CHAPTER 21: Hard to Engage Families
- Reasons Why Some Families Find it Difficult to Engage
- Definition and Recognising Difficult to Engage Behaviour
- Impact on Intervention
- Important Points to Consider
- Impact on the Child
- Strategies to improve Engagement
- When Families will not Engage at all
- Dealings with Hostility and Violence
- Hard to Engage Professionals Meetings (at time this will be a Strategy Meeting or Family Support Meeting instead)
A feature in some serious case reviews has been the lack of co-operation and/or hostile attitude of parents/carers. When there are child welfare/protection issues, a failure to engage with the family may have serious implications and non-intervention is not an option.
Some of the reasons why families find it difficult to engage include the following:
- Previous negative experience of agencies
- Experience of intervention as a young person
- Not understanding professionals concerns
- Cultural differences
- Genuine fear- will my children be removed
- Anti-authority stance
- Lack of communication from professionals
- Do not want to have their privacy invaded
- Have something to hide
Parents may present in a number of ways on a continuum from hostility, threats and violence through to superficial and ineffective engagement. Behaviours may include:
Ambivalence can be displayed when people are consistently late for planned appointments or they always have an excuse for missing a visit. When discussion an uncomfortable topic such as a worker sharing concerns, the subject will be changed and dismissive body language is used. Ambivalence is a common occurrence and does not necessarily mean it will be difficult to engage with the family. It can occur due to the family being unclear about what is expected of them or poor experiences with previous professionals.
Avoidance is very common and something that we all do in our every day lives. It includes cutting short visits due to other apparent important activities (when really the service user is anxious about the prospect of involvement and wants to escape from the situation)
Confrontation includes provoking arguments, extreme avoidance (not answering the door) and can indicate a deep-seated lack of trust leading to a "fight" not "flight" situation. It is important in these situations that workers are clear about their role and purpose by demonstrating a concern to support the family. However at some point the parent's behaviour will have to be challenged safely so they are able to understand that professionals will not give up working with the family. This may require the professional/having to cope with confrontation until co-operation can be achieved.
Refusal when families will not meet with workers or refuse for a child to be seen on their own.
Violence threatened or actual may only involve a minority of cases but is the most difficult and challenging of hard to engage behaviours to work with. People may have previous experience of getting their way through violence and intimidation. In these circumstances the child's welfare should remain paramount at all times. Professionals need to be realistic about the adult's capacity to change and internal health and safety policies must be adhered to as well as seeking legal advice where necessary. Ask yourself if I feel scared what is it like for the child living in the family.
Accurate information and clear understanding of what is happening to a child is the main focus of all work with families, the usual way to achieve this is by engagement and sharing views and working in partnership with families to plan the next step. However if families are deliberately preventing professionals from working with them it is important for workers to record and assess what areas of work are difficult to achieve and why.
Workers identifying an issue arising from concerns about poor access/engagement should seek to promptly discuss this with their line manager.
Ensure all discussions and attempts at engagement are clearly recorded
How quickly is it necessary to respond, is there a need for immediate action?
What other agencies need to be informed of the engagement difficulties?
It is useful to reflect on your own practice to consider the following;
- Am I colluding by avoiding conflict i.e. focusing on less contentious issues rather then asking to see if there is food in the house or speak to a child alone etc?
- Am I minimising negative information in order to avoid provoking a reaction?
- Am I hesitant to share my concerns in order to avoid confrontation?
- Am I keeping my concerns to myself or sharing with my manager and other agencies?
- Am I relieved when there is no answer at the door?
- Am I seeing each situation as a potential threat and becoming over challenging?
- Am I focusing on the adults needs not the needs of the child?
It is important to consider what impact the non engagement may be having on the life of the child. Is the child desensitised to what is going on around them? What have you or other professionals observed when you have seen the family together. How does the child act around the parents are they overly compliant or are they frightened. Are they protecting the parent through fear?
Every professional contact with the family is part of the engagement process; this includes that first letter and telephone call to the family and young person.
Is there previous information on the family, has a CAF been completed is there a Lead Professional that can aid you.
Be positive and courteous whilst being clear about sharing concerns with the family and what work needs to take place to achieve change
Be consistent even when you are getting a negative response
Use a trusted third party, this could be a family member or a professional the family already have a relationship with, do a joint visit as a way in to engaging with the family.
Flexibility and good communication - think about if there is a way you can meet the family half way?
Acknowledgement- acknowledge to the family and open up a discussion as to why things are not working in the context of improving outcomes for the children
Keep the relationship formal but supportive
Recognise and acknowledge progress even on a simple basis such as thanking a family for their time if they have previously declined visits.
If a parent is not allowing you to speak to a child alone they may have a genuine fear of what you are going to say what might happen to their children. Try and alleviate their fears, will they agree to a teacher or health visitor sitting in when you meet with the child.
Have a clear written agreement which shows what we expect from the family as well as what they can expect from us. (It is a two way process)
Be on time, try not to cancel and reschedule appointments
Have an awareness of key culture and religious events.
Have I asked my line manager to support me on a visit?
It is really important to seek advice and support from your manager and colleagues and remember not to take things personally or get angry yourself.
The problems arising from these difficulties may be acute or chronic in nature. They may, in some cases, mean that long-term work proceeds more slowly than it might, whilst in another, failing to see a child as planned might mean that the child is exposed to immediate and pressing risk. It is not, therefore, possible to specify in advance the type of response which may always be appropriate.
