A wild child who is shouting out for help

CASE STUDY
Situation
Lara, aged 12, is living with foster carers. She had been staying with her grandparents following a breakdown in relations with her mother, but they were unable to cope with her aggression and violent outbursts. Lara’s mother, Mary, has a dependency on class A drugs and a chaotic lifestyle associated with the drug use. Lara never sees her father and contact with her mother is sporadic, particularly as Mary frequently fails to turn up to contact meetings. Mary has lived with her boyfriend, Rob, who is also a drug user, for over a year. Lara does not get on with Rob.

Problem
The first foster placement quickly broke down after Lara attacked the male carer. She is now staying with a new set of carers, but continues to be verbally aggressive – particularly to the male carer. Lara’s behaviour dramatically worsens when
her mother fails to attend a pre-arranged meeting. The grandparents have not entirely dismissed the idea of Lara returning to
stay with them, but insist that she needs to drastically reduce her aggressive outbursts. Unfortunately, Lara’s behaviour seems to be deteriorating and her current foster carers are finding it increasingly difficult to care for her. What is the most appropriate living environment for Lara?

All names have been changed

THE SOCIAL WORKERS’ VIEW
Patrick Ayre (right), senior lecturer in social work at Bedfordshire University

This situation has all the hallmarks of a classic children’s services dilemma: combining the need for urgent action with a shortage of clear information. Ideally we might want a much better idea about the factors underlying Lara’s aggressive behaviour, with its focus on male carers. But if we take too long making a thorough assessment we may run out of options for her day-to-day care.

Her behaviour is in danger of rendering her effectively unplaceable within a family setting and every broken placement is likely to increase her anger and alienation. Unless our intervention at this stage is effective, Lara may be locked into a vicious spiral from which it may prove difficult, and costly to extricate her.

Unfortunately, few placement agencies can access the kind of crisis intervention service that might be helpful in this case.

If applied early enough, a crisis intervention approach can arrest the placement breakdown process and create an environment
in which longer-term assessment and intervention can be undertaken.

It requires that a worker, or pair of workers, be allocated to support a placement as soon as signs of serious strain become
apparent, visiting frequently and intensively until balance has been restored. This is clearly a strategy that uses a lot of resources but intervention at this level is of short duration and experience suggests that the gains for children and for the service outweigh the costs

John Diamond, CEO of The Mulberry Bush Organisation

My first concern on reading the case study is how professionals might stabilise the chaotic situation that Lara is in. If we understand Lara’s behaviour as a form of communication, we can identify some key issues to help us understand her difficulties.

Because of her mother’s addiction and lifestyle, Lara has probably never been able to come to terms with her inability to provide the continuity of care and nurture she needs. Her mother’s failure to attend contact meetings confirms this to her.

At age 12 with the onset of adolescence, we can imagine that her anger has become amplified.

Similarly, Lara’s only experience of men is through the “betrayal” of her father’s absence, and the inability of Rob to provide a caring relationship. This may help us understand her aggressive feelings towards male foster carers.

To stabilise and meet Lara’s needs at this stage would require a therapeutic residential placement. If she is to stay with the foster carers or grandparents, she will need access to therapy and active daily support or mentoring. There will be no short-term resolution. Those involved with Lara will have to be prepared to manage, and be seen to survive, the emotional pain and the challenges of her situation.

The Mulberry Bush Organisation is a charity that includes a school and a consultancy, providing care and education for emotionally traumatised children

THE SERVICE USER’S VIEW

Kim Fenna, aged 17, is in foster care and higher education

Lara is at an age where she is about to enter adolescence, this will make her feel as if the world is against her. I understand where Lara is coming from given her situation. She obviously has a problem with men and is consequently fighting back against everyone.

She needs to seek help from a councillor, who should be female so that Lara feels more comfortable in speaking out. They will
need to show Lara that they understand her point of view, and therefore make her feel that someone is on her side. A social worker should also approach Lara and ask her what she wants.

This will be the most effective technique as Lara will feel as though she has a say in what is going to happen in her life.

She will be feeling vulnerable, already being on her third placement since she left her maternal home, and needs stability. The reason that she can be violent towards men is because of her mother’s new boyfriend; she may blame him for her mother not turning up to contact and believe she cares more about him and drugs than her.

Lara’s lack of contact with her dad may also mean she feels that she can’t trust men. After counselling has been arranged, I would introduce Lara to a support group with young people in similar situations, which will give her people her own age to talk to.

Related article
For more on adoption and fostering read our expert guide