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I recently spoke at a weekend conference for parents who have been accused of physically harming their child but who deny abuse and believe there may be a medical condition that has caused their child's condition - most likely the brittle bone disease osteogenesis imperfecta (OI).

There were 12 families present at the event, organised by the Osteogenesis Imperfecta Accused Parents Support Group, and some had come with extended family members and friends. Nearly all the parents had their children removed when the injuries first came to light. Some had eventually obtained a diagnosis of OI after battling with medical authorities for many years.

Some had their children returned to them eventually while others lost their children to adoption or other alternative long-term care arrangements. Some parents present were currently involved in care proceedings. In some cases the court had found that one or both parents had harmed their child, although all the parents present denied knowingly doing so.

Social workers for such families face significant dilemmas. Councils have a statutory duty to help ensure children's safety and to protect them from significant harm. However, under the Children Act 1989, they are also meant to help support families and keep children with their birth parents or within their extended family where possible. When children sustain serious injuries that medical opinion deems non-accidental but where parents deny responsibility, social workers and courts often have to make difficult decisions regarding children's future safety and welfare.

While acknowledging this difficulty I found myself increasingly disheartened during the conference by the families' experience of social work involvement. Leaving aside the issue of whether parents are innocent or guilty of harming their child non-accidentally, all families are entitled to be treated by social workers with respect.

As social workers we have no excuse for not knowing how to work with such families. There have been clear government guidelines over many years and even a whole Department of Health publication devoted to the topic.(1) This contains a list of 15 principles that should guide social workers in approaching families where there are child protection concerns, reprinted in Working Together to Safeguard Children.(2) The effectiveness of working in partnership with parents has been found to be the most important factor in helping to keep children safe.

It was then with dismay that I listened to family after family describing social work involvement that fell well short of good practice. Social workers were time and again described as:

• Being judgmental towards parents from the outset, often assuming guilt before any formal finding of the court or criminal conviction.
• Being seemingly oblivious to the emotional and psychological impact that the child protection process imposed upon them as parents and offering little or no support.
• Using jargon and acronyms and assuming parents would understand their meaning.
• Putting seemingly arbitrary limitations upon contact with their children.
• Making illogical decisions, for example removing a baby while allowing a slightly older child under two years old to remain at home.
• Taking a very controlling and often confrontational stance.
• Failing to treat parents with respect.
• Not giving parents information about the child protection process or what might happen.
• Ruling out the possibility of having their child placed with kinship carers if extended family members voiced doubt about the parents' guilt - usually before the court had made any finding.
• Seeking only negatives and not being receptive to positives regarding the parents or their support network.
• Warning parents they would only get their child back if one of them admitted responsibility for the injuries.

The impact upon parents was profound. They reported feeling in a state of shock and disbelief when their child's injuries first came to light. As well as having to accept that their child was seriously unwell they found themselves accused of causing the harm. None had any previous experience of the child protection system and they found themselves feeling confused and powerless. There was also a sense of feeling ashamed and of being guilty until proven innocent, which in practice usually proved impossible.

Even parents whose children had returned to their care many years ago said the effects of the experience still dominated their lives and, in some cases, the lives of their children. For two families who had lost children to adoption there was particular distress as they felt they would never be able to undo what they viewed as an injustice, whatever evidence might come to light.

These families live across England. But whichever local authority handled their case, the same complaints against social workers appeared to arise, although families from two local authorities had more positive experiences. Two families reported at least some helpful contact with social workers. One family had found a hospital social worker very supportive but her involvement was relatively brief. Another family experienced hostility from hospital medical staff when their child was first diagnosed with fractures but found the local authority social worker supportive and understanding.

Overall, however, it is very worrying that the families' experience of social workers was so unremittingly negative. The adversarial context of the court process often pushes workers and families into increasingly defensive positions and core social work values of respect and being non-judgmental may be lost. Skills that workers would employ with other service users may be abandoned in such situations. (3)

When considering rehabilitation in situations where children have been injured non-accidentally but where neither parent accepts responsibility, a clear balanced assessment is required. Special skills may need to be developed to undertake appropriate work post assessment to allow at least some children to return home safely.

As long ago as 1992 Elaine Farmer highlighted the anomaly that councils often develop specialist teams regarding the fostering and adoption of children who are in the care system, but rarely develop specialist resources to help reunify children with their families.(4)  Even when such specialist skills are lacking, however, families have a right to expect a caring and professional service from social workers, even in situations where parents may have injured their children.

BOXTEXT: John Gumbleton
is a child protection consultant and family therapist in private practice. He specialises in assessments where children have been harmed or are deemed at risk, but where parents deny responsibility. He also undertakes therapeutic work to help rehabilitate children to their carers.


BOXTEXT: abstract
Social workers have clear government guidelines regarding developing partnerships with parents in child protection cases. This article reports the experiences of a relatively small group of parents who have been accused by professionals of harming their children. In most cases the parents have not found social workers either helpful or supportive. The article argues that even where adults may have harmed their children they are still entitled to be treated with dignity and respect.
References
1 Department of Health, The Challenge of Partnership in Child Protection: Practice Guide, HMSO, 1995
2 DoH, Working Together to Safeguard Children, HMSO, 1999
3 J Gumbleton, "The re-unification of children in serious child protection cases", Context, No 74, pp 2-5, 2004
4 E Farmer, "Restoring children on court orders to their families: lessons for practice", Adoption & Fostering, Vol 16, No 1,1992
contact
Email: johngumbleton@blueyonder.co.uk