The Jenna Talackova Story - some thoughts

You would have had to have been ignoring the news to miss the story of Jenna Talackova. She is the transgendered Canadian who has been seeking to compete in the Miss Universe contest. While there is a whole debate to be had on whether such contests should be held, Ms. Talackova's situation has some interesting lessons in social work and child protection.

She was born a he - Walter Talackova. By the time that she is 14, she has begun the transformation process to becoming a woman. What is worth knowing, the transgender process is one that is carefully considered by the medical profession before the process is undertaken and the surgery is arranged. She had the gender reassignment surgery at age 19. While the rules vary from jurisdiction to jurisdiction, there is generally a requirement to live as the new gender for about 2 years. It is not something that is done lightly or without going through several steps.

Recognizing that there are people who are born in one gender but, for all intents and purposes is the other gender requires us, as a society, to be tolerant and willing to see this reality.

What then does this have to do with child protection? Well, this may seem a stretch I suppose, but it may have a lot to do with the ability of a society to accept alternative lifestyles and parents who live within them. This is tricky territory but a parent should not be judged poor simply by the lifestyle - as long as - that lifestyle is not harmful to the child. But it is our willingness to be tolerant that may allow us to stand back and reflect upon the true nature of the risks - or the absence of them.

Jenna Talackova is about being open to see what should be acceptable and tolerated. You might think I am stretching the point - and I might be - but her situation caused me to reflect. I found her story interesting and compelling. I saw support from her family and acceptance from the Lake Babine Reserve in Burns Lake, B.C.,  where she is registered. They have even helped her with the costs of pursuing her dream to enter the competition. This is a story of change, difference but also one of family and community support and acceptance. These are the types of resilience factors that we are often looking for in the families with whom we work.

Child Sexual Abuse Disclosures

Two recent studies have offered some very important information on the issues of disclosures in child sexual abuse. The first is an Irish study which uses a qualitative grounded theory approach. This study of 22 children looked at the process of disclosure. They conclude that:

The process of confiding experiences of child sexual abuse is not linear and sequential as suggested in the early literature on child sexual abuse, but is, as Staller and Nelson-Gardell (2005) suggested, a dialogical process that is renegotiated and influenced by each experience of disclosure. (p.1169)

As they note, the disclosure process is a “stop-start” experience that occurs over the lifetime.

This research by McElvaney, Greene & Hogan, offered 3 overarching themes which will be of assistance to child protection and police investigators as well as therapists.

1.     Active Withholding – This included the subthemes of not wanting people to know; denying when asked and even experiencing difficulty saying that it did occur.  The latter is the experience of wanting to let something out but just not being able to do it.

2.     Pressure Cooker Effect – there was a build up of tension between wanting and not wanting to tell. There was also the effect of being in a state of distress about actively withholding. Telling may be the result of either an opportunity presenting itself of an unplanned disclosure.

3.     Confiding – Who to tell became important with the notion that telling needed the ability to confide in another person. Thus who was chosen was careful and might include the sharing of confidences or a need for confidentiality.

These researchers also noted that disclosure wasn’t a single event. There would be a number of occasions over the life span when the story may need to be retold or told in more or different detail. Thus, for the victim, it may well be an unfolding part of their lives.

The researchers also note in their literature review that there can be powerful influences which help us to understand why children do not disclose or may delay disclosure until later in life. These might include fear of the perpetrator or fear of the consequences of telling. Other factors might include other pressures not to tell. The child’s own guilt that they may be responsible for the abuse as well as considering the costs and benefits of telling. It is important that disclosing always comes with some level of internal and / or external costs.

The second important piece of research is by Allen & Tussey who conduct a systematic review of whether or not projective drawings can be effectively used to detect if a child has been sexually abused. Given the research above, that would be helpful if it could. There have certainly been claims from various corners that this is possible.  This research review carefully considers the literature and concludes:

The current literature review demonstrates that attempts to identify projective indicators of sexual and physical abuse in drawings completed by children are not supported by the existing evidence. (p.12)

This conclusion has very significant legal implications for mental health professionals. This really means that projective drawings should not be used and that any such use is unlikely to meet the Daubert or Frye tests in the United States. They are also not likely, in my view, to meet the Mohan test in Canada. This is:

(1) Test for Admission of Expert Evidence

[13] The test for the admission of expert evidence is well-established and undisputed on this appeal. At the first stage of the admissibility inquiry, the party seeking to tender expert evidence must establish on a balance of probabilities that the proffered evidence is: (1) relevant; (2) necessary; (3) not subject to any applicable exclusionary rule; and (4) to be advanced through the testimony of a properly qualified expert. Where these four preconditions to admissibility are satisfied, the second stage of the admissibility inquiry obliges the trial judge to engage in a contextual weighing of the probative value and significance of the proffered evidence to the case against the potential prejudice that could flow from its admission. See R. v. Abbey (2009), 97 O.R. (3d) (C.A.), leave to appeal refused (2010), 409 N.R. 397 (note); R. v. Mohan, [1994] 2 S.C.R. 9. (as cited in R. v. Boswell, 2011 ONCA 283)

While the Canadian test is different, the qualified expert must still tender evidence that is reliable. An expert relying on these projective tools may now well be more directly challenged on the credibility of the evidence when the research of Allen & Tussey is considered.

References:

Allen, B. & Tussey, C. (2012). Can projective drawings detect if a child experienced sexual or physical abuse?: A systematic review of the controlled research. Trauma, Violence & Abuse, published online first. doi: 10.1177/1524838012440339

McElvaney, R., Greene, S. & Hogan, D. (2012). Containing the secret of child sexual abuse. Journal of Interpersonal Violence, 27 (6), 1155-1175. doi: 10.1177/0886260511424503

Good enough parenting - a concept in need of development

Child protection is faced with difficult decisions about whether or not to sustain a family unit. That might mean that children are temporarily removed from parental care or they might be sustained in the family with supports. There are times that neither option is available.

But the question that often vexes workers is what is the standard against which to judge parents. There are certainly complex factors beyond the parents such as what are the needs of the child. By looking at parenting capacity and the needs of the child, workers can then consider the fit between the two. A parent may be capable of raising a child whose demands might fall within an average range but not be able to sustain the challenge of a high needs child.

What then is the standard of parenting capacity to be considered? There is a body of research that suggests the standard is “good enough” parenting. For example, Karen Budd has suggested this in some of her writing including her recent book on assessing parents in child protection matters. For the child protection worker, there is a need to figure out what that means in the case in front of them.

The term “good enough” appears to find its origins in the work of British psychoanalyst D.W. Winnicott who raised the idea that it is not appropriate to expect that a parent should approach perfection. Such a demand was unrealistic and something less than that is enough for children.

In a recent presentation, American writer and researcher Dr. Brenee Brown noted that a good question to ask a parent what kind of adult do they foresee their child becoming and can they model that.

Hoghughi & Speight (1998) offered the idea of three notions that could be included in the concept:

1.     love, care and commitment;

2.     consistent limit setting; and

3.     facilitation of development (p. 294).

In a very thoughtful essay, Ramaekers & Suissa (2012), explore the notion. One very valuable idea that they put forward is that parenting is a lived experience (p. 74). If so, child protection may enter the fray when the parent has fallen below a good enough standards but generally be good enough. Looking at the lived experience of the parent and the child offers ways to consider the longer view as opposed to a moment in time that resulted in child protection entering the family.  Has the event represented an exception to the lived experience or not?

Later in their article, they suggest that we might also consider how parents think, wonder, worry, deliberate, interpret and reinterpret what is going on with the child and between the child and the parent. Is there any capacity to reflect and adjust the parenting activity? Or, is the parent stuck in a lived experience that is chronically damaging to the child? What is going on in the relationship between parent and child?  To draw from Bruno Bettelheim, what is their way of doing it which leads to what outcomes for the child (see Ramaekers & Suissa, p. 85).

The concept of good enough also leads to the natural corollary that there will be mistakes. If you are not perfect and just good enough, then inevitable there will be moments when things are not good enough or certainly below desired. What then does the parent do with that?

The parent also exists in a social context. Does the standard equally apply across all such contexts? Except when there are such harmful behaviors as sexual or physical abuse (to name just two) there may well be situations that are tolerated in one social context and not in another. Child protection rolls are full of examples of disadvantaged populations being over represented. Do we look for good enough with an advantaged perspective or can we adjust the lens to know that poverty or other forms of disadvantage will change what is good enough?

An example of such a challenge is whether a disabled parent can be good enough. Swain & Cameron (2003) writing about a small sample in Australia make a fascinating argument that such parents can achieve good enough. However, they also note that the mere existence of the disability can cause child protection systems to quickly judge them as below that standard.

