Working with families who resist child protection interventions
Evidence Briefing for Suffolk Local Safeguarding Board
July 2015
Author: Maija Huttunen-Lenz, Programme Manager, Public Health
Consultant & Report Owner: Dr Mashbileg Maidrag, Consultant in Public Health
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Content List
Executive Summary
p.4
1.
Introduction
p.4
2.
Methods
p.4
3.
Results
p.4
4.
Avoidance behaviour in the context of child protection
p.4
5.
Main findings
p.5
5.1.
Factors contributing to parental resistance in the context of child protection
p.5
5.2.
Communication
p.5
5.3.
Strategies to improve parent engagement
p.7
5.4.
Effective supervision
p.7
6.
Discussion
p.8
7.
Conclusions
p.9
8.
References
p.10
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Executive Summary
Introduction
The purpose of this short evidence review is to provide evidence on best practice working with hard
to engage families. As a considerable amount of information is available in this area, the emphasis of
this research is in identifying evidence on working with families that display resistance or avoidance
behaviour pattern that is not openly hostile and threatening in context of child protection
interventions.
Methods and Results
Literature for this short evidence summary was scoped from the following databases: BNI, AMED,
CINAHL, EMBASE, Health Business Elite, and MEDLINE. The search yielded 29 potentially relevant
articles and reports, of which 10 were selected for inclusion.
Avoidance behaviour in the context of child protection
Identifying families that appear to co-operate, but actually resist and avoid any change can be
complex. Avoidance, or resisting, behaviours within the context of child protection may include;
agreeing to appoints and actions but not keeping them, selective cooperation with services, changes
occur only due to efforts of outside agencies.
Main Findings
Family’s previous experiences of discrimination and disadvantage may make them distrustful and
anxious about contact with safeguarding professionals. The distrust felt by families may be
heightened by a power difference in the relationship between them and professionals. Further,
parental shame, ambivalence, and lack of confidence can contribute to resistance.
Communication skills could be described as the most important asset that child protection
professionals have while working with troubled families. Nevertheless, it appears that the
communication style commonly adopted by professionals is confrontational, non-listening, with little
empathy shown to parents’ viewpoints. Therefore, effectiveness of communications during child
protection interventions could be improved by more frequent use of open questions, reflection, and
empathetic listening.
Conclusions
Motivational Interviewing (MI) is seen as a possible technique to enhance communication skills.
However, as MI is more commonly used in counselling, there is a risk of losing the focus on a child
and become parent-orientated. Therefore, effective use of MI in child protection context would
require child protection specific training. Frontline professionals working with families resisting child
protection interventions would also benefit from effective supervision. Supervision should provide a
space reflect on practice, thus enabling more effective working with resistant families
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1. Introduction
Upon request of the Local Safeguarding Children Board (LSCB), Public Health has undertaken
evidence review on best practice working with hard to engage families. As a considerable amount of
information is available in this area, the emphasis of this research is in identifying evidence on
working with families that display resistance or avoidance behaviour pattern that is not openly
hostile and threatening in context of child protection interventions. This brief provides a summary of
issues that may lead a family to become resistant to safeguarding interventions and the challenges
faced by professionals in such situations. Furthermore, it presents available evidence of techniques
enabling professionals to work more effective with hard to engage families. Limitations of this
research are described in the discussion section.
2. Methods
Literature for this short evidence summary was scoped from the following databases: BNI, AMED,
CINAHL, EMBASE, Health Business Elite, and MEDLINE. The scoping search strategy was kept broad
including:
o
o
o
o
o
o
family OR families OR parent OR parents OR parenthood
avoidance OR avoiding OR avoid OR evade OR obstruct* OR hinder OR jeopardy* OR resist*
OR non-compli*
work* OR worker OR keyworker OR professional OR profession OR visit* OR school OR social
behave* OR behavi* OR “challeng* behav*”
pattern OR model
child protection
Scoping search was also conducted using general search engines (e.g. google) for any relevant
material.
3. Results
The search yielded 29 potentially relevant articles and reports, of which 10 were selected for
inclusion. The search indicated that the terminology used describing avoidance behaviours within in
child protection proceedings is not consistent. Only limited research material was found regarding
resisting, or avoidance, behaviours in the child protection context.
Therefore, a pragmatic decision was made to include research material that discussed resistance
behaviours in the context of child protection. Identified research was predominantly done among
social workers in the UK. Although limited in number, some experimental research was found on
how professionals (social workers) interact on simulated child protection situations.
