In the August edition of the Webmag, we explained that a study of social work files covering the last three or four decades had suggested that there were lessons for today’s practitioners. Six topics have been chosen, and in each case, David Lane describes what he has found out from the files, and Chris Durkin comments from the viewpoint of current practice and teaching about social work. The first three Lessons covered the need for good standard practice, the value of comprehensive assessments and forms of abuse. It should be emphasised that the Lessons will all focus on general issues, and will not disclose any confidential information.
David Lane :
The Impact of Abuse
Helping children to overcome their experience of abuse is difficult work, but unless action is taken, it can be a time-bomb which can go off unpredictably at any time. It may show up during childhood, leading to behavioural problems in adolescence, for example. Other people who were abused as children find that when they form close relationships, their memories undermine their ability to trust and relate. Again, if they become parents, they may start to relive their childhood and find difficulty in ensuring that their children do not suffer as they had done. Some, of course, replicate the abuse and impose their suffering on others.
In some of the cases with which I have dealt, people who were abused as children survived by burying their experiences and denying them. As children, some of them refused to give evidence against their abusers, denying that anything had happened. Indeed, the recent process of preparing statements for the court case and the questioning by solicitors, psychiatrists etc. itself triggered unhappy memories on the part of some claimants. In a few cases the upset even broke up relationships with partners or induced feelings of suicide.
It was only in the 1980s that sexual abuse received the attention which it currently has, though there was awareness of incest before then. The damage caused by sexual abuse was not recognised as fully, and it was dealt with as one of a range of problems which children face.
Treatment
What could have been done? It is questionable what sort of treatment would have been available for some of the children, though there were Child Guidance Clinics where psychiatrists and psychologists assessed and treated disturbed children. There were also adolescent psychiatric units in mental hospitals, and in some forms of residential child care, psychological and psychiatric help were available. There were also therapeutic residential schools and homes which offered various forms of treatment, though none of these figured in the cases in which I was involved.
Abuse ignored
However, some case files betrayed a lack of concern that help might be needed, once the practical and legal measures had been taken to protect the children and ensure their safety.
In particular, I have come across a number of cases of abused girls who kept quiet and were biddable during pre-teen latency, and it seemed as if their pleasant passive behaviour was interpreted as a sign that the abuse they had suffered had not had an impact on them. Unhappily, they then proved to be highly disturbed in adolescence, missing school, running away, getting involved in sexual activity, stealing, and so on. Quite a number became young mothers.
Once they were going off the rails as teenagers, there was often little that the social workers and residential staff could do for them. One or two were placed in secure units to contain their anti-social behaviour, but these placements ran the risk of accentuating their problems, for example in enabling them to learn inappropriate or destructive forms of behaviour from other young people, such as self-harm.
Otherwise, social workers appeared to look on rather helplessly, hoping that the children would settle down and come to terms with their predicaments, encouraging them to stay in their placements, but being quite incapable of exerting any control or establishing a settled life-style for the child. It seemed a matter of waiting for the young person to mature.
Looking back, the lesson is that the opportunity to help during the placid earlier years had been lost. It may not have been apparent that there were concealed problems brewing at that time, but there will be children going through similar patterns of behaviour now, and today’s social workers need to be alert.
Since I am not a therapist, I do not know precisely what could have been done – play therapy perhaps, or counselling, or involvement in activities such as drama for self-expression, or the development of close trusting relationships?
The Efficacy of Caring Relationships
Certainly, where there was success, it was because of a caring relationship, often built up over time. Where the children were in foster care or residential care, they were able sometimes to settle sufficiently to be able to disclose abuse and start to talk about it. Sometimes teachers were used as confidantes.
The outcome was not always successful, but social workers and other professionals who saw children only occasionally were rarely able to build up the consistency of relationship required to develop real trust, even when they talked about important matters. Where there was success, it was the combination of close carers, supported by the other professionals.
Chris Durkin :
Individual Reactions
In looking at David’s article there are a number of themes that come out. The first thing I would say in looking at any area of abusive behaviour is to recognise that each case is different, and that although some of the literature talks about the impact issues for victims of sexual abuse we are talking about an individual experience. Although abuse has an emotional component and sexual abuse, in particular, can have lasting effect we have to be very careful not to make assumptions – how people cope is by definition individual depending on a variety of things including their own resilience and inner strength.
The individuality of each case means that we have to personalise every individual experience. We must, therefore, be careful and be led by the individual. Some children I have worked with do not want to look at what happened, they just want to ‘get on’, and we have therefore to be careful not to impose our own values and beliefs on them. In this situation our role as social workers could loosely be described as educational, and in this context we become a signpost informing them of the resources that are around when and if they should be needed.
I remember talking to a therapist and she was refreshingly honest – why intervene if that person feels they are coping? That was a salutary lesson because as adults we often think we know best and say that a child needs ‘to talk’, using phrases like ‘getting it off their chest’ but we often ignore their own coping skills and their individual strength.
Proper Processes
Working Together and local procedures clearly lay out the enquiry process for cases when a child wants to disclose, including both the interviewing process and how a child should be interviewed. As workers we so often forget the sanitised nature of these procedures and that we are asking a child to reveal their most intimate secrets to a complete stranger, who is an adult. What these procedures fail to enunciate is the sheer emotional trauma of the enquiry process. They also fail to take account of the power imbalance in the relationship between adult/child, professional/service user.
The procedures are rightly there to ensure that the process is managed correctly, but let us not forget that they are there as evidence-gathering, a process that is linked to the needs of the courts. We have to be careful in the enquiry not to ‘taint the evidence’ we have to be careful during the process not to influence the child, in case that child’s ability to act as a witness in the court is going to be affected. I use deliberately emotive language to make the point that the system is largely geared to the needs of the court and not to the needs of the child.
Do not get me wrong. I am not advocating that cases should not go through the courts; far from it. I would like more cases to go through the courts. What I know, however, is the vast majority of cases will not go to court and out of that small number only a fraction of perpetrators will ever be convicted and yet the system is geared up to this small number of cases. I would also suggest that the system also focuses on the ‘stranger’ – the abuser that the child didn’t know, whereas we know that in the majority of cases the child will know their abuser. The majority of children I have worked with just want the abuse to stop.
Managing Cases
In our work with children, we may be called upon to help a child or young person make sense of what has happened, helping them recognise that they were not to blame and to recognise that their individual feelings may be confused. They may love their father but hate his behaviour.
I also used the term ‘manage’ to reflect the process of managing cases. We sometimes use the language of management at times to contain cases and avoid the ‘genie’ coming out of the bottle because we ourselves do not know how to handle difficult and traumatic memories. It is important that we recognise our own limitations and refer a child or young person onto a more appropriate person if need be.
Finally, in this arena we must be honest with children and recognise that we have no magic wand and in this context ‘time may be the great healer’. There are no instant solutions, and we as workers have to be careful that we do not promise something we cannot deliver. We must not promise, for instance, that the abuser will go to prison, when that is out of our hands. We must also recognise that this is a very difficult area of work and the worker will need support and good supervision.