Recommended
More Related Content
Similar to Risks of Child Protection Work
Similar to Risks of Child Protection Work (20)
Recently uploaded
Recently uploaded (20)
Risks of Child Protection Work
- 1. Professional Dangerousness “The process whereby professionals involved in Child Protection work can behave in a way which either colludes with or increases the dangerous dynamics of the abusing family ” Morrison, T., (1990), The Emotional Effects of Child Protection on the Worker, Practice 4 (4) , p262-4
- 2. Professional Dangerousness The risk of being caught in a system where the professional is psychologically and emotionally battered by clients, by colleagues, by the system and defensively may make inappropriate and sometimes destructive responses. (Fletcher 1978) Ninth Australian Conference on Child Abuse and Neglect
- 4. Child Protection Work Stressful Rewarding Enriching Educational Painful Necessary
- 5. James Whakaruru Died 1999 4 years of age
- 6. Devices 1: Rule of Optimism 2:Cultural Relativism 3: Natural Love 4: Reframing Care and Control 5:Anxiety Responses 6:Concept of “Helping”
- 7. Manifestations Ignoring clinical observations Conflict avoidance /minimisation Role ambivalence or confusion about roles in relation to Child Protection Absence of absolute standards for care, safety and development of children Lack of awareness of personal or professional behaviour and responsibility FAILURE TO MAINTAIN FOCUS ON CHILD
- 8. DEFENSE MECHANISMS All Professionals use Defense Mechanisms to protect themselves against strong feelings. The Individual is usually not aware that he/she is using them. In Professional Dangerousness there is an over use of the defense mechanisms of Denial, Minimising and Rationalisation
- 9. BURNOUT “Itis hard to build a caring society out of the remains of people in whom the capacity to care has been systematically exhausted” Morton,Ideas in Action, Oct 2002
- 10. Antidotes 1: Role Clarity 2: Supervision 3: Regular multi-disciplinary review of case management 4: Multi-disciplinary training 5: Working in small multi-disciplinary teams 6: Personal responsibility
- 11. WHAT CAN WE DO TO MAKE SYSTEMS SAFER FOR STAFF AND CHILDREN? Intra-agency (Internal cultural) Inter-agency Individual
- 12. James Whakaruru Died 1999 The Story of this little dead boy should stir each Worker and each agency to examine their practice 4 years of age And the purpose of their activities-Roger McLay
Editor's Notes
- The Issues and Dilemmas in CP are complex and challenging. Health professionals are conditioned to work in partnership with families which eclipses the child as client and us as their agent. PD is a Term to describe a process present in many high profile child abuse cases, coined by Tony Morrison a British SW who worked for The Nat Soc for Prevention of Cruelty to Children. He is currently a SW consultant. The fact that there is minimal work by other authors on this topic does not mean that this paradigm/model lacks substance rather it is indicative of its developing status as a theory, PD is grounded in systems Theory when a Health Professional/SW intervenes 2 systems engage-the Family systen and the professional system. The professional system may accommodate the abusing family family system and interventions may focus more on the needs of the Adults. We are all vulnerable. A recent child death enquiry observed of the principal professionals who gave evidence before it,“Given the high standards of oral and written statements we are puzzled as to the reason for then falling below their own standards. Tony Morrisons work has enriched our understanding of dangerous dynamics resulting in the mismanagement of high risk families An awareness Of PD reformulates the relationships we have with families to being a relationship with the child within the construction of a family. It will also alert us to how our personal factors ie cultural anxieties, attitudes and values as well as societal attitudes and the organization we work in ,contribute to our practice. The significance Of PD is that it hasn’t disappeared despite the conclusions and recommendations of many enquiries and reports that follow the death of a child. We can’t keep blaming a lack of resources and faulty structures and procedures We must explain why highly trained professionals with knowledge of Child Protection still fail to observe the basic standards of their own professions.
- Practitioners may mirror the dynamics of abuse Individuals,teams,professional networks and entire communities can become trapped in conflict and defensive re-enactments of abuse.
- Society expects scrupulous adherence to accepted standards by those in trusted positions. The case I have selected to talk about shows the result of cumulative errors and omissions by the individuals and agencies involved. Not all children who have been maltreated and killed in this country have been known to CYFS and the Police but all were known to Health.
- The field of Maltreatment is difficult and demanding. This is because life and death decisions often have to be made about dependant children. It infringes on the cherished territory of parents rights to raise their children as they see fit vs the chldren’s rights to a safe and loving enviornment.
- A Hawkes Bay preschooler died on April 4 th 1999 of multiple injuries sustained after many beatings by his mothers boyfriend Ben Haerewa.No less than 6 Govt agencies had worked with James and his family: District Health Board CYFS, Plunket,Two GP Practices, Community Probation Service and the Police. J was seen 40 times by Health Practitioners. Roger McClay The Chidrens Commissioner at the time ordered an indepth Investigation into James’ Death following the extensive media coverage and public outcry of outrage. Dangerous practice is rarely the result of ignorance it is the unwitting failure under stress to apply the knowledge we have. The findings in the Commissioners report describe how the Multidisciplinary Network failed to focus on the child, in fact it was appallingly unco-ordinated. “ One moment weights like another, only in retrospection,selection, do we say, that was the day, the critical moment.”- T.S ELLIOT The report is littered with critical moments when the right action might have saved his life.
