Ten pitfalls and how to avoid them - What research tells us (Dr Karen Broadhurst, Professor Sue White, Dr Sheila Fish, Professor Eileen Munro, Kay Fletcher and Helen Lincoln. September 2010).
AMENDMENTIn June 2019, amendments were made throughout this chapter, and it should be re-read in its entirety.
There is a wide array of behaviours exhibited by families towards workers which may be considered uncooperative. This may range from those who are apparently (but not genuinely) compliant, reluctant, or resistant, to those who are angry or aggressive in their response to practitioner involvement. In extreme cases there can be intimidation, abuse, threats of violence and actual violence.
Whilst most practitioners have experienced such responses at some time, the concept of uncooperative families is particularly relevant to the case such as Baby Peter and Victoria Climbie. The tragic consequences for such children, is extremely well known and, in relation to these two children has been comprehensively investigated and reported (Laming, 2003; Laming 2009).
Such cases should always be borne in mind when working with uncooperative families.
However, if a worker feels intimidated, they must consider what it must be like for a child or young person living in the household. The welfare of the child / young person is paramount at all times.
The aim of this document, therefore, is to provide staff in all services and whatever their role, with useful guidance when working with uncooperative families. A worker's purpose in making contact with a family varies depending on their role and their agency; workers need to use this procedure accordingly. They need to be clearly aware of the level of authority they represent and therefore how far they are required to engage with the family.
This guidance should be used in conjunction with the NSPCC research, Ten pitfalls and how to avoid them- What research tells us.
The procedure aims to:
This guidance aims to help you make an authoritative response to the resistant family, making it clear that non co-operation is not acceptable.
In such situations you and your colleagues should reach a view about whether a family is displaying ambivalence but with whom you can work, or deliberate behaviour which means change is much more difficult to achieve, therefore a more authoritative approach is needed. In such cases a decision may have to be made about whether the child/ren should be allowed to remain with the parents / carers.
All agencies need to be mindful of the need for workers to be trained for the level of work they are undertaking. The Safeguarding Children Board's within Bedfordshire run several multi-agency courses focusing on working with resistant families, disguised compliance and working with challenging families. All of which can be booked through the Pan Bedfordshire Training Unit.
It is helpful if agencies publish a clear statement about unacceptable behaviour by those accessing their services (such as seen in hospitals and on public transport).
This procedure should be considered alongside individual practitioner codes of conduct. It is not intended to replace in-house self-defence / safety training in place within organisations.
A common pattern of Non-cooperation is when parents / carers do not comply with what has been agreed with them. As a result practitioners become stricter in their approach, and start imposing more rules, for example. The parent / carer may, as a result, make an appointment to appease the practitioner, with the GP, dentist, health visitor etc. but then does not attend. They have a plausible excuse for their non-attendance and make another appointment, which they subsequently do not attend. Each time the uncooperative parent / carer does just enough to keep practitioners away.
There are other types of uncooperativeness, as outlined below. This is not an exhaustive list.
There are a variety of reasons why some families may be uncooperative with practitioners, including:
It is important to remember that a range of social, cultural and psychological factors influence the behaviour of parents / carers, as well as issues such as substance use or mental health. See also Working with Problematic use of Drugs or Alcohol within Families and Working with Vulnerable Families Where One or Both Parents have Mental Health Problem: Joint Agency Protocol. But the more uncooperative the family, the more likely it is that the main influences are psychological, stemming from the parent / carer's adverse experiences in their own childhoods. Some people, for whatever reason, may also have aggressive and violent traits in their personality. As an adult, the parent / carer will try to regain control over their lives, but they may be overwhelmed by pain, depression, anxiety and guilt resulting from their earlier loss. Paradoxically the uncooperativeness may occur as they open up their feelings, albeit negative ones, at the prospect of help. They may not be aware of this process going on.
Uncooperative parents / carers may isolate their children from agency involvement, especially if they are attempting to hide abuse or neglect that is taking place within the family. Indicators of a child being isolated in such a way may include significant periods of absence from school, Elective Home Education or non-engagement with health agencies such as GP, health visitor, specialist health practitioner etc.
A child or young person's absence from school may be supported by the parent or carer. Therefore they may not be recorded as removed from school or truanting. This may mean they do not come to the attention of the Children Missing from Education Teams, as they are officially still attending. Significant periods of absence should be monitored by schools and early years settings (although attendance at early years setting is not a statutory requirement), and action taken according as specified within the school's procedures.
Accurate information and a clear understanding of what is happening to a child / young person within their family and community, is vital to any assessment. The usual and most effective way to achieve this is by engaging parents and their children in the process of assessment, reaching a shared view of what needs to change and what support is needed, and jointly planning the next steps.
Engaging with a parent / carer who is resistant or even violent and / or intimidating is obviously more difficult. The behaviour may be deliberately used to keep practitioners at bay, or can have the effect of keeping practitioners at bay. There may be practical restrictions to the ordinary tools of assessment - for example, observing the child in their own home. The usual sources of information, for example other workers and other family members may also be kept at bay by the family.
