Principles for effective communication with children (EP.13)

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Transcript

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Welcome to rich. Social work, practice podcast. I am rich and I am a social worker. This podcast is about practice related issues, self development and transformation. It will give you knowledge, ideas and practical tools for being an effective social worker, supporting you with assessment skills, direct work, dealing with conflict, and importantly, helping you make a positive difference in the lives of children and families. So today I'm going to explore. Some of the challenges in undertaking direct work. With children in a child protection context. And then some ideas that I developed over the years through training and. Reading. Journals and books about how to overcome some of those challenges and to build. Meaningful effective relationships with children and families. There's a couple of. Things I want to mention before we get into that. Firstly is to say thank you to Ryanne Taylor. I received a lovely email. From her in response to some of my previous episodes. And. She shared with me a Ted talk by. One of her favorite poets performance poets called Harry Baker. And if you. Google Harry Baker, the power of self acceptance. Tap talk. It's a really lovely, brilliant, wonderful. Performance that I would highly recommend checking out and I'm really grateful. To Rian for a email to me and be sending me that. Lovely. Talk or poem. The second thing I wanted to. Mention is that I'm going to be. Delivering a series of. Workshops in conjunction with Basware. And it's called bass was child protection, social work practice, master class series. And the idea behind it is to support. Social workers, both newly qualified social workers, but also experienced social workers. With some really practical research based training that will equip you with. Ideas that you can implement in your social work practice. And I really wanted to create some really jam packed. Sessions that will give you the knowledge and some practical ideas research behind some of these ideas. So that you can kind of feel more confident and re-energized in the work that you do with children and families. And the intention is. To do one a month over a series of eight months on topics that I think are really critical in terms of the role that we do is child protection, social workers. So the topics that. I'm going to explore, include why is it hard to talk to children? In child protection. Key principles and practical tools to help you overcome the challenges to capture the child's voice. Managing conflict in child protection. Effective SAS assessment in. Child protection. Working intervention. How to survive and possibly fry in a child protection context. And. Skills and principles for cultivating a relational approach to addiction and finally moral distress, impossible decisions and removing children. Which is an exploration of the ethical challenges. Of the decisions that we're required to make and developing some skills and ideas and tools to help us make evidentially robust. Evidentially sound decisions about children. And I'm aware of that. Everybody is super busy. So they're only an hour and a half and the intention is. To really cram them in with as much. Value is possible. And so I'm taking 12 years of practice experience along with. The, the obsessive tendency that I have to read and research some of these issues and bring in that into a condensed form. Because I realized that everybody's. Busy and they get caught up in the demands of the role. And so they don't always have the time to. Do the read in or go to the train. And so I'm hoping. This is one way that you can hopefully access some of the. Topics that I've just mentioned. If you are interested. Then you can go onto website and type in password, child protection masterclass series. I'm sure there's a proper email address, but I think you probably find it on Google. So less jumpin too. Direct work with children. I think. Undertaken direct work with children can be the most rewarding part of being a social worker. And yet it can also be the most challenging. I think there are two types of direct work. Firstly to ascertain the wishes and feelings of the child. And so the purpose is to discover a child's worries, anxieties and hopes and wishes. To understand how they've made. Sense for that world. And that could be part of an assessment under section 17 or an ongoing feature of our work. For example, if the child is subject to a child protection plan or is a child in care, The second type of direct work is a therapeutic piece of work to help the child understand their experiences. Especially the experiences that have warranted social work involvement, such as exposure to domestic abuse, parental mental health, and substance misuse. Now. There are a few challenges to undertake in child protection. Undertaken direct work in child protection. And. We could probably cluster these into fruity domains. Firstly, this law kind of sole social cultural element of it. The unfortunate reality of our work means that we only become involved in the child's life. If someone is concerned for a child, Therefore we have visit in children suspected of having conflict experiences, or this has already been established and we are working with them in an, in an ongoing basis. Eva way. We have to have conversations with children that you don't typically have with children. That