In some cases, it may simply be necessary to reconfigure the schedule of visits. In others, there may be the need for legal advice, or for a child protection conference to be considered. In others still, the immediate assistance of the police may be required. However, two requirements are common to all circumstances. First, contingency plans dealing with lack of engagement should be considered before the relevant contact is attempted. Secondly, careful consideration should be given to the implications of poor access for multi-agency work with the family and good inter-agency communication should be maintained.
- Continually assess the parents
- Capacity to respond in the interests of their children
- Have a regular discussion with your manager and address in formal supervision
- It is important to assess how far the non engagement is impacting on the assessment process and consider if this is placing a child at increased risk
- Consider a strategy discussion (Working Together 2010 5.52) if there are serious concerns for a child's welfare.
- Prepare to discuss strategies if one agency is gaining access, how will monitoring and information be gained.
However sensitive and supportive you are as a worker some families will still respond with threats of violence. In these instances it is important that you follow internal Health and Safety procedures as well as continued support from your line manager. Professionals and the child's safety must be assessed and managed safely. Workers and agencies have a joint responsibility to plan for safety. Always make sure that your whereabouts are clearly recorded in the office.
Threatening behaviour can be covert or implied and consist of :-
- Bombarding workers with emails and phone call
- Domineering body language
- Intimidating and derogatory language
- Physical violence
- Racist or homophobic attitudes and remarks
Making sense of responses
- Is the behaviour deliberately threatening/obstructive or violent?
- Is this behaviour normal for the person (which never the less does not make it acceptable)
- Is the person aware of the impact that they are having on you
- Is the person so used to aggression they don't appreciate how their behaviour effects others
- Is your discomfort disproportionate to what has been said or done?
- Does the person need to complain, with reason?
- Hostility can be a response to frustration related or unrelated to professionals
Ask yourself is my level of concern raised just because they are not engaging. Or do I have evidence that the non engagement increases risk and is there a need to consider a Child Protection Conference or Legal Action.
If the family are currently known to Children's Social Care then the first line manager should convene a multi-agency meeting. Sharing strategic approaches across agencies may assist in forming an action plan, in accordance with information sharing arrangements.
The multi-agency meeting should address the non co-operation in the context of the child's written plan. Depending on the circumstances this meeting could be:
- The first meeting which will devise the plan
- A review multi-agency meeting, brought forward if necessary
- A professional strategy discussion where there are child protection implications that may need to be addressed by a s47 enquiry or initial child protection conference
- A core group meeting brought forward if necessary
- A review child protection conference, brought forward if necessary
Possible strategies may include:
- Joint visiting with agency colleagues or other professionals (requesting help from police if there is a physical risk)
- Exploring the possibility of engaging other non-hostile members of the family, if this does not increase the risk to anyone
- Children's Social Care holding a legal planning meeting to clarify e.g. Child Assessment Order, Interim Care Order
When there are actual threats or incidents of violence
Where there are actual threats or incidents of violence the incidents must be reported to the first line manager immediately and local procedures followed for 'Violence at Work' in relation to supervision, support, recording and reporting incidents to the police.
Any response must take account of:
- Risks to children and other family members
- Personal safety issues for staff
The experience of violence or threats to staff should be used as evidence of the situation of the family and included in assessments of the child's circumstances.
Violence towards staff is a multi-agency problem. If one agency has information a parent/carer is known to be violent, it must alert other agencies of the risks posed.
10. Hard to Engage Professionals Meetings (at time this will be a Strategy Meeting or Family Support Meeting instead)
If the family is still not engaging when everything has been done to aid the process a child protection consultation should be considered with a child protection coordinator and a hard to engage professionals meeting should be convened.
No sole agency works in isolation and non engagement may not be universal. In these circumstances full participation and multi-agency meetings such as Family Support Meetings and Core Groups is vital. Professionals need to take ownership of concerns together rather than putting the responsibility on one agency only.
Difficulties over access to families about whom there are child welfare concerns should not result in closure of the case until there has been consultation with all relevant parties, including other key agencies working with the family. A meeting, or, where appropriate a child protection conference, should always take place where the planned contact forms part of a formal multi-agency plan to safeguard the well-being of a child.
Workers from different agencies need the opportunity to share information and discuss the best way forward when working with families who do not engage, holding a professionals meeting gives agencies the opportunity to share concerns and knowledge of the family and draw up an effective plan of working with the family which shares the decisions made from the meeting.
The most worrying scenario is when every agency cannot engage the family so every one withdraws. When the family only engages with some professionals it is important that
information continues to be shared to avoid developing a collusive relationship developing. The professionals meeting needs to support this not happening. During the meeting:
- Agencies can share concerns especially if there are Health and Safety implications
- Professionals can support each other
- A plan of action can be put in place.
When the meeting is held it is important to ensue that the threat of risk is not exaggerated by group thinking. See flow chart for potential outcomes of the meeting.
- Close - CAF out of Children and Young People's Services, other agencies to monitor and refer back if necessary mainly for S17 cases and when families are working with some professionals
- Continue - review and continue to try and engage with the family, have all options been explored, advocacy, family centre involvement. Is a Family Group Conference appropriate?
- Child Protection - is there evidence that the child may be at risk of Significant Harm and that the threshold has been met. Has a child protection consultation taken place to discuss convening an Initial Child Protection Conference or reconvening a Child Protection Review Conference early?
- Do you need to seek legal advice and consider making an application for a legal order?
- The most important thing to remember is that hard to engage families can change and the majority of families respond to assertive and positive work where they are treated with respect.