A six-point guide to how social workers can improve the lives of abused adults

When adults at risk disclose abuse, social workers must build trusting relationships with them, avoid making assumptions and put them in control of the process to achieve good outcomes, says Mike Briggs.

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Putting the person at the centre of your practice is the only way to ensure the achievement of the life outcomes that they want and deserve, and it is also the best way to help people at risk of harm to deal with abuse and stay safe.

The guidance outlined here should be at the heart of any intervention. It is aimed at social workers who deal with people who have been abused and offers a staged approach to take them through the journey from disclosure to achieving a safe outcome. It must be noted that this is only a general outline. It does not replace the multi-agency procedures or the need for good recording.

The guidance assumes that the person has capacity to make their own decisions but the principles apply equally to those without capacity. Where there is lack of capacity the work can be done in conjunction with their advocate or trusted representative, but always including the person themselves.

Stage 1: Building a trusting relationship

The first meeting with someone who has reported being abused is crucial. They may have spent many months, even years, plucking up the courage to disclose what happened to them. They will have conflicting feelings – ‘I still love the perpetrator’, ‘Am I doing the right thing?’, ‘Will anyone believe me?’. They will have conflicting fears – ‘Will the perpetrator take revenge?’, ‘Will I get into trouble?’ ‘Will I have to leave my home?’.

So the first thing to do is reassure them. Although you will not be able to offer complete reassurance about everything, there are areas where you can. For example, you should acknowledge the impact the abuse has had on their life; make clear that you take them seriously; tell them it is natural to have conflicting feelings and fears; and say that protection is available. Remain calm and do not show shock; however always take an empathic approach – you are a human being too and not a robot.

Stage 2: Helping people to disclose

Only after establishing this initial acceptance and starting to build trust can you go on and ask for evidence – in a person-centred approach you may have to switch between stages many times as the disclosure of evidence is both therapeutic and cathartic. You must use the person’s own language and constantly check your understanding; don’t assume what they think or feel. When you record what they have said, continue to write it in their own words. Only report what they say, not what you think they mean. The person’s account, and your record of it, is important evidence and can make the difference between a successful or disastrous outcome for them.

Stage 3: Establishing what the person wants

When people disclose that they have been abused they usually want something done about it. It is important to find out what that is and not make any assumptions of what you think they need. Sometimes they may have a very clear view but often they have not thought that far ahead or have a number of outcomes in mind, not all of which are compatible or even possible. Do not leap ahead and immediately discount the unrealistic outcomes, bit listen and note. Only then can you begin the task of helping them look towards their future and planning what can happen. Their views on outcomes will often change through that process.

Stage 4: Personalising risk management

It is natural that you will want to make the person safe as soon as possible, but safety is relative. People often want to be both safe and to maintain unsafe relationships. There is an important distinction between putting people at risk and enabling them to choose to take reasonable risks. The emphasis must be on sensible risk appraisal, not risk avoidance. Always look for the least restrictive option and go through the alternatives with the person. You will need the support of the multi-agency team to analyse the risks and to manage them in a balanced way. Always appraise the risks with the person and take them through the consequences of the options so that they actively develop their own risk management plan.

Stage 5: Putting the person in control

You can never promise complete confidentiality in abuse cases nor can you totally predict outcomes, but you can put the person at the centre of the whole process by giving them as much control of the decision-making as possible. They had power stripped away from them, but you can rebuild their confidence and power over their own life. This can be achieved by explaining what the options are, the extent of your own powers and those of the the police, the legal protections and procedures and how they can get justice. While you will have your own ideas (and those of other professionals) on how the case should progress, it is important that you share them with the person and build the safeguarding plan around what they want. Where it is not possible to do this then you must explain why but re-emphasisie what is within their own control.

Stage 6: Finding the right time to end

The safeguarding process will usually finish at the point when the person’s outcomes are achieved. However they may only be partially achieved or some not even reached at all, so when does the process stop? Quite simply it should be when the person says that they now feel safe and are confident that they will continue to feel safe. If you have worked in a person-centred way then the conclusion will come quite naturally. You will then need to re-evaluate with the person the levels of risk that remain and how they will deal with them. You should leave them with knowledge of their support system and what to do if they feel at risk again. Some will require a regular review if the risk of harm remains high.

Reference

Protecting adults at risk in London: good practice resource, Social Care Institute for Excellence, October 2012. 

Mike Briggs is co-chair of Association of Directors of Adult Social Services’ safeguarding network, independent chair of East Riding of Yorkshire Safeguarding Adults Board and chair of Focus, the independent social work practice for North East Lincolnshire.

Improving your safeguarding practice

For expert advice, networking opportunities and good practice examples, attend Community Care’s conference on safeguarding adults at risk in care homes and hospitals, which takes place on 4 December. Register now for a discounted place.

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