most people wouldn't have to. Have with children. Conversations about violence. Parental mental health. Death drug and alcohol use criminal behavior, sexual abuse, physical abuse, and so on. And childhood is often conceptualized as a sacred and discreet time of life. That should be. Protected. Although, I think from a historical point of view, this is a relatively new concept, a new way of positioning Tilden. Therefore it's socially acceptable and preferred to actively protect children from the often harsh realities of adult life. And in some cases, lie to them to preserve preconceived notions of innocence. And this was. Pointed out in a book by. Susie Essex and Andrew tonneau. Where they write professionals perhaps informed by an overly sentimental view of childhood innocence are often at a loss regarding how to communicate the enormity of the event to children caught up in situations of abuse. And I will touch upon this later, but it is worth. Reminding ourselves that whatever we think we are protecting children from when we have conversations with them about. Violence. Drug and alcohol use, et cetera. That we remember that they've already lived through these experiences. And. One of the more interesting research findings was that. Talking to children about. Difficult and potentially traumatic experiences. Research has found. Sorry, let me rephrase that in illustrating the importance of talking to children about difficult and potentially traumatic experiences. Research has found that not discussing the distress, distress and experience can be more damaging than the event in of itself. And that's some work by James Pennebaker. So the first challenge is this kind of social, cultural Maloo that wants us to share. Children from adult issues. Preserve that. Their innocence. The second issue is. It's professional. In that we. Thanks to challenges. I think. Firstly, the sheer volume of the work that we're expected to do as a child protection social worker. Provides a really challenging context to plan meaningful work and spend enough time to establish. A trusting relationship with a titled. Learning how to build trust efficiently becomes a necessary skill. And child protection. Secondly, we often visit children in their homes. If. The title to subject to a top protection plan. These visits. Occur quite regularly and often requires to have conversations with parents that as well. And this. I was captured. Beautifully imprudently in a paper by Harry folks and called. How children become invisible in child protection work. He writes multiple tasks had to be completed. Invariably within time limits pairs and other carers interviewed children spoken to on the road interactions between family members observed and bedrooms and other home conditions inspected to name just some. And so often. There's multiple tasks that we're expected to do when we go and spend time with a child in the home as part of a start to treat, visit. In this paper focus and also describe the challenges that social workers faced with some families. And despite being effective with some families, they could find themselves being, and this is. Quote, overcome by the sheer complexity of the interactions. They encounter the emotional intensity of the work, parental resistance, intense atmospheres in the homes. And this could result in them unintentionally losing sight of the child. So he was pointing out that it isn't necessarily the worker because the worker in some families was able to do some really meaningful, effective, direct work with. Children. But that there were certain conditions. That made, undertake and direct work. Extremely difficult. The third element is psychological. Challenges. From a personal and psychological perspective. The topics might be challenging to tolerate talking about. Even if we can overcome our impulse. To protect children from adult topics. And create enough space and time. Our attorneys could prevent us from asking questions or exploring certain issues. And a paper by John Burnham. Systemic practitioner. He described an experience that illustrated this. He was working with a woman who he fought was avoiding why she was attending therapy. Which was because of her experience of sexual abuse. And he detailed the conversation he had after he realized this. So I'll just read this from from his paper. Every time we approached that issue. You seem to change the subject. I am wondering why. As I began to speak the question, I changed it to every time we approach that issue, the conversation goes somewhere else. Who do you think avoids it more me or you. My thinking was still influenced by the idea that she was avoiding, but I wanted to be kinder by including myself in the question. She replied, Hugh, do. I was taken aback, but eventually received curiosity to inquire. How, what did I do? How did you notice that? Thankfully, she replied. Well, whenever I am close to talking about what happened. You will say something like it doesn't have to be now take your time. And several. And John Burnham reflected in this paper that in his wish to be sensitive, he had acted. Superficially. So often our discomfort about a particular top topic can lead us to avoid in it fast, denying the child, the chance to talk about it. Now of course, some tool to might not want to. And that should also be respected. But it would be a shame to close down that option to them based on our insecurities. And learning to become comfortable exploring these topics is not easy. But I do think it can be