Practice implications

Working with neglect
The risks of recurring maltreatment are higher with neglect. Practitioners need to be mindful of becoming overwhelmed, and must think and act systematically, drawing on historical as well as current information, to avoid the “start again” syndrome.

Young people
Vulnerable, hard-to-help young people need creative, responsive services that address the effect of past maltreatment. Agencies need a shared commitment and there should be a clear transition from children’s services to adult services. Arguing over thresholds leaves young people at risk.
LSCBs have a remit to consider thresholds.

Assessments
The assessment framework provides an ecological structure for the systematic gathering of information. However, this must be analysed using a dynamic, transactional model of development that informs the case formulation and plans for interventions.

Support for practitioners
Good support and supervision is needed so practitioners can work effectively with complex cases. Practitioners must be self-aware, flexible and sensitive to the factors underlying their own and the family’s behaviour and emotions.