by Jack Brookes
I cannot keep the young people I share responsibility for looking after safe.
I can’t stop them from running away and going missing. I can’t prevent them from abusing alcohol and drugs, especially the pervasive “new psychoactive substances” (formerly legal highs). I can’t stop them shoplifting painkillers to overdose on or razor blades to cut themselves with. I cannot protect them from being sexually exploited.
In truth, all these issues, and the drivers behind them, are interwoven.
Young people will get away
Children’s homes are not allowed to lock the doors as a matter of course, so the young people are free to walk in and out as they please. Although, when we did lock the doors one evening, a couple of weeks ago (we’d been instructed to by the police), one of the girls simply put a fire extinguisher through the patio doors.
We can restrain them to stop them leaving – if it can be demonstrated that the risk of harm is imminent but eventually we will have to let go and many of the young people are too strong, and full of rage, to hold safely for more than a short period of time.
I can, and do, follow them – if I am quick enough. I am fit – I can run fast, jump fences and climb over walls but all I can do is stay with them and try to persuade them to return home.
Even if I was successful on, say, three out of four occasions – a young person may make several attempts a day. They will succeed. By the time a member-of-staff has got through to a police operator, the young person may be in a car or on the train.
Of course, regulations regarding the use of physical intervention or locking doors exist for a reason – not least to protect children from the types of abusive practice seen in the past. However, think of the lengths you might go to to protect your own teenage daughter from the harm I describe above. Locking a door? Physically stopping her if you had to? A responsible parent wouldn’t think twice.
Safe
I take my responsibility for the children I look after extremely seriously, I am experienced, well trained and have strong relationships with many of the children but I still can’t keep them safe.
In response to the Ofsted report ‘Time to listen− a joined up response to child sexual exploitation and missing children’, Matthew Reed, chief executive of the Children’s Society, is quoted in the Guardian saying: “When a child goes missing it’s vital that authorities take action without delay to make sure they are safe and work out what needs to be done to stop them running away again.”
I doubt there is a sane adult in the country who would disagree with that statement. I only have two questions – how? And, what do you suggest?
The report raises many important issues and talks – wisely – of seeking to understand why some children run away. The authors are critical of practitioners describing a victim of CSE as having “made choices”. However, this very understandable desire to avoid “victim blaming” means the report fails to understand an unpalatable truth.
Some of the young people are making choices. Appallingly dangerous and unhealthy choices but, ultimately, still choices.
Running to the bad thing
These children are drawn to the dangerous situations and the people who exploit and abuse them. Put simply, they are running to the bad thing not away from it.
Acknowledging this is not the same as blaming them – it is not their fault. Acknowledging this is to try and understand the very problem that makes them so vulnerable. The reasons they make these choices are myriad, hugely complex and beyond the scope of this article. But invariably they will be to do with early years abuse and neglect, associated attachment issues, and the unconscious processes which lead individuals to repeat earlier traumatic experiences.
These deeply troubled and disturbed children are simply not capable of making appropriate choices, however much we “educate” them regarding the risks they are taking. They need responsible adults to make choices for them until they can be helped to make better ones.
Failed
A significant minority of children are being failed by the current models of children’s social care.
Typically, a child will be in foster care and they will seem to be doing OK – the impact of those early experiences perhaps not yet so apparent and any behaviour associated with it easier to manage when they are younger. As the child grows he or she will become harder to manage, start putting him or herself “at risk”.
A decision will be made to move them to a residential children’s home – the fantasy being the home will be able to manage the risk. It won’t be. Either the home or the local authority will close the placement, and the young person will be moved to another home not much different from the first and equally unable to keep the child safe.
There may be a few more children’s homes until eventually a court order is sought and the young person is accommodated in a secure children’s home for three months. The child leaves the secure unit, goes to another children’s home and continues to put him or herself at exactly the same kind of risk as before.
Futile
This is a pointless and futile waste of time and resources and does untold further harm to the emotional and psychological health of the child.