achieved through practice and the use of tools that provide a structure. To have difficult conversations. Which we're going to look into. No. So recognizing the kind of social, cultural, professional, psychological barriers, I think is the first step in overcoming them. And so I'm going to outline some key principles that I've acquired over the years that I think would increase the chance. Of us being able to meaningfully and effectively undertake direct work with children. So. The first principle is, understand the context for the child. And I'm just going to read out from. Handout that I was given by. One of the most brilliant trainers. I've experienced. His name is Rob Tucker. And. He provides training and consultancy. He's actually, there's a, there's a video on YouTube, which you can find where he does a presentation around direct work with children. We taught highly recommend this, this handout is over 10 years old and, but I've kept hold of it because I've because I found his training and his work. So incredibly valuable. So. I'll read this out here. It is a vital importance that the communication with the child is in a child centered medium. Well done in a child centered way, rather than an adult dominated one. It is incumbent upon us at adults to enter the child's world. And as their primary communication is playing activities, it is therefore this medium. Into which we must enter. When we first meet a child, they are frequently in the middle of a great big muddle of ADOT agendas. We are required to communicate with a child whom we do not know. Who may be in denial. Who's in a world may be in chaos. Who may see you as the source of terror and anxiety, rather than a source of help and relief. Who's underlying state is heavily dependent and who may be unsafe. We need to ask, what does the child see as the reason for your content? To find out how naughty I am. To find things in town. My parents. To punish me. To trick me. To find out what the special games man die play. Does he, or she want to play special games? To find out things to hurt my mom and dad. What is likely is that the child is not being given any choice about seeing you. They live in an adult world and adult makes the work rules. Grown-ups need to find things out. They come along and probe and ask questions. They threatened the child in a world. What does the child do in the face of this? They find ways to defend themselves against these probing. Question. This could lead to responses such as withdrawal, refusal to talk denial, minimization of a blaming diversion, hyper arousal, anger, or challenging behavioral responses. We also need to consider the possible reasons the child may have for not telling us about. What has happened to them or what has taken place within their family? What are the potential costs and risks to them of telling common causes for not telling them. Or denial include shame, fear of stigma, embarrassment, difficulty in discussing sexual issues. Fear of consequences to the cell phone family, difficulty divulging family secrets, preservation of self-esteem. Or trauma, panic responses such as memory blocks and disassociation. So if the child. Is unclear about the reason for us visiting, then they might be fearful or defensive. And so explain an hour role and clarifying why we are seeing them is the main way to reduce and lessen these fears. Even when we have shared the reasons for our visits, some children will remain apprehensive. We must recognize the potential cost. As Rob Tucker pointed out in terms of. What might happen if they share their experiences? Okay. One of the ways in which I tend to do this is to introduce myself. My name's rich and I'm a social worker. And I lost them. Do you know what a social worker is? Sometimes they do, and sometimes they don't. And I try and. Reassure them and let them know that there's no right or wrong. I'm just curious about what they understand. I have a social worker. And then I explained to them that. I'm a social worker and we work with children. And their parents, but we don't work with all children and parents. Do they know why we worked with som and why they down? And some children can say, because. There's worries or there's problems or because my dad has this problem, or my mom's like this. Whereas some don't know the difference. And then I can begin to say, Well, we, we only work with children. If we think there might be some worries about them. And do you know what the worries might be for you and your family? And if they still don't know. Then I might. Explain to them. Well, We're a little bit worried because. The teacher seen that your acts while I was at, or that we know that the police have come out. I mean, daddy, we're having a big argument. And so we need to Kevin speak to your mum and dad, and we want to speak to your teacher, but the most important person that we speak to is that we come and speak to you. And find out what you think and how you feel. And then we can think about how we can help your mommy and daddy to. Deal with some of the worries. So that's one way in which. I present the role of the social worker to. Two. Children. So I think that's one really key important principle is understanding the context. For the child. The second. Key principle is. Practice. Undertaken effective work and effective direct work is a skill that can be developed. Some practitioners might be innately. Skilled or talented, but most of us are not, certainly I wasn't. For the first couple of years, when I was a