Sunday, 15 June 2014

Building the Bonds of Attachment by Dan Hughes - DDP

I have been reading the above book, recommended by a clinical psychologist in my team and thought I would share a few of my musings.

This book has been particularly interesting as it follows the story of one young person called Katie who has specific problems forming attachments as a result of the neglect she experienced in her life and subsequently she has many foster placement breakdowns. Eventually she moves to live with a highly therapeutic foster carer and the book follows this foster carer's interventions, together with the work of the therapist she sees regularly. 

One thing that stood out to me was the fact that the book specifically explains that for children with these attachment difficulties, many of the standard behavioural interventions that you might use on children, even children who are 'troubled' are unlikely to work for children with this internal working model. The book also highlights the difference between shame and guilt, and that although guilt incorporates a degree of empathy and caring about other people, which these young people might not yet be capable of, they are often gripped by shame, based on their early years experiences  - shame which is a much more internal concept than guilt.

One of the elements of the book that is key is for the foster carer to adopt 'the attitude' which is summed up by the acronym PACE - playfulness, acceptance, curiosity and love. In some ways i found the book quite depressing, because I can't imagine finding many carers who are able to show the incredible degree of strength, compassion and resilience that this foster carer shows - continuing to try to adopt this attitude even in the most testing of times.  However, even if one can't adopt this attitude everyday, its helpful for me to understand the key traits, both for my own direct work with young people and when talking with foster carers who are being challenged by young people.

Another element I found particularly thought provoking was the idea of limiting the number of opportunities the child has to sabotage something - which reinforces their own notion that they are bad/evil. One example from the book, was when Katie moved to live with this foster carer and it was approaching her birthday. The carer asked the therapist how she should celebrate her birthday and whether she should plan a party. The therapist discussed the fact that Katie has sabotaged every party held for her in the last few years in foster placements and so to do so would only give her the opportunity to repeat this behaviour. The therapist recommended having a very 'low key' celebration - a cake at dinner time so that Katie could have a positive experience. When KAtie asked why she wasn't having a party, the carer was able to reflect to her that she wished that Katie was ready to have a birthday party and they'd really love to give her one but at the moment she's not ready for this - hopefully it's something for the future.  I was able to reflect on similar situations with the young people I work with, in particular one who is not coping at a mainstream school and how I feel that by continuing to send him there and for him to get excluded or told off for bad behaviours, we're potentially setting him up to fail by giving him these opportunities to sabotage on a daily basis.

The therapy sessions are also very interesting and seemingly quite radical in their approach. The therapist alternatives between playful and tactile behaviour with KAtie - tickling her, stroking her etc and then a more serious approach where she discusses her behaviour that week. She supports Katie to voice some of her inner feelings to her foster carer eg I hate it when you do this, I feel like i'm a bad child etc and when Katie can't say the words, the therapist says them on her behalf. 

Dan Hughes has developed all of this into his Dyadic Developmental Psychotherapy (DDP). DDP is based on and brings together attachment theory, what we understand about developmental trauma, the neurobiology of trauma, attachment and caregiving, intersubjectivity theory and child development. It specifically is used with children together with their caregiver to help them to learn to trust. One of the children I work with has been in DDP over the past year and I have seen the outcomes and the change in the level of trust this child has with his foster carer and the disclosures that he has been able to make, the emotions he has been able to display since being in this therapy. 

Has anyone else has any experiences/learnings about DDP/Dan Hughes/PACE attitude? Would love to hear.

Sunday, 27 April 2014

Impressions of a Newly Qualified:

So, it’s been a very long time since I’ve written a blog post about life in social work – which perhaps tells you all you need to know about how busy it is!

I’ve been qualified now just four months, but have been working in a Children in Care team just over 18 months, first as a student, then an unqualified keyworker, and now as a NQSW.

So what are my first impressions…where to even begin..

