Peace dividend

An approach informed by Mahatma Gandhi’s principle of peaceful resistance is being used in Kent to change the ways of violent young people, says Peter Jakob

All too often the same scenario presents itself to social workers in children and families’ teams: a child’s violent, truanting, absconding and dangerous behaviour spirals out of control, and family breakdown appears inevitable. In many cases, a young person showing such behaviour is set to drift in the care system, moving from one placement breakdown to another, and often ending up in residential care or secure accommodation.

While the financial burden to local authorities and the drain on resources in child and adolescent mental health services are considerable, the human cost is enormous. Parents, therapists, foster carers and social workers become more helpless, while young people find their negative beliefs about adults confirmed by renewed rejection.

It is peculiar to speak to parents, carers and often social workers and find that diagnostic categories appear to render more comprehensible the problem of a young person’s violence. To suffer trauma, to have attention deficit hyperactivity disorder, to be on the autistic spectrum, to have a conduct disorder somehow seem to suggest that if we only knew the underlying condition, someone could administer a treatment, which would alleviate the suffering all around.

Social workers will routinely refer a young person showing violent behaviour into Camhs. However, there are no outcome figures which would suggest that individual therapy for a violent child will be of any benefit. Individual therapy rewards violent behaviour with extra attention, and can inadvertently validate a young person’s sense of entitlement to act in antisocial ways. Parents and foster carers may feel implicitly blamed for the violence, due to the confidential nature of therapy, or worry about picking up the pieces afterwards. Traditional family therapy will often result in dragging reluctant teenagers into the therapy room. Parents and carers often feel they cannot fulfil the requirements of behavioural programmes or parent training.

Care plans should include measures for a child’s rehabilitation back to their parents’ care. But rehabilitation attempts often remain unsuccessful because family interaction has not changed sufficiently. Parents may be reluctant to accept their child back into the family for fear of disruption and because of their own helplessness.

Thanet Multi Agency Service has been the first therapeutic team to use non-violent resistance (NVR) in Britain, and to introduce the approach in a social care context. Developed over the past 10 years in Israel, NVR is used increasingly around Europe, including Germany. It is a systemic and community-based approach, which uses Mahatma Gandhi’s and Martin Luther King’s principles of non-violent political action.

NVR does not require the violent young person’s participation. Parents or foster carers, who have developed “automatic obedience” in the face of a young person’s demands and threats, learn to disobey strategically. They reduce their sense of helplessness by becoming better at taking direct non-violent action against violence. Another important aspect of NVR is learning to avoid a situation escalating and replacing spontaneous reactions with planned deferred responses.

Family and social networks learn to refuse to give in to violence, but do not attempt to control the young person. Anger levels in the family drop by virtue of de-escalation, and co-operation between adults becomes better planned and more effective. NVR builds bridges between home and school, while encouraging parents, carers, friends, relatives and neighbours to raise a parental presence in the young person’s life. However, high levels of violence in the community and within families’ social networks require therapeutic work that takes into account the effects of frequent re-traumatisation.

NVR is a brief intervention, but requires high staff input for up to three months, with one therapy or coaching session and two telephone support calls a week. Dropout rates are low. An as yet unpublished first controlled outcome study shows very good outcomes in significantly reducing violence and in reducing parental helplessness. It also shows that retention rates in the programme are high (about 90 per cent) compared with about 50 per cent in behavioural programmes.

In our multi-agency context, we have found it necessary to pay special attention to building a support network with the family. Parents who have been traumatised by their own experience of childhood abuse and domestic violence – and who may struggle with mental health problems or drug misuse – also benefit from learning techniques to reduce post-traumatic stress while they resist violence from their children.

With looked-after children we have found it helpful for the therapeutic service to work closely alongside fostering services; when social workers provide the telephone support as part of the intervention, foster carers feel a strong sense of entitlement to resist being controlled by a violent young person in their care.

Using NVR within a carefully developed project can help prevent young people from needing residential or even secure accommodation, and in many cases even result in the rehabilitation of children back to their parents’ care. This work is cost effective and prevents future pressures on services.

Acts of Resistance
Sarah has been the victim of violence and sexual abuse for most of her life. Her 10-year-old daughter Samantha’s increasingly violent behaviour raises her level of anxiety, and often leaves her feeling paralysed, while worrying that her outburst of anger in retaliation may put her children at risk of being removed into care. In the past, she has dealt with her extreme anxiety – interspersed with rage – by using drugs and alcohol, and has made several suicide attempts.

The older children now try to control Samantha by becoming aggressive themselves. There has been a risk of family breakdown, which would result in all five children going into care. Careful motivational conversations help Sarah become engaged in the NVR process.

Using NVR techniques, and drawing on adult support rather than support from children, she learns to strategically plan acts of resistance against Samantha’s violent behaviour. One example is a sit-in in Samantha’s room after a violent incident, in which she involves some adults as witnesses. The sit-in has been carefully planned in therapy – at which Samantha was not present – to change established behaviour patterns which she uses to exert control over her mother.

Sarah becomes increasingly confident in strategically disobeying her daughter – for example, by not allowing herself to be controlled in regard to what she cooks, whom she allows into the home. At the same time, she learns to avoid any escalation, which eventually brings down anger levels within the family. As Sarah becomes less helpless, she finds that her recurring anxiety attacks are less frequent and no longer as debilitating. However, remaining functional in the face of anxiety needs to be addressed within the therapeutic process.

The more Sarah’s confidence grows, the more time she invests in her resistance against the violence, until she finds herself spending about 15 hours a week planning and taking action. One of the most rewarding outcomes of her effort is to see Samantha engaging more with her peers, and acting in more constructive and age-appropriate ways, at school and at home.

Peter Jakob has worked for the past nine years as consultant clinical psychologist in Thanet Multi-Agency Service, which provides psychological therapies and intervention to families involved with social services. With 22 years’ experience in this field, he is now developing Partnership Projects, a consultancy promoting therapeutic service models for social services, Camhs and education.

Training and learning
The author has provided questions about this article to guide discussion in teams. These can be viewed at www.communitycare.co.uk/prtl and individuals’ learning from the discussion can be registered on a free, password-protected training log held on the site. This is a service from Community Care for all GSCC-registered professionals.

Abstract
The article describes how non-violent resistance is used to help families who are involved with social services, to address their child’s violent and destructive behaviour. The method is found to be effective in reducing violent behaviour, preventing family breakdown and stabilising foster placements.

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