social worker, I was expected to do six sessions of wishes and feelings with every child. I was the allocated social worker for. If you are a student or newly qualified, I couldn't recommend highly enough that you recommend an ask that you do this with the children that you work with. I found during this process that I could use the same worksheet with two children of the exact same age, and it would have completely different effects. I also learned that a tool that worked for a six year old didn't work, move an. Eight year old or what worked for a boy didn't work for a girl. Okay. And I just became comfortable experiment in with various techniques and tools. And realize that. You have to adapt and adjust and have a variety of tools for each child that you're spending time with. And that it's okay. If you try one tool and it's not particularly effective, that you feel comfortable enough to try a different tool or a different approach. As a result of this practice later on, when I need to, to visit children in more urgent circumstances. I learned to condense the relationship and trust-building that typically took place over several weeks into less than an hour. However, I don't think I would have been able to do this without all of the practice. As well as practice in how to communicate and interact effectively with children. I had to learn how to communicate to children about domestic abuse, parental mental health, and substance misuse. Fortunately, I came across the words and pictures. Tool, which was developed by Susie Asics and her colleagues. And then Andrew to now integrate this into the science of safety approach, which is where I learned about it. And in my opinion, every child subject to a child protection plan should have words and pictures. And I'm just going to read from. Working with denied child abuse, the resolutions approach by a hundred to now and Susie SX. Because they provide a little background too. The word, some pictures process. This approach to getting the concerns out in the open. It began to develop in the late 1980s. When Susie was chairing child protection conferences. In this role, Susie repeatedly faced the problem that children in child protection cases often knew very little. If anything, about the concern the professionals held regarding their wellbeing. Susie found that even when it seemed that a child might understand the concerns since they'd made the abuse allegation. Often their siblings did not know about the. Concerns. And the youngsters themselves were often unclear and worried about who knew what they knew. A further problem in all of this is that children and families facing allegations of child abuse. Are you usually very aware that something major is happening because for example, They can see that their parents are distressed and because they are aware events. Such as a sibling being injured and taken to hospital. The police come into a home or sibling or parent having to move out the family home. But without an explanation from adults, they often make up their own. One example of this, that Susie will always remember occurred in a situation where a teenage girl had alleged that her stepfather had sexually abused her. This led to the stepfather being arrested. I witnessed by his five-year-old son. But the boy was given no explanation for the event. That night, the five-year-old saw the lead television news story about an IRA bombing and concluded that his father had been arrested for that crime. As well as forming their own often misguided conclusions. When children don't have an appropriate explanation of dramatic events in their family, this content to prepare them towards anxiety, reactions, and obsessive compulsive behaviors. Aware of these problems. Susie began asking parents and carers. What the children knew of the concerned. Often the parents had said little to the children, typically they were worried about what to say and where to start if they were to try and explain the events. This was not a problem. Simply faced by parents professionals. We're often, also at a loss regarding how to communicate the enormity of the event to children caught up in situations of abuse. Whatever the cause of the difficulty professionals have in talking openly to children. Research we've looked after children confirmed the reality that many of these young youngsters do not know why they're in care. So. The words and pictures is an approach. When you collaborate with the parents to develop a narrative for the children about why we are involved to social workers. And it follows four areas. Who's worried about the children, what they are worried about what happened then? And what we, the family and professionals are doing about the worries. And this really had a transformative. Effect on my practice. Because I started to write explanations for children. In ways that. Was appropriate to that developmental. Age. And the process of writing about. That also enabled me to feel more comfortable. More confident in talking to children about the same issues. So I'll give you a, an anonymized version of some words and pictures that I did. With. Some children who were subject to quite severe levels of neglect. And there was issues around domestic abuse. And substance misuse. So I'll just read out the, what they are worried about. So who is worried? And then the second question is what they're worried about. Mommy and mommy and daddy love. Joe and Josephine anonymous names. Very much, but they did not always make sure that they were