Presumed Guilty

    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

    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
    • 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
    • Making illogical decisions, for example removing a baby while
      allowing a slightly older child under two years old to remain at
    • Taking a very controlling and often confrontational
    • 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
    • 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

    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.
    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

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