The Narrative Model for Communicating with Children about challenging issues

1. The Narrative Model for Communicating with Children about challenging issues Ms Lynda McGill, Team Manager Ms Louise Crangle Faulkner, Senior Practitioner Therapeutic Team for Looked After & Adopted Children NHSCT NISCC Lunch Time Seminar 28 February 2017

2. Facts and Figures re: NHSCT • Population of almost 436,000 people across a geographical area of 1,733 square miles making it the largest geographical trust in Northern Ireland. • Currently responsibility for approximately 634 Looked After Children and approximately 200 Post Adoption Children in NHSCT catchment area (Sept 2016)

3. Introductions to the TT-LAAC Team • Multidisciplinary Team in NHSCT established in 2011 • Integrated within Children’s Social Services • Seeking to improve the outcomes for LAAC through placement stability • Replaced multiple therapeutic referral pathways to ensure a coordinated approach

4. Entry into the care system is a challenging experience for children and young people: • They have to leave their home and family often in crisis and can be highly distressing • Sometimes children are placed separately from their siblings. • Children are required to get to know new carers and others who live in the household. • Needing to make sense of new rules and expectations within placements of the household.

5. Often unclear about the reasons for coming into care. • Managing uncertainty • What's happening next? • Is it my fault? • Am I going home again? • Who’s looking after my teddy? • Not knowing what to say about it to: parents, siblings, carers, professionals, school and indeed friends • Understanding and adapting to contact arrangements.

6. How the Narrative Model evolved • Psychological Perspectives from practice • Repeated Findings from literature on social work practice (Munroe 2011, Our Life in Care 2013,Voypic’s third CASI survey) • Themes from referrals to TT-LAAC- requests and challenges • The need of the care giving network to be able to provide a congruent narrative to aid the child’s understanding. explain network in supporting a child develop a narrative about their experience.

7. What do we mean by a Narrative? • A Narrative is an opportunity to communicate with a child about an aspect of their story- not their life story. • An opportunity for significant adults to have a framework within which they can share and agree what needs to be communicated with child. • In a shared language that is appropriate to the child’s stage of development • Helps the child to understand and communicate about the experience which supports the adjustment process

8. The Narrative Model has 7 core components • Caregiver Network • Use of Narratives • Delivering the Narrative to the child. • Responding to the child’s emotion. • Responding to the child’s questions. • Broadcasting the narrative to significant others. • Building on the narrative.

9. What are people saying about the model? • Anecdotally feedback has been very positive- • "This service assisted Children's Services delivering information to an eight year old child about issues in his family re sexual abuse. This was a useful service and provided resources in order to provide this work in an age appropriate manner“ • “The children have demonstrated a better understanding and insight in relation to their current living arrangements and the reasons for it.”

10. What are the Care Giving Network saying?

11. Satisfaction Survey • Satisfaction Survey commenced in February 2016 • Rationale for undertaking survey- • Better outcomes • What do social workers find most helpful • What components of the model in particular aid the communication process. • Sample size Social Workers N=18 Children N=54 • Social Workers experience ranged from 2 years post qualification to 23 years with a mean of 8 years.

12. Key Results • In 100% of cases, SW’s involved in narrative work felt that it was important for children to know why they are in care and all were satisfied overall with the model. • 63% of cases the social worker involved agreed that it was difficult to talk to children about why they were in care- this did not appear to be influenced by number of years qualified or training level. • All but two respondents were aware of the Narrative Model prior to completing the narrative piece of work.

13. In 35% of cases, SW’s had formal training in the Narrative Model prior to carrying out work • In 71% of cases the opinion was that the work promoted placement stability • All social workers in all cases stated that the model had benefited the child and had also strengthened their confidence as practitioners. • As with all surveys limitations exist- small sample size, poor response rate and missing data.

14. Building upon the Model • Development of the Narrative Training DVD, published article and future articles • Experiences of Birth parents inclusion in using the Model. • Hearing the Children's voice! • Considering the challenges inherent within Foster Care and Kinship Care.

15. Keeping it Real-a practice example

16. Case example • Care Giving Network / Use of a Narrative -Care Giving Network Meetings to develop a shared and agreed understanding of what the children required from a narrative, what was required to meet the children's needs and how and whom the process should involve. - Individual support sessions with grandparents - Supported the social worker in constructing the narrative - Involved the parents and grandparents in the process, obtained everyone’s agreement that the content was factual and detailed their version of the story • Delivering the Narrative • Agreed who would be presentfor the delivery • Planning re room, timing, children's need for emotional support through toys etc and availability of support to carers, parents and children post delivery Ensured the father obtained feedback as to the children's responses to the narrative

17. Responding to the Child’s Emotion • The children voiced their relief in knowing the narrative was shared and agreed by all adults -1st time the family agreed since the injury • Presented as accepting of their care plans but angry that their brother was hurt by their father, some confusion as they still loved him but feared him • Following the narrative support was provided to the caregiving network to support them in responding to the children’s emotional needs • Responding to the child’s questions • Encouraged the children to further share their inner world within the safety of the congruent care giving network • Broadcasting the narrative to significant others. • We agreed in this case that the school did not require the full narrative but were involved in the process and kept updated throughout • Building on the narrative. • Process of desensitization to prepare the children, carers and parents for contact and possible questions/responses the children may have had

20. Thank you – Questions?