Keeping the child in focus

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Keeping the child in focus

• Leah Bromfield Briony Horsfall
• National Child Protection Clearinghouse

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National Child Protection Clearinghouse

• The Clearinghouse provides a range of services to
  policy makers, practitioners and the community
• Research Help-desk for information advice
• childprotect email discussion list
• Publications (hard copy and electronic)
• Library collection (online catalogue)
• Conference papers, workshops and seminars
• Website
• The Clearinghouse also undertakes new research
• To find out more or to join go to
• http//www.aifs.gov.au/nch/about.html

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Overview

• The child in child protection
• Why keeping the child in focus is important
• Child focused practice
• Why it is hard to keep the child in focus
• How can we do better?

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Have we been missing the child in child
protection?

• The audit
• Case file audit of 100 families involved with
  Child Protection from 1994-2002
• Sub-set of 36 cases
• Frequency count of activities recorded in case
  files
• Limitations
• Only recorded activities
• Frequency of activity types not time taken for
  activities
• Excludes administrative activities (i.e.
  recording case files)

Bromfield (2005)
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Audit of activities recorded in case files(n
36 cases)
Bromfield (2005)
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Audit of activities recorded in case files(n
36 cases)
Bromfield (2005)
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Have we been missing the child in child
protection?

• During investigation phase
• 47 home visits, 37 interviews with parents, the
  children were recorded as having been sighted on
  35 occasions, and as being interviewed on 26
  occasions
• During case management phase
• 174 home visits, 593 phone calls with parents,
  275 instances of sighting the child, and 28
  instances where the case files include a record
  of the case worker speaking with the child. There
  were 1,164 phone calls to service providers
  recorded.

Bromfield (2005)
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Have we been missing the child in child
protection?

• Concluded
• The most common activity undertaken by statutory
  child protection workers was telephone calls
• Calls were made predominantly to professionals
  and services involved with the family
• Contacts with families were primarily between
  workers and parents (e.g. during case management
  telephone contact, office and home visits with
  parents represented 23 of activities)
• In comparison, contact with children (e.g.
  transporting children, supervising access,
  sighting and speaking with children) represented
  10 of activities

Bromfield (2005)
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Mothers of primary client

• Study of 100 families involved with child
  protection services in Victoria found that
  mothers rather than children were the primary
  client of child protection services
• Family 8, notification 5Children witnessed
  domestic violence perpetrated by their
  step-father (mothers de facto) against their
  mother. With the assistance of professionals from
  a domestic violence service the mother was able
  to evict the perpetrator from the home.
• Family 64, Notification 4Police attended a call
  out, observed broken glass near babys cot
  (broken during domestic dispute). Mother left the
  father as a consequence of the domestic assault
  and was assessed to be acting protectively
  towards her child.

Bromfield (2005)
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Mothers as primary client

• Concluded that focusing exclusively on mothers
  problems may result in statutory child protection
  services
• failing to assess the impact of maltreatment on
  children, and
• consequently failing to facilitate service
  provision to ameliorate the effects of
  maltreatment.

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Why keep the child in focus?

• We keep the child in focus
• to ensure their immediate safety
• to help them develop safe and well
• to uphold their human rights

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Immediate safety

• An estimated 25 Australian children are killed by
  their parents each year (Mouzos Rushforth,
  2003)
• In response to the death of an infant, the WA
  Child death review committee (2008) noted
• an issue of concern for the Committee was the
  lack of a child focus particularly as not all
  children in the family were seen and/or
  interviewed when concerns had been expressed (p.
  35)

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Immediate safety

• The WA Child Death Review Committee (2008)
  emphasised the importance of sighting and knowing
  the child and their siblings
• Similarly, the Victorian Child Death Review
  Committee (2008) profiled direct contact with
  children as an element of positive case practice
• Cooper (2005) commenting on prominent child death
  reviews in the UK also observed that there was a
  need to ensure the frequent physical sighting of
  vulnerable children

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Children develop safe and well

• Child protection services keep cases open when
  they have assessed the child will be at risk of
  further abuse and neglect without their
  involvement
• Abuse and neglect puts children at imminent
  physical risk
• Repeated and prolonged instances of maltreatment
  also put children at risk of cumulative harm

Bromfield Miller (2007)
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Children develop safe and well

