Tag Archives: communication; case conference reports;

Only connect – how language can get in the way of communication

Genuine ignorance is profitable because it is likely to be accompanied by humility, curiosity, and open mindedness; whereas ability to repeat catch- phrases, cant terms, familiar propositions, gives the conceit of learning and coats the mind with varnish, waterproof to new ideas (Dewey, 1910: 177).

What happens when we not only haven’t shared the same experiences, but don’t share a common language to talk about our differences? Kate Wells, a retired social worker discusses how communication can be sabotaged by the gulf between us. Kaylee and Jessica are not real people; but the challenges each of them face are informed by real experiences.  

Kate concludes by expressing her doubts that therapeutic intervention will help improve Kaylee’s parenting skills. 

A tale of two children.


Kaylee and Jessica were both born on the same day in January 1990 – in different hospitals but only 12 miles apart.

Kaylee (known as K) was born in the City Hospital, the third child of the family.  Her mother was a single parent and there were 2 older brothers.  The family home was a high rise flat in a deprived area of the inner city.  Her father and mother were separated before she was born.  Her older brothers both had different fathers.

When K was 3 years old, her mother was in a new relationship and so K and her brothers had a step-father, and a 4th child was born.  K started school at aged 5 and liked her primary school – there were bright coloured crayons and story books and the teachers were kind.  One of them kept clean shorts and T shirts for K to wear on PE days, and she loved the school meals.  She played out with friends who lived in the same high rise block, but older children broke the few swings and the roundabout.  Her mom and step dad shouted at each other a lot and K was scared of her step-dad because he shouted at her and sometimes sent her to bed without any tea.  There were no holidays or days out (though K remembers going to visit a farm on a school trip) no birthday or Christmas presents.  Her eldest brother bullied her and their step dad used to hit both the boys.  There was not much contact with the extended family, K’s mother had fallen out with her own parents and although she had 6 siblings, there was very little contact with any of them.

K moved to secondary school at aged 11 and felt scared because the new school was so big and there were all different teachers.  She didn’t have a proper uniform and her shoes were too small for her and hurt her feet.  She didn’t like the lessons and by the time she was 13 she was “kicking off” in school and getting into all sorts of trouble.  She hated the school and the teachers and started truanting and then got into more trouble.  One day she had a fight with another girl and swore at teachers and was suspended.  By this time her eldest brother was in prison for burglary. K was finally permanently excluded from school at aged 15 and went to a Pupil Referral Unit where all the pupils had behaviour problems.  K got into fights with the other pupils but made a couple of friends and they used to go shoplifting together. They were caught and went to Court and got a Conditional Discharge. K had no educational qualifications.

K became pregnant when she was 16. The father was also 16 and lived in the same block of flats, but he denied he was the father and they split up before the baby was born.  Her mother had separated from the step-dad and had a new partner.  He said K was a “slag” and her mother agreed.  The baby (B) was born when K was just 17 and they continued to live in the flat, which by now was very over crowded.  There were lots of arguments and when B was 8 weeks old, there was a big argument over some stolen cigarettes and K’s mom “kicked her and the baby out” – K went to stay with friends and moved around the town, staying with different people.  K asked her mother if she’d look after the baby till she could get a place of her own but she refused.  K was drinking alcohol whenever she could and shop lifted again to buy vodka and cider.

Eventually Social Services became involved when B was aged 12 weeks and he was made the subject of an EPO and placed with foster carers.  He was later adopted.

K was homeless and was staying with whoever would put her up for a few nights and then she got a room in a Hostel in the city.  She started using cannabis and other drugs and continued abusing alcohol.

Between the ages of 18 and 25 K had several different relationships and 2 more children, both of whom were removed from her care and placed for adoption. At aged 25 she is pregnant for the 4th time and has been doing quite well with the Substance Misuse Team, and is on a script for methadone.  There is a suspicion that she is still abusing alcohol although she denies this.  She is living with the father of the baby and wants to keep this baby.



