1. Jane Mitchell February 2015
When Families Break Down - Taking the Last Stand
As harsh as it seems, not all children are able to live within a family unit.
Although it is well known from research that the majority of children will
achieve best outcomes from a family environment, for a very small
minority, that emotional intensity is unendurable, and leads to extremes of
behaviour as the child acts out their overwhelm and fear. However, there
is a way forward in these cases whereby the child can maintain the
advantages of inclusion in a family, as long as Local Authorities and other
professionals are prepared to work alongside adoptive parents to find a
solution. Let me tell you about an example of such a case.
This case study involves a 14 year old girl whom we shall call Annabel.
Annabel was born in 2000. Her birth Mum suffered chronic depression,
anxiety and OCD. Her birth Father separated from the birth Mum before
Annabel was born. Birth Mum had previously had 4 children by separate
fathers and had been unable to care for any of them. She was, however,
determined to try and be a mother to her new baby. Unfortunately, she
found the intensity of caring for a new-born too much to manage, and
Annabel went into foster case at three weeks. She then returned to her
birth Mum, only to be returned again to foster care from a few months
old, until 18 months old. At this time she returned to her Birth Mum with a
package of care to support her including 4 days with a specialist
childminder per week. When Annabel was just over two years old, she
was placed in foster care, and then adopted into a family at age 3.
Annabel presented early on as a challenging child with complex needs.
Her foster mum – who was very attached to her - nonetheless found her
exhausting and difficult to care for. She showed extremes of temper and
would often resort to physical attacks such as hitting, pinching or kicking
as a vent for her frustrations, not helped by the fact that even at age
three she had an extremely limited vocabulary.
Annabel was placed with a family where there were already three birth
children, and parents who had both been childminders and were well
versed in childcare from personal experience and in the case of the
adoptive mum with additional knowledge due to study. The new Mum
took on the task of learning more about the challenges her new daughter
was facing and over time absorbed new knowledge as it emerged about
attachment disorders, neurological development, and nurturing a
traumatised child. (As this was 2003 onwards, this was a rapidly
expanding field with new understanding continually developing over the
subsequent period). The new Mum studied, attended courses, reflected,

2. Jane Mitchell February 2015
and worked on behalf of her daughter to get support in place, including
two sessions of play therapy, resources, and inclusion on useful seminars.
Over the next few years the family as a whole experienced extreme
challenges in meeting Annabel’s complex needs, maintaining
boundaries, developing strategies, and thinking and rethinking ways to
help her to manage her overwhelm. The family began to feel the strain,
and other family members and friends became less tolerant and
withdrew, reducing the available support system around the family
considerably. Annabel was referred to CAMHS, who diagnosed her with
autism which gave an additional perspective to consider as a likely cause
of some behaviours and anxieties.
Fast forward to age 9, and Annabel enters puberty, and a whole new
challenge emerges as she struggled to deal with her body, which was
defiantly maturing at a rate of knots. Not an eventuality that Annabel
was emotionally prepared for, she found the process scary and
uncomfortable – as her developmental age was around 7, she could not
comprehend what is happening to her and her mood swings started to
escalate in line with her menstrual cycle. She started to menstruate at
age 10.
The combination of transition to secondary school and onset of puberty
proved a very difficult and heady mixture. Although there were no really
challenging behaviours at school in the first year, her home behaviour
became worse, plus of course she grew much bigger and stronger. Her
adoptive parents were concerned about their ability to manage her
strength. After September at the start of her second year at secondary
school, there was a massive escalation. Annabel had been getting more
and more violent towards her adoptive mum, frequently attacking her
verbally and physically, with regular bouts of destruction in and around
the house and garden. She was threatening to kill her adoptive mum,
and threatening suicide. She started scratching her wrists. The adoptive
Mum got a referral to CAMHS and an assessment procedure started in
October. Annabel and her Mum went every week to explore her feelings
a bit, with the intention of helping her to talk through and gain insight into
her overwhelm. Many strategies were suggested and adopted, and
many more were thought up and put into place by the family. In the
meantime her ability to manage school also deteriorated, with a huge
escalation of unpredictable outbursts and incidents until the school felt
unable to manage her needs, and am assessment of special educational
needs was instigated.

3. Jane Mitchell February 2015
Finally following two episodes where Annabel needed to be restrained by
professionals to keep her from attacking her Mum at the CAMHS offices
Annabel was admitted to an Adolescent Mental Health Unit. Here they
instituted a routine for Annabel which really concentrated on her autism,
as well as an additional diagnosis of being emotionally dysfunctional and
of course attachment disorder and she settled into the environment and
regular visits from her family, and was sent home, with a support package
provided by a local charity. She was unable to return to her school, and
temporary arrangements were made pending the Local Authority’s
decision regarding a suitable placement for her.
Annabel responded well to the new strategies which were put in place on
her return home, but was still attacking her Mum, and also attacked
several other carers from the charity, after which multiple carers were
provided to lessen this eventuality. A specialist school was identified for
her, but unfortunately she suffered another severe escalation, again
needing to be restrained by a member of the CAMHS team after severely
attacking her Mum, and was again admitted to a psychiatric unit. By this
time, most people who knew the family were scared of her
unpredictability and outbursts, and felt completely unable to visit. Friends
and family were very scared on behalf of the adoptive mum, who was
the usual target.
It was suggested now that Annabel should not return to the family home
because of the danger to her Mum, however it proved difficult to find a
suitable placement, and in the meantime, Annabel really settled down
and the family felt that they could try again, because a lovely school had
been identified that she really engaged with, and it was hoped that an
appropriate school environment would make the difference for her in
reducing her overwhelm. Unfortunately this proved not to be the case at
home. Annabel’s violence escalated and her adoptive Mum had to take
a decision that she could no longer keep herself or Annabel safe – at this
point, her older children had left home, her husband had left, and she
was on her own. There had been attacks with cutlery knives and other
weapons, and escalating physical and verbal abuse. Police were called
to the house on several occasions – 5 times over the course of one single
weekend. In the opinion of the consultant psychiatrist, this was because
Annabel found the emotional intensity of the relationship (especially with
her Mum) too difficult to manage. At a multi professional meeting, the
adoptive mum asked for her daughter to be accommodated under a
voluntary placement order, making it clear that this was for safety reasons
and in no way impacted on her love for her daughter or her wish to
continue to have parental responsibility.

