Tag Archives: trauma

The Troubling Role of Trauma in Social Work – a parent’s view.

I am grateful for this guest post from contributor looked_after_child@yahoo.com. She asks how do social workers perceive ‘trauma’ and what impact does that perception have on their decision making? Are social workers being tempted to make ‘diagnosis’ of conditions that are outside their expertise?

When we see pictures of puppies or kittens we may have a strong impulse to go ‘Aaaah’. When we hear of ‘traumatised/abused/neglected children’ we should feel a visceral sense of revulsion. Social workers working with children will see it as their professional role to make things better for the ‘traumatised/neglected child’ but what does a traumatised/neglected child look like? That can be very hard to assess. At one end of the spectrum the child may be very quiet and at the other end a child may be beyond control and have any number of difficulties from extreme anxiety to violence. Are the problems of such children a result of abuse/trauma or could there be other reasons for their difficulties?

What if a social worker takes it upon themselves to assess the problem and becomes so fixed in his/her views that he/she fails to robustly assess all possible reasons for a child’s difficulties and take any steps he or she can to pinpoint exactly where the problems are? I believe many social workers have reached the point where they are now in danger of making these calls based on their own ‘hyper-vigilance’ around trauma/neglect.

What is trauma?

I must confess I never paid too much attention to ‘trauma’ before social workers entered my life and I began to hear this word again and again. I suppose my idea of trauma would have been a natural childbirth – the most natural thing in the world even if it is challenging when you are going through it.

Social workers seemed to use trauma as shorthand to explain why someone might be having a difficulty. This version of trauma seemed to me to be closer to a therapist’s version of trauma, an emotional wound or rupture that needed to be addressed before the person could move on with their life.

I’ve since had the benefit of hours of support from therapists around the ‘fall-out’ around our family situation so I think I really do now understand trauma – the life-changing, perspective-altering, ‘no-going back, get used to it’ type of trauma but I still have serious reservations about how social worker perceive trauma and the role it plays in people’s lives. The idea of a social worker fixing emotional wounds may help social workers get through a very challenging day but it seems to me to bring with it a number of really quite serious problems.

The danger of scapegoating

I believe that social workers often deal with parents in distress/despair including the ‘just about managing’ who have tipped over into crisis. They may, for example, be caring for disabled children, in poor health, living with violence, carrying debt they have no chance of paying off or in poor/insecure housing and employment. They may also not speak English very well or be dyslexic or have learning disabilities. They may have a whole range of vulnerabilities that they need help with including help parenting a child with unexplained emotional and behavioural difficulties.

I don’t want to make this an article about the destructive effects on families of policies that are ‘rebalancing’ our society so that we all become ‘economically productive units’ but it is a fact that these policies are really hurting many of the ‘just about managing’. Social workers may feel powerless when faced with the effects of these policies and may not have the resources to meaningfully address the difficulties of those affected but it is an undeniable fact these policies are having a hugely detrimental effect on the mental health of many of our children. (See http://www.childrenssociety.org.uk/news-and-blogs/press-releases/nine-homes-by-the-age-of-nine-–-housing-instability-marks-lives-of#163961_20170330102705)

When supporting families in dire circumstances, it is tempting for the social worker to take on the role of ‘expert’, stick a label of ‘incompetent’ on the parent without acknowledging the role of factors beyond the control of social worker or parent on the child’s difficulties. Parenting classes are a rite of passage for parents in this situation. Having being on an excellent but wildly inappropriate Troubled Families Programme this is emotive territory for me. There may be no money for anything else but in my view it is unethical to send parents on parenting courses without a very clear idea of the child’s/families difficulties and how the course will help in all spheres including around personalised health support.

The ‘nature vs nurture’ debate.

Where to start…
Trying to find answers for a child’s difficulties is such a highly contested area and moves well beyond the social work world. This contest is fought out for example in the arenas of genome sequencing and brain scanning and there are also a small number of clinical trials challenging myths that have informed whole policies including policies on social work training. (See http://link.springer.com/article/10.1007%2Fs10803-015-2680-6 ) There are ‘dirty tricks’ including presenting brain scans of children brought up in environments where they have been extremely mistreated,used to evidence harm caused by parental incompetence.

This battle is also fought by people based on their own difficult experiences of childhood or of parenting a child with unexplained and profound difficulties for whom they have been unable to get help. Few players do not have strongly held beliefs or professional reputations at stake.
Clinicians are grappling with the implications of this in terms of clinical practice. Policy makers have identified a tsunami of demand and know there are very limited clinical resources with the expertise to make these calls for individual children.

As an example of the difficulties clinicians face there are two diagnoses for virtually the same set of symptoms. Attachment disorder for the children of the disorganized, unresponsive parent living in poverty that is unable to parent their child successfully (cause – parental neglect) and late diagnosis Autism/Asperger Syndrome possibly with a demand avoidance profile for the children of ‘competent’ parents. (cause – as with all the Autisms largely genetic with a possible in-vitro environmental element).