Jessica (known as J) was born in a hospital 12 miles away from the inner city hospital.  She is the first born child – mother is an educational psychologist and father is an IT Manager.  The family home is a spacious 3 bed semi with a garden situated in a quiet backwater of an upmarket town.  J’s mother stays at home till J is 18 months and then works 2 days per week – J is cared for by maternal grandmother.  When J is 3 years another daughter is born and mother stays at home to care for the children.

At aged 3.5 years J attends a local nursery for 2 mornings per week.  At home J’s mother plays with the children, reads to them, and provides opportunities for painting and messy play both inside and outside.   There are visits to the park and other child friendly places.  Birthdays are celebrated with parties and birthday cake and Christmas is celebrated in the traditional manner.  There are annual holidays to Devon and Cornwall.  The children enjoy a good relationship with both sets of grandparents, aunts, uncles and cousins.

At aged 5 J starts school at the local primary school and enjoys all aspects of school life.  She could read before starting school which gave her a head start and she loves reading and writing and makes new friends.  She learns to play the recorder and violin.  At weekends there are family outings and swimming and ballet lessons. J takes her SATS exams in Year 6 and scores 5 in all subjects (4 is the average) Her end of primary school report says that she has been “a pleasure to teach through her primary education.”

At aged 11 years J transfers to Secondary School, a state comprehensive but with a good catchment area and rated as Outstanding by OFSTED.  Many of her classmates from primary school transfer to this school and she also makes new friends.  J is a little unsettled at the beginning of Year 7 and there is a period of adjustment, from primary to secondary education.  By the end of the first term J is settled and has a nice group of friends.  Teachers describe her as “a conscientious pupil who works hard and is a popular and mature member of the class.”  Interests outside of school include swimming, dancing, music and drama.  J joins a drama group and continues to play violin.  By the time she is 15 J is able to go “out and about” with her group of friends, to the cinema, bowling alley, swimming etc.  They spend time at each other’s homes and spend a lot of time on social media.  J is doing well academically and is conscientious about her homework.  By this time her mother has returned to work and there are family holidays in the Mediterranean and visits to European cities.

At aged 16 J has passes in 10 GCE subjects with good grades.  She transfers to the local 6th Form College and begins A levels.  She is more inclined to the arts, and chooses to study Psychology, English and Drama at A Level.  She would like a job “helping people” – maybe teaching or social work.  At aged 18 she has passes in 3 A level subjects with good grades.  She is still thinking of a career in social work and contacts the Admissions Tutor of the social work degree course and is told that she needs relevant experience.  Undeterred J sets about embarking on voluntary work.  She volunteers in a Home for Older People, a Children’s Centre, and a nursery in a deprived area. J has a Saturday job but is mainly supported by her parents.  At aged 22 she successfully applies for a place on the Social Work Degree course. At aged 25 J is a newly qualified social worker.

J begins her social work career with a nearby LA and is a member of a Child Protection Team.  After 6 months, she is allocated a case – Kayleigh and her unborn child.


The parent and the junior social worker; first meeting

It is at this point that Kaylee and Jessica meet for the first time.  J has made her way up to K’s flat.  K opens the door – she is pale and thin, apart from a baby “bump” – she has tattoos around her neck and huge gold hooped ear rings.  J has long shiny hair, tied back and is dressed in smart casual clothes.  She smiles brightly at K, and introduces herself.  K makes no comment, walks away but leaves the door open for J to follow her.

Neither K nor J has the slightest idea of each other’s lives.  It isn’t important that K knows nothing of J’s background but it is of huge importance that J has some understanding of K’s background and how this has shaped the adult she has become.

But J can’t know – it isn’t her fault – she wants to help people who are disadvantaged – she wants a more just society.  She realises she has had opportunities that have been denied to her clients.  She hopes to be able to support people and bring about improvements in their lives.

J follows K into her flat – the curtains are drawn even though the sun is streaming in, there is a worn sofa and chair, a coffee table and a rug on the floorboards.  K’s partner (G) is sitting on the floor in front of the TV playing on the Xbox.  K sits down and rolls a cigarette. J tries to introduce herself to G who vaguely looks in her direction and goes back to his game.

