professionals and service users (family/parents/carers) in which professionals are kept at bay by partially complying with professional plans. • Also splitting professional opinion

7. Disguised Compliance - some indications • No significant change at reviews despite significant input; • Note need for a plan and a review • Parents/carers agreeing with professionals regarding required changes but put little effort into making changes work; • Change does occur but as a result of external agencies/resources not the parental/carers efforts; • Change in one area not matched by change in other areas; • Parents/carers will engage with certain aspects of a plan only; • Parents/carers align themselves with certain professionals; and Child’s report of matters is in conflict with parents’ report.

8. RESPONSE TO CHANGE EFFORT COMMITMENT TO CHANGE HIGH LOW Horwarth, 2001

9. Manipulation of professional relationships • SCRs often note splits across agencies • Often a deliberate if at times unconscious process Splits between agencies can result in: • individuals and agencies blaming each other and therefore colluding • Those who are not experiencing hostility can find themselves taking all the responsibility • those who are “approved of” and “praised “ may feel gratified and unable to accept that there are problems or risks • Enables adults to harm children/adults unchallenged

10. Developing an overly optimistic approach/ Focus too much on small improvements rather than considering families’ full histories • Develop ‘fixed views’ that are not updated in light of contrary evidence Implications for practice Presentation details

11. Working in the context of violence and hostility: First Principles • Workers have a right to feel safe, to be heard when they voice fears and concerns and to know that the response should include appropriate action being taken. • Professionals must feel able to talk about these issues • Professionals must not be blamed for other’s violence and aggression • Authoritive practice

12. THREATENING BEHAVIOUR • 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

13. The importance of naming the problem • This raises dillemmas – by naming the problem now are we labelling people for ever • However if we are not clear about the nature of the problem hard to change/address • Do not fully capture history of problems • Do not enable others to address • Lack of naming it might also indicate that a professionals has not been clear with the service user

14. What is the nature of the problem? Is it about you ???????? Is it about me ?????? Is it about someone else ??????

15. Factors to do with service users and their experiences • Experience of seeking help in the past – influence on the present • Experience of help seeking attitude • Trust and Attachment • Experience of authority • Attitude to change • Cultural issues /Racism/discrimination • Disability issue – e.g having a learning disability • Have something to hide

16. Factors to do with Professionals • Lack of engagement skills – making relationships critical • Lack of confidence in own role and task/confusion about what is required • Not adopting an authoritative approach • Self reliance/capacity issues/ people can make their own decisions • Not acknowledging racism/discrimination oppression • Not recognising the impact of issues such as • Learning disability • Domestic abuse • Parental Mental health • Not seeking to find a shared understanding of the issues to be addressed

17. Responsive The Authoritative Practitioner Permissive Authoritative Demanding Undemanding Authoritarian Neglectful Unresponsive

18. Practitioner is keen to offer support – both emotionally and practically (Eg by offering financial support and access to services) but asks for nothing in return; fails to differentiate between competing needs; is essentially in a collusive and ‘one-way’ relationship with specific users (normally parents/carers) Practitioner is both responsive to and respectful of the user and his/her needs, but demands appropriately assessed changes in behaviour/honesty/parenting and genuine collaboration in return Responsive Authoritative Permissive Demanding Undemanding Neglectful Authoritarian Practitioner is over-directive, showing inappropriate/disproportionate and/or unnecessary use of control and authority; can lead to unobservant of and unresponsive to user needs Practitioner forms passive and/or collusive relationships with users, in which needs are neither recognised nor differentiated (Eg between parent/carer and child). Fails both to assess accurately and use authority when appropriate Unresponsive Practitioner - Service User styles matrix‘Demandingness’ – the extent to which practitioners show control and maturity, and make demands for change based on assessmentResponsiveness – the extent to which practitioners respond to the differentiated and assessed needs of service users Adapted from Hackett (2003)

19. Factors from others • Adults who are “behind the scenes” including “shadowy males” • Children and vulnerable adults who are dependant on others • WAS NOT BROUGHT V DID NOT ATTTEND

20. Making sense of the problem • Need for reflection • Analysis of the cause of the problems – importance of hypothesising • Remember tendency to take fixed positions • It is my fault/it is your fault • Test this out • Risk assessment and resilience • Strategies to address • Review – is it working – or have we got the cause wrong • Change in strategies • Have a plan and review it

21. What helps • Relationship based practice – working with everyone “Think Family” • An authoritative approach • Good assessments • Appropriate plan and review • Tools such as • Genograms • Culturagrams • Discrepancy matrix • Awareness of risk and consequences • Reflective supervision