Transformed by confinement

Case notes

Practitioner: Andrew Reece, acting team manager and Barbara Shirley, social worker 

Field: Children looked after team 

Location: East London 

Client: Theresa Griffin, a 15-year-old young woman who lived with her mother and a man whom she believed to be her mother’s boyfriend but was also her father. 

Case story: Theresa first became known to the department in 2000 because of a homelessness dispute between two councils, but became more prominent following her mother’s imprisonment for fraud. Until then, Theresa was living a reasonably stable life, but began a spate of running away. Upon her mother’s release from prison things did not quieten down – indeed her relationship with her mother deteriorated. This was exacerbated by her mother’s disclosure that the man who lived with them was not only her mother’s boyfriend but was Theresa’s father. The trauma of her mother’s imprisonment followed by the disclosure proved too much for Theresa to handle. Theresa was briefly accommodated, but her absconding continued as she became caught up in prostitution and drug misuse. 

Dilemma: A secure placement could have a negative effect on someone so unwilling to be contained. 

Risk factor: If not accommodated by social services, Theresa’s sexual abuse through prostitution and alarming weight loss could prove potentially fatal.  

Outcome: Theresa’s progress has been exceptional – she is about to move into her own accommodation, is attending college and has plans to work with children.

One of the most rewarding aspects of social work is being instrumental in transforming a client’s life – of making a difference. And the case of Theresa Griffin is one that serves to remind us why people go into social work in the first place.

Theresa’s regular teenage life was dislocated following her mother’s imprisonment and later disclosure that the man Theresa had known only as her mother’s boyfriend was, in truth, her father. This all proved too much and put her beyond parental control and into the care of the local authority. However, she started absconding.

“Although accommodated in a children’s home the absconding continued, with Theresa sometimes gone for days,” says social worker Barbara Shirley.

Theresa, now well-known to the vice squad, was proving a troubling young woman. “Each time I saw her, you could see that she was more entrenched in her risky lifestyle. You could see it taking its toll. She was like a Charles Dickens-type waif and stray. We knew that if we couldn’t get her out of her environment to work with her, she’d be another statistic on the street – she’d be dead,” says Shirley.

However, placements in East Anglia and Wales also failed to contain her.

Theresa trusted no one and was becoming worryingly thin. “She went missing for a long period as we started care proceedings,” says acting manager Andrew Reece. “We decided the only way we could safeguard her was to place her in a secure unit.” It was a critical decision that very possibly saved her life.

Finally, Theresa turned up at a drop-in centre for vulnerable young women. She disclosed to workers that she had been raped by four men. However, rather than press charges, she changed her story. “This is a pattern for her – she wants to confront but fails to follow it through – possibly because she so distrusts people,” says Shirley.

On a very cold morning in November last year she turned up at the social services offices. “She had a skirt and mini-top on, her legs were red raw and she could hardly keep her eyes open. I got her something to eat and she just fell asleep all afternoon,” says Shirley, who that evening placed her back in the children’s home. But come morning Theresa had run off again.

However, as Christmas Day approached Shirley suspected that Theresa might turn up at the children’s home. “All agencies and professionals who knew her were notified that she should be taken straight to the secure unit,” says Shirley.

For the first time in about 18 months, Theresa was contained.

“She had hit rock bottom. But within a week of being placed in the secure unit the transformation was amazing. Her whole persona changed. I expected her to be kicking and screaming but she wasn’t. I apologised for placing her in a secure unit but explained it was the only way I could think of to keep her alive and safe. And she said, ‘No, I don’t mind – I like it here.’ For once she had consistency and boundaries,” says Shirley.

With the corner turned, Theresa’s life-view improved. She talked about going to college and wanting to work with children. “We found a small therapeutic drug rehab unit in the north of England, which worked very well with her. Importantly, Theresa also wanted to change things, and that was very positive for her,” says Reece.

Theresa has progressed well. Taking an HIV test was a big step for her. “She was worried about this, but it was clear. She’s back into education – and she has responded exceptionally well. She’s put weight on and is a lot healthier, more bubbly,” says Reece.

“We discussed with the children’s guardian that we wanted to accommodate Theresa – and her mum agreed – so that we could support her better and monitor her progress,” says Reece, realising the benefits – continuing social work support in particular – that she could receive under section 20 of the Children Act 1989 coupled with the Children (Leaving Care) Act 2000.

Theresa is now set to return to London where she will be placed in semi-independent accommodation, continue her education and receive support until she reaches 18.

Shirley has been the lynchpin, says Reece: “She’s worked exceptionally well with Theresa -Êthey have an excellent relationship.

“She is also taking the matter of the alleged rape forward herself – so she’s gaining confidence in herself to tackle these things. All the inner strength is there and it’s coming out slowly but surely,” says Reece. It’s also a sign that she’s also learning to trust again.

Arguments for risk

• The workers tried everything to persuade Theresa to work with them but she simply absconded at every opportunity. However, Theresa’s turning up at her mother’s, the drop-in centre, children’s home and social services offices all indicated a cry for help. 
• Theresa would deny that she was into drugs and prostitution or that she had a controlling adult in her life, but evidence suggested otherwise. She needed to be removed from this environment.  
• The adults in her life gave Theresa little to believe in – particularly her mother. On one occasion, she disclosed that one of her mother’s boyfriends had sexually abused her twice. Her mother flatly refused to believe it. This caused Theresa to run away again. Despite efforts to persuade Theresa to give them a chance to work with her, Theresa simply had no trust that she wouldn’t be let down again. She started to use adults in the way she perceived they used her.    

Arguments against risk 

• Secure accommodation is not a route to be pursued lightly. For people who abscond regularly, the notion that they will be, if necessary, physically prevented from doing so can have a devastating effect. This restriction could lead to increased aggression and reinforce the “me and them” mentality that Theresa holds about adults. 
• Couple this enforced restriction with the similarly enforced removal of drug use, and add in her confused and rebellious attitudes, and there is a risk that the chances of Theresa self-harming or worse would not only increase but become a real probability.  
• It could be argued that better co-ordination of those involved in her life could have presented a stronger, more consistent message to Theresa. As well as her family, she was known to the social work service, police, drop-in centre and children’s home – all of which have a strong presence in the community. Regular meetings would have ensured that communication between all parties was maximised. 

Independent comment  

Working in a situation where danger is as prominent as it was in this case can place social workers under extreme pressure to act decisively, even when they have grave doubts about the likely effectiveness of their actions, writes Patrick Ayre.  

Children in danger expose all those working with them to risks including exposure in the media, censure within their organisations, negligence claims in court and blame for any tragic outcomes. When we work to minimise risk, we must always ask ourselves whether we are focusing mainly on reducing the risk to ourselves or on the risk to the child. 

Faced with a young woman such as Theresa whose health and well-being are seriously threatened by the life she is leading, it is a brave practitioner who would not think seriously about the use of secure accommodation. However, the possible adverse effects of such a step are set out in the case description.  

The forces that keep young people within lifestyles characterised by drug use and prostitution are often complex ones. And “rescuing” them by simply lifting them out of the circumstances in which they are found all too often leads to a speedy return as soon as our backs are turned. However, when a young person has a basic desire to change, however well hidden beneath a defiant and rebellious exterior, secure accommodation can offer a safe and secure space within which her life chances can start to be reframed. 

Patrick Ayre is senior lecturer, applied social studies department, University of Luton and an independent child welfare consultant.