Working with Non-engaging Families/Resistance

1. Working with Non-engaging Families/Resistance Anne Salter Lead Officer Child Protection Clackmannanshire and Stirling Child Protection Committee

2. Exercise • Speak to the person next to you and share any experiences you have had when you have been worried that a child, young person or parent/carer is not engaging with you and/or the service.

3. Why is it Important? • Resistance is an integral and challenging aspect of work with involuntary service users. • Resistance needs to be identified and acknowledged in practice since it can impact on decision-making and interventions and have negative consequences for the child or young person. • Resistance can also have a very negative impact on staff.

4. What is Resistance? • Resistance is a multi-faceted concept which, in the context of child protection, can refer to parents’/carers’ resistance to the offer of help, to engagement or to change.

5. Exercise • In small groups think about the ways resistance may appear.

6. How does it manifest? • Resistance may manifest in a variety of active and passive behaviours, attitudes and interactions ranging from reluctance or non-engagement to disguised compliance or overt hostility and violence. • Resistance can be fluid, dynamic and change very quickly.

7. Exercise • In small groups share your ideas about why children, young people and families may show resistance.

8. Why does it exist? • Resistance is complex and the reasons why it exists are numerous but range from previous negative experiences with services to being used deliberately to keep practitioners at a distance. • Resistance from parents/carers can also be influenced by the practitioner who faces the challenge of building a relationship with the parent whilst at the same time remaining “healthily sceptical”.

9. Examples from Significant Case Reviews:Daniel Pelka • Daniel’s mother and stepfather set out to deliberately harm him and deceive professionals about what they were doing. They also involved Daniel’s sister Anna in their web of lies and primed her to explain his injuries as accidental • At the time of his broken arm, in January 2011, professionals too readily accepted an accidental cause. • Health Visitor observed Daniel with a bruise to the side of his head. Mum said he fell and saw the GP but there was no record of this in GP notes. • Domestic abuse a known factor.

10. Examples from Significant Case ReviewsDaniel Pelka (continued) • Daniel presented as hungry and taking food from bins and other children. Mum said he had a health problem. Daniel continued to get thinner before worry increased for Education staff and further action was taken to liaise with other professionals. • Daniel had a spiral fracture and bruises to his abdomen but on investigation Police found Daniel’s sister supported the parent’s story and therefore no further action was taken. • Daniel’s mum told the school nurse he had behavioural issues. A plan was made to support mum with Daniel’s poor behaviour (which mum never engaged with) although the school continually reported Daniel never presented as naughty or disruptive. • Daniel’s mum did not attend for court proceedings saying her child (Daniel) was ill.

11. What might help? • Practitioners need support/supervision to consider their own contribution to the process of resistance from families including relationship dynamics and the authoritative use of power. • Practitioner/service user relationships where the practitioner demonstrates empathy and listening and avoids the use of confrontation can be effective. • Communication styles such as motivational interviewing are also helpful. • Supportive structures should exist within the workplace to mitigate risk relating to lone working and aggressive service users and supervision should be used to consider the implications of this.

12. Implications for Practice • Practice utilising an authoritative negotiated approach which honestly and openly acknowledges which factors are influencing resistance, focuses on the harm to the child and formulates an action plan is suggested. • An “eyes wide open approach” is required so that workers are alert to the possibility that some parents are aware that what they are doing is harmful and will endeavour to hide this from professionals. • Supervision and support are essential for workers faced with challenges such as the impact of fear and threats, inadvertent collusion with families and risk of over optimism in particular cases. • Disguised compliance, being able to determine who is capable of change and involving men in assessments are particularly challenging areas of practice for practitioners who require training and supervision.