It is important to explicitly work out and record what areas of assessment are difficult to achieve and why.
The presence of violence or intimidation needs to be included in any assessment of risk to the child living in such an environment.
If you feel threatened by the parent or carer, think what life must be like at home for their child/ren.
The worker needs to be mindful of the impact the hostility to outsiders may be having on the day-to-day life of the child / young person. They may:
In order to assess to what extent the hostility of the parents / carers is impacting on your assessment of the child, it may help to ask yourself:
Am I focusing on the needs of the child/ren?
All agencies need to work in partnership with families to achieve the agreed outcome. However, all parties involved need to understand this partnership may not be equal, depending on whether the involvement is with statutory or voluntary agencies. Non-statutory agencies may need to access advice and potentially escalate the case to Social Care if they feel the family are not co-operating with them on a voluntary basis, or if the family fail to improve the lived experience of the child/children despite attempts to intervene early.
Sometimes parents / carers may be hostile to specific agencies or individuals. If the hostility is not universal, then agencies should seek to understand why this might be and learn from each other. Where hostility towards most agencies is experienced, this needs to be managed on an inter-agency basis otherwise the results can be as follows:
When parents / carers are only hostile to some individuals / agencies or where individuals become targets of intimidation intermittently, the risk to good inter-agency collaboration is probably at its greatest. Any pre-existing tensions between agencies and individuals, or misunderstandings about different roles are likely to surface. The risks are that splits occur between the agencies / individuals, with tensions and disagreement taking the focus from the child / young person, for example:
Staff should alert other practitioners who know a family to be aware of potential difficulties and risks. Any agency faced with incidents of threats, hostility or violence should routinely consider the potential implications for any other agency involved with the family as well as for its own staff and should alert them to the nature of the risks.
Regular inter-agency communication, clear mutual expectations and attitudes of mutual respect and trust are the core of inter-agency working. When working with hostile or violent parents or carers, the need for good inter-agency collaboration and trust is paramount and is also likely to be put under greatest pressure. It becomes particularly important that everyone is:
Caution may be needed about how to disclose personal information about certain family members to other services. Concerns about possible repercussions from someone who can be hostile and intimidating may be an added worry. However, information sharing is pivotal in order to safeguard and promote the welfare of children and young people, as is practitioners being explicit about their experiences of hostility, intimidation or violence with named individuals. See Pan Bedfordshire Practitioner's Guide to Information Sharing to Safeguard Children and Young People for more information. It is important that you are open and honest with parents, carers and other family members when you have to share information about them with other services. You should tell them what information you are sharing, with whom and for what purpose. However, you should not inform them if so doing would jeopardise the safety of a child or young person, yourself or others.
If you answer yes to any of the following questions, you should share them with your manager and any other practitioners involved with the family:
|Do you have previous experience of the adult linked to the child being hostile, intimidating, threatening or actually violent?|
|Is it general or in specific circumstances? - for example drink related / linked to intermittent mental health problems?|
|Are you intimidated/ fearful of the adult?|
|Do you feel you may have been less than honest with the family to avoid conflict?|
|Are you now in a position where you will have to acknowledge concerns for the first time? - and are you fearful how they will respond to you?|
|In their position, would you want to be made aware of these concerns?|
Avoiding people who are hostile is a normal human response; however it can be very damaging for effective inter-agency work under Child Protection Plans, which depend on proactive engagement by all practitioners with the family. Collusion and splitting between agencies will be reduced by:
Although it is important to remain in a positive relationship with the family as far as possible, this should not be at the expense of being able to share real concerns about intimidation and threat of violence.
Options to consider are:
Remember that although working with hostile families can be particularly challenging, the safety of the child is your first concern. If you are too scared to confront the family, consider what life is like for the child.
Unfortunately for the worker making the approach, the underlying feelings of the family may be masked by anger or avoidance, as these parents / carers do not easily trust and may be fearful of closeness. It is best for the practitioner to be honest, giving clear indications that the aim of the work is to achieve the best for their child.
It is essential that the parent / carer recognise that you are a practitioner with the authority to be involved with their family. To do this you must clearly state your practitioner authority, and balance support with challenge. The motivations and capacities of the adults to respond cooperatively in the interests of their children, with the help of the worker and their agency will need to be continuously assessed. However, both control and care will be needed, and the worker must confront uncooperativeness when it arises, albeit with understanding and empathy.
You should seek supervision from your manager or advice from senior staff to ensure you are progressing appropriately with the family.
If you are going to be involved over a longer period, you will need to help the parent / carer to work through their underlying feelings as you support them to engage in the tasks of responsible child care.
In some cases, despite making every effort to understand and engage the parents / carers, you may find the family remains completely resistant and will not allow you to become involved. In such cases you should discuss with your manager, and together consider if other action might be necessary. It is important for workers in such situations not to feel a sense of personal failure or practitioner incompetence.
