Storing up trouble: NCB report exposes major failures in the system

In September 2017, the All-Party Parliamentary Group for Children (APPGC) launched an inquiry into the causes and consequences of varying thresholds for children’s social care. The Inquiry’s findings are published in the report ‘Storing up trouble: a postcode lottery of children’s social care’.

This vital document exposes major failures in the system designed to support families and children. The main concerns raised:

• Thresholds for child protection or enabling access for support are often too high and thresholds vary significantly between local authorities
• Children in need of a child protection plan are, in 2/3 of cases, being left vulnerable to continued abuse or neglect
• Only a “small proportion” of resources is spent on early help and family support
• Families and children in need experience a high turnover of social workers assigned to them

A persistent theme in the report is that support often comes very late, i.e. when a child is at risk of being taken into care. This increases cost to the state and delays the opportunity to relieve suffering. “Tolerance” for early help is “based on resources” – there is simply not enough capacity in the system.

One major conclusion that we can draw is that short term failure to offer appropriate services leads to long term increased cost and more children suffering the impact of developmental trauma and needing more complex services later on.

The report acknowledges (without specific reference) that there is often a combination of Adverse Childhood Experiences present for children in need of early help.

Help us help children and adults recover from early developmental trauma – a right acknowledged by the United Nations and signed by the U.K. under the UN Convention on the rights of a child.

Turning Children’s Lives Around

At our latest Best Practice Forum in June 2018, our keynote speakers Richard Cross (Head of Assessment & Therapy for Five Rivers Child Care) and Alison Hodgetts (a Registered Clinical Psychologist) gave a talk entitled “Turning Children’s Lives Around” – overcoming the impact of childhood adversity through therapeutically focused integrated care.

The presentation focused on the Five Rivers model of ‘trauma and attachment informed care’ and the knowledge, organisational structures and supports that are required to ensure good outcomes.

Five Rivers Child Care is a social enterprise that has been dedicated to addressing the impact of abuse, trauma and neglect for almost three decades.

The care provider has made significant investments into developing knowledge and understanding about what works in accurately identifying the needs of the child or young person. This has ensured the right therapeutic environment to meet the needs of children and young people who have experienced trauma.

Richard shared how this unique approach was embedded across Five Rivers Integrated services of Education, Care and Assessment & Therapy – and how a partnership with researchers from University College London and The Anna Freud Centre was successfully developed.

Richard and Alison further explained how Five Rivers Integrated case management maximises the use of the assessment comprising “three key strands” (attachment, trauma and disassociation). The approach aims to transform and maximise the impact in responding to the emotional needs of the child or young person.

Fountain House, a Five Rivers residential facility, has developed an attachment and trauma informed residential therapeutic environment. Richard explained that this approach has demonstrated how it can ‘transform children’s lives’ by minimising the impact of their traumatic experiences as they develop’.

Concluding the talk, Richard made an important point to the audience, that ‘the integrated model provides the glue and a shared understanding helps people to connect’. Summing up the necessary steps to develop an integrated service, he stated that the following key areas were essential to successfully delivering this model:

1. Develop a relationship-based therapeutic model
2. Capture the hearts and minds of the workforce
3. Help children and staff to understand what is happening
4. Provide training and a toolkit for staff
5. Develop a supportive culture for staff
6. Undertake a full assessment of the child/young person’s past experiences and current issues to identify their needs

The Earl of Listowel thanked them for their presentation and the audience then took the opportunity to ask questions.

Our Speakers

Richard Cross is Head of Assessment & Therapy for Five Rivers Child Care – an innovative and progressive social enterprise dedicated to ‘Turning children’s lives around’ who have experienced trauma, abuse and neglect. His focus is on ensuring the development of effective identification of need (assessment) and deliverer of therapeutic interventions that make the difference.

He is a UKCP, EAP, WCP registered Psychotherapist and Child Psychotherapist who has worked with children, young people and adults who have experienced trauma since 1991. He has sought to support the development of a range of relationally based therapeutic programs to improve outcomes for maltreated children e.g. New Zealand advanced EQUIP program (2002), Adapted SOTP for adolescents (1998) and piloted a trauma informed approach across 16 residential homes (2007 – The Sanctuary Model). He is a member of the European Society for Trauma & Dissociation (ESTD) and a member of the International Society for the Study of Trauma and Dissociation (ISSTD).

Alison Hodgetts is a Registered Clinical Psychologist who has worked with children, young people and their families over the last 10 years, both in the NHS and privately. The focus of her clinical work has been with children and young people who are fostered or adopted; providing assessments, therapy and consultation, as well as training carers, parents and professionals.

Her professional interests include Attachment Theory, Developmental Trauma and attachment-based psychotherapy. She has completed her Level 2 Dyadic Developmental Psychotherapy (DDP) training and is working towards completing the DDP practicum. Alison joined Five Rivers 12 months ago and works with the Fostering teams in the West Country.

 

Rotherham CSE and need to provide trauma recovery

A large-scale national disaster is being unveiled by the media across the UK, following the launch of the Rotherham Abuse Inquiry report released on 26th August 2014. No one knows the true scale of child sexual exploitation (CSE) in Rotherham, but the current conservative estimate is approximately 1400 children sexually exploited over the full Inquiry period from 1997 to 2013.

What is noticeable in the media is that once again the primary focus is not on the children, or on the emotional impact to them. The focus doesn’t seem to be acknowledging that each individual who was raped, assaulted or coerced into behaviour that terrified them has faced, or now faces, years of recovery from trauma. The focus in the media is not on the need for the victims to easily access trauma therapy that can help them process the horror, shock, shame, torment and pain over the coming years. We need to fight for a child centred focus.

Trauma recovery takes time. You cannot rush a person into psychological recovery. Each child has to listen to their own voice recounting the horror that they hope to forget, and explore the shock and deep sadness of what could have been. Every person has a right to emotional support as they face interviews, questions, their own memories, flashbacks and nightmares. But where is this support? How do people find it? Who will finance it?

As the child and their families wrestle with the shame, shock and horror of what has been experienced, there needs to be support in place; offering a listening ear and a shoulder to lean on as they process the trauma. But most victims will not be able to find appropriate professional support or – worse – won’t be able to afford it.

‘Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering.’ (Levine and Kline 2007;3)

 Central and vital questions need to be raised about the response to this national tragedy. Who is going to finance the trauma recovery for these victims? Who is going to ensure that it becomes a priority for the police and other frontline practitioners to understand how to identify the signs of abuse and the complexities of CSE?  Who will finance the recovery from trauma for the families, teachers and friends of those who have had to listen to and support the victims?

Despite being British, we need to acknowledge that human kind is not in-built to ‘just get over it’ or ‘forget it now and move on’. Neuroscience has shown that our minds and response to trauma is complex. Unprocessed trauma can lead to a host of physical complications, depression and anxiety, difficulties with concentration, learning and working, and long term relational challenges amongst many other symptoms.

We believe that we need to communicate clearly that justice is not just the perpetrators being arrested and prosecuted; it is also the facilitation of the right to recover from the traumatic experiences.