INTRODUCTION. Acknowledgements



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APPENDIX 3 SERVICES LINKED WITH DUAL DIAGNOSIS TEAM

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INTRODUCTION Acknowledgements Contributors Lead editor Dr Arnon Bentovim, Child and Family Training Editorial group Dr Arnon Bentovim, Child and Family Training Dr Tara Weeramanthri, South London and Maudsley NHS Foundation Trust Hillary Eldridge, The Lucy Faithfull Foundation Liza Bingley Miller, Child and Family Training Child and Family Training 2013 Support and advisors Department for Education The South London and Maudsley NHS Foundation Trust The Lucy Faithfull Foundation Swaay Jenny Gray Prof Bruce Chorpita Lucy Berliner Prof David Kolko 2

INTRODUCTION Acknowledgements Writing group Dr Arnon Bentovim, Child and Family Training Dr Tara Weeramanthri, South London and Maudsley NHS Foundation Trust Dr Andrea Danese, Institute of Psychiatry, King s College London Alice Newman, Lucy Faithfull Foundation Caroline Robertson, Lucy Faithfull Foundation Mette Whittaker, Swaay Nicola Gilderthorp, Swaay Samantha Richards, Swaay Dr Clare Gates, Child and Family Practice Malcolm Ward, Former Manager, Southwark Safeguarding Board Child and Family Training 2013 3

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Aim of the Hope for Children and Families project and manual The HfCF project includes a Manual for Practitioners a resource pack designed for work with children and young people and their parents and carers to prevent abusive and neglectful parenting and the associated impairment of children s health and development. The manual is aimed at all practitioners whose roles are to intervene to provide services to children and families where there are concerns that a parent may harm or neglect their child and where there is risk the child s health or development is impaired. Child and Family Training 2013 6

Introduction The development of the Hope for Children and Families project (HfCF) is part of a two-year DfE-funded initiative on childhood neglect run by Child and Family Training (C&FT). Builds on initial work on developing evidence-based approaches to assessment, analysis, planning interventions and identifying measurable outcomes with children and families to includes development of practice tools and accompanying training: Child and Family Training 2013 7

Introduction Assessing parenting and the family life of children using the HOME Inventory and the Family Pack of Questionnaires and Scales Assessing families in complex child care cases using The Family Assessment Communicating with children and young people using the In My Shoes Interview Using The Attachment Style Interview in child care, fostering and adoption contexts Child protection decision-making using the SAAF Safeguarding Assessment and Analysis Framework - analysis of risks of future harm to a child and prospects for intervention. Child and Family Training 2013 8

Seven Stages in Assessment, Analysis and Planning Interventions Stage 1 Identification of harm and initial safeguarding Stage 2 Making a full assessment and creating a comprehensive chronology Stage 3 Establishing the nature and level of harm and harmful effects Stage 4 Safeguarding Analysis Stage 5 Child Protection Decision Making and Care Planning Stage 6 Developing a plan of intervention Stage 7 Identifying outcomes and measures Child and Family Training 2011 9

Who might use the manual? Practitioners who would be able to use the approach include: Social care, education, probation and health practitioners such as social workers, family support workers, teachers and education support staff, educational psychologists, school nurses, health visitors, CAMHS staff; and Those working in: children s and family centres such as those involved in individual, family, group and community outreach work family intervention teams, multi-agency teams and troubled families focused services schools and education support services, looked after children, Youth offending and community services. Child and Family Training 2013 10

Underpinning Research DEVELOPMENT OF THE HfCF APPROACH Alternatives for Families and Multi-systemic therapy integrates a number of different approaches Trauma-focussed CBT The Project SafeCare approach, tackling neglect Improving parent/child interaction and attachment using PCIT, Circle of Security and Bio-behavioural approaches A variety of approaches to modifying disruptive behaviour, e.g. CBT and MST In practice there are always combinations of abuse and neglect, and combinations of approaches. Child and Family Training 2013 11

Underpinning ideas Key underpinning ideas about intervention A common practice elements approach which conceptualises practice in terms of generic components that cut across many distinct specialist treatment protocols and specific clinical procedures and processes. (Forty-seven distinct practice elements were distilled from twenty-five random controlled trials.) A common factors framework personal and interpersonal components of intervention (e.g. alliance, client motivation, therapist/helper/practitioner factors) common to all interventions are contribute to successful treatment outcomes. Child and Family Training 2013 12

The Manual for Practitioners Practice elements are integrated to form modules -provide step by step guidance, resources and tools to deliver an evidence-based intervention. Building blocks and a tool kit for foundation skills in intervention across a wide spectrum of levels of harm and risk of future harm; Intervening at varying levels of severity and complexity parenting problems individual, family and environmental factors impairments to children s health and development Child and Family Training 2013 13

INDICATIONS Where there may be specific risk of harm to an unborn child Where there is evidence of abusive and neglectful parenting potential or actual impairment, identified by a variety of services With children where there is evidence of impairment of their health and development - traumatic symptomatology or disruptive behaviour Family Intervention Teams working with multiple problems Child and Family Training 2013 14

Contraindications: Specialised interventions required Harmful sexual behaviour perpetrated by parents Serious self-harming, aggression and serious sexually harmful behaviour Severity of adult, individual and family problems Multi-agency planning and consultation is a crucial part of safeguarding work. Child and Family Training 2013 15

Assessment Framework A map of relevant data to be collected Education Emotional & Behavioural Development Identity Family & Social Relationships Social Presentation Selfcare Skills Health CHILD Safeguarding & promoting welfare Basic Care Ensuring Safety Emotional Warmth Stimulation Guidance & Boundaries Stability FAMILY & ENVIRONMENTAL FACTORS Child and Family Training 2011 16

Relevant Data 17

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The Modules Forty modules have been developed across 5 key areas: Engaging families and engendering hope Working with parents to modify abusive and neglectful parenting Working with children and young people who have suffered emotional and traumatic impairment Working with children and young people who have responded with disruptive behaviour Working with the family to manage relationships and to link with the community Child and Family Training 2013 27

Each module includes: The goals DESCRIPTION OF A MODULE OF INTERVENTION A briefing for the practitioners The step-by-step approach to achieve goals Materials to support the development of therapeutic work Tools to assess the success of intervention for the child Guidance on the skills required to deliver the module and how the modules can be integrated. Child and Family Training 2013 28

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Presented for Child and Family Training by Jenny Gray, Social Work Consultant and ISPCAN President Email: jennyagray@ntlworld.com Website: childandfamilytraining.org.uk 30

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