Stage 3 - Deciding what to do
- The new social worker has recognised mother's commitment to her
children and her desire to work to prevent the children entering
- The family’s personal support network is very limited
- There are no local foster care placements that would enable the
children to stay together or remain in close contact
- The 10 year old has had a couple of temporary placements but has
- The local family centre cannot begin work with this family for
- There are still high levels of concern about the men and the risks
they pose for this family. One is a Schedule 1 offender and the
other is under his influence.
- The health visitor is sceptical as a result about the prospects
- What can be done to keep these children safe and to address their
wider developmental needs?
- What steps can be taken to reduce the risks posed by the father
and former step-father?
- What can be done to support the mother?
- What resources are available?
- What will she accept?
- What contribution can other professionals make and what support
from other agencies is available realistically?
- What protection and resources can legal and policy frameworks
Research focused questions
- What are the needs and risks that merit top priority?
- What outcomes are you seeking to achieve?
- What range of interventions are likely to achieve those outcomes?
- What evidence is available about: 1) the implications of doing
nothing, 2) the likely effectiveness of any services you might offer.
- What legal interventions can be used to support positive outcomes?
These lead to more key questions
- What objectives need to be set over what timescale?
- Who is going to do the work?
- What is it likely to cost?
- What are the mother's and children's views about the plan?
Reference has already been made to the DoH Framework
Assessment of Children in Need and their Families. This has
a useful chapter devoted to Analysis, Judgement and Decision-Making
- p.53-62. Among the factors that need to be considered are: how existing
good relationships and experiences can be nurtured and enhanced; what
type of interventions are known to have the best outcomes for the particular
circumstances of the child who has been assessed as in need; and what
the child and family can cope with at each stage (p.57). These are important
considerations in any complex case. Taking on too much at the same time
may be unproductive. Equally, following a single track without an understanding
of the whole picture may also lead to parallel disappointment.
One of the indicators for unsuccessful cases in the David
Jones chapter, p.107, referred to in the 'Beginnings' section was
parents who refuse or do not co-operate with professional help. In this
particular case in previous years the men had successfully held professionals
at arms' length, using threats, bluff and moving around to escape effective
scrutiny. However, the men are now both out of the family home and the
mother is actively seeking help. This is a time of opportunity to work
with her provided there is firm action in relation to the men. Positive
indicators are where children and families are able and willing to co-operate
with helping agencies and where successful partnerships between professionals
and family members have occurred. We do not know whether active collaboration
will be forthcoming, but it is time to test what can be achieved despite
the scepticism of the health visitor.
with Children, Adolescents and their Families. This is a highly
useful book because of its successful and rare combination of clearly
explained theory with many practical examples of relevance to child
Ronen's chapter on Cognitive-Behavioural
Therapy summarises six rules which could be applied to either
the mother here or to individual children. Each would require a separate
programme so a key decision would necessarily be which should take priority
and where you start. The six rules are: think behaviour (this is opposed
to thinking about problems; the emphasis is on action rather than interpretation);
think solution (this is opposed to getting bogged down in the history;
it requires thinking about the future that you want to achieve); think
positive (not easy amid so many obvious reasons for being depressed);
think small steps (care plans are sometimes made meaningless by their
failure to be specific and realistic when setting objectives); think
flexible (do not fall in love with your plan or your method; be open
to new learning and be willing to adapt); think future (the past is
important but it can become a snare; focus on the changes that people
want to make). Ronen then quotes a twelve step process which could be
- Inventory of problem areas
- Problem selection and contract
- Commitment to co-operate
- Specification of target behaviours
- Baseline of target behaviour
- Identification of problem-controlling conditions
- Assessment of environmental resources
- Specification of behavioural objectives
- Formulation of a modification plan
- Implementation of modification plan
- Monitoring outcomes
- Maintenance of change
It is not suggested that cognitive-behavioural therapy
is the only or even necessarily the most appropriate approach in this
case but it is certainly worth consideration because it is being grounded
in empirical research. A less ambitious programme might arise out of
Marsh's description of Task-centred
Work in the same volume. Here the progression is from identified
problems and needs to goals negotiated with the family via a series
of tasks. Tasks are, in effect, the stepping stones which enable the
family and the worker to move towards their agreed objectives. Its strength
as a method is its concreteness (tasks not just talk) and the fact that
any plan of work is based on an explicit partnership. It is also highly
amenable to evaluation. Objectives are clearly spelled out which helps
make success or failure much more visible to everyone.
As for stage 2 but also:
S.& Thomas N. (1999) On the Move Again? What works in creating
stability for looked after children? Barnardos
G. & Winkley A. (1999) What Works in Child Protection?,
T. (2002). Developing Evidence Based Practice in Social Care: locating,
appraising and using research findings on effectiveness - Guidelines
If you are looking for something more weighty, there
are two books that can be recommended:
works for children? Effective services for children and families.
works? Evidence-based policy and practice in public services.
As the title implies the second book has more policy relevance while
the first is more geared to practitioners.