looked after. Rich, the social worker was worried that Joe and Josephine. Did not get enough cuddles, a chance to play, go outside to the park and have stories. Read to them. When the social workers visited, they were worried because the house would be untidy. The bats that y'all slept on didn't have sheets on them. Often looked very dirty. These are things that are really important for children, so that they feel happy, loved, and looked after. Sometimes mommy and daddy would shout and fight with each other. One young children see, or hear grownups shouting and fighting. They can find this scary and upsetting. Sometimes when mummy and daddy had fights, the police would come to check that everybody was okay and they would ask daddy to leave the home so that he could calm down. It can be frightened in having police officers come to your house. Daddy would sometimes drink alcohol and this would affect his behavior. He would stumble over hurt himself or punch the ball. And on occasion he fell asleep at home when he was looking after you. Drinking alcohol meant that sometimes daddy was happy, but more often he would be sad and sometimes he would be angry. So. That's an example of trying to convey to children. Some of the reasons that we are worried, and if you need some support or help with this. There's a really brilliant book called adoption conversations. They basically break down explanations for children. Based on different issues. Substance misuse, domestic violence. And then they break it down into aged four to six or six to 10. And it's the book originally intended for? Adoptive parents to help. Adopted children make sense of their experiences. But I found it incredibly useful. Four. Okay. Practice in and developing words and pictures. So that's the second key principle is the value and the importance of practice. The next key principle is to enter the child's world. And this really requires us to meet the child where they're at. Wherever they are four years old or a teenager. We need to adjust ourselves to enter the interaction in their preferred way. I'm going to read. From a book. Cooled sexual abuse, the child's voice by match Bray. And she says he From attempting to impose an adult centered medium upon children. I had unwittingly been minimizing the potential for true communication to take place. Asset the adult who possessed the power and the interaction I had made the rules, which dominated our content. Because sitting on chairs and using language to communicate became naturally to me, as it does to most adults. I am post this on children without thinking. Yet surely play was the child's first language through which faults, feelings and dilemmas were communicated to the world. I needed to enter the child's world rather than trying to drag a child, kicking and screaming into mine, demanding that he cooperate on my terms. So. There's something about adjusting or adapting the way in which we. Cultivate relationships with children and young people. In order to meet them where they're at. And so that might involve sitting down and playing with a child who's 3, 4, 5 years old. But it also might mean. Going into the room of an adolescence and plan the X-Box with them. And you used in the shared activity as a space in which to have a conversation with them. It's about. Me and them where they're at, rather than expecting them to come to our world into our way of communicating. The fourth key principle that I wanted to talk about was around. How we conceptualize. Wishes and feelings, which is to, I think, provide children every opportunity. Two. Share. What's happening for them in their life. So when I was an allocated social worker for a child. I really wanted to ensure that they were provided every opportunity to share their wishes and feelings. Now it's important to know. I don't think it's our job to force children to talk about their experiences. But rather to maximize the chance that if they want to, that they're given the opportunity. The challenge is that most children won't easily open up about their experiences because it's all that they've ever known. For example, asking a child what it's like to live in a pervasively neglectful home is unlikely to yield anything because they don't know anything different. Or. They are fearful about the repercussions for that parent or unsure whether they can trust you. Concern. This latter point of building trust. I tend to take this to the extreme and. I think if a child isn't opening up and talking about their experiences, then I'm responsible. I need to be more proactive, adopted different tack, or find a way to build more trust. And in the vast majority of cases, this is. Is successful. In some cases, this isn't possible. Possible. And then in those cases, I provide a hypothesis. For the underlying function of that reticence, but we'll only do this when I know that the reason isn't a function of my failure to be able to relationship. I think. Too often we meet some resistance from the child and build in a relationship and then quickly retreat, because we're worried about. Upset in them or. It's not conversation that we feel comfortable or confident in having. And so it's easier for us to kind of take a step back at the first hint of resistance, but their resistance might just be to see if you're going to really be committed to them or if they can, if they can trust you. If you don't feel confident. Or comfortable. Exploring the topic, the child will intuitively pick that up. And not allow you to come