It’s a privilege when a child in care is delighted it’s you. R. J. (Sean) Cameron and Colin Maginn. 2021. The Pillars of Parenting Ltd (Publishing), Sunderland, pp 204. £26.00 (paperback). ISBN 978-1-8381-3410-5
Book review by Dr Chris Hanvey.
Children require two things from their parents: “roots and wings”. Roots help make stable emotional growth possible and then permit the wings of independence to develop. Goethe’s paraphrased words, here, (1) are not just a vital requirement for parents but for all of those who care for children in residential care, through fostering and adoption and in therapeutic settings. And yet why is it that, in most countries, the vital task of caring for other people’s children is often delegated to those with minimum training and knowledge? In March 2018 there were 75,420 looked after children in England, with nearly three quarters in foster care, 11 per cent in residential homes and the remainder either returned home or placed for adoption. £8.94 billion was spent by local authorities in England on children’s social care between 2017/18(2) and yet we have a system that often appears to be at breaking point. The authors argue that from an economic viewpoint alone some £43,000 could be saved for each child where a stable environment was found and from which “roots” and “wings” could then become possible.
Cameron and Maginn have written a practical and very readable text book which is aimed directly at all of those who take on the role of parenting or caring for children. Although the book is set in a UK context, it has an applicability which makes it readily available to a range of international child care practitioners. Cameron is an educational and child psychologist and Maginn a social worker who has run secure units and children’s homes in the London region. Theory is underpinned with practical examples; each chapter clearly sets out its aims and provides measurable outcomes against which the contents can be evaluated. In terms of practical examples, at one stage they describe the day in the life of a children’s home in which Paul, an eleven year old boy, receives a bike from his grandparents which he understandably wishes to ride to school. Meanwhile, another resident has smashed his bedroom and barricaded himself in and a third resident has been suspended from school for assaulting a classroom assistant. In the midst of this, Paul’s mother visits the home and demands to know why her son has bruises on his shins. Just when things couldn’t get worse an unannounced inspector arrives. Authors who describe this degree of daily granularity really have experienced the slings and arrows of residential care! And towards the end of the book is practical advice, aimed not just at the carers but young people themselves: for example, preparing for an important meeting that might affect their future.
Through their years of practice the authors have developed what they call “emotional warmth parenting”, an attachment and strengths based approach which uses psychological research into parenting to build a model for practitioners. They quote the American novelist John Steinbeck’s words that rejection and not being loved is the hell children fear most. They may have added the novelist’s equally prescient words that this rejection is played out in a variety of ways, with one child committing crime, another turning to violence and a third vainly seeking to buy love(3).
The book begins by looking at four differing styles of parenting from the permissive and indulgent to the authoritative, arguing that ensuring children’s survival means more than meeting basic physiological and safety needs, since “healthy” children require emotional competence and long-term well-being. They draw upon Maslow’s hierarchy of needs, beginning with the fulfilment of those staples which children need, such as food, warmth, water and sleep, in a pyramid which moves through security and safety, belonging, self- worth and eventually self-actualization, where potential can be met.
From this Cameron and Maginn have constructed what they describe as the Eight Pillars of Parenting which are at the centre of the book. As you may expect, pillar 1 is about experiencing primary care and protection. But, as well as attending to physical care, it includes offering reassurance during periods of distress and supporting the child’s growing engagement with education. The pillars move from forming warm attachments, achieving a sense of belonging, building resilience, enhancing self- management skills and, in the final pillar, developing personal and social responsibility.
Each pillar is described in some detail and the practical examples which accompany their description could be of significant help to those carers in fostering and adoption, as well as in residential settings. For each pillar, there is also a useful theoretical underpinning. But the eight pillars are only part, albeit an important one, of that armoury which leads the authors to their emotional warmth parenting.
Returning to John Steinbeck they explore the impact of rejection, neglect, exploitation and abuse on the emotional and social development of children. Chapter 4, Trauma –Informed Parenting could stand alone as part of any course undertaken, for example by potential foster or adoptive parents. In looking at the effects of trauma on children they explore the growing body of evidence which has considered the effects this has on the brain.
One of the positive developments of the last twenty years has been the development of neuro -scanning technology and the long term effects of trauma. As the authors argue, for a long time it was believed that the growing brain contained flexibility and resilience which enabled children to recover from early traumas. But recent research has demonstrated that all three of the main brain systems are affected by traumatic experience. The “cortical”, “limbic” and “regulatory parts of the brain are all affected in differing ways and the fact that trauma takes place at a particularly vulnerable stage of development can have profound effects on children. In chapter 4 the authors describe a healing process to address this damage which begins with “stabilisation” and ends in “emotional growth”, through processes of “integration” and “adaptation”.
