Her mother threw her out

CASE STUDY

Names of service users and family members have been changed

SITUATION: Clare Lawson is a 14 year-old who had been living at home with her mother, Hazel, and her mother’s partner, Duncan, who have two children together: Zoe, 18 months, and a new baby boy, Harrison. Clare has, on and off, been involved in crime over the past 18 months and has been violent and aggressive. Her mother, suffering postnatal depression, decided she couldn’t cope with Clare and “the police coming around all the time” and threw her out. Clare and Duncan have had a difficult, confrontational relationship since he moved into the house when Hazel was pregnant with Zoe.

PROBLEM: Clare was placed in an emergency foster home but was removed after attacking the male carer and throwing a chair at a window. She was then placed in a children’s home until another family placement (carers experienced in dealing with challenging and aggressive behaviour) could be found. Staff at the home report that after an initial torrent of verbal and physical aggression Clare has become very withdrawn and quiet. She has begun self-harming – scratching and scarring herself and has twice attempted to take an overdose. Staff have also discovered a letter from Clare’s birth father dated two months earlier saying that he was out of prison (he served a custodial sentence for, in part, actual bodily harm to Clare’s mother) and that he would be turning up any day to take her back. He hasn’t been in touch since.

Practice Panel – Children and Famiies, Warrington Social Services

Panel Members: Carolyn Connor – Team manager, over 12’s team and leaving care ; Lisa Jamieson – Team manager, fostering and adoption ; Barbara Costello – Specialist mental health nurse youth offending team ; Anne Woods – Housing manager ; Sue Buffel – Social worker over-12’s team

Panel responses

Carolyn Connor
For Clare, those 18 months (coinciding with Duncan moving in) have seen a number of significant changes, most notably the birth of Zoe and Harrison. This together with her mother’s postnatal depression would mean that Clare would be unable to cope with the changes without adult support, and is responding to the situation in a negative way in order to get the attention she requires.

Exacerbating this situation is her birth father’s letter promising Clare he would be “coming to take her back”, but not making any further contact. It’s important to note that Clare’s father had assaulted Hazel which could have been witnessed by Clare.

Clare may feel that the adult males in her life have abandoned her. This may present a gender issue and could be the cause of Clare attacking the male carer in the foster home. Also, Clare’s self-harming and mood changes are serious and require immediate action.

The main objective would be to return Clare to her mother and family, with a contingency plan should this not be possible. An initial assessment, carried out by child and adolescent mental health services (Camhs), should consider Clare’s self-harming, recent low mood and aggressive behaviour; the impact upon Clare of the current family dynamics and her mother’s postnatal illness; and her current education status.

In the medium term, a core assessment should be completed, with a referral to advocacy services for family reconciliation work (if Camhs are not taking on this work). A visit to the birth father should take place to discuss his position regarding Clare and his conviction.

In the longer term, a children in need meeting should be arranged with the family (although perhaps not the birth father) with professionals from health, education, advocacy and Camhs. This would consider contact issues (previously discussed at the looked-after children review); a phased plan to reintegrate Clare back with her family (if appropriate) within agreed timescales and a package of support to Clare, her mother, step-father and family, which would identify frequency of visits by workers and outreach support.

Lisa Jamieson
We would firstly check that all options for Clare to live with extended family members and friends had been explored. 

In regard to looking for a family for Clare we would request an in-depth referral of Clare’s needs, which would include some assessment of the type of family that would meet her needs as well as location of placement, Clare’s education needs and any contact arrangements.

We would need to know the level of Clare’s involvement with any other agencies such as Camhs or youth offending team. We would also need to look at the proposed length of the placement and what work was being done with mum and Duncan.

A risk assessment would need to be completed to provide a safety net for both Clare and any prospective family. Placements are most likely to succeed if carers are given all the relevant information at the start.

As with most local authorities we have a limited number of foster carers who can look after older young people with complex needs. If no resources were available in-house we would seek permission to access a placement from an independent agency, but we would try to find the independent placement within the Warrington area.

Maintaining Clare within Warrington would be particularly important because of the need for stability in her educational placement and also because the location may impact upon any future contact with her mother and could assist with any possible rehabilitation plan.

