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.

7 Comments

Filed under conference report, Discussion

7 responses to “Child on Parent Violence: Beginning of a paradigm shift?

  1. Great to have this discussion instigated by Girish Vaidya – who is a genuinely compassionate clinician. The exploratory research shows a wide gap between professionals and the families they help in terms of understanding. I see CPV as the symptom and woild like approaches to focus on the cause, and encompass other trauma behaviours – especially sexual harm and sexually problematic behaviours, which can be so common in adolescence in a vulnerable young abuse survivor, and which is a terrifying problem to report for an adoptive parent. The child and parent can end up being criminalised and separated by risk averse professionals in a system where a knowledgable parent is viewed as a threat to professionals with no adoption expertise or understanding, but who end up dealing with the family. I feel very uncomfortable about the idea of rating scales of risk – having seen how this creates all sorts of problems for the child, to be stuck with a label that impacts so strongly on self identity, and whose vulnerabilities can be exploited by organisations/professionals – to cover their failure to take timely positive action.. It can be a case of do nothing for too long and then rip the family apart and exaggerate risks – make as if the adoption was all a big mistake. The permanence of adoption is being undermined at the moment and the ASF does not reach families where professionals have decided to break up the family. Reunification is almost impossible to achieve in such cases. Organisations can ruin young lives with impunity (politicians fail to act and legislation is outdated and hugely problematic), and with the assistance of an adversarial court system and inequities of legal help. Cafcass Guardian’s lack sensitivity and are poorly trained in the breavement issues affecting adoptive families facing care severances because of risk. The distress of a loving parent unable to put right misunderstandings can be misunderstood, seen as an inconvenience, and is even exploited as a sign of poor coping abilities, Basically reporting may not have a positive outcome in a system where there is organisational defensiveness, rank closing, unlimited access to legal help for professionals, and the already traumatised child will almost certainly be exposed to further corporate trauma with parent and child labelled as potentially harmful – to society. Reporting carries great risks currently for families dealing with these incredibly difficult problems coming out of trauma – and it is this risk that should be rated with a scale!

  2. alce m

    I was lucky enough to be at the conference Clara. I blieve that learning disability (rather than trauma) is at the root of many of these behaviours for many young people. Adopters are more vocal and organised than most and also feel a sense of injustice very keenly. This paradigm shift by adopters is essential in my view and I agree with many of the points you make – thank you for making them so ably.

  3. It can be both trauma and learning disabilities and either one. Corporate trauma can unfortunately be the outcome of reporting in all cases. We adopters are not organised at all and there is no official forum to speak of our problems accessing support. There is quite a lot of denial and organisational rank closing. There are a lot of bloggers though.

  4. The ‘feeling’ of injustice comes about when one is made into an adversary after reporting – by the professionals and organisations involved.

  5. alce m

    I’ve been through the s20 process so I really do understand Clara. These are ‘my tribe’ here – http://www.pdasociety.org.uk/forum#/discussions
    Very small steps but a lifeline and now getting a real momentum – run by parents, for parents.
    I know a lot of groups move to Facebook but I’ve never been comfortable with that – just me I guess.
    Keep well

    • I know what you mean by Facebook and social media. It is very hard as one can feel one has been so extremely misunderstood and misjudged. And what one needs most of all is privacy.

      Professionals were only interested in my compliance and if I didn’t agree with them – they would take over. They nearly succeeded.

      The legal system has such inequities with legal aid gone, and there are, for good reason, issues of being in contempt of court if one speaks out. But this can mean problems are obscured. If the case has gone to court it seems professionals and agencies can close ranks – protecting their opinions, decisions and actions – and doing their utmost to hide any errors or failings. Very successfully it turns out!

      The politicians and those involved obviously want to promote their policies and show what a good job they are already doing – so along with privatisation of social care it can feel there is a conspiracy of silence about those that still cannot access the support they need – which is, presumably, why it has taken so long for all this to come out.

      Usually the argument of scant resources is put forward to justify failings and inaction – it doesn’t hold water in some cases – where vast resources were squandered with impunity – on court proceedings; on private care homes and on numerous assessments, some done without the knowledge or consent of those being assessed.

      Even now there is no mention of the trauma of child sexual abuse – and the challenging behaviours that come out of this particular trauma – for a parent or caregiver to deal with. These children also do not feature in the CSA inquiry, which does not consider cases where survivors were abused by a family member. Perhaps there was discussion at the conference – where I was not in attendance.

      Legal professionals accept instructions from authorities without any thought given to the impact of their role – where they may be effectively discrediting and persecuting a loving parent – and child.. Parents are supposed to be the key to a child’s future – but they can be pushed out of the way when problems get too complex and difficult. This solves the problem – but creates even bigger ones. The solution is worse that the problem – the cure is worse than the illness, which has the negative effect of discouraging reporting of concerns.

      It seems no one is actually scrutinising this. The LGO does not consider the opinions of professionals so ultimately complaints procedures are not satisfactory. Courts rely on experts.

      That is why a scale is needed. It was a serious joke. Risks and benefits need to be carefully considered – with decision algorithms costed out. The cost of permanently removing a child from their family – often instead of timely appropriate help – leaves a heavy burden on society, quite apart from the immense human cost.

      There is little expertise in adoption reunification after a care severance in local authorities. It is a one way street to separation in most cases. Dialogue about reunification is impossible to achieve if this is not what the authority intends to happen for the child – regardless of a child’s wishes and feelings – social workers do not overrule their managers, who decide from a distance, never meeting the child.

      We were so fortunate to have a parent supporting us who witnessed our ordeal. Otherwise I am not sure I would believe it myself. The local parent partnership organisations and groups funded by the authorities were deeply unhelpful, as were leading charities and some agencies, foster carers and care homes. They would have had to bite off the hand that fed.

      It was all so far removed from what I ever expected when I adopted a child who had survived neglect and abuse on a scale that was almost incomprehensible that he had survived at all.

      As far as I am concerned there are extremely serious and major systemic failings. This is a silence that should not have had to be broken. Now that it is there needs to be swift remedial action. Things must change NOW before more lives are ruined.

      Politicians MUST put legislation in practice to protect help seeking parents like us – doing so would not be difficult. It would save vast amounts of ££.

      It is a case of getting the right experts involved early – who support the family as a whole – and keeping them in place so there is continuity of care. No blaming or discrediting of parents in assessments where behaviours and responses are considered out of context by professionals with limited expertise. No covert police meetings. These practices must be stopped.

      Trust IS an issue for support to be effective and experienced as supportive.

      There must also be apologies when a parent or child has been wrongfully discredited and blamed – and errors made. Without any action taken against the organisations responsible, these practices will continue.

      It is very sad and those that seek help urgently need and deserve a better system where they are safe to report and can be able to speak out collectively – to protect the family’s need for privacy. We shouldn’t have to use social media, as an individual, to offload the troubles we face when we ask for help, which are too much to contain.

      • As always I say too little. I say too much. I feel like an REM song!
        My compliance was wanted to remove my child from his family, against his wishes, and I wasn’t prepared to go along with this when I knew, as the ‘victim’ that errors were made and accepted in assessments- and risks were poorly understood.

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