ENGAGING RELUCTANT AND RESISTANT FAMILIES

WELCOME

• Welcome to 1 day training on Engaging Reluctant and Resistant Families

• 9.30 – 4.30• Lunch at 12.30pm• Housekeeping arrangements, fire, lavatories,

refreshments

TASK

• Your name, and the kind of work that you do• What’s brought you here for this day

AIMS FOR THE DAY

• Understand the variety of ways in which families can fail to engage and cooperate, and explore some of the causes

• Have an increased awareness of helpful strategies

• Be clear about maintaining professional boundaries and keeping themselves safe

• Be clear about the need to effectively assess risk factors affecting children who are being cared for by uncooperative adults

• Understand the importance of multi-agency practice

• Be aware of some practical strategies for managing the work

PROGRAMME9.30:Welcome and Introductions10.15: Defining Reluctant and Resistant Families11.00: Refreshments11.15: Assessments: Working in Partnership and Multi

Agency work12.30: Lunch1.30: Working with Strengths2.00: Trigger Families2.20: Managing Violence and Challenging Behaviour 3.15: Refreshments3.30: Support and Systems4.15: Ending4.30: Close

GROUP AGREEMENT

• Phones• Timekeeping• Confidentiality• Participation• Respect• Richness of difference• Ok to be serious and to be playful• Take care of ourselves and try hard not

to make assumptions

FEELINGS ALERT

• The day will be personally challenging and emotionally charged

• Will involve thinking about our own experiences

• Will involve thinking about personal and professional experiences

• Will involve thinking about emotional responses as starting point for professional responses

AINLEE LABONTE Born 24th June 1999 Died 7th January 2002

“ The assessment of Leanne’s relationship with her daughter….was lost in the power struggle between Leanne and the agencies”.

“Leanne and Dennis were aggressive to all professional staff and in turn each agency limited the contact. Health Visitors and Housing staff would not visit her home because of intimidation. Leanne and Dennis were barred from the Housing Office and staff at clinics and hospitals would only see them when supervised”.

AINLEE LABONTE Born 24th June 1999 Died 7th January 2002

One by one the agencies withdrew for personal safety issues…..….The communication between the agencies was not constructive; the different perceptions and failure to convey the implications of not accessing the family were not assessed.”

AINLEE LABONTE Born 24th June 1999 Died 7th January 2002 There were concerns for the welfare of the

children and attempts to make sure they received health care, but the impact on them of the violence of their parents was not evaluated. The children were living in an environment that adults were not prepared to visit.”

AINLEE LABONTE Born 24th June 1999 Died 7th January 2002

The essential good practice issue has to be that if the parents create the responses in professionals, which cause them to retreat,

then what must the experience be for the children?”

Taken from the Integrated Review into Ainlee’s death.

TASK

• Think individually about a parent or family you’ve found difficult to engage

• DON’T choose a piece of work where there are lots of unresolved or unhappy issues

• Write down a brief anonymous summary of your work with them

ESSENTIALS THAT UNDERPIN THE WORK• Workers trained, developed and supported to carry out

the level of work expected of them.• Clear, published statement about unacceptable

behaviour• Risk assessment and clear structures underpinning all

Managing Violence policies. • Culture of working with the strengths of families.• Support in thinking about, understanding and dealing

with feelings and thoughts.• Threats and violence never minimised -always taken

seriously.• Equality issues key in providing good services to all

families.• Communication, discussion, sharing good practice and

agreement underpinning all multi-disciplinary work.

TASK

• In 3 small groups, discuss:• What are some of the kind of behaviours that

characterise difficult to engage families?• What are the most challenging behaviours for

you?

POSSIBLE REASONS FOR NOT ENGAGING

• A refusal to acknowledge that there is a problem

• Resentment of invasion of privacy • Having something to hide• Resentment of interference• Cultural differences• Not understanding what is expected and why 

POSSIBLE REASONS FOR NOT ENGAGING      Poor previous experiences of involvement

         Resentment of staff changes         Dislike or fear of authority figures         Fear that children will be taken away     Fear of oppressive judgements (particularly

for disabled or substance misusing parents)

POSSIBLE REASONS FOR NOT ENGAGING Fear of stigmatisation       

Being overwhelmed by emotional pain, depression, anxiety and guilty

Having nothing to lose, if children have already been removed

TASK

• Turn to the person next to you, and think about the list of possible reasons.

• Have you ever dealt with anything on the list?• What didn’t help?• What did help?• Is there anything you’d add to the list?

