Taking a resiliency approach

One of the challenges in child protection, is being faced with an onslaught of significant problems. There is the daily dose of abuse, neglect, addictions and violence. It is not hard to become overwhelmed with the repeated stories of tragedy. Case loads, when high, also make it challenging to get out from under.

Workers faced with this, have a natural tendency to see deficits as the story of the client or the family. Further, the majority of assessments tend to emphasize those issues. Many of the mental health and psychometric tools are largely focused on the deficit or identification of problems. Mental health practitioners look for diagnostic clues which can skew their perspective to a symptom based analysis.

I have become interested in the notion of resiliency in child protection as a way to shift not only our view of the client but also the nature of the relationship that we have with them. There is research that tells us that the relationship is the most powerful tool that we have in our work. I am reminded of the work of Maiter, Palmer & Manji which notes:

Parents appreciated workers who were caring, genuine, empathetic, exceptionally helpful, non-judgmental, and accepting. Negative qualities of workers identified by parents were being judgmental, cold and uncaring, poor listeners, critical, and insincere.(from the abstract, 2006)

To gain trust and be effective, we also need to have patience and begin to understand the ecological reality of the client - including their strengths. What got me thinking about that is a TedTalk by Dr. Gabor Mate speaking about addiction. He suggests that we ask the question "What is right about it?" Imagine asking that question with our clients. We begin then to explore the value of what the client has been doing even when we can easily see it as harmful. 

The power of the relationship can also be seen in a Canadian study in 2012 by Gladstone et el.:

 A relationship was found between workers' perception of parent engagement and parents' perception of their own engagement, as well as between the perceptions that workers and parents had around their own respective engagement. Workers who were satisfied with service outcomes were significantly more engaged than those who were unsatisfied. Parents thinking that their children were safer as a result of intervention were significantly more engaged than parents who thought that their children were less safe. The strongest reason given by parents for positive change was being able to trust their worker (p < .001) and believing that their worker was knowledgeable about parenting (p < .01). (again from the abstract)

I reflected further on this when working with a client recently who has a substance abuse problem, mental health issues and self harming behaviours. It is quite easy to get focused on the problems. But when I went to Mate's question, I began to see how she had survived and coped with a long list of traumas in her life. Her support system had collapsed and her internal resources were overwhelmed. She had found a way to exist. Reframing the behaviours in this way changes how she is seen but most importantly, how she reacts to the relationship.

One of the barriers to change can be what we believe is possible. If we do not see that it can be done, then it takes a strong client to prove us wrong. Not to be mistaken, there are clearly situations where clients resist change or it is just too much for them.

There are also now indicators that, just as trauma can pass between generations through DNA (e.g think of the study of epigenetics) there is also data that suggests that recovery, resilience and strength can pass as well. For an interesting brief read on this, you might look at Dr. Laura Kerr's blog. 

There is also research out of the United Kingdom suggesting that it is worth looking at the child's well-being. The Children's Society has recently published the 2015 Report, The Good Childhood. I like this report as it invites us into a broader and richer view of seeing how a child is doing. The report starts by noting:

Though it is easy to slip into a shorthand of happiness, well-being is about so much more than this. It is about how young people feel about their lives as a whole, how they feel about their relationships, the amount of choice that they have in their lives, and their future. Wellbeing matters as an end in itself, but also because it is correlated with other outcomes in life such as physical and mental health...

In essence, what this all begins to tell us that there are very good reasons to be hopeful in many of the cases we work with - not all - but many. It is also worth remembering that our goal is not perfection but good enough (Choate & Engstrom, 2014).

References:

Choate, P.W. & Engstrom , S. (2014) The “Good Enough” Parent: Implications for Child Protection, Child Care in Practice, 20:4, 368-382, http://dx.doi.org.10.1080/13575279.2014.915794

Gladston, J., Dumbrill, G., Leslie, B., Koster, A., Young, M. & Ismalia, A. (2013). Looking at engagement and outcome from the perspectives of child protection workers and parents. Children and Youth Services Review, 34 (1), 112-118. doi:10.1016/j.childyouth.2011.09.003

Maiter, S., Palmer, S. & Manj, S. (2006). Strengthening social worker-client relationships in child protective services: Addressing power imbalances and 'ruptured' relationships. Qualitative Social Work, 5(2), 161-186. doi: 10.1177/1473325006064255

Pople, L. The Children's Society, Rees, G., Main, G. & Bradshaw, J.. (2015). The Good Childhood Report 2015. London: The Children's Society.