Are We Listening – Really Listening?

The cornerstone of all our work with children should be our ability to listen, and yet unfortunately all too often we fail to hear what they are saying. As a parent, I sometimes hear myself saying to my own children, “Give me a couple of seconds” (which could mean anything from two seconds to an hour) because I am too busy or am reading or watching television and don’t want to be disturbed.

This is not to say that children should not wait, nor is too say that they should always get their own way, but what I am saying is that sometimes we do not give people time, or we are too focused on our own agendas or issues to hear what children are actually saying. The legislative framework also guides us to take account of the views of children and young people, depending on their level of understanding.

Whatever systems are put in place, if we don’t listen or more importantly hear, we will miss what children are saying. As I have argued before, a significant part of the Government’s social policy agenda appears to respond to our most vulnerable young people by draconian responses that sucks them into the criminal justice system and ultimately into prison.

Again it is worth stressing that I am not advocating an anarchic free for all, far from it. What I do feel, however, is we need to respond to behaviour, problems and issues proportionately, in a way that attempts to address their needs, and in a way that tries to give people something to look forward to, i.e. a future. If people do not feel they have a future or a stake in their society, we know what can follow.

I was reminded of the importance of listening when I had sight of a press release from the Department of Health. In this press release it talks about Multi-systemic Therapy for young people, and refers to two documents. The first one, entitled Reaching Out: An Action Plan on Social Exclusion, was published in September 2006 and the other was the recently published white paper Care Matters: Time for Change.

Both advocate “…the development of Multi-systemic Therapy (MST) as an effective specialist intervention for older children and young people on the edge of care”¹ and also as a early intervention prevention for young people experiencing social exclusion. As a result the Government is in the process of setting up six pilots studies to see how successful this approach could be in the English context.

Two things are particularly important in this initiative :

• first, they are seeking evidence to see if it works, rather than rushing head long into yet another scheme borrowed from the United States,
• secondly, they are stressing that they need to see if it will work in a local context.

MST is not some form of wishy-washy talking therapy that lasts for an eternity but doesn’t seem to go anywhere. It is time-limited (three to six months), is based on evidence and located firmly in the young person’s family and community. It is an ecological model that identifies the strengths and weaknesses through family sessions “…and is, therefore, family driven rather than therapist driven”².

What is important in this approach is that it draws on evidence that shows that serious antisocial behaviour is complex and “…is determined by the interplay of individual, family, peer, school, and neighbourhood factors…”⁴.

The evidence from the United States appears pretty impressive and has produced evidence, in their work with juvenile offenders, to demonstrate:

• reduced long-term rates of criminal offending in serious juvenile offenders,
• decreased recidivism and re-arrests,
• reduced rates of out-of-home placements for serious juvenile offenders,
• extensive improvements in family functioning,
• decreased behaviour and mental health problems for serious juvenile offenders,
• favourable outcomes in cost savings in comparison with usual mental health and juvenile justice services. ³

The first principle of the intervention (which draws on a variety of theoretical approaches) is to make sense of what they call the young person’s own ‘social ecology’. What is crucial is that this approach is individually oriented, and attempts to engage the young person, family, friends and community in the process. No intervention will work if the therapists merely impose their own world view on the situation; the young person must be fully engaged and the therapist will have to listen and work out an intervention strategy based on perceived need. If these pilots are successful it will not be a cheap option but may help to provide long term solutions.

¹Grant for the Development of Multisystemic Therapy (MST) Pilots http://www.cabinetoffice.gov.uk (accessed 16/8/2007)

² Multisystemic Therapy http://www.mstservices.com/text/treatment.html (accessed 16/8/2007)

³ Multisystemic Therapy http://www.mstservices.com/text/treatment.html (accessed 16/8/2007)

⁴ Multisystemic Therapy http://www.mstservices.com/text/treatment.html (accessed 16/8/2007)