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‘Building relationships to strengthen networks –
the evidence for moving away from a deficit-based
and problem-focused approach to child protection
           work with alcohol and drugs’


                                Wulf Livingston,
               Senior Lecturer in Social Work, Glyndwr University




Conwy & Denbighshire LSCB Annual Conference - March 2013 - 9.00am till 4.00pm

Theme : The interface between safeguarding children, alcohol and substance misuse
Context
Risk
Interventions
Kelly and Gary
Why are we here?
Harm is not up for debate (huge evidence trail) –
(we know this and this is not the focus of this presentation)

but….
How many more – Inquiries?

• Fisher (Colwell) 1974
• Butler-Sloss (Cleveland) 1998
• Laming (Climbie) 2003 (Baby P) 2009
• Francis (Mid-Staffs) 2012
• Hughes 2006 –Canada

• Woods Commission 2008 -Australia
More Communication
More Information Sharing
More Training
More Procedure
More Monitoring
More Support
More Communication
More Information Sharing
More Training
More Procedure
More Monitoring
More Support

                           Why does it keep happening?
                           What can be done differently?




                           Perspectives on Risk
                           Perspectives of Interventions
Risk Hierarchies
Orientation affects perspectives/approaches
• Organisation
• Managers
• Employees
• Service Users
• Carers
• Public
Risky Business

• A Control Management (with) Professional
  Judgment
-There are increasing (evidence-based) calls for
  front-line professionals to be supported in and
  empowered to take informed risks – risk
  taking is necessary in the promotion of growth
    (for service users and professionals)


           •EVIDENCE - Barry, Bonat, Bytheway, Littlechild, Monroe, Stanford,
The rhetoric of risk is used within neo-liberal risk society
to mobilise fear as an emotive, defensive and strategic
medium for advancing the values of safety and security.
In this context it is argued that risk, driven by the politics
of fear, has re-oriented (social work) practice towards
managing and securing against risk as opposed to
genuine attempts to respond meaningfully to need.

According to this discourse (social) workers are fearful -
we fear for our physical and mental well-being; we fear
that we will be blamed when things go wrong; and we
fear the loss of the integrity of our profession.



                               Stanford, S -British Journal of Social Work (2010) 40, 1065–1080
Risky Business

• A Control and Management
• B Deficits and Strengths
• -From Paternalism to PARTNERSHIP
• -Department for Health's 1995 "Child
  Protection; Messages for Research“
• -Honest Use of Power
Signs of SAFETY
(Yes) – Identify the harms but also consider

•Positions towards abuse (these are
multiple)
•Exceptions (when it does not happen)
•Family strengths and resources
•Willingness, Capacity and Confidence (in
change)



                                Evidence - Turnell
          l
Why has Mickey not been to school this Friday?


How have you succeeded in getting Mickey to
school four days this week?
both HARM and SAFETY in our considerations
•   Factors which make the child or young person more vulnerable to harm or
    safer from harm
•   Pattern and history of harm and safety - for the child or young person; in the
    parents’ care of children
•   Factors in the beliefs and relationship between the child/young person and
    parents/ carers which may increase the likelihood of harm or of safety
•   Characteristics of the parents/carers and their lifestyle which effect their
    capacity to protect and care for their children
•   Family and community supports and services which assist in protection and
    care - isolation to engagement
•   Factors which increase the opportunity for harm or of safety for the child or
    young person
Local Family
                 Knowledge




                 Comprehensive
Danger            Assessment             Safety
                    of Risk




           Professional Knowledge
                 Network and Authority




         Partnership and Strengths based approaches at heart of
         evidence-based interventions
Whole Population




 Individual
Jenny and (John)
Interventions –
   Key evidence for 3 levels/areas

•Service user/s and worker relationship
•Families and not individuals
•Peer and community support


•Apply – Alcohol, Drugs, Mental Health and in some contexts
Domestic Abuse
Common Qualities


• An emphasis on relationship building
• Empathy
• Excellent communication skills, including active
  listening and reflection
• An empowering attitude and approach
• Non-judgemental attitudes

                           EVIDENCE – Livingston and Galvani
Relationships supported by
• Advice and Brief Interventions
• Motivational Interviewing


