Social Work / Social Care & Media

Introduction

Parental resistance and avoidance can negatively affect the safety and well-being of children in protection work, posing significant risks   to workers and children as a result of certain forms of power/control dynamics used by a   small     number of very challenging families in child protection work.  The vast majority of interventions from social workers when there is a query about possible abuse, or when it is identified to be there, are at least to some degree positive due to the skills, commitment and dedication of workers in this area. However, we also need to acknowledge that we need to consider much more carefully in practice, supervision and interagency working,  issues concerning that  very small but significantly risky set of parents who are resistant and avoidant to those assessments and interventions.

The article addresses how child protection workers   and agencies can best understand   such resistant behaviours, and consequently respond most effectively, arising from an review of   the findings from research and serious case review (SCR) reports. The effects on practice, policy   and the use of authority in child protection work of the current    policy and regulatory environment on   risk assessments and responses to violent and resistant behaviours from parents are then considered.

In his 2003 report for the government on the death of Victoria Climbié, Lord Laming was concerned that child protection workers  “ face a tough and challenging task” when they are working with adults who deliberately exploit the vulnerability of children, and   who act in devious and menacing ways.

“They (resistant parents) will often go to great lengths to hide their activities from those concerned for the well-being of a child…(child protection) staff have to balance the rights of a parent with that of the protection of the child” (Lord Laming 2003:3)- a message   reinforced in his 2009 progress report on child protection   (Lord Laming, 2009: 51-52).

Such resistant behaviours from abusers can include threats, abuse, and physical violence. Child protection staff and their employing agencies   can struggle to engage with     parents who act in such ways against workers, which can mean that it is very difficult to address the parent’s’ abusing behaviour, and the effective safeguarding of the child (see e.g. Calder, 2008; Farmer and Owen, 1998; Littlechild, 2005, 2008a, 2008b; Ferguson, 2011).  This article will concentrate on one   particular form of resistance, that of avoidant and uncooperative behaviour.

Humphreys and Stanley (2006) and Hester (2011) note how the violence of male partners is ignored and left unchallenged in the majority of assessments by social services departments, despite the known association between adult domestic violence and child abuse, a factor evident also in the SCR findings examined later in this article. Hester (2011) notes in her   ‘3 Planet Model’ the lack of a common understanding over such violence and of the subsequent negative effects of upon collaboration between those working in   their    ‘habitus’ domains of child protection, domestic violence, and child contact work  (see Bordieu, 1989, in Hester, 2011). This presents barriers for workers on how to recognize, assess   and effectively respond to the accruing effects of each of those domains on children, and challenges us on how we can develop the assessment of risks and interventions across these different areas in order to protect both abused women and their children.  In the same way that Hester has proposed inclusion of these 3 areas in policies and professional understandings, this article proposes that   any model or policies for child protection   needs to include an understanding of the effects of avoidance and resistance by parents on the protection of children in conjunction with our other levels of understanding, alongside those proposed by Hester.

Child protection workers and their supervisors have often found great difficulty in dealing with    issues of parents’ use of power and control   strategies   in abusive families (Littlechild, 2005; Ferguson, 2011). This has   not been helped by government guidance which has minimal    recognition of these areas within Assessment Frameworks, regulations or guidance (Marshall, 2011; Littlechild, 2008a, 2008b).  Fauth et al in their C4EO report which sets out to provide guidance to agencies and practitioners in their work with resistant families note the paucity of research or government guidance on this area (Fauth et al, 2010).

In an early indication of recognition of the effects of parental avoidance, Bell’s   research (1999) found that    one third of her social work respondents stated they not been able to undertake a thorough child protection investigation due to lack of co-operation from the family.

Most recently, a Community Care/Reconsruct survey (Community Care, 2011) of nearly 600 social work and social care staff discovered that the small number of parents who exhibit such behaviour to a significant degree   can pose a real threat   to their children through the effects this has on the ability of staff to carry out their assessments and interventions effectively and adequately.

In the survey,

• 91% of respondents stated that their caseload includes parents who are hostile or intimidating
• 51% said that they   dealt with such parents on a weekly or more frequent basis.
• 44% of respondents said that they agreed or strongly agreed that vulnerable children are being put at greater risk because they do not get enough supervision and support when dealing with hostile and intimidating parents
• Only 25% said    their organization had existing procedures/guidelines that they all use in dealing with such parents.