These children need sustained psychotherapeutic intervention. This doesn’t just mean being taken to see a counsellor once a week but living in a home where staff have thorough training in the impact of early years’ trauma and neglect and in creative therapeutic approaches for responding to it.
A home with a therapeutic model embedded into the day-to-day structure, routines and culture, and overseen by experienced child psychotherapists who have input into the children’s care but also provide staff with genuine clinical supervision.
Of course, no therapy will be possible, let alone effective, if the young people do not feel safe and contained. It is certainly a waste of time if the child is not even present to receive this level of care.
So these homes will need to be secure. It shouldn’t be thought of as a three-month placement but as a ‘for as long as is needed’ placement.
As the young person develops, gains ego-strength, starts to heal, the professionals involved can make decisions giving them greater freedom – outside activities with staff, then incrementally larger amounts of time out on their own.
If the young person puts him or herself at significant risk they can move back and forward through greater or lesser levels of containment without having to move to different homes and experiencing the constant disruption and ending of relationships with carers.
The majority of looked after children do not need this type of care, but a significant number of extremely traumatised and disturbed young people do.
Jack Brookes is a pseudonym. He works in a children’s home, and grew up in care himself. He blogs anonymously at lostincare.co.uk. You can follow him on twitter @Lostincare.
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I guess Jack I worry about blanket terms like ‘attachment issues’ applied to the LAC population.
My autistic son is in a semi-independent unit as a former LAC. His difficulties are complex and I’d argue sustained psychotherapeutic intervention is not the answer for him. To be honest ‘the impersonality’ of the semi-independent unit is what he craves and the freedom he has there has brought a kind of stability to his life because there is no-one ‘bugging’ him.
We, his parents, were ‘bugging him’, because we did’ent know he had Aspergers and could’ent get access to a psychologist to help us understand why he was ‘crashing’ out of ‘normal’ life.
I’m not really in favour of any one size fits all solutions particularly when many young people in care with Aspergers may never receive a diagnosis because all are looking at behaviours not needs.
I’m certainly not suggesting a one size fits all approach
We have fostered for over 20 years and looked after as many children in that time. It takes an awful lot of patience to care for some of the children in the ‘system’ these days. No amount of matching prepares you for the way some of them present and more often than not they come to us as emergency placements.
If there are CPO’s attached it brings a frenzy of reviews, planning meetings and Hearings and some families contain multiple children all sent into foster homes. Maintaining contact with their families can be hit and miss and sometimes chaotic experience, unsettling the children afterwards. You have to be there to pick up the pieces.
More often than not you just get an inkling that somethings not right with a young person but they have slipped through without any diagnosis or been labelled as difficult and rebellious, taking risks all the time no matter what advice you give them. They do not seem to have a switch off button.
I recently did some extra training on challenging behaviour where I was shocked to learn that maybe two or three behaviours only out of possibly twenty or so could be considered really challenging and that it should be possible to change their behaviours by showing you care for them and not always be ‘at’ them negatively. Praising them for the smallest good thing they manage to do.
Getting back to basics, taking them back a few years and repeating things over and over as you would to a small child may help for the right things to sink in. Mostly they have not had good role models and nurturing so are not able to self regulate themselves.
When you see some of the behaviours you don’t really know where to begin to stop it. It isn’t easy putting all you have learnt into practise in the heat of the moment. It’s no wonder placements break down one after another with residential and secure being the only option left.
The police, schools, and social workers no longer have the resources to keep up with the amount of damaged children coming into care never mind the shortage of carers.
None of us have the answers to make miracles happen and change their outlook on life unless we bond with them first and that seems to be the secret. So we shall keep going in the hope of making life a bit better for some kids who’ve missed out on having a decent childhood. It’s worth it when they thrive and do well.
While the previous comment is fair, one size won’t fit all, overall the article rings very true to me. The systems we have in place don’t keep these children safe, we don’t have that combination of security and therapeutic support needed on anything like the scale required
I have worked with children who are in the care system, about to enter it or just left it now for over 10 years.