-          First is to say, I still love it. I love the variety of the work, I love working with children and young people and having the privilege to play such an important role in their lives and I love thinking of new ways to carry out direct work – exploring new resources, going on great training ( have used my AYSE budget to go on 2 days with the Child Centre for Mental Health – would really recommend, although they’re on Saturdays.)
-          I have definitely felt surprised and at times, a little overwhelmed, by how much responsibility you have so quickly. I have probably said this before, but whilst working in advertising, you were always part of a big account team, and everyone knew what was going on and was playing some kind of role in the account. As a social worker, sometimes it can feel a little more isolated, and the responsibility is very much on you as an individual worker, to share information, where you think relevant, with your supervisor, or your wider POD – if you work in that way. I think communication is vital – not just in the way we learn about in training – in terms of sharing with the wider multi-disciplinary team to avoid child protection crises, but for more informal things too. I like to chat regularly to the supervising social workers/link workers about anything that is going on for my children and is having an impact on their foster carers – it also helps me feel part of a wider team.
      But yes responsibility is a big part and something I take pretty seriously and like to seek guidance wherever possible. I have recently been preparing a child for their transition to adoption – the first one I have done. I have found it has made a huge difference asking a therapist to sit down with me and give me guidance on the best way to handle this transition, discussing the right timing for revealing information to the child and strategies as to how to do this. It has left me feeling so much more empowered and it’s been amazing watching how well the transition has been going (fingers crossed!)
I    ’ve learnt lots about attachment and its implication for neuroscience – through my training and in turn different techniques to use – including art therapy and play therapy techniques and a greater understanding for why many Looked After Children are constantly drawn to extremes and chaos – for them, a life in the middle is not familiar. It was, my hero – Camila Batmanghelidjh, who discussed this on one of my training days, that helped me to understand one of my teenagers a bit more clearly.
            I’ve felt blessed that we have such a great bunch of professionals at work – everyone is kind and friendly and this makes a huge difference to day to day life. We do a tough job and one that often be emotionally draining, so being able to laugh and joke in the office can make all the difference

To conclude, I think, in a not particularly philosophical way, that the job is what you make of it. I recently had a student shadow me for a couple of visits and she was asking for some advice (which given my limited experience, was probably not too profound!)  but I talked about the importance of the little things. I’ve just sent out all my cards to my teenagers wishing them luck for their GCSEs. Whereever I can, I try to send birthday cards. I’ve put all their GCSE exams in my diary so I remember to wish them luck – my mum would never forget to wish me luck, and we’re their corporate parent. I did the same as a student for one of my kid’s SATS exams. I think it’s important to text or email just to check in with the young people and see how they’re doing, show you’re holding them in mind. I pushed to get budget to take them for a meal on their 16th birthday.

My favourite part of the job is advocacy. Advocating to get these kids what they need and deserve and trying where possible to push the limits.

All of this is hard to do inbetween the mound of paperwork and constant deadlines. And without a doubt you can feel hit over the head with emails about targets and data. But we know why we do the job and as long as we can remember that, it’ll be okay (I tell myself!).

On another note, there’ been some amazingly interesting tv shows of late:
From 15,000 kids and counting on Channel 4, to Louis Theroux’s documentary on sex offenders in America, BBC3’s prison programmes – life and death row, life behind bars, death behind bars etc. Love this stuff!

Anyway, that’s all for now!

Wednesday, 4 December 2013

First thoughts on raising the leaving care age to 21

My amateur thoughts on the legal duty to raise the leaving care age: 

Firstly, what incredible news. It feels like an absolutely massive shift to be able to support young people in their foster family placement until 21, especially as the average age that a young person not in care leaves home is 24 - and probably rising in this economic climate. 

My dissertation explored the emotional support network for care leavers and the number one recommendation was to raise the leaving care age. So, job done?

I have a few initial thoughts about the implementation of this change:

a) the young people I interviewed said that at the time of leaving care, they wanted it. They were excited to live on their own and it was their choice. It was only after they moved that they realised how difficult it was, both practically in terms of financial difficulties and emotionally as this is often the first time they've been on their own with time to reflect on their experiences. (They've also now passed the cut off for access to child and adolescent mental health services but that's a whole separate issue!).

