Tag Archives: Yvonne Newbold

Child to parent violence: an unhelpful phrase?

Once upon a time, when I didn’t know so much about “parent abuse” it seemed a little exciting to be at the forefront of a new phenomenon. It felt important to speak clearly and categorically, for clarity, and the avoidance of misunderstanding – which was commonplace. “Parent abuse? You mean abuse BY parents? No? You must mean older people then?” Now it seems that the more I learn, the less certain I am about anything – other than the fact that many, many more parents than we would like to think about are struggling daily with much, much more than anyone should ever have to face within their family.

What we call this has been a constant running theme throughout the last 11 years that I’ve been involved. I quickly ditched “parent abuse” for the reasons above, though some still favour it as describing a subset of family / domestic abuse. I do still refer to it on my website home page (documenting parent abuse), but generally these days I have been using “child to parent violence”. Right from the start I was aware of questions around whether the term “abuse” was more appropriate than “violence”. It seemed important to me to capture the very active sense of terror that parents experienced; and I went with the whole phrase because it included relationship, direction and action. It’s probably worth saying at this point that I have counted over the years more than 30 different phrases in use, either in the literature or by practitioners.

Last week I barged into another conversation on twitter. People were talking about how they found the phrase “child to parent violence” unhelpful. Tell me, what was I supposed to do!

First of all, why does all this matter?

It would be really helpful if we could come up with a phrase that worked for everyone. It would potentially make it easier for parents to identify their experience and ask for help, for practitioners to understand what parents were saying, avoid confusion among policy makers, enable more realistic counting, and help us all to be sure we were talking about the same thing. At the moment the media seem to be au fait with “child to parent violence” so should we bite the bullet and stay with that?

Does it matter who chooses the name?

Hmmm. Well I would like to think we let ‘someone’ other than the media define what we’re talking about! In the beginning it was mostly academics talking, and each person adopted the phraseology that most suited what they were addressing in their paper. Many articles, dissertations etc begin with an explanation of the choice of name, quite apart from a definition. The few practitioners who were also writing similarly used terms which captured the issues they saw, and the family configurations they worked with, while continuing to wrestle with the abuse / violence question. (Hence “adolescent violence and abuse”) But are we comfortable, in the 21st century, with professionals naming a situation experienced by others, and imposing that name, if the individuals concerned would prefer something else?

Some snippets from the conversation …

My personal feeling is that children aren’t ‘abusing’ parents.

I am reluctant to give people terms which make them think badly of my child.

I wouldn’t class my child’s behaviour as violent – but other people would.

Some people, who lived through the seventies and eighties, would call this “false consciousness”, but that’s probably not terribly helpful. More useful is to think about the shame that stops families coming forward for help, the love that keeps them going day after day after day, and the loadedness of some terminology in the way it is used in different contexts. Saying that child to parent abuse can sometimes feel like intimate partner violence is one thing. Acknowledging what that means in terms of how you understand your child is quite another.

Hiding inside this conversation is, of course, the definition debate. Does intent matter? Is this one thing or many?

Do we need different names for different situations?

To some extent, we have already started down this road. Yvonne Newbold has blogged and spoken about preferring the term Violent Challenging Behaviour (VCB) for children with severe learning difficulties and mental disabilities. (But there are some who dislike the use of the word “challenging”, finding it a simplistic generalisation which excuses our own lack of understanding or curiosity as to the reason for the behaviour.)

I find this to be an unanswerable conundrum. Clearly there is a huge gulf between children and young people with severe disabilities who lash out, and those who deliberately and provocatively inflict harm to people and property. But there are so many young people in between, so many different scenarios, and overlaps of diagnoses.

If anyone would like to enter this debate they are more than welcome! If you can come up with a better turn of phrase then please let us know. In the meantime, I will leave you with some thoughts from ‘Mumdrah’ from the other evening:

For now ‘violence’ is all we have; we need better words for sure.

Whatever the label, this stuff is beyond hard to understand.

 

Update, August 8th 2017

As usual, the comments and replies came via twitter ….. The consensus seems to be to use the phrase “child to parent violence and abuse” as more accurately reflecting the lived experiences of families. I can’t argue with that!

 

 

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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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