The 10 year old girl ran away because her step-father
hit her and put his hands around her neck. Although her behaviour can
be challenging, she is a bright and able girl.
- How serious would you rate the risks of
impairment or harm if you did nothing?
- What are the needs of the individuals within
- What protective factors can be identified?
- What is the balance between needs,
risks and protective factors?
There is a companion volume, The
Mental Health Needs of Children Looked After, that looks,
via some case scenarios, at some of the mental health issues that
may arise for children looked after.
The Brown & Harris study, Social
Origins of Depression: A Study of Psychiatric Disorder in Women,
despite its age, still offers a useful model for identifying key social
factors in an individual's history which may lead to depression in
later life. These include the experience of loss in childhood, the
absence of a supportive relationship with a partner, the physical
and emotional responsibility for several young children who are close
in age and the lack of the stimulus and support gained through working
outside the home. Given the pressures on the mother in this case from
the men in her life and the absence of support from relatives, it
would be surprising if she were not depressed. This mother may well
need considerable investment in her own right to help meet the needs
stemming from her own early years before she can increase her capacity
to meet the needs of her children.
Finding the evidence: a gateway to the literature
in child and mental health (second edition), edited by Angela Scott,
Mike Shaw & Carol Joughin, Gaskell, 2001, ISBN 1901 242 684. This
resource is published by the Royal College of Psychiatrists and can
be downloaded from their website. Although its scope is far wider
than this particular case, it offers material that is likely to be
relevant and useful. Apart from the wide-ranging information about
specific disorders, it provides guidance on searching for evidence
to make the process more efficient and effective.
Policy Research Bureau has undertaken a number of studies relating
to parenting in recent years. Parenting
in Poor Environments: Stress, Support and Coping is a large
scale study of parenting against the odds. It looks at those families
who are likely to be the most vulnerable, how formal support services
could improve and how crucial it is to families that sources of external
support, formal and informal, do not become sources of external control.
Among the other Policy Research Bureau studies available
is one in summary form at the Joseph Rowntree Foundation website.
This is How
family centres are working with fathers . This describes
how often family centres in reaching out to women and children are
sometimes less than welcoming to many men. Taking
Fathers Seriously is another recent work that argues for
a more constructive approach to working with men.
matters: What works? has information about a number of parenting
programmes. P.67 offers a list of potential benefits of parenting
groups that would be relevant in this case. They can: help socially
isolated families meet people and make friends; help build cohesiveness
among group members; provide opportunities for individuals to share
views and learn from others; encourage parents to listen and respond
to the needs of others; provide appropriate role models; boost confidence
and self esteem; and be cost effective compared with services focused
on individuals. There is a basic distinction between relationship
and behavioural parent education programmes. Overall, behavioural
programmes produce the biggest changes in children's behaviour (P.73)
and there are research abstracts about four such programmes P.74-80.
Needs - Parenting Capacity: The Impact of Parental Illness, Problem
Alcohol and Drug Use, and Domestic Violence on Children's Development
is an especially useful resource because of the way it is
structured around two of the domains in the DoH Assessment Framework.
It looks at the implications of adult behaviour for children's development
under the dimensions of health; education and cognitive ability; identity
and social presentation; family and social relationships; emotional
and behavioural development; and self-care skills at the different
stages - for the unborn child; for children aged 0-2; then 3-4; 5-9;
10-14; and 15 and over. As with the Gilligan chapter quoted above,
protective factors are identified alongside the risks.
As an example which relates to the younger children
in this case here are some of the pertinent problems
for the 3-4 year age group: children may have their
physical needs neglected; their cognitive development may be delayed
through lack of stimulation, disorganisation and failure to attend
pre-school facilities; their attachment may be damaged by inconsistent
parenting; they may learn inappropriate behavioural responses through
witnessing domestic violence; they may take on responsibilities beyond
their years because of parental unavailability; they may be at risk
because they are unable to tell anyone about their distress. On the
protective side is the potential of support to the
family through primary health care, pre-school facilities and social
services which might include day and respite care, accommodation and
For the 10 year old in this case
the potential problem list includes the following:
children have to cope with puberty without support; they are at increased
risk of psychological problems; they fear being hurt; their education
may suffer because they find it difficult to concentrate; their school
performance may not reflect their ability; friendships are restricted;
they are cautious of exposing family life to outside scrutiny; they
feel isolated and have no one to turn to. Protective factors
include regular attendance at school; sympathetic and vigilant teachers;
and having a trusted adult with whom the child is able to discuss
The previous section mentioned the Prediction
book. This is highly relevant for the analysis required for this making
sense and the next deciding what to do stage.
Other relevant references
D. & Ramchandani P. (1999) Child Sexual Abuse: Informing Practice
from Research Radcliffe Medical Press
National Study of Parents, Children and Discipline in Britain: Summary
of Key Findings. This four page summary gives an empirical
baseline for what are 'normal' methods of child discipline in Britain
today. Unless practitioners have a reliable knowledge base in this
area, their judgements are likely to be too dominated by personal
Runaways: an analysis of the SEU's Report. The SEU here is
the Social Exclusion Unit and here is a brief review of its findings.
Each year there are 129,000 incidents reported of children staying
out overnight without parental agreement. 77,000 children and young
people are estimated to run away for the first time each year.