Promoting Effective Direct WorkWith Children

The value of interactive resources

Bridget Betts

IFCO Madison 2005

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197619972003

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Vera Fahlberg observes that ‘it is difficult to grow up as a psychologically healthy adult if one is denied access to one’s own history.’

What lessons have we learnt from the experiences of those who have lived apart from their birth families, and have perhaps lost part of themselves along the way?

Children in public care sadly routinely experience rejection, loss, and change, experiences that a well-supported and confident adult would need considerable personal resources and support to manage effectively. Some children feel that they have received little help with their feelings about the changes in their lives, starting with the events that led to separation from their family. For some the most acute loss is separation from siblings who have remained with their family, or have been placed elsewhere. Children are often left struggling not only to make sense of the decisions that have shaped their lives, but also to manage their feelings about what the future holds.

The Challenge - Listening to children

• Children who are separated from their families of origin find themselves the focus of professional networks and complicated procedures

• For children who are separated following troubled, confusing and often abusive and neglectful experiences profoundly challenges their fragile sense of who they are and where they fit in the world.

• The decisions that need to be made are life changing – What kind of family? What contact? With who?

• Taking children’s wishes and feelings into account is a challenge for decision making and family placement

Communicating with children

• Listening to children was 1 of 6 priority areas for funding in the first year of Quality Protects (A UK Government initiative to improve outcomes for looked after children)

• Strengthening the voice of the child remains a key issue within child care work, child protection and work with looked after children

National Adoption Standards England, 2001 imp. April 2003

• Standard A4

“Every child will have his or her wishes and feelings listened to, recorded and taken into account. Where they are not acted upon, the reasons for not doing so will be explained to the child and properly recorded.”

NAS cont’d

• A6

“Children will be give clear explanations and information about adoption, covering what happens at each stage (including court), and how long each stage is likely to take in their individual case.”

NAS cont’d• A7 “Children will be well prepared for joining a new

family. This will include clear appropriate information on their birth family and life before adoption, and information about adopters and their family. Children are entitled to information provided by their birth families, which will be kept safe by agencies and adopters. It will be provided to adopted children, or adults, at a time and in a manner that reflects their age and understanding, as well as the nature of the information concerned.”

Impact of Trauma, Neglect and Abuse

• Development is likely to be affected in a variety of ways - delays in reaching expected milestones and 'patchy' progress i.e. the child seems to 'act their age' in some respects but not in others.

• Some children with gaps in their earlier development may appear to be 'stuck' at an earlier chronological age.

Vera Fahlberg also highlights:

• The impact of developmental delays in any or all key areas of development i.e. physical, cognitive and psychological

• the child may have developed maladaptive patterns of behaviour

• unresolved separation issues may cause the child to become stuck

• misperceptions can hinder the usual progression of growth and change

The impact of loss

As Claudia Jewett observes ‘Each of these losses creates another chance for

misunderstanding, self blame, and feelings of not measuring up in some way. ….. because children are so often fully convinced that they have caused their own losses, they are understandably reluctant to discuss their failures with a helper If they have skipped over parts of their grief process, the discussion may awaken old pain and confusion as well.’ (p96)

Cared for population

• Highly vulnerable

• Likelihood of multiple family problems

• Culture of secrecy, non-disclosure e.g. CSA

• Impacts on child: inc. risks of low self esteem and lack of choice, control etc.,

• Lack of continuity (e.g. impact of moves and different carers: pre care and during)

Research, SSI Reports

• Between 20-25% of adopted children do not have a Life Story book (SSI 1996, Lowe & Murch 1999) ?figure pre-adoption

• In the UK agency practice needs to improve considerably if it is to meet the criteria for good practice set out in the SSI’s report For The Children’s Sake this requires amongst other things, that:

Research, SSI cont’d

• “Specific work is done with children which helps secure for them both an understanding and a record about their circumstances and their origins”

• Most children who had LS books felt positive about them and found them helpful

• A few did not understand or retain all the info. contained in them or conveyed during the work itself.

The scope of life story work

‘No ones life is a mere collection of facts, any more than a person’s body is a mere collection of molecules. Thus in creating a life story book we are gathering everything that makes a human life – the facts, stories, anecdotes, memories, fiction, religious and cultural life, fantasy, expectation, loss and fulfilment, hope realised and hope dashed, family idiosyncrasies, the good and the bad.’ Rose and Philpot

A continuing journey ….not a destination

‘Life story work involves taking children along their journeys step by step, not passing over events, facts and beliefs or making the assumption that a child has understood or accepted when that may not have been the case. At each step it is necessary to ensure that the child has first of all listened and then that she has understood.’ Rose and Philpot (p18)

Why Life Story Work matters:

“Through their life books our children have to come to own their story little by little, mainly because they have gone through them so often with other people and each time it comes clearer to them. Besides in retelling it, they think of new questions to ask and gain new realisations each time.”

SW quoted in Ryan & Walker, 1999

Direct work: a process not a one-off activity can help children

• Repeat – info. in different ways

• Revisit – explanations and explore feelings

• Recycle – at different ages and stages, events will, or may be perceived differently

• Reminders – opportunities for carers to acknowledge that past is not forgotten

• Reappraise – the meaning and impact now

Revisiting, Repairing and Resolving

Jay Vaughan (2003) observes that ‘a coherent and authentic narrative, however stark, painful and unpleasant, is essential for resolution and mature reflection - life books when accurate, can provide a useful chronology on which to base therapy, with the aim of re-engaging the child with his past and putting it into words.’ Revisiting, repairing and resolving are part of this process.’

Without Life Story work:

Lack of information > multiple impacts

• Impact on identity and self esteem

• Cognitive distortions e.g. self blame

• May affect the child’s capacity to settle and to make new attachments

• Impact on sibling relationships, contact, future searching etc.,

Without life story work

• Misperceptions can impede child’s ability to settle and develop new attachments

• Adopters responding to the consultation document Providing Effective Adoption Support (2002) highlighted Life Story Work as 1 of 7 areas of intervention that they found most useful after placement

Vera Fahlberg

sees Life Story Work as 'an opportunity to identify strong feelings about past events, to resolve issues, to correct misperceptions.'

It can help:

• to organise past events chronologically

• to aid in ego development

• to increase self-esteem

Fahlberg - cont’d

• a child re-read at his/her own pace

• a child share their past with selected others

• build a sense of trust with direct worker/ carer

• gain acceptance of the child's life, help the child accept their own past; and

• facilitate bonding

‘Opening up’ can be difficult

“Children want to belong to ordinary families. When parents’ problems lead them to behave in unpredictable or embarrassing ways children want to keep it secret.”

Cleaver et al, (1999)

p.72 Children’s Needs – Parenting Capacity

“Mummy is that a true promise?”

• Life story work must take account of differing accounts and perspectives

• Children will often have receive mixed and confusing ‘versions of reality’

• The experiences of siblings may vary substantially > impact on relationships and placement

Taking account of different perspectives

Rose and Philpot observe

‘No child is an island. In working with children on life story we also have to work with those adults whom they have known … people who have tried to help them, people who have harmed them. …. In doing this we are learning how to create a life story book that incorporates the whole of a child’s experience.’ (p23)

We all communicate in a range of ways

• Different methods facilitate communication

• Providing children with some choices helps empower them

• Computers = less boring and less ‘adult driven’!

• Children are often more at ease when ‘doing something’ and talking