Adopting: real life stories

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I was a bit surprised when this book first dropped through my letter box. I hadn’t offered to review it and so for a while it lay on a very tall pile of “books to read when I have some spare time”. But of course the title should have given it away…

If anyone was thinking that love is all that’s needed, or was tempted ever to say that “all kids do that”, then this is a book for them! Not that it’s all doom and gloom by any means. Adoption stories are statistically more often positive and affirming, but it is a sad fact that as many as a third of families will experience real struggles (see Beyond the Adoption Order) and Ann Morris quietly and without drama shows us both sides of the coin.

She brings us voices of both adoptive and birth parents, as well as some of the children themselves. From thinking about adoption – and the advice that was given – through to children reaching adulthood or sadly moving out of the home for other reasons; adopting children with special needs, thinking about particular issues such as race and religion and different models of parenting; understanding attachment and how this plays out in school as well as in the home … it is hard to think of topics that have not been covered, or questions unanswered. Strikingly, many of the stories involve difficult to understand behaviour: behaviour that tests and sometimes breaks relationships. Behaviour that is violent and abusive. Sometimes it is portrayed as a response to early trauma or to damage in utero, sometimes a deliberate and calculated attempt to establish control within the home. It is heartening to read of the advice and support that many parents were able to access, and the way a transformation was achieved; but the pain of those simply struggling through each day, or recounting the decision to bring an end to the relationship, is tangible and a challenge to all those working in the field of adoption support.

Marketed at adoptive and prospective adoptive parents, counsellors and social workers, and others working placing children in families, its real importance is in bringing us the voice of the real experts: those who have already walked the journey.

With a foreword by Hugh Thornberry (former Chief Executive of Adoption UK), this is the second book by Ann Morris documenting the experiences of adoptive families. The first was written around 20 years ago and much has changed in that time in terms of legislation, practice and understanding.

Adopting: real life stories, 2017, Ann Morris, Jessica Kingsley Publishers. ISBN: 978-1-84905-660-1

 

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#CPV: What does it look like, part 2. Intent stuff

One of the issues that makes it difficult for us all to talk about child to parent violence and abuse is the fact that there is no one agreed definition. The one I tend to use when speaking to people is that proposed by Amanda Holt:

“A pattern of behaviour, instigated by a child or young person, which involves using verbal, financial, physical and /or emotional means to practice power and exert control over a parent”, and “the power that is practised is, to some extent, intentional, and the control that is exerted over a parent is achieved through fear, such that a parent unhealthily adapts his / her own behaviour to accommodate the child.”

For me this seems to be broad enough, while encompassing the main features of what I am thinking and talking about. It builds on and refines earlier definitions that have been proposed. But the more I speak with other people, the more I realise that everyone’s experience is different and there are many, many parents who experience something that looks and feels very similar without necessarily ticking all the boxes. I wrote about this most recently in a post at the end of March, when I started thinking about the boundaries and edges of the definition we use. This is an issue that troubles me because it seems that a lot hangs on how readily we start to bring different aspects of violent behaviour into the CPV camp. Today I want to think about intent more specifically, and I hope that you will feel free to join in the conversation in the comments section.

A couple of months ago, Al Coates posted about the definition of child to parent violence, following discussion with other members of the adoptive community, some of whom felt unsure that perhaps theirs “didn’t count”. He and Dr Wendy Thorley further grapple with the discussion in their final paper about Adoption and CPV. The question of intent can be tricky, as parents may talk about a child sometimes acting out of frustration or trauma, and at other times choosing very deliberately to hit in a controlled way.

Consider this family …

 

A child in crisis, or triggered by a particular situation, dysregulated, out of touch with all going on around them, may cause a great deal of harm to their surroundings, to those around them whether adults, other children or animals, and also to themselves. That is not to say that, in that moment, those around them will not experience the violence, terror even, and find themselves forced to change their own behaviour, then and in the long term. But the element of intent is surely absent.