So it's possible that this news won't be as exciting to all young people as it will be to professionals. How can we professionals support young people to make the most informed decision about when to leave care? And will there ever be a time when it's possible for them to have an opportunity to go back after a trial period ( much like many of us 'boomerang population' who went home when we couldn't pay the bills)?

b) many of the teenagers I work with are in private agency placements. Local authorities have pressure to bring them back to live in in-house placements which are cheaper, but in my experience, if they go into the placement in their teens, it might be easier to leave them in their placement as they'll leave care by 18. Now it may be 21, will this change? Will private agency placements be even more disrupted, forcing more placement moves. Which, if I'm cynical, might mean the young person will say they'll just live independently rather than have to move again.

c) similarly, how will foster carers feel about the extension of age? Many I work with will love it and would have been planning to keep their young people anyway through Staying Put arrangements, despite the lesser financial support because they are so committed to the young person. However, some it will be a shift for some and an even greater commitment if you are offering long term foster care. Will foster carers receive extra support from their supervising social workers to think this through? 

d) we already have a 9000 shortage of foster carers in the UK. How is this going to impact that as foster placements are 'full' for longer periods?

e) finally, what about children in residential care who are often the most vulnerable and most likely to have been placed out of borough only to find themselves moving out at 16-18 and brought back to their home borough where their support network might be lacking. How can we support them for longer?

These are just a few initial thoughts and I'm sure they've all been raised and explored by people with far more experience than me and will continue to be!

For now though, this is incredibly welcome news and should send the message that children and young people in care are being taken seriously at all. 

Congratulations to everyone involved in campaigning!

Tuesday, 6 August 2013

Young people, cyber-bullying and suicide - just a thought

Dear Mr Timpson,

I'm a social worker, working in a local authority children in care team, prior to which I worked in advertising strategy for 5 years.

I have been reading with much sadness about the rising number of young people taking their own life after being bullied online on various social media sites. I realise that this is a complex issue which needs a multi-agency prevention strategy, however as a short-term and simple possibility, I was wondering whether a button could be added to many of these sites which just said something like 'I'm being bullied'. By clicking this button, the young person would immediately be taken through to an existing online support forum - for example NSPCC Childline  or another service that must exist and allow the young person to chat to a mentor/counsellor online or call them if they felt the need. I feel that many young people need help in that instant, which is what social media and indeed the digital age is all about - and expecting young people to reach out to a teacher the following day, or a parent later that evening, or even pick up the phone to call a helpline, is to misunderstand their mindset and the behaviours that have been ingrained, which mean that in that moment they are fully in the digital world.

It's just one thought but I would be interested in your response.

Kind regards,

Tuesday, 16 July 2013

Few tips from training on giving evidence in court

Check out this link on the revised PLO and how it affects Social Workers and their statements:

Separate out immediate risks and long terms risks in your statement and drill down to the why eg yea lack of supervision is a problem but why specifically, give examples. 

In court when giving evidence add your analysis when giving evidence in chief, ie to your own counsel to avoid it coming up in cross examination

Be ready to give top 5 risk concerns proving kids at immediate risk of harm. Have them prepared 

If you have time to find a research case to back up your evidence then do eg to prove why contact arrangements are the right amount 

Ask your counsel to start by asking whether you have given evidence before, if its your first time as will make judge sympathetic with you 

Meet counsel early before court to give them updates on case  

Be clear on separating fact and opinion and first hand vs second hand account. 

Recognise positives about parents to show you are being balanced. 

Show you have considered the harm of removing child vs harm of keeping them in home.  

Use legal terms like 'good enough parenting'. Don't say we want to improve child's outcomes, that's not the court/state's job, that's social engineering 

If applying for ICO, you really have to show kids at immediate risk of harm now and can't wait til final hearing. Especially difficult in neglect cases.

Friday, 14 June 2013

Raising the Leaving Care Age - Fostering Net's campaign

For those of you are unaware, The  Fostering Network is currently campaigning to increase the leaving care age from 18 to 21.

This is a cause I am particularly passionate about, having recently completed the first draft of my dissertation looking at the emotional support network for care leavers, through direct interviews with young people.

The average age for young people in the UK to leave home is 24 and you might be familiar with the term 'boomerang generation' describing the trend for young people to return home when the going gets tough but yet we seem happy to release our most vulnerable young people out into the world on their own at age 18.

I have been trying to help by writing to my local MP - and encouraging friends and family to do the same.

I was glad to see some responses from a few MPs - below is the letter Lynn Featherstone sent to Children's Minister Ed Timpson and a further response from the Redwood MP.

In addition, my email is nothing special - but if it makes it easier to copy and paste it to your MP or amend it as you want, i've included it below. Please join in the campaign!!

Date: 14 June 2013

Dear Edward,

RE:  Children and Families Bill – Amendment NC4

I am writing on behalf of constituents of mine who have expressed concerns regarding the continuing support structure in place for foster children.