The    ‘rule of optimism’   that can affect assessment and decision-making in child protection work was   first identified by Dingwall Ekeelaar and Murray (1983). The key concern here is that child protection professionals may wish to ‘see the best’ in people, and have hope and optimism that their interventions can help   the safety and well-being of the child involved. This   important set of attitudes can, however, also leave children being abused and neglected because of a lack of focus   in agency procedures and national policies on resistance, which can hinder   managers and practitioners recognizing and responding to the effects of abusive and controlling power/control dynamics from parents, and the consequent risks the child faces (Laming, 2009; Marshall, 2011).

Resistant and violent parents: Findings from individual child abuse death inquiries/Serious Case Reviews

This section sets out findings from a selection of child abuse death inquiries/SCRs that are   illustrative of a number of different forms of resistance and avoidance.

Professionals visited Jasmine Beckford’s family    78 times (O’Hagan, 1997), but in the 10 months before she died in 1984, she was seen just once, in a room with her parents present. At that time Jasmine had an untreated broken leg from the abuse.  The   professionals’  ‘habitus’ had not prepared them to look for any such injuries or even query what state Jasmine was actually in from her perspective.

The ‘rule of optimism’ was seen to be at play throughout professionals’ interventions, and the result was that the social worker was diverted from attention to Jasmine and the abuse of her by way of implausible excuses on nearly all visits to the family about the whereabouts of Jasmine.  The social worker focused on the needs of the parents, but not those of Jasmine (Parton, 1986).

23 years later, Haringey health, police and social work professionals saw Baby Peter Connelly over 60 times in total over a period of eight months. The report found   Haringey’s Children’s Services lacking in   ability to identify children at immediate risk of harm and that its staff were not able to effectively talk directly to such children, thereby compounding the risks that    involuntary parents/carers as gatekeepers pose to vulnerable children. The same issues about active non-cooperation and diversionary tactics from uncooperative parents were also present in the case of Ainlee Labonte, where avoidance, resistance and threats of violence to staff   contributed to the elaborate concealment of Ainlee’s abuse from the workers and agencies by the parents. Professionals were unprepared to visit, thereby colluding with the avoidance of the parents (Newham Area Child Protection Committee, 2002).    The professionals, as with Jasmine Beckford, had focused on the parent, not the child, missed significant injuries, and operated under the rule of optimism.

Barking and Dagenham Safeguarding Children Board’s  (2011) SCR on 2 children, one of whom died as a result of abuse, found   a long history of avoidance of contact and engagement with health, social care and educational support and monitoring. This avoidance was not  challenged appropriately by agencies, and the mother

“.. frequently complained about anyone who challenged her approach to the care of the children.” (p. 13).

A number of professionals in different agencies   showed an unjustified level of sympathy for the mother,

 “because she was perceived as a victim of abuse and isolation from her family. This led them to lose their focus on the children and to underestimate the level of risk”  (p44), whilst her difficult and aggressive and behaviour meant they avoided challenging her:

 “ (this) had a profound bearing on the assessment of risk to the children… professionals were intimidated by her hostile behaviour” (p44).

The Khyra Ishaq SCR concluded that the lack of focus on children’s welfare was partly to blame for the seven-year-old’s death by starvation. The parents withdrew from contact with support agencies, and were aggressive to professionals. The report found a lack of any prescribed opportunities for children to formally express their views, or to have any independent access to external processes (Birmingham Safeguarding Children’s Board, 2010).

In one situation where 3 children   suffered serious abuse from their adoptive parents, the conclusion of the SCR was that

“.. many professionals struggled to maintain a child focus when faced with M and F’s aggressive behaviour and their ‘disguised compliance’..there is a need for practitioners to develop confidence in differentiating between families genuinely engaged with services and those who are displaying “false compliance” ” (Cheshire East Safeguarding Children’s Board, 2011, paragraph 6.5).

This disguised compliance and manipulation as a form of resistance was a key feature in the Baby Peter Connelly case.  His mother   misled and   deceived professionals in claiming that no men lived in the house, although her boyfriend and lodger resided there, and was untruthful about how Baby Peter’s injuries were sustained, smearing chocolate on his face to conceal   bruises from the child protection workers. The social worker   erroneously perceived his mother to be co-operating despite the baby’s repeated injuries while in her care.  According to Munro (2008), ‘Robust supervision should have challenged this flawed appraisal,’ and help guard against the social worker’s biases that were impairing her judgment; a point made more generally about the key importance of supervision in her report of 2011 (Munro, 2011), and echoed by Lord Laming (2009:32).