-Providing information
-Helping folk to consider change
-Identifying choices and supporting decision
   making


    Evidence –Alcohol Learning Centre, Lundhal et al, Miller and Rollnick
Family Interventions



How much more evidence do we need?

before




we truly implement The Children's Act
 1989?
Interventions that seek to work in
partnership with families, using the critical
moment of their children’s referral to social
care as an opportunity to support parents
 in accentuating the positive reasons for
   changing their behaviours (including
alcohol and other drugs) and, at the same
 time, highlighting the existing strengths
                they have.
Family Interventions
•Home Builders (strengths)
•Option 2 (critical and crisis)
•IFSS
•SBNT (extending support for users)
•‘5 Step Model’ (supporting other family
members)
•CRAFT
•DARRT
                      EVIDENCE - Copello, Orford, Templeton, Velleman
Family Interventions
• They help not only the user (problem) but the
  other family members who are the strength
  (safeguard)
• Impact is beyond just substance use or mental
  health – into family functioning
• Use in conjunction with ‘signs of safety’
  approaches
• The impossibility of assessment
For Families, Peers and Communities we need to
                 think beyond……
Peers and Community


• Self-Help
• AA and NA
• SMART, INTUITIVE
• Recovery
• COSA                Support and/or
                      Service Provision

                      EVIDENCE –Humphries, Moos, Wardle, White
Peers and Community
•   Self-Help
•   Recovery



                •Role Models
                •24/7
                •Peer Challenge
                •Filling the voids
                •Safer socialisation



                        EVIDENCE –Humphries, Moos, Wardle, White
Peers and Community
•   Self-Help
•   Recovery
                •Role Models
                •24/7
                •Peer Challenge
                •Filling the voids
                •Safer socialisation




                          Your role
                          •Knowledge of
                          •Support to participate
                          •Facilitate

                                       EVIDENCE –Humphries, Moos, Wardle, White
Concluding Thoughts
• Alcohol, Drugs, Mental Health and Violence – does
  harm children
• Safeguarding – needs to be protection plus prevention
  , if not prevention plus protection
• New frameworks of risk – trusting you
• There are effective interventions and change is very
  much possible (knowledge and belief)
• Relationships and Families (communities) are the
  solution
• Who is missing –here in the room if these
  conversations are to meet these aspirations?
Thank you for listening

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Wulf Livingston, March 2013. LSCB conference

