‘The best predictor of good outcomes is engagement’

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Pam Simmons Guardian

Practice wisdom and the more rigorous evidence base, tell us that early intervention with families experiencing problems will benefit children and their families.  Investment in universal programs for parents and children is good investment.  The programs usually reach those who can and do seek help.  Targeted services are good investment too, and bring help to the families who don’t always know they need it.

The families that worry us most are the ones who have high need and are excluded, sometimes by program design or failure to engage, or because they self-exclude.  It is their children who are at highest risk of harm and for whom the statutory child protection system exists.  On the one side there is a family who can’t or won’t get their children to the GP or to school.  On the other are ‘visitors’ who are offering help.  What could be easier than that?

In truth, what could be more difficult?  For a start, everyone is afraid.  The families are fearful of judgement and punishment. They fear losing their children, they fear being found out, they resent external authority.  The world they occupy is not the world the visitors know. The visitor is an alien, who assumes the right of entry and the moral right to judge.

The ‘visitor’ – the social worker, health worker, truancy, police, or tenancy officer – is afraid too.  Not always and not all of them but if you are new to the job, you are often unprepared for the mess, the threat, the chaos and the attitude. You come offering help and in return you get disdain or anger or bemusement.

We have a choice to continue to focus effort on rescuing children from ‘bad parents’ or we work more with families to be responsible for the good care of their children.  Easily said, not easily done.  Experience in the UK and elsewhere of attempts to make such radical change, that is, to move from an investigation-driven child rescue system to a family support model, suggests that it cannot be done without significant structural and cultural change.*

There are many good ideas about the structural change required and some have commenced; fewer ideas about the cultural change.  Professor Marianne Berry, then Director of the Australian Centre for Child Protection, addressed cultural change in a public address in SA late last year, when she talked in detail about the importance and challenge of engagement with families.  She turned the ‘visitor’s’ view of the family into the family’s view of the visitor. What the family saw was someone in their home who doesn’t look like them, making a list, and leaving them with brochures, letters and phone numbers.

Professor Berry said that the best predictor of good outcomes is engagement.  Among other things, this means no judging or blaming parents or children, listening without jumping in to help, working towards goals with the same sense of urgency as the family, providing practical support, and being honest.

In turn the visiting worker needs the calm and wisdom of a senior officer who provides a depth of discussion on return to the office, respect for opinions and shared decisions to act and not react.  They will also need flexible funds for some creative solutions and timely cooperation from other agencies as needed.

While the structural changes bringing child health, education and child protection government agencies under one umbrella continue, we need to have a conversation and take action on delivering services in a very different way.

* See Higgins, D and Katz I (2008) Enhancing service systems for protecting children: Promoting child wellbeing and child protection reform in Australia Family Matters No, 80 pp 43-50.

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