4. Avoidance behaviour in the context of child protection
Resistance by families towards frontline professionals involved in child protection and safeguarding
work can take many forms. Recognising openly hostile or aggressive behaviours by families, such as
threats towards staff, are likely to be straight forward to identify. However, identifying families that
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appear to co-operate, but actually resist any change, can be complex (1). Avoidance, or resisting,
behaviours within the context of child protection may include:
o
o
o
o
o
o
o
Agreeing, but not keeping appointments
Agreeing to actions, but not completing them
Limited efforts to make agreed changes to work
Failing to make important changes
Selective cooperation with services
No significant changes identified during reviews
Changes occur, but this is due to efforts of outside agencies (1)
Manipulative behaviours can be also employed as a form of avoidance. Manipulation and deception
aim to divert professionals’ attention from child protection issues to other, non-relevant, issues,
such as blaming a school for failing a child. Identifying manipulative and deceptive behaviours can be
difficult, as these can be disguised as a worry about a child, or as allegations of professional
misconduct. Furthermore, families may, for example, constantly contact a professional to discuss
their case, thus appearing co-operative. In reality, however, this may be a form of disengagement
and avoidance of actual actions. (2,3)
5. Main findings
The available information is divided on four sections: factors contributing to parental resistance,
communication, strategies to improve parent engagement, and role of supervision.
5.1. Factors contributing to parental resistance in the context of child protection
Family’s previous experiences of discrimination and disadvantage may make them distrustful and
anxious about contact with safeguarding professionals. The distrust felt by families may be
heightened by a power difference in the relationship between them and professionals. The
relationship between child protection professionals and a family involved in the proceedings are not
equal, as child protection professionals have more power in the relationship.(4)
Parental shame, ambivalence, and confidence are also factors contributing to resistance. Shame of
having to reveal personal secrets to a stranger and stigma of being involved in child safeguarding
proceedings can be powerful motivators in development of resistance behaviours. Expectations of
willingness to change from outside agencies may also be overestimated. Despite desirable course of
action being obvious for outsiders, parents may persist in continuing behaviours that put their child
in continuous risk. Therefore, ambivalence, or conflicting feelings, towards change is considered as a
key difficulty in achieving desired behaviour change in family. Finally, confidence to change, or
rather lack of confidence, may be the cause of avoidance or resistance behaviour. (4)
5.2. Communication
Forrester at al. (4) argued that resistance behaviours do not exist only within a client involved in
child protection procedures, but can be created by the communication between a professional and a
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client. Importance of clear communication (1) and communication style (5) with families facing child
safeguarding concerns can be considered crucial in;
o
o
o
o
Preventing development of resistance behaviour (4)
Achieving disclosure (5)
Setting expectations from parents (1)
Increasing cooperation (1)
Research has indicated that social workers involved in child protection issues have a tendency to use
confrontational non-listening communication style with parents. Lack of empathy and unwillingness
to take a parent’s view point seriously has also been observed among social workers in experimental
situations. Although it is recognised that un-empathetic and confrontational communication style
can promote non-cooperation and avoidance behaviours among parents, using confrontational
communication style may be seen as an assurance that a practitioner will not be colluding with
parents. (6)
General advice regarding working with families resisting safeguarding interventions includes being
open, establishing written contract with agreed actions, and ensuring that the family understands
the benefits of co-operation.(1) However, being able to achieve good communication with families
that are reluctant to engage can be challenging.
Research with social workers in simulated child protection interviews has identified considerable
variations in communication styles, which may implicate a lack of consistency and effectiveness of
communication.



Firstly, frequent use of closed, instead of open, questions tended to give interviews an
interrogative atmosphere, which hindered reciprocal communication and information
disclosure from families.
Secondly, use of reflection and summary reflections of what had been discussed during a
child protection interview was limited. Lack of reflection and recognition of strengths within
families during a child protection interview may give these situations confrontational feeling.
Thirdly, the research indicated that use of empathy while raising child protection concerns
appeared an effective strategy in achieving good rapport and more comprehensive
information disclosure. (5)
According to Forrester et al. (5), good communications skills ensure that parents are empathically
related to. This, in turn, appears to enable open discussion of any concerns relating to child welfare
concerns. Forrester et al. (4) argue that Motivational Interviewing (MI) may be used as a basic
communication skill in a complex social work situation involving parental resistance. The core skills
of MI include:
o
o
o
o
Good listening
Positive non-verbal communication
Empathic listening
Use of open questions
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o
o
o
Affirmation of positives
Use of reflective statements
Having a strategic object (e.g. child’s welfare and potential harm)
It is recognised, however, that as MI is more commonly applied in a therapeutic and counselling
situations, there is a risk of losing the focus on a child’s needs and become parent orientated.