  • 1. ‘Building relationships to strengthen networks – the evidence for moving away from a deficit-based and problem-focused approach to child protection work with alcohol and drugs’ Wulf Livingston, Senior Lecturer in Social Work, Glyndwr University Conwy & Denbighshire LSCB Annual Conference - March 2013 - 9.00am till 4.00pm Theme : The interface between safeguarding children, alcohol and substance misuse
  • 4. Why are we here?
  • 5. Harm is not up for debate (huge evidence trail) – (we know this and this is not the focus of this presentation) but….
  • 6. How many more – Inquiries? • Fisher (Colwell) 1974 • Butler-Sloss (Cleveland) 1998 • Laming (Climbie) 2003 (Baby P) 2009 • Francis (Mid-Staffs) 2012 • Hughes 2006 –Canada • Woods Commission 2008 -Australia
  • 7. More Communication More Information Sharing More Training More Procedure More Monitoring More Support
  • 8. More Communication More Information Sharing More Training More Procedure More Monitoring More Support Why does it keep happening? What can be done differently? Perspectives on Risk Perspectives of Interventions
  • 9.
  • 10. Risk Hierarchies Orientation affects perspectives/approaches • Organisation • Managers • Employees • Service Users • Carers • Public
  • 11. Risky Business • A Control Management (with) Professional Judgment -There are increasing (evidence-based) calls for front-line professionals to be supported in and empowered to take informed risks – risk taking is necessary in the promotion of growth (for service users and professionals) •EVIDENCE - Barry, Bonat, Bytheway, Littlechild, Monroe, Stanford,
  • 12. The rhetoric of risk is used within neo-liberal risk society to mobilise fear as an emotive, defensive and strategic medium for advancing the values of safety and security. In this context it is argued that risk, driven by the politics of fear, has re-oriented (social work) practice towards managing and securing against risk as opposed to genuine attempts to respond meaningfully to need. According to this discourse (social) workers are fearful - we fear for our physical and mental well-being; we fear that we will be blamed when things go wrong; and we fear the loss of the integrity of our profession. Stanford, S -British Journal of Social Work (2010) 40, 1065–1080
  • 13. Risky Business • A Control and Management • B Deficits and Strengths • -From Paternalism to PARTNERSHIP • -Department for Health's 1995 "Child Protection; Messages for Research“ • -Honest Use of Power
  • 14. Signs of SAFETY (Yes) – Identify the harms but also consider •Positions towards abuse (these are multiple) •Exceptions (when it does not happen) •Family strengths and resources •Willingness, Capacity and Confidence (in change) Evidence - Turnell l
  • 15. Why has Mickey not been to school this Friday? How have you succeeded in getting Mickey to school four days this week?
  • 16. both HARM and SAFETY in our considerations • Factors which make the child or young person more vulnerable to harm or safer from harm • Pattern and history of harm and safety - for the child or young person; in the parents’ care of children • Factors in the beliefs and relationship between the child/young person and parents/ carers which may increase the likelihood of harm or of safety • Characteristics of the parents/carers and their lifestyle which effect their capacity to protect and care for their children • Family and community supports and services which assist in protection and care - isolation to engagement • Factors which increase the opportunity for harm or of safety for the child or young person
  • 17. Local Family Knowledge Comprehensive Danger Assessment Safety of Risk Professional Knowledge Network and Authority Partnership and Strengths based approaches at heart of evidence-based interventions
  • 18.
  • 21.
  • 22. Interventions – Key evidence for 3 levels/areas •Service user/s and worker relationship •Families and not individuals •Peer and community support •Apply – Alcohol, Drugs, Mental Health and in some contexts Domestic Abuse
  • 23. Common Qualities • An emphasis on relationship building • Empathy • Excellent communication skills, including active listening and reflection • An empowering attitude and approach • Non-judgemental attitudes EVIDENCE – Livingston and Galvani
  • 24. Relationships supported by • Advice and Brief Interventions • Motivational Interviewing -Providing information -Helping folk to consider change -Identifying choices and supporting decision making Evidence –Alcohol Learning Centre, Lundhal et al, Miller and Rollnick
  • 25. Family Interventions How much more evidence do we need? before we truly implement The Children's Act 1989?
  • 26. Interventions that seek to work in partnership with families, using the critical moment of their children’s referral to social care as an opportunity to support parents in accentuating the positive reasons for changing their behaviours (including alcohol and other drugs) and, at the same time, highlighting the existing strengths they have.
  • 27. Family Interventions •Home Builders (strengths) •Option 2 (critical and crisis) •IFSS •SBNT (extending support for users) •‘5 Step Model’ (supporting other family members) •CRAFT •DARRT EVIDENCE - Copello, Orford, Templeton, Velleman
  • 28. Family Interventions • They help not only the user (problem) but the other family members who are the strength (safeguard) • Impact is beyond just substance use or mental health – into family functioning • Use in conjunction with ‘signs of safety’ approaches • The impossibility of assessment
  • 29. For Families, Peers and Communities we need to think beyond……
  • 30. Peers and Community • Self-Help • AA and NA • SMART, INTUITIVE • Recovery • COSA Support and/or Service Provision EVIDENCE –Humphries, Moos, Wardle, White
  • 31. Peers and Community • Self-Help • Recovery •Role Models •24/7 •Peer Challenge •Filling the voids •Safer socialisation EVIDENCE –Humphries, Moos, Wardle, White
  • 32. Peers and Community • Self-Help • Recovery •Role Models •24/7 •Peer Challenge •Filling the voids •Safer socialisation Your role •Knowledge of •Support to participate •Facilitate EVIDENCE –Humphries, Moos, Wardle, White
  • 33. Concluding Thoughts • Alcohol, Drugs, Mental Health and Violence – does harm children • Safeguarding – needs to be protection plus prevention , if not prevention plus protection • New frameworks of risk – trusting you • There are effective interventions and change is very much possible (knowledge and belief) • Relationships and Families (communities) are the solution • Who is missing –here in the room if these conversations are to meet these aspirations?
  • 34. Thank you for listening