Placing young people with carers from an independent agency can throw up its own challenges in that we are relying on other people’s assessments and information to inform us of the carer’s strengths. In finding a placement it would be essential to take a co-ordinated approach.

The most likely care plan for a young person like Clare would be eventual return to birth family. This means that work would be undertaken to look at family relationships. Clare’s social worker would need to locate Clare’s father, as not knowing his whereabouts will add to Clare’s distress.

Clare’s self-harming would need to be closely monitored and support put in place for both Clare and any carers. Any placement would be reviewed regularly through the statutory review system.

User view
I recommend that Clare sees a counsellor, who may be able to get to the bottom of some of her difficulties, writes Mark Houston. But the first step in resolving the situation should be to ask Clare what she wants. The decisions about her future placement should be largely determined by her views and opinions.

It is very important to speak to her about how she feels about seeing her father. Given that he has convictions for violent offences, it might not be wise to allow Clare to live with her father. But if she does want to establish contact with him, then the authority should make attempts to allow this. Of course, the children’s services department would need to carry out the appropriate risk assessments.

I do not feel it appropriate that Clare moves back with Hazel. It seems that Hazel is also going through a very difficult period and so it may be better to give Hazel some space to deal with her own problems. Also, it is important to consider the welfare of Zoe and Harrison, who would obviously be affected by being exposed to Clare’s violent behaviour. Nevertheless, the authority should try to promote contact between Clare and Hazel.

The council should try to give Clare as much stability as possible. The fact that she was “thrown out” by her mother must make her feel rejected and has, in my opinion, been a major factor in lowering her self-esteem. It has also caused Clare much frustration, which at first she expressed through aggression towards others, and now expresses through self-harm.

She needs to feel loved, appreciated and valued. This will require her carers to devote a lot of time and attention to her. If foster carers who could offer her this are identified, then I believe that this placement should be arranged.

However, if the placement were to break down, Clare would probably feel more rejected and her morale would be even lower. Hence I suggest that such a placement only goes ahead if the social worker and other relevant professionals can be almost certain that the placement will be fairly long-term.

Every attempt should be made to support Clare at school. I also recommend that she is encouraged and supported to engage in youth activities (this is especially important given that she is becoming very withdrawn and depressed).

Clare will need lots of encouragement. Her carers should build on what she is good at and motivate her to further progress.

Mark Houston is a care leaver.

Names of service users and family members have been changed
SITUATION: Clare Lawson is a 14 year-old who had been living at home with her mother, Hazel, and her mother’s partner, Duncan, who have two children together: Zoe, 18 months, and a new baby boy, Harrison. Clare has, on and off, been involved in crime over the past 18 months and has been violent and aggressive. Her mother, suffering postnatal depression, decided she couldn’t cope with Clare and “the police coming around all the time” and threw her out. Clare and Duncan have had a difficult, confrontational relationship since he moved into the house when Hazel was pregnant with Zoe.
PROBLEM: Clare was placed in an emergency foster home but was removed after attacking the male carer and throwing a chair at a window. She was then placed in a children’s home until another family placement (carers experienced in dealing with challenging and aggressive behaviour) could be found. Staff at the home report that after an initial torrent of verbal and physical aggression Clare has become very withdrawn and quiet. She has begun self-harming – scratching and scarring herself and has twice attempted to take an overdose. Staff have also discovered a letter from Clare’s birth father dated two months earlier saying that he was out of prison (he served a custodial sentence for, in part, actual bodily harm to Clare’s mother) and that he would be turning up any day to take her back. He hasn’t been in touch since.