• Researchers investigating brain development have
  used the term toxic stress to describe the
  prolonged activation of the stress management
  system without support (e.g. repeated incidents
  of maltreatment)
• Toxic stress can damage the developing brain
• Practitioners need to observe and interact with
  the child to see if they are
• Meeting developmental milestones, or
• Experiencing trauma symptoms

Bromfield Miller (2007)
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Uphold childrens human rights

• Australia is a signatory to the United Nations
  Convention on the Rights of the Child (ratified
  December 1990)
• Principles of the Convention are embedded in
  legislation and policy regulating provision of
  child protection services in Australia

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UN Convention on Rights of the Child

• Key principles include
• Article 3. 1. In all actions concerning children
  the best interests of the child shall be a
  primary consideration.
• Article 6.2. Parties shall ensure to the maximum
  extent possible the survival and development of
  the child.
• Article 9.1. Parties shall ensure that a child
  shall not be separated from his or her parents
  against their will, except when such separation
  is necessary for the best interests of the child
  ...
• Article 12.1. Parties shall assure to the child
  who is capable of forming his or her own views
  the right to express those views freely in all
  matters affecting the child, the views of the
  child being given due weight in accordance with
  the age and maturity of the child.

www.unhchr.ch/html/menu3/b/k2crc.htm
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Voices of the child

• Uphold childrens human rights by supporting and
  recognising the agency of the child
• Giving children appropriate information and
  opportunities to participate in decisions that
  affect them
• Needs to be appropriate to context and stage of
  development
• Children may give their view directly and/or
  indirectly via a trusted adult/advocate
• Not just at formal decision making points, but
  routinely by visiting and talking with the child

Winkworth McArthur (2006a)
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Child centred practice

• In 2008, Tasmania adopted a new practice
  framework
• The practice framework was developed in New
  Zealand by Dr Marie Connolly
• The practice framework comprises three sets of
  philosophical principles guiding practice
• Child-centred
• Family-led and culturally responsive
• Strengths and evidence-based
• Prioritises a child-centred approach

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Why it is hard to keep the child in focus

• Systemic issues
• Pragmatic constraints
• Individual attributes

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Why it is hard to keep the child in focus

• Systemic issues
• Issues associated with the nature and structure
  of child protection and the legal and policy
  framework regulating practice that reduce (often
  inadvertently) the focus on the child

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Decision-making study

• Lack of child focus not always obvious
• For example, in Victoria the definition of a
  child in need of protection is framed in relation
  to the child having been, or being likely to be,
  significantly harmed
• On surface, child focussed draws attention to
  impact on child rather than parental actions

Bromfield (2005)
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Decision-making study

• Case file review of records for 100 families over
  8-year period (1994-2002)
• Impact of the maltreatment on the child was not
  identified in 64/82 substantiations
• Impact of harm on child most likely to be
  identified where it was easily linked to recent
  events (short-term outcomes) and physically
  observable by professionals (eg bruising)

Bromfield (2005)
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Decision-making study

• Lack of attention to the psychological and
  developmental impact of child maltreatment
  (long-term outcomes) esp. neglect emotional
  abuse
• Abusive/neglectful behaviour and children being
  placed in risky situations assumed harmful
  without assessment of child
• For example, Family 8, notification 2
• Emotional abuse substantiated without any record
  on case file of the children being sighted by a
  child protection practitioner

Bromfield (2005)
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Decision-making study

• Focus on harm consequence may lead to difficulty
  in linking specific abusive or neglectful
  behaviours with long-term outcomes for children
• Family 93, Notification 1 Baby reported with
  poor skin pallor, lethargy, not reaching
  developmental milestones. However, when fed
  infant reportedly responded like a normal baby.
  Reporter believed that mother was failing to feed
  infant regular meals. Child protection advised
  that there was insufficient information on
  specific incidents of neglect to warrant
  protective involvement and the case was closed at
  intake (Unsubstantiated)

Bromfield (2005)
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Decision-making study

• Concluded
• Despite a legislative focus on child outcomes,
• In practice, child outcomes were overlooked in
  the process of making risk assessments and case
  decisions

Bromfield (2005)
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Review of policy procedure manual

• Winkworth McArthur (2006a, 2006b) undertook a
  review of the ACT Child Protection policy
  procedure manual to determine the extent to which
  practice standards were child-centred

Winkworth McArthur (2006a, 2006b)
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Review of policy procedure manual

