Joy Barlow presentation, Safeguarding conference 2015

1. Safeguarding in Treatment Services:
Everybody’s Business
Adfam, DDN, CRI, Indivior-Birmingham November 2015
‘Healthy Scepticism’ – What lies Beneath assessment
Joy Barlow MBE
Independent Consultant
Formerly Head of STRADA

3. “ About suffering they were never wrong, the
Old Masters; how well they understood its
human position; how it takes place while
someone else is eating or opening a window or
just walking dully along;
“How everything turns away quite leisurely
from the disaster”
(W.H.Auden – “Musee des Beaux Arts”)

4. Summary of Presentation
• Assessment
• The Challenge of engagement
• Risk
• Partnership
• Implications for Recovery
• Parenting capacity and problem substance use
• Conclusions

5. Definitions
Assessment:
‘The act of judging or deciding the amount, value, quality, or importance of something,
or the judgement or decision that is made.’
Scepticism
‘doubt as to the truth of something’
Cartesian Scepticism:
‘Certain knowledge is impossible’

6. Assessment
• What – wider than drug/alcohol misuse – strengths based – used as an
intervention
• Why – determine risk; nature of intervention
• When – single agency; multi-agency
• By whom – universal and specialist services
• How? - interagency

7. • Incorporate “respectful uncertainty” and “compassion” with
“sustained and dogged professional challenge… rigorous, systematic
thinking and analysis.” (Brandon, 2007-9)
• Demonstrating empathy and acceptance are important but this needs
to be balanced with healthy dose of scepticism. (C4EO)

8. • Information of various kinds is:
• Collected
• Sifted
• Synthesised
• Analysed
• Informed by “respectful uncertainty and a
• research mentality” – (Milner & O’Byrne 1998)
• In turn harnessed to a clear value base
(Milner and O’Byrne 1998)

9. “Practitioners need to find the middle ground and not be either
collusive or confrontational.” (C4EO)
Research has identified an ‘adversarial dynamic’ in which both
practitioner and family avoid acceptance of responsibility for lack of
change and blame each other for the failure. This results in denial,
resistance and blame and a professional view of families who either
‘co-operate’ or ‘resist’.
(Morrison, in Horwath, 2010)

10. The Challenge of Engagement
Unresponsiveness to
treatment/Disguised
Compliance

11. The Challenge of engagement
• Consider the interaction between numerous factors, such as:
• Present context, including additional stress factors
• Past history – early experience of parenting and attachment, internal
working models (unconscious)
• Beliefs (conscious)
• Needs, especially emotional and psychological needs, feelings and desires.
• Stressors and supports, including the quality of the relationship with the
worker
• Expectations
• Abilities (physical and cognitive)

12. What do we mean by risk?
• Physical
• Emotional
• One off events
• Cumulative events
• Insipient concerns
• Significant?

13. Management of Risk
• Interventions – evidence based and methodologically sound
• Ownership by ‘systems’
• Understanding of common thresholds of vulnerability
• Action after assessment
• Partnership with parents – what does this mean?
• Assessment – thresholds, integrated, timeous and on-going

14. Definitions
Partnership to be one of a pair on the same side of a game. A person
who shares or takes part with another, especially in a business firm
with shared risks and profits.
Collaboration – cooperate traitorously with an enemy, work jointly.
Concise Oxford Dictionary 1992

15. Effective partnership working requires…
“respect, genuineness, empathy, humility, quiet
enthusiasm, personal integrity, attunement and
technical knowledge.”
RiP 2010

16. “Then you should say what you mean”, the March Hare
went on. “I do” Alice hastily replied, “at least…at least I
mean what I say – that’s the same thing you know”.
(Lewis Carroll(1885) ‘Alice in wonderland’ chp.7) Quoted by Reder & Duncan
(2003) ‘Understanding Communication in Child Protection Networks’ Child Abuse Review
Vol.12

17. Implications for/of the Recovery Agenda
• Individualised, personalised respectful approach/treatment delivery
• Hearing the voice of the person involved
• Identifying signs of change in an individual as opportunity for
intervention
• Assertive engagement with the ambivalent/long term support of
those ‘in recovery’
• Quality of therapeutic engagement
• Quality of assessment – change and advice
• Family and the ‘recovery’ community!

18. Gendered Recovery

21. ‘When sorrows come, they come not
single spies, but in battalions’
Claudius in ‘Hamlet’ Act IV. Sc.V William Shakespeare

22. Conclusions
• It’s about people:
• Practice dilemmas
• Reflection on and in practice
• Communication
• Over optimism
• ‘the long haul’

24. Thank you and Acknowledgements