My constituents point out that those in foster care remain vulnerable once they reach the age of 18, and are concerned that from that point their continuing support and care depends upon an individual local authority’s discretion. This is of particular concern given that average age of leaving home in the UK is 24.

My constituents point to evidence which suggests those who stay longer with a foster family are more likely to be successful later on. This has the important consequence of lowering their need for support later on in life.

As amendment NC4 to the Children and Families Bill did not reach a Commons vote, I would be most grateful if you could comment on the specific issues that have been raised. Thank you for your kind attention in this regard and I look forward to your response.

Kind regards,

Lynne Featherstone MP

Liberal Democrat Member of Parliament for Hornsey and Wood Green

Thank you for your email concerning NC4 to the Children and Families Bill. I will study the arguments carefully before deciding how to vote, should this new clause be put to the House for decision.

Best Wishes,

The Rt Hon John Redwood MP
Member of Parliament for Wokingham

I am writing to you to ask you to please support the amendment NC4, Continuing support for former foster children, in the Children and Families Bill, which would give young people the opportunity to stay in foster care until the age of 21, rather than 18.

I'm very passionate about this cause, as a social worker who works in a Looked After Children team and as someone who has just finished their Social Work MA, and completed a dissertation about the emotional support network for children leaving foster care.

The average age for the general population to leave home is going up and up, and yet young people in care, the most vulnerable young people, get pushed out at 18, even if they are not ready. I've interviewed many care leavers who talk about ending up in debt, not eating for days and struggling to cope with the loneliness and isolation they have had to deal with at such a young age.

Please take action to support this amendment, to ensure our most vulnerable young people have the same opportunities that other young people do. The outcomes for care leavers are well known to be terrible - including underacheiving educationally, teenage pregnancy rate, high rates of homelessness, mental health problems and crime. From an economic point of view, it would clearly save the UK a great deal of money, to give these young people more support to help them make the right choices, with the love and encouragement of a family behind them.

Friday, 31 May 2013

The transition from student to professional: emotional intelligence

I’ve come to another transition in my career as today marks the end of my student placement, my last ever day and in a week’s time, I’ll begin my career as a social worker, in a LAC team, exactly where I wanted to be.

I should be excited and I am – I’m intrigued to find out which cases I’ll be getting. I’m keeping one teenager who I have worked with for the past 6 months but the rest will all be new. But I’m also quite apprehensive. 

Over the last few months I have absolutely loved what I have been doing, but I have also come to see the emotional impact that the role can have and the importance of good supervision. I have been lucky to have had a very warm and caring supervisor, ready to listen to  me the following day if I messaged her after a tough evening session with a young person. However, it’s hard to know what my new team will hold, and although I can see many positives about the new pod model – particularly the benefits of gaining the perspective of many more professionals to help with decision making, I wonder whether it will allow for the same warmth, or potential for reflection or containment that one on one supervision has the power to do.

I have also already seen a colleague off sick a lot, ‘fatigued’ ,having been pretty new to the team, and I’m aware that there will be a big jump between the protected caseload that I have been holding and the cases that will greet me shortly. In addition, I feel the huge sense of responsibility that comes with this role – as well as the privilege that accompanies it, the privilege of working with some of these young people who inspire me on a regular basis.

I’ve been asking on twitter for tips and strategies that people have used to cope with the emotional element of the role. I’ve been told about the importance of supervision, reflection, work life balance. I’ve been told about the importance of creating a network of other professionals with whom you can be honest about feelings around your cases.  This is a big one for me. I’ve been lucky to have a fellow student and friend working alongside me on this placement, and certainly in my past career in advertising, my colleagues became my friends and we used to sit and discuss all our work, and that didn’t hold the emotional element. I think this is such an important support network for us as social workers.

One tip that my practice educator gave me which I think could be useful if you have the self-discipline to put into practice, is to identify a landmark on your way home from work, and when you hit that landmark, tell yourself to switch off from work from this point.

It will be interesting to see what the future brings but I feel ridiculously lucky, to have managed to change career to be a social worker and to have gained a job in the exact team that I wanted. I absolutely love working with children and young people and I want to make sure that I continue to keep the wishes and feelings of my young people at the heart of everything, and keep advocating for them, regardless of the bureaucratic challenges I may face.

Here’s hoping to a fulfilling and inspiring career, and the hope that I can make a difference, however small, to the lives of many people!