Perhaps we need to acknowledge that we need  not agree with a parenting strategy but accept it if that strategy allows a child to develop in a context in which they are likely to be successful. Prusak (2008) has written a very challenging piece in which he looks at that argument in the context of the Amish people in the USA who may not allow their children to finish school in the public system. Are they doing harm or are they raising children within a belief system that can work and provide the child with a developmental trajectory that is at least good enough?

We have much more work to do in this area but this is an important debate that has not received sufficient attention. Child welfare workers are guided by legislation but it is understanding the concepts of things like good enough that will help them apply legislation in a way that helps children and families.

References:

Budd, K.S., Clark, J. R. & Connell, M.A. (2011). Parenting capacity assessment in child protection. New York: Oxford.

Hoghughi, M. & Speight, A.N.P. (1998). Good enough parenting for all children – a strategy for a healthier society. Archives of the Diseases of Children, 78, 293-296.

Prusak, B.G. (20-8). Not good enough parenting: What’s wrong with the child’s right to an “open future”? Social Theory and Practice, 34 (2), 271-291

Ramaekers, S. & Suissa, J. (2012). Good enough parenting? In (eds). The claims of parenting: Reasons, responsibility and society (pp. 73-97). London: Springer

Swain, P.A. & Cameron, N. (2003). ‘Good enough parenting’: Parental disability and child protection. Disability and Society, 18 (2), 165-177.

Social Worker Sanctions

CommunityCare in the UK has reported that two social workers have been sanctioned as a result of their work in a case known as Child F.

Barry Smith was suspended from the social care register for two months and Marilyn Tweedale received a three-year admonishment, following two conduct hearings held last week.

The serious case review found that there were practice errors. The East Riding Safeguarding Children's Board notes that the "Agencies did not coordinate and manage the risk that Adam Hewitt was known to pose to children and information passed to the police  from Children's Social Care should have led to the police reopening the case against Hewitt following earlier allegations." The social workers were sanctioned were noted to have failed to properly assess the risk associated with the case.

As we have seen in many cases, there was a lack of coordination of information between agencies that hampered effective decision making. The Serious Case Review states: “No agency thought to take stock and initiate a process that would have brought all the information about Male 1 into a single arena from which a plan should have merged, to assess and manage the risk he presented to children. “

The SCR also notes a flawed initial assessment that meant that Mr. Hewitt was able to continue access to the child. This raises one of the fundamental issues in case management. What we initially see in a case tends to lead to the unfolding of a case plan. If the social worker becomes attached to that case plan, then the case direction does not get the ongoing re-assessment that is often needed. We never know everything in a case and often lack quite substantive information. This means that we should be open to reconsidering case plans on an ongoing basis.

Very telling about the environment in which the case occurs, are these comments from the SCR: the social worker involved felt overwhelmed by complex cases and had little opportunity for reflection and planning. This goes some way towards explaining how on one hand the social worker understood the risk factors as evidenced in the case closure letter sent to Ms A, but also failed to consider successfully the risk factors in a comprehensive recorded account. The social worker clearly required direction and support which managers failed to make available. It is also noteworthy that the social worker felt “too junior” to challenge the direction offered by managers.  Lord Laming in his 2009 recommendations identifies the need for “respectful challenge” for childcare professionals.”

If a social worker is not in a position to challenge issues within a case, not able to ensure that case consultations are occurring, and have time to consider what is going on in a case, then poor case management occurs. In addition, cases are often very complex and it is unwise to expect that one case worker is going to be able to determine the best course of action. Supervision is crucial.

In what might be a self serving view, the SCR notes comments from the mother. “The mother of Child F states that the message from the assessing Social Worker did not convey the clarity that was necessary regarding the level of risk posed by Male 1.  Her view is that she was told he possibly posed a risk but other men were also named as possible perpetrators in the earlier allegations.  The mother considers that had she been given clear information that he was believed to be the perpetrator of the injuries, she would have terminated the relationship.” However, these comments do raise an important issue that social workers need to attend to – being very clear with clients. When there are risk factors that a client must attend to, the social worker should not be couching language in ways that can lead to an ambiguous understanding.

Social workers also need to be ready to state that risk exists and to take the steps needed to protect a child. That may anger people which makes them harder to work with. Such is the nature of our work.