J is trying to form a relationship with K as that’s what she’s been taught on her social work degree course.  She asks about the pregnancy and how K is feeling……..K says “they’ve took 3 kids off me and now you’re here to take this one as well – I know you lot and I don’t trust you, none of you.”  J tries to reassure K that her job is to try to keep families together and asking a court to remove the baby would be a last resort.  K snorts in derision – J says she’s pleased that K is keeping her ante natal appointments, and it’s really good that K has done so well to get off heroin with the help of the Substance Misuse Team.  K says “yeah – I’ve cleaned me act up” and G looks over and says “apart from the vodka” and starts laughing.  J looks anxious and asks if K is drinking vodka…….K replies “take no notice of him, he’s a wanker.”  J doesn’t want to press the issue any further but talks about the dangers of using alcohol in pregnancy.  K makes no comment and after a fairly desultory conversation J makes another appointment in 2 weeks and leaves.

J records her visit and in supervision she talks to her Team Manager about her concerns about K’s possible abuse of alcohol while pregnant.  TM talks about the dangers of Foetal Alcohol Syndrome (FAS) but J has never heard anything about this and agrees to make sure she is better informed on this issue.  J is a bit scared of K but she doesn’t want to tell the TM about this…….

At home J talks to her mother about some of her cases (her mom will keep the matters confidential) and says she’s a bit scared of K as she looks “mean” (she isn’t aware of the reality, that K’s face shows the hurt inflicted on her as a child) and she knows she has a temper and is worried about upsetting her.  J’s mother wonders whether J would have been better doing teaching or nursing.  J also talks about her caseload and how it feels overwhelming and she’s not getting much support from the Team Manager or from anyone else in her team.  She’s starting to feel anxious and is having trouble sleeping.

Over the next few weeks J continues to visit K and smells alcohol on K’s breath sometimes.  K’s mother phoned in to say “K was a “smackhead” and an “alki” and wasn’t fit to have kids.  There had been ongoing conflict between K and her mother for many years.  J finally plucks up courage to tell K she’s concerned about her possible abuse of alcohol.  K gets angry and says “for fuck’s sake, it’s never enough for you lot, I’ve given up drugs, now you’re on about me having a can of cider now and again, you’re all the fucking same, you’ll find something to pin on me so you can take this kid like the others – well I’ll tell you something it ain’t gonna happen so you can just fuck off.”  J is scared as K is shouting loudly but she tries to calm K by saying she’s not accusing her of anything, she’s just worried that alcohol in pregnancy can really harm the baby.  K says “yeah right” – “you got any kids then” and J shakes her head NO “I thought not” says K sarcastically.  The visit ends on a hostile note.  J is very worried about this case.


The report for a case conference:

J writes:

I am concerned about K’s parenting capacity and her ability to put the needs of her child before her own.  She has done well on the drugs issue but I believe she is still abusing alcohol though she refuses to discuss this issue.  She appears largely unaware of the dangers of alcohol abuse in pregnancy and the possibility in particular of Foetal Alcohol Syndrome, caused by alcohol being passed via the bloodstream into the placenta and adversely affecting the foetal cells in utero, a process that cannot be reversed or rectified.

K is mostly hostile in interviews and is disinclined to communicate effectively with me.  Her partner G is sometimes present but shows no interests in any discussion about K’s pregnancy, or the coming baby.  He appears somewhat immature and is usually playing games on the internet.  The flat is generally grubby and both K and G smoke rolled up cigarettes which would be harmful to a young baby.  Furthermore K’s mother has made allegations that K is still using heroin and is abusing alcohol, although this has to be treated with caution as allegations and counter allegations are frequently made, which cannot be verified.

K is furious with this paragraph in the report and says she doesn’t know what J is on about and WTF does she mean with all these big words, and smoking doesn’t harm a baby cus all her mates smoke and they have kids, so what’s J on about……………..and why are you taking notice of what that cow of a mother says about me – she drinks from morning till night and so what right has she got to talk about me………………

J has been using the elaborated code of language, whereas K uses the restricted code.