Another child – and perhaps even that same child – may on another occasion, show remarkable discernment and control in the manner in which they choose to act. They may target precious possessions in their rages, they may choose words they know will cause the most hurt, they may kick where there are already bruises.

 

As we learn more about the families who are experiencing violence and abuse, we see a huge range of issues which can contribute to the abuse, often layer upon layer in one child or family. As we start to think about responses, we need to unpick these issues. Different approaches for different situations; a trauma-informed response here, a behaviour oriented response there. Elements of each in different situations? There is certainly no blanket “one size fits all” answer.

Why does a definition matter? Are we simply being pedantic by arguing about intent? In a fast developing field such as child to parent violence, where knowledge and understanding is growing all the time, is it not inevitable that definitions are refined? Well, yes! But in a fast developing field it is also important that we know what we are talking about; that people sharing knowledge are talking about the same things; that parents can feel confident about asking for help and believing they will be understood; that services designed in response are fit for purpose and meet the needs of those they seek to serve. It can be a tremendous step for a parent to finally acknowledge the violence being committed within their own family. What may seem obvious to those outside, can still be passed off as “normal” teenage behaviour, or as something that is somehow deserved, by those on the receiving end. Shame, stigma, and ignorance all contribute to parents not identifying their situation to themselves or others.

As the conversation gets louder, and more people start to identify what they experience themselves as CPV we need to be sure we have got it right for them, right from the start.

 

 

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“An Act Relating to Support for Parental Victims of Child Domestic Violence”

Fantastic news this week from Florida, where Alice Flowers has been campaigning for legislation in this field, since the tragic death of her sister.

FL HB 1199 makes the requirement for Support for Parental Victims of Child Domestic Violence; Requires DJJ, in collaboration with specified organizations, to develop & maintain updated information & materials regarding specified services & resources; requires department to make information & materials available through specified means; requires domestic violence training for law enforcement officers to include training concerning child-to-parent cases.

After the bill was passed unanimously in the Florida Senate, it passed to the House of Representatives, where it was sponsored by District 45 State Representative, Kamia Brown. The final vote on May 3rd was again unopposed, and it now goes to be signed by the Governor, Rick Scott, after which it will be enacted on July 1st. Florida then becomes the first state in the United States to recognise child to parent violence.

Here’s Alice celebrating!

Alice talks to CBS reporters here about how her campaigning came about.

The Florida Channel covered the vote in their nightly update programme. You can  find the courage here from 16.34 to 17.32.

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Adolescent to parent violence – take part in this new research project

A team at Monash University is conducting new research into Adolescent Family Violence and seeks participants. Although focus groups will only be conducted locally in Victoria, responses to the survey are invited from around the world.

 

In 2014 ‘family violence’ was declared a national emergency in Australia. Investigating adolescent family violence  is a project being conducted by a multidisciplinary team of Monash University researchers from the School of Social Sciences,  the Department of General Practice, and the Department of Social Work. It will explore attitudes towards, patterns of, and the impact of AFV. The project builds on, and compliments, work being conducted in the United Kingdom (titled Investigating adolescent violence towards parents). It is part of the new awareness of the harms of family violence and seeks to enhance the safety of women and children.

To view more information about the project, and to access consent forms and the survey itself, use this link.

Thank you for your support.

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Breaking the Silence on Violent Challenging Behaviour: a conference review

Last week I brought you the reflections of Dr Girish Vaidya, who had attended the Violent Challenging Behaviour conference, organised by Yvonne Newbold. The post has attracted some interesting discussion. This week Yvonne has kindly allowed me to repost her own reflections and review of the conference.