Remember: all workers experience such rebuffs at some point during their working life. There are some families who are resistant despite anyone's efforts.
Workers' 'coping' strategies that may merely obstruct engagement with any other family can be pitfalls when working with hostile families. As a result perceived or actual harm to the child / young person may be minimised or underestimated by the worker. You will need support to understand the family's behaviour and your own response to it.
Workers may unknowingly use the following strategies:
Practitioners need to ensure that clients are treated with respect and dignity at all times. Being practitioner not only involves keeping appointments, and on time, but also ensuring that families are engaged wherever possible and understanding and recognising the impact of cultural differences.
Families may develop a resistance or hostility to involvement if they perceive the worker as disrespectful, unreliable or dishonest, or if they believe confidentiality has been breached outside the agreed parameters.
It is vital that, as when working with any family, you make a full record of:
All paper based records should be signed, dated, and timed with your contact details. Electronic records should automatically record time, date and who completed them, via user identification numbers used for system logins.
A Chronology of all concerns relating to a child or young person and their family, dated and sourced, should be recorded in the files of all concerned practitioners. A chronology lists in date order all the major changes and events in a child or young person's life. It can be a useful way of gaining an overview of events in someone's life. It should be used as an analytical tool to help practitioners understand the impact, both immediate and cumulative, that events and changes may have on the child or young person's developmental progress. This includes Non-cooperation of parents / carers.
A chronology should include, for example, changes in the family composition, addresses and any moves, educational establishments and any moves, the child or young person's legal status, any injuries, periods in hospital or other medical treatment, and any disclosure of abuse.
Despite sensitive approaches by practitioners, some families may respond with hostility and sometimes this can lead to threats of violence and actual violence. It is therefore important to try and understand the reasons for the hostility and the actual level of risk involved. It is critical both for your personal safety and that of the child / young person that risks are accurately assessed and managed.
Threatening behaviour can consist of:
Threats can be covert or implied, e.g. discussion of harming someone else. In order to make sense of what is going on in any uncomfortable exchange with a parent / carer, it is important that practitioners are aware of the skills and strategies that may help in difficult and potentially violent situations and that they consult their own agency guidance.
Working with potentially hostile and violent families can place workers under a great deal of stress and can have physical, emotional and psychological consequences. It can also limit what you can allow yourself to believe, make you feel responsible for allowing the violence to take place, lead to adaptive behaviour which is unconsciously "hostage-like", and also result in distressing physical or psychological symptoms.
The impact on workers may be felt and expressed in different ways, for example:
Factors that increase the impact on workers include:
You have a responsibility to plan for your own safety, just as your agency has the responsibility for trying to ensure your safety. Workers should consult with their line manager to draw up plans and strategies to protect their own safety and that of other colleagues. There should be clear procedures on information sharing (both internal and external). Staff and managers need to be aware where further advice can be found.
Prior to contact with a family consider the following questions:
Don't give your personal contact details, such as e-mail address or mobile phone number to families; always give work details.
Managers have a statutory duty to provide a safe working environment for their employees under the Health and Safety at Work legislation, including:
Managers need to ensure:
For more information, see Ten pitfalls and how to avoid them - What research tells us.
Each agency should have a supervisory system in place that is accessible to the practitioner and reflects practice needs. Supervision discussions should focus on any hostility being experienced by workers or anticipated by them in working with families. It should also address the impact on the worker and the impact on the work with the family.
Managers must encourage a culture of openness, where their workers are aware of the support available within the team and aware of the welfare services available to them within their agency. Managers must ensure that their staff members feel comfortable in asking for this support when they need it. This includes ensuring a culture that accepts no intimidation or bullying from service users or colleagues. A 'buddy' system within teams may be considered as a way of supporting workers. Some agencies have confidential staff support systems, which involve sympathetic listeners. Managers should ensure that staff know how to access such support.
Workers must feel safe to admit their concerns knowing that these will be taken seriously and acted upon without reflecting negatively on their ability or professionalism.
Discussion in supervision should examine whether the behaviour of the service user is preventing work being effectively carried out. It should focus on the risk factors for the child within a hostile or violent family and on the effects on the child of living in that hostile or aggressive environment.
An agreed action plan should be drawn up detailing how any identified risk can be managed or reduced. This should be clearly recorded in the supervision notes. The action plan should be agreed prior to a visit taking place.
The practitioner should prepare for supervision and should bring case records relating to any violence/threats made. They should also be prepared to explore 'uneasy' feelings even where no overt threats have been made. Managers will not know about the concerns unless the practitioner reports them. By the same token, managers should be aware of the high incidence of under reporting of threats of violence and should encourage discussion of this as a potential problem.
Health and Safety should be a regular item on the agenda of team meetings and supervisions. In addition, group supervision or team discussions can be particularly useful to share the problem and debate options and responsibilities.
Files and computer records should clearly indicate the risks to workers and mechanisms to alert other colleagues to potential risks should be clearly visible on case files.
Only valid for 48hrs