Distorted assessment resulting at least partly from disguised or partial parental compliance was also revealed in the Victoria Climbié case.  Professionals appeared incapable of conceiving that   Victoria’s great aunt could be abusing her, due to the aunt’s apparently normal maternal relationship to Victoria. Social and health care professionals seemed unable to accept the idea that she was complicit in his abuse (Karpf, 2008).

The research findings and systematic reviews of child abuse death inquiries/SCRs reveal the same concerns.

Lessons from research and systematic reviews of child abuse death inquiries/serious case reviews: A continuum of co-operation /non-cooperation

Systematic reviews of child abuse death inquiries and the later SCRs have demonstrated that there is a continuum of behaviours from parents on a sliding scale, with     full co-operation at end of the scale, and planned and effective resistance at the other.

Brandon et al in their biennial analysis of SCRs for the Department for Children, Schools and Families examined 161 cases of child fatality or serious injury and concluded that in many situations   parents were hostile, with workers   often frightened to carry out home visits.  This could have a paralysing effect on practitioners, negatively affecting their ability to “reflect, make judgments, act clearly, and to follow through with referrals, assessments or plans” or keep a focus on the needs and experiences of the child, where “children went unseen and unheard” (Brandon et al, 2008:3).

Stanley and Goddard (1997) identified how some workers can accommodate service user aggression as part of their defence mechanisms, and how some abusive families can use a complex set of dynamics within tactics to draw the worker into the role of victim, which means they are unable to challenge the abuse, or utilize procedures properly. They also suggest that at times, workers appear to indulge in self-deception and denial of violence.

Littlechild’s research also found that responses to parental avoidance, including the use of threats and intimidation against child protection social workers, can lead to victimization of workers, and subsequent avoidance of challenging these behaviours (Littlechild, 2005).

Drawing on a sub-sample of 47 cases for which more detailed information was available in their analysis, Brandon et al identified a continuum of co-operation between families and agencies. On the co-operation end of the continuum families showed neutrality or a willingness to engage with agencies and seek help; at the other end of the continuum researchers found hostility, avoidance of contact, disguised or partial compliance, and ambivalent or selective co-operation (Brandon et al, 2008).

In the subsequent review of 189 SCRs between 2005-7 and detailed study of 40 of these, in three-quarters of situations the parents failed to co-operate with services. Forms of hostility and lack of compliance included

“deliberate deception, disguised compliance and ‘telling workers what they want to hear’, selective engagement, and sporadic, passive or desultory compliance…..  At times the enthusiasm for a strengths-based   approach precluded seeing and weighing up the risks of harm to the child” (Brandon et al., 2009: 3).

This dilemma of how to work to a strengths-based approach, whilst also maintaining a critically evaluative focus on whether parental avoidance is confounding such approaches and thereby avoiding the abuse and unwittingly allowing it to continue, is found again in Ofsted’s evaluation of 50 SCRs (Ofsted, 2008). This review found that professionals placed too much reliance on what parents said, and that families were often hostile to contact from professionals and developed skilful strategies for keeping them at arms length.

One of the key messages from one of the SCRs, which the report authors believed was applicable more generally to safeguarding work, is that a family support perspective can deflect from the need to ensure children are properly protected, and that the outcome of the massive amount of support provided to this family was to “‘simply prop up and perpetuate a profoundly abusive situation’.. (and that) agencies should be aware of the concept of professionals unwittingly colluding in the ongoing abuse of children” (Ofsted, 2008:28).

The review panel for this inquiry concluded that the mother’s learning disability led to professionals and agencies   minimising the experiences of the children, and their not fully appreciating the mother’s inability to change and improve (Ofsted, 2008:28).

In a follow up exercise in 2011, incorporating analysis of findings from 67 SCRs, OFSTED again concluded that:

“…practitioners focused too much on the needs of the parents, especially on vulnerable parents, and overlooked the implications for the child” (Ofsted, 2011a:4).

A further Ofsted   review of 210 SCRs involving babies under the age of one year concluded that  “There are repeated examples of ways in which the risks resulting from the parents’ own needs were underestimated…. some reviews found that there had been too much emphasis on the mother’s needs at the expense of a focus on the baby, either during the antenatal period or after the birth” (Ofsted, 2011b: 9).

Such consistent findings do not however   appear to have had an effect on regulation, policy or guidance.