You have literally published my own thoughts and feelings. I couldn’t have said it any better.
So many of us in this profession have the same feelings and ideas, and yet nothing is ever changed. All comes down to money, which is horribley oversighted. Spend and invest in the young people now, and it will save so much money, time and services in the future.
Really well written piece, Jack. It’s a real struggle and I agree with your overall themes
I do agree with Jack with most of what he has said . But it’s never easy putting something like this into practice , each individual is unique and each have very different needs to be able to feel secure and safe within themselves .
”More often than not you just get an inkling that somethings not right with a young person but they have slipped through without any diagnosis or been labelled as difficult and rebellious, taking risks all the time no matter what advice you give them. They do not seem to have a switch off button” – This really sounds like ADHD?
It is very challenging for natural parents (not just carers!) to keep adolescents with say ASD and ADHD safe in adolescence, particularly if the young person have no idea how to keep themselves safe and are not coping for what ever reason. Children with ASD have particular communication needs – they will interact with the world differently. These disabilities can have an environmental cause and be exacerbated by poor parenting but any kind of restraint including putting a hand on my son’s arm is likely be traumatising. You have to be able to watch and reflect very carefully before intervening and each child is different.
Therapy dos’ent cure disability not matter how much you want it too. Love dos’ent make everything better. There is not nearly enough focus on disability in the care system and learning how to bridge gaps in communication and adapting practice to the needs of the child. There should be no child in care with a disability without a diagnosis – this should be the objective and it is achievable but not without a change in culture
One size never fits all but Jack eloquently illustrates the awful impotent and much maligned circumstances within which our residential carers operate every day.
Our children are consistently failed and a revision of how we support them is imperative otherwise we perpetuate an evergrowing injustice in our society of marginalisation and repeated reactive behaviour patterns which impact on future generations.
The children and young people deserve better and those that fall through or bypass early help need better resourcing including consistent specialist help. Our strets are full of people we have failed.
Well done Jack whoever you are.
Couldn’t agree more. It would help immensely if the media stopped being so sentimental and finger pointing.
Last word from me on this…Where severely disabled children have behaviour that challenges this is best practice from the Challenging Behaviour Foundation – If you think this is not relevant bear in mind 70% of LAC have identified SEN
Sometimes help is needed from a specialist ‘behaviour support team’ or equivalent. This team includes, or works closely with, a range of professionals including clinical psychologists and psychiatrists who have expertise in understanding and assessing challenging behaviour.
Speech and language therapists and occupational therapists should also be involved, to help teenagers find effective ways of communicating with the people around them.
A ‘positive behaviour support’ approach is recommended by the key professional bodies.
It includes:
• treating the person with dignity
• creating meaningful relationships
• teaching new skills to replace behaviours which challenge
• not using punishment
• having access to meaningful activities.
A comprehensive behaviour assessment should include:
• a functional assessment of behaviour (to look at reasons or ‘functions’ for challenging behaviour)
• medical health check
• mental health check
• communication assessment
• social or environmental factors that may affect behaviour.
Using information from these assessments, a behaviour support plan should be developed setting out how and why behaviours occur, what keeps them going, what is likely to prevent them and how families and carers can respond in more effective ways. It is vital to have a consistent approach across everyone supporting the person.
Physical intervention – including restraints such as arm-splints or helmets – should only ever be used as a last resort. If they are employed, it should be with clear guidelines on their use, and alongside a range of other ways of supporting the person with their behaviour. This should be recorded and regularly reviewed with a clear aim of eliminating their use. Carers should ask for training in physical aspects of behaviour management, to help them support their child more confidently and avoid hurting themselves or their child. Medication similarly should only be used if there is a clear and specific reason for its use (e.g. depression or epilepsy).
The simple statement ‘providing for their ‘needs’, rather than just focusing on containing or managing their behaviour, is very poigniant, it is far more beneficial providing for needs in a family environment in Foster care than in a childrens home.
Sadly there arent enough quality trained & experienced Foster Carers,t
Great article
Very moving article followed by useful advice by various contributors.