Fraudsters abound with ‘bleach cures’ and dubious ‘therapies’ and families are desperate for answers. There are virtually no diagnostic paths for Fetal Alcohol Spectrum Disorder. No matter what the circumstances of their parents, it is, in my view, likely that the low priority given to mental health services for children has all-but failed a generation of self-harming, anxiety immobilised adolescents and their families, many with unidentified disabilities and difficulties such as sensory and sleep disorders,. (https://epi.org.uk/report/time_to_deliver/) It is also likely that low self-esteem is a major contributing factor for many children/young people with ‘behavioural’ difficulties. Somewhere in the mix comes trauma – the ‘emotional wound’ type and the ‘neglect’ type and the type you ‘recover from’ and the type you ‘learn to live with but never recover from’. The good news where trauma is concerned is that recovery is often possible with the right support unlike disability which is life-long.

Imagine what is like for a parent really struggling to get help for their child to be told the child’s difficulties are ‘on your head’, caused by ‘trauma’ and by a social worker to boot and yet many social workers believe this is their call.

What is the Social Workers role?

It may or may not be true that there is widespread mis-diagnosis of ADHD, ASD, Attachment and anxiety and similar disorders but it takes another clinician to make this call for an individual child and to generalise you need evidence of widespread mis-diagnosis via randomised clinical studies or equivalent.

I believe when trying to help a young person with profound emotional, behavioural difficulties social workers should be alert, question, look for guidance from clinical colleagues, raise concerns where you have them, provide personalised support to the best of your ability, fight for their clients rights for good support including good clinical support but you should always stick to your area of competency. The ability to make clinical diagnoses as a result of trauma just does not fall within it.

National Adoption Week – An Adopter’s view Part II

Who or what is helping traumatised children?

We are grateful for this second post about National Adoption Week from the perspective of an adopter. She queries why the only open and honest debate appears to be coming from adopters or adoptees. This is particularly so when talking about the impact of trauma upon children and their development. That the only intervention for traumatised adopted children appears to be to put them in section 20 accommodation is a ‘national disgrace’. 

I have spent a little too much time reading, listening and watching the coverage of National Adoption Week 2015. I was hoping for a bit more honesty than previous years. I am not at all surprised but am saddened that we really are having the same old tripe being spurted out by those who should know better.

The only honest, open, truly adoption focussed reality checks have come from adopters or adoptees.

We have seen this years strapline emblazoned on some important buildings in a few cities
`Too old at 4’. What the strapline or the hype don’t mention in a realistic way, is the level of trauma those children have suffered or the fight that adoptive parents will have to get them the help and support needed to live with that trauma.

A report published in 2014 ‘Beyond the Adoption Order’ gives a very detailed description of the difficulties.

Children who have suffered trauma – who promotes their ‘best interests?’

In this guest blog, I want to tell you about what can happen when those that should know better do not act in ‘our’ children’s best interests. When I use the term ‘our’ I am talking about adopted children who have, in reality, if not law, two families.

Our children’s trauma usually takes a while to surface, often years and often during the turbulent teens. There will have been a few signs during primary school days for many. Our children will struggle with friendships, with the structure of the school day. They will get far more than their fair share of fixed term exclusions and even permanent exclusions before anyone in local authority education depts will agree to assess them for an education, health and care plans.

The evidence is clear that children in care do not fair well in comparison to their peers and yet adopters struggle to get those in education to believe that our children will suffer the same , if not more, difficulties. We have been able to access the pupil premium over the last few years and we know how it should be spent to help our children. Sadly this doesn’t happen in most local authorities because our children do not have a right to have their education overseen by a virtual school head teacher like children in care do.

If our young people get through the education system, they may not be so lucky in the way their sometimes fragile mental and emotional health is concerned.

The failure of CAMHS Teams and the disgrace of long term section 20 accommodation

Despite their early maltreatment and unresolved trauma, many Child and Adolescent Mental Health (Camhs) teams fail to address the mental health of our children. Adopted children got a mention in an overview of current Camhs provision and their particular difficulties have very recently been the subject of a roundtable discussion.

Social care are often no better than education or health. Adopters have something that birth families, special guardians or kinship carers don’t. We have access to post adoption support social workers. Like many services nationwide, those services vary in quality. The good ones come into their own when our children start to live their trauma out in the here and now. The children make allegations of abuse against their adoptive parents. Thankfully, many of the allegations are false and in a tiny amount of cases where they are found to be true, we all need to know that those children will be kept safe.

However, the majority of allegations are false. We know why our children make allegations but childcare social workers have little experience of traumatised children who are now safe with their adoptive families , safe enough for the trauma of their past to leak everywhere.