TEXT: panel responses
Carolyn Connor
For Clare, those 18 months (coinciding with Duncan moving in) have seen a number of significant changes, most notably the birth of Zoe and Harrison. This together with her mother’s postnatal depression would mean that Clare would be unable to cope with the changes without adult support, and is responding to the situation in a negative way in order to get the attention she requires.
Exacerbating this situation is her birth father’s letter promising Clare he would be “coming to take her back”, but not making any further contact. It’s important to note that Clare’s father had assaulted Hazel which could have been witnessed by Clare.
Clare may feel that the adult males in her life have abandoned her. This may present a gender issue and could be the cause of Clare attacking the male carer in the foster home. Also, Clare’s self-harming and mood changes are serious and require immediate action.
The main objective would be to return Clare to her mother and family, with a contingency plan should this not be possible. An initial assessment, carried out by child and adolescent mental health services (Camhs), should consider Clare’s self-harming, recent low mood and aggressive behaviour; the impact upon Clare of the current family dynamics and her mother’s postnatal illness; and her current education status.
In the medium term, a core assessment should be completed, with a referral to advocacy services for family reconciliation work (if Camhs are not taking on this work). A visit to the birth father should take place to discuss his position regarding Clare and his conviction.
In the longer term, a children in need meeting should be arranged with the family (although perhaps not the birth father) with professionals from health, education, advocacy and Camhs. This would consider contact issues (previously discussed at the looked-after children review); a phased plan to reintegrate Clare back with her family (if appropriate) within agreed timescales and a package of support to Clare, her mother, step-father and family, which would identify frequency of visits by workers and outreach support.

TEXT: Lisa Jamieson
We would firstly check that all options for Clare to live with extended family members and friends had been explored. 
In regard to looking for a family for Clare we would request an in-depth referral of Clare’s needs, which would include some assessment of the type of family that would meet her needs as well as location of placement, Clare’s education needs and any contact arrangements.
We would need to know the level of Clare’s involvement with any other agencies such as Camhs or youth offending team. We would also need to look at the proposed length of the placement and what work was being done with mum and Duncan.
A risk assessment would need to be completed to provide a safety net for both Clare and any prospective family. Placements are most likely to succeed if carers are given all the relevant information at the start.
As with most local authorities we have a limited number of foster carers who can look after older young people with complex needs. If no resources were available in-house we would seek permission to access a placement from an independent agency, but we would try to find the independent placement within the Warrington area.
Maintaining Clare within Warrington would be particularly important because of the need for stability in her educational placement and also because the location may impact upon any future contact with her mother and could assist with any possible rehabilitation plan.
Placing young people with carers from an independent agency can throw up its own challenges in that we are relying on other people’s assessments and information to inform us of the carer’s strengths. In finding a placement it would be essential to take a co-ordinated approach.
The most likely care plan for a young person like Clare would be eventual return to birth family. This means that work would be undertaken to look at family relationships. Clare’s social worker would need to locate Clare’s father, as not knowing his whereabouts will add to Clare’s distress.
Clare’s self-harming would need to be closely monitored and support put in place for both Clare and any carers. Any placement would be reviewed regularly through the statutory review system.

BOXHEAD: user view

BOXTEXT: I recommend that Clare sees a counsellor, who may be able to get to the bottom of some of her difficulties, writes Mark Houston. But the first step in resolving the situation should be to ask Clare what she wants. The decisions about her future placement should be largely determined by her views and opinions.
It is very important to speak to her about how she feels about seeing her father. Given that he has convictions for violent offences, it might not be wise to allow Clare to live with her father. But if she does want to establish contact with him, then the authority should make attempts to allow this. Of course, the children’s services department would need to carry out the appropriate risk assessments.
I do not feel it appropriate that Clare moves back with Hazel. It seems that Hazel is also going through a very difficult period and so it may be better to give Hazel some space to deal with her own problems. Also, it is important to consider the welfare of Zoe and Harrison, who would obviously be affected by being exposed to Clare’s violent behaviour. Nevertheless, the authority should try to promote contact between Clare and Hazel.
The council should try to give Clare as much stability as possible. The fact that she was “thrown out” by her mother must make her feel rejected and has, in my opinion, been a major factor in lowering her self-esteem. It has also caused Clare much frustration, which at first she expressed through aggression towards others, and now expresses through self-harm.
She needs to feel loved, appreciated and valued. This will require her carers to devote a lot of time and attention to her. If foster carers who could offer her this are identified, then I believe that this placement should be arranged.
However, if the placement were to break down, Clare would probably feel more rejected and her morale would be even lower. Hence I suggest that such a placement only goes ahead if the social worker and other relevant professionals can be almost certain that the placement will be fairly long-term.
Every attempt should be made to support Clare at school. I also recommend that she is encouraged and supported to engage in youth activities (this is especially important given that she is becoming very withdrawn and depressed).
Clare will need lots of encouragement. Her carers should build on what she is good at and motivate her to further progress.
Mark Houston is a care leaver.