Working with
‘disguised compliance’
and resistant families
Sue Woolmore
June 2010
Resistant or reluctant?
“A problem for social workers and others is that coverage
of recent high profile cases in some parts of the media
has contributed to an impression of all parents who
maltreat their children as conniving, cold-blooded
individuals, set on abusing or even killing a child and,
in the process, deliberately setting out to deceive the
authorities.”
C4EO knowledge review 2010
Resistant or reluctant?
“Irrespective of whether they co-operate, it is worth
remembering that most parents involved in the child
welfare system are involuntary participants in a
process they may resent.”
C4EO knowledge review 2010
Sources of knowledge and thinking
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Biennial SCR studies
Academic commentary
C4EO commissioned knowledge review
Practice experience
Reflective supervision
‘Disguised compliance’
Identified in Beyond Blame 1993
Family provides sufficient evidence to convince
workers that it is co-operating with agencies to
protect the child, whilst effectively neutralising
professional concern and insight into reality of the
child’s life experience.
Colloquially described as, “doing enough to get social
services off my back”
Examples of disguised compliance
 clean the house week before review
 school attendance improves for 2 weeks
 welcome, rather than usual hostility, at home visit
 plausible excuses for missed appointments
 presenting for clinic appointment day before crucial
home visit
Identifying disguised compliance
• conflicting accounts of family life from family members
• conflicting accounts/evidence from different professionals
• conflicting accounts from neighbours
• persistently unmet needs of children
• presentation and behaviour of children conflicts with adult accounts
• repeat incidents of harm/neglect to children
• analysis of detailed, multi-agency chronology
• observation of parent child interaction
(there is convincing evidence that simulated
sensitive parenting is very difficult to sustain
- C4EO 2010)
Close associates
• Dependency
• workers’ belief that helping parents helps the child
• potential competition for worker’s attention
• Closure
• family tightens boundary around itself to exclude professionals
e.g. closed curtains, missed appointments
• the more interest/control shown by professionals, the more
threatened family feels
• increased vulnerability for child as family ‘closes’
• Flight
• family closes boundaries further by moving
elsewhere
Beyond Blame 1993 – Reder et al
Learning from Serious Case Reviews
“Apparent or disguised cooperation from parents often
prevented or delayed understanding of the severity
of harm to the child and cases drifted. Where
parents made it difficult for professionals to see
children or engineered the focus away from
allegations of harm, children went unseen and
unheard.”
Biennial analysis of Serious Case Reviews 2003 - 2005
Collusion with disguised compliance?
• Rule of optimism
• workers are required, if possible, to think the best of
carers
• ‘Start again syndrome’
• attractive to both practitioners and managers
• past is complex, overwhelming, sense of helplessness
• clean slate – ‘intelligence’ from history is lost
Ingredients for ‘resistance’
Ambivalence
Denial/Avoidance
Unresponsiveness to treatment/
disguised compliance
Violence/Hostility
C4EO knowledge review 2010
Learning from Serious Case Reviews
Almost 75% parents/carers characterised as
uncooperative:
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hostility towards workers
actively avoiding contact with workers
missed appointments
disguised compliance
ambivalence
Biennial analysis of Serious Case Reviews 2005 - 2007
Messages for practice with resistance
• Children in families without detailed assessment four times
more likely to suffer repeat abuse
• Information for assessments must be organised and analysed
• Sources of information other than just mother must be sought
• Direct observation of parent-child interaction is essential
• Consistent message about effective
supervision
C4EO knowledge review 2010
Challenges for practice with resistance
• Working with complex families, practitioners focus too much on
small improvements, rather than context of family history
• Parents’ needs eclipse needs of children
• Parents make it difficult to see child alone
• Men, grandparents and siblings often left out of picture
• Practitioners feel pressurised to close cases quickly
• Agency policies encourage workers to create a (false) dichotomy
between ‘in need’ and
‘at risk’ of harm
C4EO knowledge review 2010
Effective interventions with resistance
• Focused, long term services, rather than episodic
interventions
• Accuracy of assessments enhance service, including
attachment behaviours and detailed family history
• Child protection system is powerful tool – practitioners
should harness power
• Attitudes and behaviour of practitioners have major effect on
families’ engagement
• Workers need to show empathy and acceptance,
coupled with an authoritative, child focus
• Services that include practical help
for families
C4EO knowledge review 2010
Resistance or poor services?
• What practitioners perceive as resistance may
actually be family’s lack of satisfaction with services
• Parents express frustration when not involved in
assessments and interventions
• Parents don’t always receive help they ask for
• Negative traits in practitioners cited:
cold, insincere, one-sided
C4EO knowledge review 2010
Role of supervision
“Supervision helps practitioners to think, to explain and
to understand. It also helps them to cope with the
complex emotional demands of work with children
and their families.”
Biennial analysis of Serious Case Reviews 2003 – 2005
Reflective practice
• Mature practice should critically review and revise
judgements about family functioning and risk:
• admitting you might be wrong is powerful weapon
against making crucial errors
• there is tendency to form a judgement and then stick
with it, despite contrary evidence
• alternative temptation to swap one theory for another
and not reach a coherent conclusion
Reflective practice
“Reflective practice needs to be supported at the
individual, team and agency level and requires careful
nurturing, time and space in which to thrive.”
Safeguarding : Briefing 3 C4EO
Sheryl Burton , National Children’s Bureau
References
Beyond Blame: child abuse tragedies revisited 1993
Peter Reder, Sylvia Duncan, Moira Gray
A required mind-set for child protection practice: comments on Munroe (1999)
Peter Reder and Sylvia Duncan
Letter to the editor
Child Abuse and Neglect vol 24, No 4, pp 443-445, 2000
Analysing child deaths and serious injury through abuse and neglect: what can we learn?
A biennial analysis of serious case reviews 2003-2005
Brandon et al
Effective practice to protect children living in ‘highly resistant’ families
Rebecca Fauth, Helena Jelicic, Diane Hart, Sheryl Burton, David Shemmings
Knowledge Review published by C4EO 2010
The oversight and review of cases in the light of changing circumstances and
new information: how do people respond to new (and challenging) information?
Sheryl Burton , National Children’s Bureau
Avoidable and unavoidable mistakes in child protection work
Eileen Munroe
British Journal of Social Work (1996) 26, 793 – 808