• They defined child-centred practice principles
  as
• Recognising critical timeframes - early in the
  life of the child and early in the life of the
  problem
• Accounting for developmental needs of children in
  all practice contexts
• Providing children and young people appropriate
  opportunities for participation
• Promoting collaborative practice - sharing
  information, recognising interactions between
  levels of childs environment (home, school,
  neighbourhood)

Winkworth McArthur (2006a)
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Review of policy procedure manual

• Child protection legislation and policy were not
  necessarily written with a child-focused approach
  
• Failure to be child-focussed can be unintentional
• For example, the emphasis on family support can
  unwittingly detract from childrens perspectives
  and experiences
• It can take time for child-focused amendments to
  legislation and policy to reach practice

Winkworth McArthur (2006a)
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Why it is hard to keep the child in focus

• Pragmatic constraints
• Pragmatic constraints are factors unlikely to
  change in the short-to-medium term and over which
  practitioners, policy-makers, and their
  respective organisations have little influence
• For example, organisational structure, resources,
  capacity to implement change, work roles, the
  economic and political climate, and prevailing
  community attitudes

Holzer, Lewig, Bromfield Arney (2007, p.12)
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Pragmatic constraints

• Practitioners have expressed concern about the
  day-to-day demands of the job, large caseloads,
  competing priorities within cases and staff
  shortages (Holzer, Lewig, Bromfield Arney,
  2007, p. 12)
• Winkworth McArthur (2006b) noted that
  increasingly complex and procedurally driven care
  and protection processes mean that there is a
  risk that the childs experience of these
  processes become lost
• The Victoria Climbie Inquiry in the UK found that
  procedural guidance could obscure rather than
  illuminate the childs perspective

Winkworth McArthur (2006b)
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Pragmatic constraints

• Winkworth McArthur (2006b) observe
• With so many agendas running concurrently it is
  easy to lose sight of the child in these
  processes and to allow other interests to
  dominate (p. 5)
• They concluded that
• Being child centred means being guided by
  contemporary knowledge about the welfare of
  children and young people and includes keeping
  the child and young persons perspective and
  experience uppermost in all considerations (p. 5)

Winkworth McArthur (2006b)
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Why it is hard to keep the child in focus

• Individual attributes
• A persons own values, beliefs, assumptions and
  experiences are likely to influence the manner in
  which individuals practice and the way in which
  they react to the nature of the work

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Individual attributes

• Personal risks and safety
• Child protection practitioners are routinely
  expected to visit the homes of violent people
• Potential harm to practitioners is a real risk
• Threats of violence and hostility associated with
  home visits are stressful

Stanley Goddard (2002, p. 119)
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Individual attributes

• Emotional labour of child protection work
• Child protection can be emotionally intrusive to
  the practitioner
• Practitioners need to manage their feelings
  (internal) and emotional expression (external) in
  interactions with multiple others (managers,
  colleagues, parents, and children)
• Emotional labour of engaging with children and
  developing a relationship may impact child
  focused practice

Gibbs (2001, p.327)
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Individual attributes

• Therapeutic collusion
• The challenge of balancing empathy for the
  parent/s who may be trying to cope with their own
  difficulties and making some effort to change,
  with the needs of the child
• When there may be desire on behalf of the parent
  for change but progress to address serious
  adverse impact on child has been insufficient

Cousins (2005)
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Individual attributes

• Normal ways of coping can de-centre the child
• Individual reactions to the nature of the work
  and strategies for maintaining physical and
  emotional safety (conscious and unconscious) may
  contribute to decisions not to visit the family
  home and to see and talk with the child
• Focus on, and empathy for, parents may prevent
  practitioners from seeing that parents have not
  been able to make changes or to progress fast
  enough to meet the needs of their children

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How can we do better?

• Keeping the child in focus in case work
• Assessment - Assess impact on child of
  environment or events (short- and long-term
  effects matter)
• Planning - Engage child in decisions effecting
  their lives
• Action - Thoughtful interventions that assist
  child in recovery as well as addressing safety
• Review - Good practice can involve trial and
  error - have your interventions changed things
  for the child

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How can we do better?

• Supervision reflective practice
• Beyond case management, supervision can ensure
  emotional and cognitive support for practitioners
  (Gibbs, 2001 Munro, 2002)
• Training
• Training for case workers, carers and residential
  workers to engage children with developmentally
  appropriate and culturally sensitive approaches
  (Osborn Bromfield, 2007)

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How can we do better?

