I have had this blog on the tip of my tongue for several weeks, but couldn’t quite work out what I wanted to say. As ever, a space to reflect with colleagues has helped to bring clarity; and to find the perfect analogy to bring it to life. It is about the journey of transformation we are embarking on in children’s services and how hard it can be to hold onto the ideas that will bring about a real step change in addressing their mental health and emotional well-being. The energy, enthusiasm and shared commitment to do things differently is not in question. The struggle is pinpointing the key elements that will deliver a paradigm shift; verses changes that are positive and welcome but will essentially result in perpetuating more of the same.
At the core of this struggle, I believe, is vulnerability. The vulnerability of the children we work with; and our own vulnerability in acknowledging the extent of their distress and the limitations we have as individuals to help. The system protects us from this in so many ways – from the evidence base that tells us what approach to use or how many sessions to offer; to the drawing of lines around referral and eligibility criteria; to the carving up of which agency is responsible for what aspect of their lives. The reality, however, is much more complex – particularly for our children and families who struggle the most. Often there are many layers of difficulties that families are up against; in communities that are equally depleted in both resources and, more concerning, in hope. It would be so much simpler if a referral to one service or another, or a neat intervention would sort the problem.
It is so exciting, therefore, that there is a genuine recognition locally that we all need to be in this together if we are to turn the tanker; and that this will involve new ways of working together and new ways of collaborating with children, their families and carers to find creative solutions to seemingly intractable problems. But this is also unknown territory for us all – and as such makes us more vulnerable to snapping back to familiarity and old ways of working and thinking. Like an oyster we have begun to open up – exposing the pearls of wisdom that come with trust, shared goals and compromise. But the uncharted waters we are entering may make us want to protect ourselves and snap shut.
Forewarned is forearmed and so I will try to highlight some of the threats that risk us closing up. I am sure there are many more as I will have my own blind spots; but it is a start that I hope others will join me in:
- the threat of old narratives that place blame on one service or organisation or agency or even the children and families themselves. Whether it’s about thresholds or expectations or funding or engagement– these are common loops we have all been on. It is of course, much harder to do if we are in the same room together, but if we hear it creeping in we are snapping back to safety
- the threat of unrealistic expectations about the evidence base. It has a place, of course, and informs our practice. However, the families that we worry most about across services are often the one’s who don’t come to clinic, or attend groups in the first place. We need to have confidence to draw on the evidence base to design and evaluate new and innovative services that draw on shared core values; our extensive knowledge of child development and what children need to thrive; and practice based evidence gained over years of working in the local communities. Most importantly we need to talk to children and families about what helps them most and seek their help in designing services that meet their needs more effectively than those currently in place. We need to evaluate these, of course, but if we insist on only the highest level of evidence before we even start then we are destined to do what we have always done; snapping back to safety
- the language of ‘othering’ is something we need to caution against – whether that be target groups of children or families, or specialist professionals to ‘take this on’. That is not to say that we won’t be thinking about need or drawing on expertise. However transformation for children means helping everyone to be able to ‘hold on’ not ‘refer on’. If we find ourselves thinking too much about access criteria or passing problems on then we are snapping back to safety
- indeed language is critical and using terminology that is straightforward, strengths based and everyday is essential if we are to break down barriers across agencies, and more importantly for children and families. Instead of ‘assessing’ why don’t we meet? Instead of ‘screening’ why don’t we ask? Instead of ‘formulating’ let’s think together? It is scary to relinquish professional boundaries, and we must always rigorously embed our expertise, knowledge and competencies in the work that we do – but how much do we hold onto unnecessarily and at what cost? How many barriers do we unknowingly erect? If we are holding on too tightly to our professional identity then we are snapping back to safety
- finally, and most importantly, is the importance of basic qualities that can and do make all the difference to children and families; and are not the domain of any one profession, agency or institution. Kindness, curiosity, hope and the intention to be helpful will have more impact than any number of sophisticated models, services or interventions. If we all prioritised these basic qualities in every aspect of our work then we would achieve great things. If we minimise their importance and allow other priorities to dominate then we are snapping back to safety.
Equally there are many signs that we are in safe waters and can be vulnerable. This takes time, and trust, and building meaningful relationships – mirroring precisely what children need to flourish. I have been in more meetings in the last year than in my whole career where we started with a thorny and seemingly insurmountable issue and by the end had reached a positive, and at times, ground breaking solution. The pearls of wisdom that emerge as a result of these endeavours have been precious indeed; and a real privilege to bear witness to.
Thank you to the Gwent Attachement Team for some invaluable thinking space to formulate these ideas.