4. Jane Mitchell February 2015
Annabel was moved to a specialist residential home, where there were
very few other resident children (one other girl at first), a nice homely
atmosphere, multiple carers and 1:1 care. She gradually settled and
calmed. Her family were able to assert their right to remain her parents,
and to maintain this as a voluntary arrangement. The placement was
some distance away, and visits were shared – each parent taking an
alternate week. There was also phone contact.
Over time, this reassurance that her family were still her family, and still
loving and caring for her helped Annabel to manage and settle in her
new environment. She calmed down and found new confidence and
self esteem, and lost her fear of rejection and abandonment as her family
remained a constant presence, and her sisters and other family members
were enabled to visit and have phone contact as well.
Annabel relied heavily on this contact with her family for support and
reassurance, which they were able to provide and she was able to
accept because the intensity of the relationship when living in the same
house all the time was no longer present. In this way she was able to
develop resilience and confidence in the family unit. Previously this had
not been possible as her inability to manage her overwhelming emotional
state and subsequent attacks on her Mum eroded her ability to believe in
the unconditional love which was offered.
There were some factors which enabled this outcome, which are useful
for other adoptive parents in similarly difficult situations to bear in mind:
1. The adoptive parents were able to continue to support Annabel
despite their own relationship issues.
2. The adoptive parents were very clear about the reasons why
Annabel could no longer be accommodated in the home.
3. Correct procedure was followed regarding safeguarding and
restraint according to Local Authority guidelines.
4. The adoptive parents were consistent and clear in asserting their
right to be indentified as Annabel’s parents, and her right to retain
her family.
5. There was an effective team of professionals that were able to work
together to find solutions. Parents had access to professional’s
meetings with few exceptions.
6. Disagreements and concerns were openly canvassed and
discussed, with a degree of compromise being achieved by all
parties at different times.

5. Jane Mitchell February 2015
7. There was clear paper evidence in terms of reports, emails, letters
and minutes to meetings. All important discussions and decisions
were requested as a written record.
8. Where there were concerns about Local Authority decisions, written
requests were submitted to have those concerns responded to, and
to ensure that there is absolute clarity where decisions have gone
ahead that the adoptive parents have not agreed with.
In dealing with Social Services, keep clear records, always ask for written
confirmation of verbal discussions, minute meetings yourself or take
someone who will do so for you, if you can afford to, then take legal
advice. Identify the managers and ask to deal with them directly. Above
all, be aware of your rights and those of your child.
The case outlined above is not of course unique. Adoptions placed under
this level of stress can break down. What some adopters are not aware of
is that they can assert their own rights as parents and their child’s rights to
continue to be a part of the adoptive family so that further rejection,
separation and loss is minimised, and after a period of time the
relationship may be strengthened and be an extremely positive influence
for the child, even if it is not possible to live together as a family. These
situations are also not unique to adoptive families – birth families whose
children have suffered developmental trauma or have a severe leaning
difficulty may also be sufficiently violent to be accommodated away from
home, without any suggestion that this may be due to poor parenting. In
the model above, the effects of further traumatisation due to loss,
rejection and abandonment were minimised for the child and also
significantly minimised for the family.
If you are struggling with violence within your own home, do ask for help.
Be clear about the extent of the problem. Involve professionals such as
your GP or CAMHS or the Police that may be able to help you. By raising
awareness of the issues that are sometimes faced, we can help to bring
about a necessary change of attitude.
Our children need us to be the best parents we can be – and all families
are different. Maybe we need to think of ways to enable families to be
intact through separation. Families need to be listened to, but in order to
be heard you have to speak out. It is part of parental rights that their
views are heard and taken into account, and as longs as views are

6. Jane Mitchell February 2015
expressed appropriately and coherently, there should not be issues as a
result of parents asserting those rights.
Adoptive families are committed, motivated, loving and change lives – I
wish all of you success in your individual journeys.
About the Author:
Jane has been a trainer for AUK for 8 years. She has worked in Early Years
Education and as an FE tutor teaching Childcare and Health and Social
Care, and has managed a local Children’s Service. Jane has recently
decided to concentrate on delivering training and supporting adoptive
families, and is awaiting OFSTED registration.

7. Jane Mitchell February 2015
expressed appropriately and coherently, there should not be issues as a
result of parents asserting those rights.
Adoptive families are committed, motivated, loving and change lives – I
wish all of you success in your individual journeys.
About the Author:
Jane has been a trainer for AUK for 8 years. She has worked in Early Years
Education and as an FE tutor teaching Childcare and Health and Social
Care, and has managed a local Children’s Service. Jane has recently
decided to concentrate on delivering training and supporting adoptive
families, and is awaiting OFSTED registration.