into there. Space into their internal world. Another reason that children might find it difficult is that they've developed coping mechanisms to deal with their experiences. And I would say that I've observed two common reactions. Firstly, some children. Develop a way of coping with their experiences that involves them. Ignoring or minimizing the effects of difficult experiences. So they learn to inhibit and hide their emotions and then comply with adults, a tie and take care of them in a role reverse in strategy. Part of that difficulty in opening up is that they've developed a self protective coping mechanism. That requires them to avoid negative feelings and therefore distract away from topics that invoked negative feelings. The second. Reaction that I've seen that's common is that children can be quite hyperactive or unable to concentrate. And flit about from one task to another. They will refuse to join in with a conversation or a game designed to elicit wishes and feelings. Through challenging provocative behavior. These children are anxious and the distracted. Distracting behavior might function in a home where the problems are too frightening or scary for them to attend to. But two important to it. Ignore entirely. Therefore, they find it difficult to engage in a sustained dialogue, especially about. Issues that are going on at home. And these two strategies constitute attachment patterns developed in response to certain experiences. So if these strategies dominate our sessions, The compulsively inhibitory. Tiled who avoids talking about anything negative, but it's really keen and compliant and eager to please, or the child who's hyperactive. A little bit destructive, difficult to regulate. If they dominate the session, then I can, then I begin to hypothesize about their behaviors function and seek further information by observing the child at home and speaking with the parents and teachers to test the hypotheses. For example, Does the child live in a unpredictable, unsafe, uncertain home environment whereby the amplification of their emotional behavioral needs is adaptive being hypervigilant. And. A lot, having lots of energy is a good way to keep yourself responsive to any potential dangers. And in my opinion report and on a child's coping strategy, I think is a way of encapsulating that wish some feelings. And that kind of leads on to the next key principle. Which is. That what. Child verbalizes is only one part of obtaining their wishes and feelings. Sometimes. What a child doesn't say can also be valuable. For example. We receive a police report due to mom and dad fighting while intoxicated. When the police attend, there's lots of commotion. The children were present. They were observed to be disheveled in distressed. Now, in this example, I think there's a two-step process. If we were to visit the following day. Firstly, we ask the child generally about their life to see if they voluntarily discuss what happened the night before. So we go and see the child in school. How's things at home. How's your week been? Has anything significant happened? And then if that's unsuccessful, I think we can ask them a more direct question about the police attend in their home. We are in an unusual position in child protection. As we often understand what is happening for the child at home. Unlike, for example, a teacher who spends time with a child. This means that we can share our knowledge with the child that we know. That their mom and dad had been fighting or that dad was drunk over the weekend. Suppose the child still chooses not to discuss. In that case, our analysis will need to include. The evidence of the domestic abuse incident, and then the child's willingness to discuss this. And then think about some possible reasons as to why they don't feel able to talk about some of their. Wishes and feelings. So that is. Five. Principles for direct work. And. I think there's probably at least 10, or at least there's going to be 10. I'm going to explore. In the masterclass series that I'm going to be providing later on in the year. So, if you want to. Hear more about some of these. Principles, but also get some more detail and specific ways to. Implement some of the principles. And then please by all means, check out. Check out the basketball website. See if that might be interest in. I also. I want to mention a couple of resources that I think are especially helpful. Calf casts have some really brilliant resources. If you type in cat cast direct work with children, resources. They have a mind needs, wishes and feelings pack, which is just a really useful tool. To undertake direct work with children. And then the second tool. I would recommend is. A. Tool that was developed by. Joe Dillon. Pheon Evans and rot Kip. Pin through research and practice and the tool. Was called is called, enabling and embedding creative participation in child and family social work. And that's a really useful engaging tool that I would definitely recommend checking out. So many, thanks for listening to this episode. If you haven't already please consider subscribing or sharing with your colleagues. Please, please do leave a comment. Positive or negative or feedback is very welcome. And finally, if you have any questions, please get in touch. I'll leave my email in the show notes. If you want to. Reach out. I would love to. I have some questions or responses that I can share on in the next episode. Or if there's people that you'd like me to speak to and please do get in touch.