ASSESSMENTS:THE CHILD

Children and young people may:• have become desensitised to violence• have learnt to appease and minimise• be too frightened to speak about their

own experiences• feel guilty and anxious• identify with the aggressor and share

their hostility and aggression 

ASSESSMENTS: THE WORKER

Am I colluding in avoiding conflict by focusing on “safe” issues

• Am I changing my behaviour to avoid conflict?• Am I afraid to confront the family about my

concerns?• Am I keeping my anxieties and fears to myself and

not sharing them with colleagues and manager

ASSESSMENTS: THE WORKER

• Do I suspect the child may be keeping itself “safe” by not telling me things?

 • Do I think the child has learnt

minimising and appeasing behaviour? •  Do I feel relief when no one is in? • Do I feel relief when I finish a visit?

ASSESSMENTS:THE WORKER

•Do I say, ask and do what I usually do when making an assessment? 

• HOW DO I THINK THE CHILD FELTHOW DO I THINK THE CHILD FELT WHEN I LEFT?WHEN I LEFT?

TASK

• Individually, create an Eco map to show your relationships with other agencies.

• What are some of the positives and some of the challenges?

• What are some of the stereotypes and fantasies that can exist?

MULTI AGENCY WORKSplits between agencies can result in:• individuals and agencies blaming each

other and colluding with the family those who are not experiencing hostility

can find themselves taking all the responsibility

• those who are “approved of” and “praised “ by the family may feel gratified and unable to accept that there are problems or risks

MULTI AGENCY WORK

• those feeling under threat can feel that it is personal

• no unified or consistent plan being made to inform and coordinate the work

MULTI AGENCY WORK

If all agencies experience hostility, this should be managed on an inter-agency basis. If this doesn’t happen:

• everyone may back off, leaving the child unprotected

• there may be a split between those who want to appease and those who want to oppose

• everyone may collude

MULTI AGENCY WORK When working with uncooperative, hostile or

violent parents it is ESSENTIAL that everyone:• is aware of the impact on their own response

and on other people• respectful of the concerns of others• aware of the vital need to share information

about safety concerns

MULTI AGENCY WORK

• is actively supportive of each other and their different experiences

• is open and honest when disagreeing • is aware of the dangers of collusion

MULTI AGENCY WORK• is open to discussing strategies if one agency

is unable to work with the family

• is aware that workers in different settings and roles may have different thresholds of concern and different experiences of having to confront difficult behaviour.

TASK

• In pairs-share a time when you felt powerless• DON’T focus on an experience where there are

lots of unresolved or unhappy issues• How did you feel? What impact did your

feelings have on what you did?• Repeat for a time when you felt powerful

KEY EQUALITY ISSUES• Particular resources• Language• Workers and family's identity• Euro-centric child development• How are men included?• Is specialist input needed?• Support and supervision

TASK• In three small groups, think about the family.• Use a “weakness” model to think about them.• We’ll share, and then consign the model to the

bin.• Return, and use a strengths model.

WHAT HELPS

• Being formal and being clear that aim of the work is to achieve the very best for the child

• Being clear and confident about your authority

• Using supervision and support• Working with the parents’ feelings and

past history• Being clear when “enough is enough”• Feeling fully supported by colleagues,

manager and agency

WHAT DOESN’T HELP

• Being convinced you’re incompetent and a failure

• Seeing the situation as a battle which must be won

• Colluding• Focusing on personal fears and anxieties

at the expense of being alert to the child’s needs and experiences

• Avoiding thinking about negative information

• Feeling helpless and unable to make decisions

THREATENING BEHAVIOUR

• Deliberate silence• Written threats• E-mails and telephone calls• Intimidating or derogatory language• Racist and other oppressive remarks• Physical intimidation• Swearing• Shouting• Throwing things•  Physical violence

THE IMPACT OF HOSTILITY AND VIOLENCE •        Surprise•        Embarrassment•       Denial•       Distress•        Shock•       Fear• Self doubt 

THE IMPACT OF HOSTILITY AND VIOLENCE

• Anger • Guilt• Numbness• Loss of self-esteem and confidence• Helplessness

THE IMPACT OF HOSTILITY AND VIOLENCE

• Sleep disturbances, including nightmares• Repetitive stressful thoughts• Illness• Post traumatic stress

INCREASED IMPACT•  Previous traumatic experiences• Regularly in threatening and violent situations• Threatened in their personal lives• Male workers find it difficult to admit to being afraid• A culture of denying or minimising

violent episodes• Violence and abuse directed at race, disability, gender or sexual orientation

MAKING SENSE OF HOSTILE RESPONSES

• Are you prepared, and supported?• Have you aggravated the situation?• Does the parent have a legitimate

complaint?• Is the parent aware of the impact they

are having?• Is the behaviour deliberately

threatening and abusive?• Is this ordinary behaviour for this

family?

TASK

• In pairs, focus on the first question.• What has been your experience of dealing with

threats or violence?• What do you think the “culture” about violence

is, in your work place?• What’s positive?• What’s challenging?