Child protection discourses in regulation and guidance

Despite this evidence of the effects of violence, resistance and avoidance in the parents of severely abused children, there has been a diminution of focus on these issues in official guidance from the Government in recent years. This evidence challenges some of the assumptions underlying the current child protection discourse within   various central government publications which largely ignores or minimizes issues of aggression and resistance from parents, when these may be key features in the continuation of the abuse suffered by children (e.g. Department of Health, 1995; Children’s Workforce Development Council, undated; HM Government, 2010).

For example, in the ‘Orange Book’ (as it was known) central government guidance (Department of Health, 1988), there was a section on  ‘Professional Dangerousness’, drawing upon the work of Dale (1986) concerning ‘Dangerous Families’, which set out how parents   who are highly manipulative and plausible can thereby    successfully keep the child’s abuse away from the gaze and attention of the protection workers. This element   of the guidance   then related these matters to how workers can collude, even if not intentionally, with such parental resistance strategies, leading to avoidance of contact with the child or family due to unacknowledged fears for personal safety and/or in being caught up within the ‘rule of optimism’ (1988: 12).

These elements and concepts have now all but disappeared from Government guidance, possibly in part due to the ‘refocusing’ agenda arising in the 1990s from concerns that there was too much intrusive and coercive interventions from child protection agencies, and the need for a ‘lighter touch’ as it was known (Littlechild, 1998).

There was a brief mention of the effects of violence against child protection staff in the original ‘Working Together’ regulatory guidance on child protection work, which was contained within a one-page checklist of ‘Ten Pitfalls and How to Avoid Them’  (Department of Health et al., 1999: 44). This however disappeared in subsequent versions.  In the 383 pages of the UK Government’s latest (and longest) 2010 version of ‘Working Together’, there   is    no mention of these   factors, apart from one sentence:

‘Some children may be living in families that are considered resistant to change.’ (HM Government, 2010: paragraph 9.7).

This   lack of recognition of the realities of resistance and avoidance by parents in these discourses may then   limit the ways in which child protection workers, supervisors, managers and practitioners can focus on   abusive power/control dynamics in a family. Given the fears they may have of moving beyond   statutory guidance and regulation, and the perceived risk by them of doing so, this is perhaps not surprising.   “Compliance with regulation and rules often drives professional practice more than sound judgment drawn from the professional relationship and interaction with a child, young person and family.”  (Munro, 2010:8); and

“Too often in recent history, the child protection system has, in the pursuit of imposed managerial targets and regulations, forgotten that its raison d’être is the welfare and protection of the child” (Munro, 2011).

The focus of child protection assessments

Evidence from research, child abuse death inquiries and subsequent SCRs has been presented in this article concerning the potential serious negative effects of non-co-operation, threats and avoidance by parents in   child protection work. Following the Baby Peter court case in November 2008, Lord Laming highlighted the importance of taking into account these issues when assessing the risk of harm to a child: ‘Signs of non-compliance by parents, or indeed threat or manipulation, must form part of the decision to protect a child’ (Laming, 2009:33).

Graham Badman, Haringey Safeguarding Children Board’s independent chair, said: “I believe the most important lesson arising from this (the Baby Peter) case is that professionals charged with ensuring child safety must be deeply sceptical of any explanations, justifications or excuses they may hear in connection with the apparent maltreatment of children”  (Community Care online, 2009).

Alan Jones, author of the 2^nd SCR report on Baby Peter, said the biggest lesson to be learned from that and   almost every other SCR he had ever written or studied, was the “need for social workers to challenge parents more”.

Jones states that he believed there had been little learning from   the Baby Peter case, with “ no suggestion by government or service leaders that they should place more importance on this learning  (about avoidance in parents and the need to challenge this) in the provision of our child protection services”. 

He stated that he believed that without a change in approaches to authoritative practice by all protection agencies,  “we will not prevent the continuing catalogue of avoidable non-accidental deaths”; and that current government guidance puts more importance on social workers supporting families and parents to try and keep the children at home if at all possible, rather than recognizing and dealing with the issues of avoidance from parents  (Community Care online, 2010).

One way forward to remedy this gap in guidance and emphasis is to develop checklists that would act as ‘aide memoires’ on these   and other key areas to be employed in agency policies and supervision. These could then provide    a focus during initial risk assessment and risk management processes, and   a means of reviewing progress or otherwise as part of this focus. Lord Laming makes the point in relation to social work, but the message is relevant to all child protection professionals and their agencies:

“It is important that the social work relationship, in particular, is not misunderstood as being a relationship for the benefit of the parents or for the relationship itself, rather than a focused intervention to protect the child and promote their welfare”  (Laming, 2009: 23).