Yvonne begins by recounting the hopes of those attending, and ends with her own dream that this, by breaking the silence, will be just the start. “Part of achieving this level of widespread acceptance must include training for all frontline professionals about the issue, and why it happens and how they can help. Ideally, I’d like to see a future where professionals and parents work together in a spirit collaborative respect to find individual support and solutions that work for each child.” There are some salutary lessons for professionals in her post. Please do read it and understand that this is the real experience of many parents, while we always acknowledge that there are also informed, compassionate practitioners already out there who do truly “get it”.

What did parents want? Continue reading

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Child on Parent Violence: Beginning of a paradigm shift?

I am grateful to Dr Girish Vaidya, Clinical Director at Sheffield Children’s NHS Foundation Trust, for allowing me to repost this recent blog on his experience of discussing CPV with colleagues.

Originally published on April 8, 2017

Al Coates and Dr Wendy Thorley’s 3 reports (the last of which is linked here) into an online research project provided fascinating reading and prompted me to present the subject in a CPD seminar for fellow psychiatrists in Sheffield’s Child and Adolescent Mental Health Service (CAMHS). I was particularly keen to share the findings of the reports, my fellow professionals’ experience of this issue and how they managed to address it.

It was heartening to hear that all my colleagues were aware of the issue. When I invited them to think about the impact on the families experiencing, their guesswork was entirely in line with the findings from Al Coates and Dr Thorley’s investigation. What this meant was that once seized of the behaviour as a problem, professionals were able to consider its consequences to the children, families and wider society.

There were also some examples that colleagues offered. One Learning Disability CAMHS Consultant recalled how she was horrified when confronted with a suggestion from social services that a child – who had earlier required 5 people to restrain him – had been advised to be returned home to his frail mother. Quite a few chipped with their experience of Sheffield Children’s Social Services and expressed their pleasant surprise at the speed of response and collaborative nature of working. It was also acknowledged, much in line with what Mary Aspinall – Miles said at a recent conference, that “parents should consider carefully before calling the police”.

So, what should parents (and professionals) do when dealing with a difficult subject like Child on Parent Violence?

My fellow psychiatrists were keen that professionals and parents work out a ‘pre-emptive emergency plan’ so that parents are not left in a dilemma about what they should do. A couple of colleagues were passionate about treating CPV on the same level of child abuse. They were also aware of the Sheffield Domestic Abuse Coordination Team’s MARAC (Multi Agency Risk Assessment Conference). Some suggested that parents should be asked about their ability to cope vs. their ability to manage their life.

Reassuringly, there was a near universal desire to have a ‘rating scale’ on the lines of various risk rating scales that professionals use, to have a common language about CPV. (I am not aware if there is any such scale and if there is, would be keen to know about it). If there isn’t a scale, my colleagues are keen to work with anyone to help develop one.

Writing this, I am reminded of an incident many years ago when one family’s holiday came in for professional scrutiny. The child had been inflicting severe violence on his parents which had destroyed many a family holiday for the rest of the family. Parents decided that they wanted to do something which didn’t wreck their other children’s holiday. They planned to take separate holidays – father with the other children and mother with the lad. They would swap the following year. It was deemed to be a demonstration of family pathology that they didn’t manage to have a family holiday without a fight. I felt that was being a bit too harsh since the family were trying to find a way out of a very challenging situation not fully appreciated by professionals. What do you think? Would you agree with Hannah Meadows’ assertion that self-care is an intelligent response to dealing with long term stress? Or would you rather that the family learn to live with the CPV on holiday?

What next?

Feedback from the CPD seminar suggested that this is just the beginning of our journey. Professionals want to know more, need to know more so that they can support more. Everyone agreed that it was a less discussed issue in clinical discussions and many emphasised that they would be on the lookout for CPV in their clinical practice in the future.

Let us continue the conversation…………………………..

If you are keen to collaborate on scientifically researching this challenge, we – as an organisation and I as a Clinical Director – would be keen to work with you.

 You will find the original here.

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Child to parent violence: Realities, Enigmas and Ambiguities

A number of new papers – academic and discussion – have been published recently, and I have gathered them all up here together for ease. Continue reading

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