In order to rebuild from trauma and achieve some kind of resilience, the authors conclude the chapter with practical examples of how all four stages can be addressed. So, “stabililisation” logically begins with establishing clear and predictable paths of daily events for a child and “integration” stresses the normality of emotions such as sadness, anger, guilt and regret. One key optimism in the book lies in the authors’ belief that emotional growth can follow adversity, providing the right support, tools and help are provided.
An essential element of emotional warmth parenting- and of considerable value to all carers- is the handling of aggression. The authors have developed a taxonomy of aggression, which ranges from fear induced aggression to territorial aggression, aggression which is triggered by pain or tiredness and what they describe as “learned or instrumental aggression” which is absorbed from others. For each there are a series of preventive or de-escalating strategies, again based on their clinical work in a range of differing settings.
In the treatment of childhood aggression- as in other parts of the book- the authors develop tools which provide a framework for both examining why challenging behaviour has happened and how it might be tackled. This leads to an examination of their “ABCD” model, in order to move from causation to some resolution. Logically, it begins with antecedents which may be events or triggers which precede a particular type of aggressive behaviour. Coupled with this is the background events or the setting and context in which the behaviour occurs. This moves to the consequences which follow a problem behaviour and the task of identifying how adults currently respond to the child’s behaviour in order to develop more effective management and positive support. A particular strength of this model is then identifying what the authors describe as skill deficits. What is missing in the young person that makes it difficult to self-manage behaviour? It could, for example, lead to lessons in anger management or simply talking openly in order to explore how such situations occur.
The remainder of the book focuses on physical constraint, building strengths in vulnerable young people, the importance of education and the ethical principles for those working with children. The authors do not fall shy of tackling how violent behaviour might be contained. Logically, they stress the importance of good risk assessment and reduction and small, practical actions that carers can take to develop “emotional self calming”. These range from controlled deep breathing to counting to 10 or even 21 before reacting. There are some useful references for when some degree of physical control is absolutely necessary, although the point is made that this is unlawful when used as a punishment. The authors are realistic in acknowledging that there are no quick fixes when it comes to the management of aggressive behaviour. Most likely to succeed are environments which have previously thought long and hard about key milestones for all those who work with challenging children- how to dissipate violence and aggression.
One of the book’s most important chapters is on the importance of education. It is an all-too familiar cry that children in the care system often have poor levels of educational attainment and subsequent employment. In the UK, for example, just 6% of young people with experience of care will attend university; compared with almost 50% of the general population. Addressing some of these deficits begins with pre-school provision for those in the care system and the absolute necessity to reach out to those often in greatest need. For those in full-time education there needs to be an acknowledgement from teachers, that challenging behaviour could conceal the hidden needs of children in the care system. This may be reflected in continuous demands for attention, reluctant or low motivation to learn anything or simply refusing to complete tasks. It is why integrated children’s services are so important, embracing not just social services and health but other professional groups like teachers, who have such an invaluable role to play in addressing these emotional deficits.
Lastly, the authors embrace the International Child and Youth Care Network’s seven international ethical principles for all of those who have a professional responsibility for children. These range from valuing and respecting each child or young person as an individual to facilitating optimal growth and development in each child or young person. As the authors assert, these principles are also embedded in their emotional warmth parenting approach.
This book has a wide range of potential readers. It combines theoretical input, mainly from child psychology, with practical suggestions and advice for those engaged with troubled and troubling young people. Parts of the book could profitably be used in the training of foster and adoptive parents or as in-house training for children’s homes and therapeutic communities. Behind the Eight Pillars of Parenting is a wealth of experience and a value base that shares Eglantyne Jebb’s assertion, accompanying the 1922 Declaration of Geneva that “for better or for worse the world can be revolutionised in one generation according to how we deal with the children”.
References.
Paraphrase of Johann Wolfgang von Goethe (1749-1832) quoted by the authors p195
- Department of Education. www.gov.uk/government/statistics/children-looked-after in England- including adoption 2018-19.
- East of Eden. John Steinbeck (1952).
Dr Chris Hanvey was CEO of the Royal College of Paediatrics and Child Health and now works as a free-lance consultant.