Sometimes that trauma shows itself in the violence that our children perpetrate against us, their parents, to their siblings, their friends or even to animals. They can also turn the violence to themselves, taking risks that belie the range of normal teenage risk taking or self harming.
At this point in their lives, many of our children will become `looked after` for the second time in their lives. They will be voluntarily accommodated under Section 20 of the Children’s Act.

For many of our children, they will remain in the care of the local authority under S20 until adulthood. This is a national disgrace. That a maltreated child, removed from their birth family for all the right reasons, does not get the help they and their adoptive families need to resolve (or at least come to terms with) their trauma, is unforgivable in a civilised society.

My message throughout NAW was that children and young people must always be at the core of everything that is done in their name. Those who have returned to care are no different.

‘OUR’ Kids must always be the priority.

National Adoption Week – An adopter’s view

We are grateful for this post from an adoptive parent, who calls for an end to the distorting rhetoric about adoption; without honest and open discussion of what is gained and lost through adoption, we risk losing focus on what should be the fundamental core of all our endeavours here –  the children and what they need.

During National Adoption Week, as a society, will we be able to finally have the conversation we urgently need? Or will rhetoric and political agendas continue to stifle that debate?

I have come to understand that adoption is more about loss than gain

Today is the start of National Adoption Week (NAW) when Adoption Agencies (on behalf of the Government) want and need to inform the public about how their country needs them. Not to go to war but to parent children and young people through adoption when nothing else will do

I am an adopter. I have a few problems with National Adoption Week. I probably shouldn’t because I can recall seeing some daytime tv 16yrs ago and thinking – `yep, that is what we need to do.’ Hubby and I would make good parents and if children need a forever family, that can and should be us.

Over the years that followed that day, I have come to understand that modern adoption is more about loss than gain. I hope you will understand why I think that by the end of this week.

I am a member of a peer support group for the parents of traumatised adopted children and young people. Trauma is a term we think best describes the losses our children have lived with. It describes their loss of birth family, identity, childhoods where they had rights to be kept safe, physically and psychologically.

A few weeks ago a few of us attended the first Family Law Class open to all . It was a good class. We were well aware that ‘our’ children’s birth families could be sat next to us and that was ok. It was ok because we know about their loss, their difficulties with communicating and dealing with professionals at an immensely difficult time in their lives. We know because a minority of experienced adopters go through the same experience with social services as many struggling birth parents. I will talk about that later this week.

Today I want to talk about what I feel is often unsaid during NAW, about birth parents, adopters and ‘our’ children.

The elephant in the room – what will happen if my child’s birth parents didn’t harm them after all?

Those professionals and interested adopters will know that the answer to the question is – probably nothing. The circumstances under which any Judge will reverse a decision involving an Adoption Order (certainly after some time has elapsed) are very rare.

But experienced adopters are well aware of the miscarriages of justice that have happened in the UK. I speak for many adopters who feel that these miscarriages of justice are a travesty. A child and maybe their siblings will have lost their birth parents, each other and everything they hold dear. They may be moved from pillar to post within the care system, being sent to live with strangers and one day, will have to learn that none of that should have happened. Such a loss can never really be put into words can it?

Adopters feel for birth parents where miscarriages of justice have happened. We have genuine empathy for them and hope that agencies (& if necessary the courts) do everything in their power to ensure that those children, birth parents and adoptive families are enabled to build a mutually rewarding relationship in the future. It can be done, I am sure of it. Society needs it to be so.

But what of those children and young people that were rightly removed from their birth parents?

People approved for adoption will have been told and will have read reports written by social services about the children’s life with birth parents. We will have been told that the children need a new `forever` family because birth parents are not able to safeguard them. The birth parents are deemed by all in authority to not be `good enough parents’.  This is my first problem with NAW.

NAW will have you, the person wanting to be a parent, believing that that is absolutely the case. It may well be, but I have been concerned for a number of years that it isn’t that simple.
Prospective adopters need to believe that for `our` children to have been placed for adoption, their birth families must not have been ‘good enough’ to do the job. Parents need to keep the children safe, not to abuse or neglect them, to put the children’s needs above their own. Parenting isn’t just about loving them. Social services are meant to prove that to be the case. Family law courts are supposed to ensure that that is the case before they agree to a placement order and thereafter an adoption order. Adopters need to believe that social services have also ruled out that other forms of permanence would not be in their child’s best interest too.

We will be led to believe that some birth parents should either never have direct contact (I prefer to say `have a relationship with`), or should absolutely have a relationship. We need to know that all the decisions made in relation to `our` children are made with the best of intentions.

We adopters need to know these things because contrary to some rhetoric, adopters do not want to steal children, we are not a market of middle class do gooders or people that need to have a child as a fashion accessory. We are not the reason that children need to be removed from the otherwise loving caring homes any more than the government have `targets` for removing children to support some black market.

We are just people who know we can give love, nurture and care to traumatised children and young people. We can and do put our children’s needs above our own.

My message throughout NAW is that children and young people must always be at the core of everything that is done in their name.

`OUR’ kids must always be the priority.