This relatively new service started January 2004 in response to the ‘Every Child Matters’ Green Paper, which advocates a universal children and family service. It is a Lancashire County Council initiative. This service was established as it was felt that there was an over-reliance on residential care, and the family centre and nursery services previously in place were obsolete due to the influence of agencies such as Sure Start and Home Start.
It was planned as a targeted service whose key aims were to reduce the number of children entering the care system and to empower parents. This service is therefore consistent with the five Key Outcomes outlined in the Children’s Bill, i.e. Being Healthy, Enjoying and Achieving, Staying Safe, Making a Positive Contribution and economic well-being. It offers 7 days per week service, if required, 8am – 8pm. The service provides support to children, young people (0 -18) and their families.
The Service Manager told me that nine wards in the Morecambe Bay area are in the 20% most deprived in England, and that approximately 10% of Lancashire’s 260,000 children 0-17s live in Morecambe Bay. In and around this area, Social Services work with nearly 900 children with a disability, approximately 41 children are on the Child Protection register, and there are approximately 162 ‘Looked After’ children. England’s north-west also has some of the highest teenage pregnancy rates in Europe.
The needs the Family Support Resource service provides for include parenting skills with a view to; addressing routines, stimulation, health and safety, behaviour management, self protection, parenting assessments, the imminent danger of young people being Looked After, help with life skills, assisting teenage parents, individual work with children/young people and providing supervised contact sessions.
These needs are addressed by individual work in the Centre, family homes and other settings, Co-Working on a multi-agency basis, and specific groups and courses to address particular needs, e.g. Parenting Courses and Young Parents Groups. A tailored package of support is available to the Service User.
The Initial Assessment Team Social Worker made a request for Family Support work to help Tommy (names have been changed) and his family, under Section 17 CA1989, which states that a child shall be considered to be a Child in Need if:
a) He is unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining a reasonable standard of health and development without the provision for him of such services by the local authority
b) His health or development is likely to be significantly impaired, or further impaired without the provision for him of such services
c) He is disabled
The Local Authority has the duty to provide a range of services for Children in Need to safeguard and promote the welfare of such children and so far as it is consistent with that aim, to promote their up-bringing by their families.
Assessment and Planning
I was to assist the family with parenting skills and to work directly with the young person to address any challenging behaviour he was demonstrating. Section 1.23 in the Framework for Assessment (1999) states:
The provision of service has a broad meaning; the aim may be to prevent deterioration, i.e. to stop situations from getting worse, as well as to improve the child’s health and development. It should be stressed that services, such as direct work with children and families may be offered at the same time as family proceedings are in progress. The one does not preclude the other. Furthermore, services may be provided to any members of the family … to assist a child in need.
Before my Initial Visit to the family, I read the original multi-agency referral the school sent the SSD, the Initial Assessment form, and the Social Worker’s referral to FSRS (Family Support Resource Services. Each referral apparently indicated problems within the family; including younger child Tommy’s challenging behaviour and the parents’ ill health, which was affecting the family’s life. The information indicated there could be attachment, behavioural or possibly medical issues. Chastisement by the father also caused Child Protection concerns. The aims of working with the family were to prevent Tommy’s situation worsening and to promote his standard of health and development.
Thompson (2000) outlines that
social work practice premised on the principles of existentialism should be: ontological – sensitive to the personal and social dimensions and interactions between the two; problem-focused – sensitive and responsive to … existential challenges … particularly those … related to social location and social divisions; systematic – with a clear focus on what we are doing and why (our goals and our plans for achieving them); reflective – open-minded, carefully thought-through and a source of constant learning rather than a rigid, routinized approach to practice; emancipatory – attuned to issues of inequality, discrimination and oppression, and geared towards countering them where possible. (Pg 23).
Working this case, I attempted to demonstrate the principles of anti-oppressive practice and anti-discrimination throughout the process of assessment, planning, intervention, review and evaluation. Dominelli (2002) interestingly comments on anti-oppressive practice that negotiation techniques between worker and client can reverse perceived power imbalances, stating:
The power relationships between them have no predetermined outcome. The practitioner can become disempowered and the client can be empowered through their interactions together. (p.183)
This was the ideology behind the systematic approach I decided to undertake with Tommy and his family. My goals, and plans for achieving them, ultimately so empowered the parents that service intervention became obsolete.
I discussed the case with the Social Worker, who outlined that there was a previous family history and they had been previously known to SSD. The mother had had children, now placed with their father, on a Care Order in a previous relationship. This information helped me realise the need for family support services more clearly, as the mother’s background indicated that she found caring for her children increasingly difficult after the ‘baby stages’.
