Safeguarding in the 21st century – where to now?

Safeguarding in the 21st century – where to now? Bournemouth and Poole September 2010 Susannah Bowyer All presentation content credited to Jane Barlow (2010) and Barlow and Scott (2010)

The Safeguarding review is the best thing we’ve seen for a decade or two in this area. The proposed model is comprehensive, subtle, wide-ranging and thoroughly evidence-based in the proper sense of that term. Professional judgement is positioned at the heart of the framework but systematically linked to research and policy considerations. This is the publication that should drive government and professional body thinking in the coming period. Professor Andrew Cooper (UEL & Tavistock Clinic)

In this presentation: 

What we know about emotional abuse/neglect and child development

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Relationship-based practice

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Assessment

New Evidence about early Development 

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The early environment plays a major role in shaping children’s development Most important is the relationship that a child has with their early caregivers The key aspects of the interaction is the role this plays in regulating the infants’ affect and arousal via the attachment system

Early Development and Later Wellbeing Parenting

Self-esteem Behaviour

Infants’ brain

Emotional Regulation Relationships

Emotional regulation via attachment

Empathy Learning

Smoking/drugs Promiscuity School failure Delinquency Obesity etc…

The infant’s brain-softwiring 

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Unique wiring of individual brain determines how we behave, think, feel, memories etc and our sense of ‘self’ Wiring takes place during prenatal period to school-entry – important first two years Rapid proliferation and overproduction of synapses followed by loss (pruning)

‘Use it or lose it’ – lost if not functionally confirmed

For example…  

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Looks and smiles help the brain to grow Baby looks at mother; sees dilated pupils (evidence that sympathetic nervous system aroused and happy); own nervous system is aroused - heart rate increases

Lead to a biochemical response - pleasure neuropeptides (betaendorphin and dopamine) released into brain and helps neurons grow Families doting looks help brain to grow Negative looks trigger a different biochemical response (cortisol) stops these hormones and related growth (Gerhardt, 2004)

Early experiences of persistent neglect and trauma

Need for Core Developmental Model 

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In maltreating families parent-child interaction is characterised by hostility; low levels of reciprocity, engagement and synchrony, unpredictability (ignoring plus intrusive hostility) Around 80% of children who are abused have a ‘disorganised attachment’ Disorganised attachment predicts a range of poor outcomes Practice MUST recognise the importance of attachment

All assessments should include evaluation of: 

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Parent-child interaction informed by specialist training

Parents’ capacity to change: should include use of standardised tests and observations Parenting capacity: motivation and capacity to acquire parenting skills should be assessed over 4-6 months

Cycles of abusive parenting 

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Abusive parents have mostly been exposed to early parenting that did not meet their own developmental needs They find their children’s needs and fears overwhelming and profoundly evocative Respond by withdrawing, or being intrusive and hostile

The early representational and relationship patterns that are developed as a response to poor parenting and/or trauma are re-enacted throughout the individual’s life

What works? 

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long-term ‘relationship-based practice’

Some evidence about the effectiveness of manualised programmes effective intervention during the first four years of life involves dyadic interventions The team around the child model appears to offer benefits in terms of both families and professionals

Relationship-based practice 

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a supportive therapeutic stance based on principles of acceptance, empathy and trust giving parents an opportunity to reflect on the parenting they are providing in the light of their own experiences The relationship as an intervention - emotionally restorative experience - a model for other relationships - Underpinned by partnership model of practice

‘Bringing about change’ in parent-child relationship  

Expectations are currently far too low We aren’t working effectively because our services/interventions are not often underpinned by:

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Evidence-based models of change

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Developmental models with regard to children

Conclusion 

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Need for new conceptual model to underpin 21st century safeguarding Need for new ways of working with regard to assessment and intervention - Relationship-based and reflective practice - Evidence-based attachment and dyadic interventions

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Need for better organisational structures to support such practice