- Tony Morrison calls these concepts Devices There are three Key Devices that Contribute to Dangerous Practice. Rule Of Optimism-Professionals find the most positive explaination of a situation,one which creates the least conflict with parents and within themselves. James W Probation Officer asked no questions of Ben Hawera. Evidence in Kahui Trial”House was warm, Babies appear well.” Give example of reframing confrontational S/F meeting . Refer to Patrick Kelly”Strengths based home assessments don’t work” Cultural Relativism-Immobilises professionals when dealing with families of a different culture.”White Freeze”This creates an elastic set of norms re core risk assessment and advice. Rationisation eg “That’s normal for families in this town” eg of Mental Health Worker in training session. James W-No involvement of wider whanau hapu or iwi. No culturally appropriate consultation. Natural Love-Assumes all parents love their children,or because they love their children they wouldn’t hurt them. Transference-Projection “Hes gorgeous she must adore him” You think she sees him as you do. James W-CYPS Workers accepted James Mothers assurance that she would protect her son by not living with Ben Hawera again. Reframing Care and Control- Ambivalence about using control esp statutory control. James W-The CYFS SW used the relatively informal intervention of encouraging one family member to seek custody of James through a civil process instead of calling for an FGC. Societal Ambivilence about Child Abuse and attitude towards Child Protection “ Hitler Boots-----Useless Anxiety Responses Flight-Failure to act by denying there is a problem or reframing it as something else. Avoiding the family,closing a case without a proper assessment. James W-SWs falsified documentation “Not at Home. Plunket ceased involvement after several unsucessful attempts to make contact ‘they did not advise the listed Gp or any other agency . Freeze-Immobilization due to fear and a sense of being overwhelmed. Monitoring instead of intervening FighT- The need to make things better. Health Professionals can become” driven by the need to do” Procedures are carried out in a meaningless way. Concept of Helping- Every ‘helper can have strong feelings of helplessness which deminish when we help some one else Health Professionals engaged in the “helping role may become enmeshed or collusive. The catch cry for enmeshment is “You don’t know this family like I do” or the belief that addressing the issues for the child would “damage my relationship with the family ”A professional relationship which cannot include discussion of real concerns reveals itself as not a relationship at all but an avoidance of conflict and difference. Enmeshment is also characterized by the professionals doing the main share of the work because of a lack of real commitment to making positive changes by the family
- Ignoring-Give Example Conflict Avoidance- Contact with the family at any price! Role Ambivilance-Smacking Debate as an example. More power to Govt Agencies vs Nanny State too intrusive. Absense of standards of care-”Ive seen much worse” Suspicion of Child Abuse puts everyone in crisis and the Health Professionals Judgement is under scrutiny. The notion of Professionalism needs to be addressed more fully. For many of us our training and profession is associated with our confidence, ability and right to act as autonomous practitioners. In particular the importance of confidentiality. This can fly in the face of child protection work. All the processes I have described have certain things in common which contribute to denial ,minimization and inaction .On the whole such behavior operates at an unconscious level.There is an absence or lack of awareness around the emotional impact on self.
- Eg of Rationalisation A worker does not follow through with a notification rationalising”it is too late” It won’t be given priority anyway” “A notification will damage my relationship with the family” Strong feelings exercise In pairs-When I see a child being treated badly I feel…….. When I have to make a notification I feel………. If we were to become totally absorbed our ability to assist would be impaired. The danger is if we never allow these feelings to surface, or become totally emersed in ours or others. BURNOUT is high in our Profession
- BURNOUT- A syndrome of emotional exhaustion. Personal and organisational consequences of burnout. Workers compensation and stress claims Absenteeism Sick leave Deterioration in quality of work Low Morale High job turnover
- There are Antidotes to the Processes I have described. Cases that have gone fatally wrong highlight the poor quality or complete absence of these Antidotes. Role Clarity- professional - agency and legislative reponsibilities Supervision – At the core of good practice -Crucial to enable us to examine our focus,directionand relationships with families It must challenge us cognitively and help us process the realities of working with difficult families. The last three rely on clear, focused, honest communication between workers teams and agencies. Every professional requires a secure and supportive work environment in order to perform well . Maintenance of a Healthy workplace is essential when working in child protection. Personal Responsibility-To be alert to own feelings as often this is the cue that content and process are not in tune. -acknowledge and seek help and support when we are tired,angry afraid or just stuck. -Develop an awareness of the Defense Mechanisms eg Denial, Minimisation that can operate to prevent us identifying or taking action when children are at risk of abuse.
- Intra- agency – Have comprehensive child protection policies, provide staff with initial and ongoing education about child abuse, provide staff with blame free supervision and support, accept feedback from other services. Inter-agency – Know and trust our colleagues in CYFs, police, and other support services, have formal ways of sharing information with other services. Individual – have a thorough understanding of child protection, community resources, and referral mechanisms, communicate well ie verbally and documentation, accept child protection as our responsibility
- And in the end there was a child. One small broken boy whose mischievous little face may well have remained unknown to us if the many professionals and agencies involved in his short life were aware of Professional Dangerousness. The story of this little dead boy and the many more children who have followed should stir each worker and each agency to examine their practice and the purpose of their activities. IT is incumbent upon all to honour the relationship between professional and client/patient in abiding by regulations,best practice and the moral imperatives of their professions.