Therapy lifeline for learning difficulty parents

People
with learning difficulties who manage on their own often find it harder to cope
when they become parents and may have to face the trauma of their children
being taken into care. Now a specialist psychotherapy service can help them to
survive. Rachel Downey reports

Losing
a child to the care system is a devastating experience for any parent. When you
have a learning difficulty and becoming a parent has re-ignited painful
memories of childhood abuse, the trauma intensifies.

But
there is an organisation that provides support for parents with learning
difficulties whose children have been taken into care, and those who are about
to lose their children – the Respond Parenting Project.

Tamsin
Cottis is assistant director of Respond, a charity that offers counselling and
psychotherapy to people with learning difficulties, many of whom have suffered
abuse. Respond established the parents project a year ago after staff were
coming into contact with parents whose children were taken into care and who
were returning again and again after having more children.

Statistics
are lacking, but a small research study and anecdotal evidence suggests that
slightly less than half of all parents with learning difficulties lose their
children to the care system. Behind this figure lies one of the most difficult
and complex dilemmas faced by the social care profession – the rights of a
person with learning difficulties to parent versus the rights of a child.

"It’s
terribly difficult, and perhaps the most complex and emotional areas of the
Human Rights Act 1998 – the fact that to make these rights available to people
with learning difficulties may bring us into conflict with the rights of the
child," says Cottis.

The
working assumption is that if the parent has learning difficulties, there will
be problems, she says. Some people with learning difficulties can parent, some
need support to parent, and some find it impossible. Often people with mild
learning difficulties have never used any services but when a child is born,
they cannot cope. Sometimes they do not want to acknowledge their own learning
difficulties but are forced to when they become parents. And some parent
successfully for many years until some incident strikes. One woman was referred
to the project after bringing up her two children for a decade. When they were
9 and 11, she met and married a man. Her husband then became friendly with
another man who raped him and her.

While
professionals understand the need to pass practical information on to new
parents, there is less awareness of the emotional needs of the parent and how
these can affect their parenting ability. When there are no practical
difficulties, professionals often do not look for emotional difficulties, says
Cottis.

The
scale of mental health problems the project has uncovered is far greater than
it anticipated, she adds.

Jake
Spencer is a psychotherapist and provides most of the therapy. "It is not
normal psychotherapy," she explains. "You cannot just allow someone
to open up a can of worms. We tread on a tightrope between allowing them to
continue functioning while talking about their trauma. It’s a bit like working
with sex offenders; you cannot afford for them to fall apart, because that’s
when they are most vulnerable to reoffending. The difference is that we put in
a positive impact. We provide ego support and containment. It is more
directive. We give recognition about how it feels from their point of view –
what it feels like when people call you stupid."

A
primary function of the project is to assess parenting ability. "We are
used to the most severe cases that are causing the most worry for
professionals, where there are complications and severe child protection
issues. Often the learning difficulty has not been taken into account – that
knowledge base is not there," says Spencer.

Referrals
come from a range of professionals, and discussion takes place before someone
begins therapy. How long the therapy continues is a source of contention. In
its general work, Respond usually refuses to begin therapy that will continue
for less than one year, but with the parents project there is more flexibility.
Pressurised social workers coming up to a final court decision over the fate of
a child can usually secure only three months’ funding to cover the period just
before, during, and after the court ruling. "The pressure to begin work
with someone for only three months is enormous," says Cottis.

The
level of support received by parents with learning difficulties in the community
is also a contentious issue. Spencer argues strongly that support has to be
long-term. "There’s often a time limit, or people want one to be put on.
The thinking around this has to change."

Spencer
is frustrated at times, primarily when delays occur. But she has never
disagreed with the decision of the social workers to remove a child.

"I
cannot imagine a trauma worse then losing a baby. I am working with a woman who
has just lost her fifth child. It’s a grief situation without the history of a
death. It means you are constantly affected by things that are very difficult.
In some ways it’s what the children and families social workers are dealing
with every day. But in a children and families team, there’s a need to switch
off from how you are feeling. In this setting, your job is to stop and think
about feelings." Spencer herself receives substantial support and
supervision from the organisation and also from outside – monthly supervision
sessions with a child psychologist.

The
dilemma takes its toll on the professionals involved, usually children and
families social workers and community nurses in learning difficulties teams.
"It’s an enormous emotional impact, and most professionals do not have the
support to help them think about that," says Spencer. The professionals
that arrive at the project "look completely done in", according to
Cottis. "They are on the edge. You can see in their face and body language
that they are just exhausted by it."

The
project provides training, advice and support to all professionals involved.
"I was surprised at how emotionally demanding it is," says Cottis.
"I was sure of the political and service context, but there’s something
about a small child having a catastrophic childhood that affected me."

Spencer
agrees. "It’s not calculated cruelty that I see. It’s the fact that
children are not having the kind of experiences they should have. And the pain
of parents for the loss of their child. When you sit in the room and hear them
describing their feelings of loss, it’s terrible."

Both
see demand growing for the project because of a range of factors: the
government’s new learning difficulty strategy; the fact that more people with
learning difficulties live in the community, form relationships and have
children; and the advent of the Human Rights Act. They want the project to
expand so it can be self-funding. Currently it can offer a reduced rate for its
service because of a grant from the Department of Health.

The
project can help some parents with learning difficulties cope with having their
child removed but the staff realise that there are no easy answers to the
dilemma.

"I
sometimes feel so sad," says Cottis. "There’s no good outcome for
anyone. If you work with adults with learning difficulties, your professional
credo is the individual, and that’s very much in conflict with the credo of a
children and families worker. You cannot change that – you can only work with
it constructively and try to meet people’s needs. You cannot work to a happy
ending but you do have to work as thoughtfully and thoroughly as
possible."

Project profile

Project:
Respond Parents Project

History:
Set up in October 2000 by Respond, a charity that provides counselling and
psychotherapy to people with learning difficulties. The project provides
therapy to people with learning difficulties that have issues around parenting.
It also undertakes specialist parenting assessment where child protection
concerns arise. Staff also offer training and support to workers dealing with learning
difficulties and parenting. The idea for the project came from the referrals to
Respond.

Funding:
Department of Health – about £150,000 over three years.

Staff:
One full-time worker but use of sessional psychotherapists, and plenty of
support from other staff at Respond.

Clients:
Anyone with a learning difficulty who has concerns to do with parenting.

Contact:
Jake Spencer, Respond Parents Project, Third Floor, 24-32 Stephenson Way,
London NW1 2HD, telephone: 020 7838 0700. E-mail: parents@respond.org.uk. The helpline
is on 0845 606 1503.