To support this, training and development of managers is needed to ensure they have an appreciation of, and strategies to deal with, these well-evidenced    problem areas for staff, agency, and children, including the need to make extra efforts to ensure the worker is fully appreciating and assessing the risks of non-compliance.

Agencies and staff can develop their range of responses that are    available, operated by whom, in what ways, to deal with possible avoidance by:

1. Parents
2. Workers
3. Supervisors
4. Child protection conferences

Such an approach can in particular provide a clear focus for assessment and intervention in child protection plans, and indeed evidence in court reports if such resistance is making protecting the child impossible.

Some of the areas agencies and staff may find it helpful to address in policies, procedure and supervisory practice could be:

• Are there clear risk assessment procedures in place which to take into account our knowledge of avoidance, with systematic planning and reviewing of the assessment and interventions over time?
• How are approaches to the different types of resistant/avoidant behaviours identified, agreed and set out in agency and interagency policies, and maintained within agency culture, supervisory practice, and with parents?
• How clear are these to workers and parents, and how effectively are they spelt out, reviewed and maintained over time?
• What range of responses should be available, operated by whom, in what ways to ensure these approaches are operationalised and kept in place?

Front line staff however report that policies in many authorities do not explicitly include reference to these areas (Community Care, 2011).

In assessments and reviews of interventions, areas that are indicated from the knowledge base would be:

• Have any workers or agencies, currently or in the past, experience of the parents(s) being hostile, intimidating, threatening or actually violent, and/or experiences of   resistant and avoidant behaviours   from them?
• Might any of the workers involved   see the parent(s) as victims themselves, with too much focus on ‘feeling sorry’ for the parents?
• Are staff seeking to access children’s experiences/ views appropriately, particularly when there are concerns   that abusive parents may be keeping the child in fear of breaking the secret of abuse to the workers?
• Is the worker exhibiting signs they are not being objective about the risks because of the effects of the rule of optimism, fear of the parent(s), or their own avoidance of challenging the parent(s) avoidance and resistance?
• Might the use of complaints by the parents be affecting the worker’s/agency’s assessment and intervention?

Conclusion

This article has proposed that child protection professionals and agencies need to be better equipped to identify aggression, avoidance and manipulation from   parents.  There is a need for managers, supervisors and front- line workers to develop   effective means    to understand   the forms and effects of such resistant behaviours in order   to carry out their professional, agency and legal functions in protecting children. Improved  support and training for managers and front line staff is needed    to enable them to more clearly distinguish between the 2 ends of the spectrum of parental engagement with genuinely productive partnership work with parents at one end and resistance at the other.

Arguments have been presented   that the nature, motives and effects of parental avoidance and manipulation need to be taken into account in a more systematic manner by child protection professionals and agencies by way of assessment and intervention in appropriate situations.  In order to do this, central and    local policy guidance and regulation could   specifically address and provide a focus upon these issues   for child protection workers’ considerations.  Within practice, professional supervision then needs to have this as one of the key areas to routinely focus upon as one means to overcome a current ‘habitus’ that can avoid these areas.

Join @SWSCmedia debate on Resistant Families: Avoiding Avoidance Tuesday (29-May-2012) at 8:00 PM London / 3:00 PM (New York) @SWSCmedia & share your views.

Prof. Brian Littlechild (@blittlechild)  is the Associate Head of School of Nursing, Midwifery and Social Work  at the University of Hertfordshire. Prof. Littlechild’s research has a focus on production of knowledge which aids policy and practice within the social work, social care and health settings. Prof. Littlechild acts as Consultant to the Council of Europe on youth offending policies and practices and is a Council member of the British Association of Social Workers, and Chair of its Ethics Committee.

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Join @SWSCmedia debate on Resistant Families: Avoiding Avoidance Tuesday (29-May-2012) at 8:00 PM London / 3:00 PM (New York) @SWSCmedia & share your views.

Prof. Brian Littlechild (@blittlechild)  is the Associate Head of School of Nursing, Midwifery and Social Work  at the University of Hertfordshire. Prof. Littlechild’s research has a focus on production of knowledge which aids policy and practice within the social work, social care and health settings. Prof. Littlechild acts as Consultant to the Council of Europe on youth offending policies and practices and is a Council member of the British Association of Social Workers, and Chair of its Ethics Committee.