• Recognise systemic and pragmatic constraints
• Munro (2005) recommends a systems approach to
  analysing and responding to child protection
  failures
• One step at a time
• Systemic change takes time
• Strength in Tasmania - Practice framework with an
  explicit child centred approach

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Discussion

• In your practice
• Are there issues that make it difficult to be
  child centred? What are they?
• What would help you to be more child centred?
• What can change now?

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National Child Protection Clearinghouse

• Australian Institute of Family Studies
• Level 20, 485 La Trobe Street Melbourne
• 03 9214 7888
• www.aifs.gov.au/nch
• This presentation can be downloaded
  fromwww.aifs.gov.au/nch/pubs/presentations/diary
  

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References

• Bromfield, L. (2005). Chronic Child Maltreatment
  in an Australian Statutory Child Protection
  Sample. Unpublished Phd Thesis, Deakin
  University, Geelong.
• Bromfield, L., Miller, R. (2007). Specialist
  Practice Guide Cumulative Harm. Victorian
  Government Department of Human Services,
  Melbourne.
• Child Death Review Committee Western Australia.
  (2008). Annual Report 20072008. Government of
  Western Australia, Perth.
• Cooper, A. (2005). Surface and depth in the
  Victoria Climbie Inquiry report. Child and Family
  Social Work, 10(1), pp. 1-9.
• Cousins, C. (2005). But the parent is trying
  The dilemmas workers face when children are at
  risk from parental substance abuse. National
  Child Protection Clearinghouse Newsletter, 13(1),
  pp. 3-6.

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References

• General Assembly of the United Nations.
  Convention on the Rights of the Child. General
  assembly resolution 44/25 of November
  1989,Office of the High Commissioner for Human
  Rights, Geneva. Retrieved 20th February, 2009
  from www.unhchr.ch/html/menu3/b/k2crc.htm.
• Gibbs, J. (2001). Maintaining front-line workers
  in child protection A case for refocusing
  supervision. Child Abuse Review, 10, pp.
  323-335.
• Holzer, P., Lewig, K., Bromfield, L., Arney, F.
  (2007). Research Use in the Australian Child and
  Family Welfare Sector. Australian Institute of
  Family Studies, National Child Protection
  Clearinghouse and University of South Australia,
  Australian Centre for Child Protection,
  Melbourne. Retrieved 23 February, 2009 from
  www.aifs.gov.au/nch/pubs/reports/researchutilisati
  on/stage1/research.pdf

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References

• Mouzos, J. Rushforth, C. (2003). Family
  homicide in Australia, Trends Issues in Crime
  and Criminal Justice No. 255. Australian
  Institute of Criminology, Canberra. Retrieved 17
  March, 2008 from http//www.aic.gov.ai/publicatio
  ns/tandi2/tandi255.pdf
• Munro, E. (2005). Improving practice Child
  protection as a systems problem. Children and
  Youth Services Review, 24(4), pp. 375-391.
• Munro, E. (2002). Effective Child Protection.
  Sage Publications, London. Osborn, A.
  Bromfield, L. (2007). Participation of children
  and young people in care in decisions affecting
  their lives. Research Brief, 6. Australian
  Institute of Family Studies. Retrieved 23
  February, 2009 from www.aifs.gov.au/nch/pubs/brie
  f/rb6/rb6.html

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References

• Stanley, J. Goddard, C. (2002). In the Firing
  Line Violence and Power in Child Protection
  Work. John Wiley Sons, England.
• Victorian Child Death Review Committee. (2008).
  Annual report of inquiries into the deaths of
  children known to child protection 2008. Office
  of the Child Safety Commissioner, Melbourne.
• Winkworth, G. McArthur. M. (2006a). Being
  child centred in child protection What does it
  mean? Children Australia, 31(4), pp. 13-21.
• Winkworth, G. McArthur, M. (2006b). Principles
  for child centred practice. Australian Catholic
  University, Institute of Child Protection
  Studies, Canberra. Retrieved 23 February 2009,
  from http//inet.acu.edu.au/download.cfm/F1F59635
  -AFC1-5109-10D054CA6B292444/x/ICPS_Principles-4-Ch
  ild-Cnetred_Practice.pdf