A manager and I made the introductory visit, to undertake a risk assessment and seek permission for me to work alone with the young boy. My initial reflection about the situation made me aware I was prejudging it without any evidence. Other professionals were suggesting the boy might have Attention Deficit Hyperactivity Disorder (ADHD). He appeared quiet and friendly, and seemed to be oppressed by his father, not suffering from ADHD as stated by the referral and his parents. Thompson (2000) states:
It is important to note that a non-judgemental attitude is important as a basis for a sound working relationship … such a relationship must be based on a degree of trust and respect – two things that are unlikely to be present if the worker indulges in being judgemental (pg110)
Social work values emphasise that we should have an awareness of our own prejudices that could impact on practice: It was not for me to judge whether Tommy was suffering from ADHD – I was not from a medical background. I was working in a multi-agency forum promoting negotiated co-working between different perceptions, values and interests (Beresford & Trevillion, p.14). The medical diagnosis had to be discussed at the Multi-Agency Meeting, and I had to take the advice of attending medical professionals regarding how to work with this diagnosis.
The National Occupational Standards for Social Work, Key Role Unit 13 states: Assess, minimise and manage risk to self and colleagues. I ensured I read the Lone Worker Policy and understood the instructions, checking with a work base supervisor that I had understood the policy. I was to record my time of leaving the building, how long I would be, which family I was visiting, car registration and contact number. If not returning to base, I had to ring there before returning home. A mobile phone was available for this.
Crisis Intervention – I approached my Initial Visit with a non-judgemental attitude. The family’s breakdown appeared to be imminent due to the parents’ serious ill health. The father looked exhausted, and the mother had remained in bed, although knowing we would be attending that afternoon. The father was requesting that the child be removed into care for the summer holidays. With my background knowledge about other children taken into care, I assessed that there was an urgent need for respite provision. Caplan (1964), quoted in Trevithick (2000), defines crisis as ‘a situation where an individual is thrown for a time into an upset in a steady state and as a result, finds himself unable to benefit from their normal methods of coping with such problems’ (p.184). Crisis intervention to help the parents adjust to a higher level of functioning seemed necessary. We could then review the larger issues facing the family.
The Local Authority has the duty to provide a range of services for Children in Need to safeguard and promote their welfare and. so far as it is consistent with that aim, to promote their upbringing by their families (S17 C.A.1989).
To enable Tommy to remain with his parents, I assessed their need for urgent respite and identified services in the area that would provide daytime activities. To obtain funds for these activities from the Local Authority, I had to complete a form, attaching a report recording reasons why I considered funding appropriate. This went to the Local Authority’s panel for consideration.
This I found frustrating. I assessed the situation as being a crisis. I was aware that, according to psychoanalytic theories (particularly ego psychology), crisis situations occur when the introduction of a new schema challenges when a person’s equilibrium. Tommy’s challenging behaviour was the new schema being introduced. Piaget’s theory discusses ‘Accommodation’, which occurs when existing schemas must be modified to fit new situations. Existing schemas are then expanded, or new ones are created (Crawford & Walker, 2003, p.39). During this period, however, a person is thrown into a state of disequilibrium, or crisis. The situation needed urgent intervention to prevent deterioration, i.e. to prevent it deteriorating (Section 1.23 in the Framework for Assessment, 1999).
The Local Authority eventually decided that funding was appropriate, and Tommy was provided activities, including outreach activities. However, during this two week period, I had to monitor the situation very closely with respect to Child Protection. The Code of Practice for Social Workers indicates that ‘I should respect the rights of Service User whilst seeking to ensure that their behaviour does not harm themselves or other people’ – here, Tommy.
During the next three sessions, Tommy’s parents were invited to vent their feelings. Assistance was given to help them restore their equilibrium. Alternative solutions were offered, including specific achievable goals such as reorganising the kitchen drawers to prevent Tommy reaching any hazardous equipment, such as gas lighters and knives. (Coulshed and Orme, 1998, p.103).
Trevithick (2000) would state that this enabled Tommy’s parents to develop new adaptive ways of coping, so they could function at a higher level; achieving ‘assimilation’ (p.185). This facilitated a move to a ‘Task centred’ social work intervention approach.
Task Centred Approach – Barker (1995) as discussed in Trevithick (2000) refers to this model of social work intervention as short-term. The Social Worker and client identify areas or specific problems and the tasks needed to change these problems. A contract is then developed in which various activities are to occur at specific times. The tasks and goals are chosen because they are achievable, and highlight people’s strengths and builds on the person’s self-esteem, promoting respect for individuals as expected in Social Work values. This theory allows a person-centred approach; which I consider encourages empowerment of the person, which was my main purpose in using this approach (p.184).