Language: the Elaborated and Restricted Code

These are terms introduced by the British sociologist Basil Bernstein in the 1960s, referring to two varieties (or codes) of language use, seen as part of a general theory of the nature of social systems and social rules. The elaborated code was said to be used in relatively formal, educated situations, permitting people to be reasonably creative in their expression and to use a range of linguistic alternatives. It was thought to be characterized by a fairly high proportion of such features as subordinate clauses, adjectives, the pronoun I and passives. By contrast, the restricted code was thought to be used in relatively informal situations, stressing the speaker’s membership of a group, relying on context for its meaningfulness, and lacking stylistic range. Linguistically it is highly predictable, with a fairly high proportion of pronouns, tag questions, and the use of gestures and intonation to convey meaning.

The attempt to correlate these codes with certain types of social class background, and their role in educational settings (such as whether children who are used to restricted code would succeed in schools where elaborated code is the norm) brought the theory considerable publicity and controversy.

How could the case conference notes be use to improve communication between J and K?

I am worried whether K will be a good mom and make sure the baby’s ok before thinking about herself.  K doesn’t talk to me about how much alcohol she drinks.  She doesn’t know that drinking when you’re pregnant can harm the baby.  FAS means the alcohol can get in the mom’s blood stream and get into the womb and harm the baby and nothing can be done to make the baby better once it’s born.  K isn’t friendly with me when I visit and doesn’t seem to like talking to me.  G is a bit young for his age and doesn’t seem to bother much about K or talking about the baby.  K thinks smoking is ok around a baby but I’ve told her that it isn’t.  K’s mom says she is still smoking heroin and drinking a lot, but we don’t know if that’s true, because K accuses her mom of always being drunk and her mom says the same about K.


Would therapy help K to keep her baby safe?

I don’t think so – firstly I would very much doubt that K would agree to this kind of intervention.  She has experienced a traumatic and abusive childhood and suffered immense emotional harm as a result.  She has never experienced any kind of relationship (either as a child or adult) where she has been valued and given the unconditional love that children need, to thrive and become emotionally well-adjusted adults, and able to be caring and nurturing parents to their own children.

K has only one model of parenting – the one she experienced herself.  It was abusive and neglectful.  Parents who are physically and emotionally available to their child and offer calm, safe and consistent care from the very earliest hours of birth will form secure attachment patterns with the child.  This will be a protective factor for the child throughout the lifespan.   Conversely children who share K’s experiences of parenting will learn that adults are not to be trusted, they won’t have learned to regulate their emotions, so anger is the emotion that is often dominant, although this often masks feelings of helplessness and worthlessness. They will be unable to sustain lasting relationships and have little emotional resilience.  There will often be a significant gap between their chronological and emotional age, so a 25 year old may well be functioning as a young teenager, or even pre-teen in extreme cases. They will form insecure attachment patterns with their parents, which will persist in creating difficulties for them to a greater or lesser extent throughout their life.

For therapy to be effective there needs to be the motivation from the person seeking to engage in a therapeutic alliance with the therapist.  They will need to feel safe and comfortable enough to talk about the issues that have brought them to therapy.  They will need the insight to understand and conceptualise abstract ideas and start to link their behaviour with their past experiences. Most parents in this position will not be able to understand abstract concepts as they tend to be “concrete thinkers.”  All of this will take time – there are no quick fixes and there will be times when the therapy will “plateau out” and motivation dips, but with perseverance the therapy can continue, and this can take many months, if not years, dependent on individual circumstances.  And it is true I my view that the “child does not have time to wait.” Sadly many parents will not be helped towards better parenting via therapeutic intervention.

I think that many parents can’t understand this issue of “likely to be at risk of significant harm” and call it “gazing into a crystal ball” because they have no awareness of how the past affects the present and the future.  They complain that they are being penalised because they were ill-treated as children, and of course that’s true, but because of their lack of understanding about the relationship between their own parenting as a child and how they parent in turn, it adds fuel to the fire of anger that they feel towards social workers in particular.


Further reading

For further investigation of how parents engage in child protection procedures, see the research from Dr Karen Broadhurst on accomplishing parental engagement. She reports on the findings of a qualitative study of interaction between professionals and parents in the quasi-judicial setting of pre-proceedings meetings in England.

See Professor Sue White’s examination of how practitioners need to look with care at the language they use as they attempt to forge working relationships with parents.

See comment on this recent case where the Judge criticised a social worker’s report, saying it may well have been written in a foreign language.