Therefore, effective use of MI in child protection context requires staff to be trained in the
technique and its application within child protection context. (4)
5.3. Strategies to improve parent engagement
Research among social work practitioners involved in child protection system has indicated that a
number of strategies can be employed to ensure better engagement with families. (3,7) Perhaps not
surprisingly, it is suggested practitioners require persistence to engage with families that are
reluctant to cooperate with child protection. Further, engagement with reluctant families can be
improved by the consistency between practitioners’ talk and actions, and allowing some flexibility to
institutional timescales if appropriate.
A family’s reluctance to engage with child protection may be caused by lack of understanding of
professional jargon used in meetings and official reports, thus creating uncertainty of what is
happening. Further, a family may be feeling disempowered and not being able to express their
understanding of the situation. To overcome these obstacles to achieve better family engagement,
research has suggested the following practical strategies:
o
o
o
o
Practitioners should allow time to explain clearly what is happening and why
The number of professionals at meetings should be limited and the service user/s should be
allowed to bring a support person
Avoidance of professional jargon in meetings and reports
Involvement of the service users in preparation of reports. (3,7)
Similarly to the previous research by Forrester et al. (4–6), Gallagher et al. (7) and Semmings et al.
(8) have concluded that important factors in building a successful rapport with a family are:
o
o
Empathy and respect while discussing difficult issues
Recognising positive factors while being clear about risks.
5.4. Effective supervision
Quality and effectiveness of supervision has been highlighted as an important source of support for
front-line child protection professionals. (9,10) It is argued that effective supervision supports critical
thinking from professionals and allows professionals to challenge any assumption formed during
child protection cases. It is suggested that the role of supervision is too often understood as
checking on front-line professionals practice. Although an important part of supervision is ensuring
competent and accountable performance of the front-line professionals, this should not be
understood as its sole purpose. It has been argued that effective supervision covers four areas:
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o
o
o
o
Managerial
o Ensuring competent and accountable performance
o Access to more experienced and authoritative staff members when required
Personal development
o Assessment and evaluation of strategies used at work
o Critical analysis and reflection of action and strategies employed
o Experience and knowledge sharing
Support
o Help in coping and managing stressful situations
Mediation
o Representation of staff needs to the higher management
o Negotiating services or resources
o Clarifying resource limitations to other organisations (9).
6. Discussion
Research in working with families facing child protection proceedings points out that a professional
is likely to experience some form of resistance from families. As the power in relationship between a
child protection professional and a family is not equal, this has the potential to create resentment
and fear, which may be expressed as hostility and resistance towards a professional and child
protection interventions. Resistance against child protection proceedings can be expressed in a
variety of ways, ranging from explicit threats to apparent co-operation. For a child protection
professional, recognising and finding ways to work with resistant families can be challenging.
The scoping search for this paper indicated that there is rather a limited amount of direct research
available regarding working with families that resist child protection interventions by avoidance
behaviours. Regardless of the limited evidence, communication style emerged as a possible
mechanism to overcome some of the resistance. Parental factors such as shame, ambivalence
towards change, and confidence to change contribute towards development of parental resistance.
However, the style deployed by child protection professionals to communicate with families can
have a significant impact on development of resistance and avoidance behaviours.
Communication skills could be described as the most important asset that child protection
professionals have while working with troubled families. Nevertheless, research has indicated that
social workers involved in child protection issues may not be using communication skills effective. It
appears that the communication style commonly adopted by professionals is confrontational, nonlistening, with little empathy shown to parents’ viewpoints. Despite many professionals recognising
that un-empathetic and confrontational communication style can promote non-cooperation among
parents, using confrontational communication style may be seen as an assurance that a professional
is not colluding with parents.
Research recognises that achieving a good communication with families that are reluctant to engage
is challenging. Furthermore, it is recognised that there is considerable variation between individual
professionals in their ability to communicate effectively. However, available evidence indicates that
effectiveness of communications during child protection interventions could be improved by more
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frequent use of open questions, reflection, and empathetic listening. However, learning good
communications skills requires effort. Motivational Interviewing (MI) is suggested by Forrester et al.
(4) as a possible communication technique that incorporates good listening skills with effective
questioning style. Although applying MI techniques to child protection interventions has a potential
to improve quality of communications with families and ultimately outcomes for children, focus on
the welfare of a child should not be lost. As MI is more commonly applied in counselling, there is a
risk of losing the focus on a child’s needs and become parent orientated. Therefore, effective use of
MI in child protection context would require child protection context specific MI training.
Frontline professionals working with families that resist or avoid child protection interventions
would benefit from effective supervision. Although part of the supervisor role is to ensure
competent and accountable performance of frontline professionals, it should not be forgotten that
effective supervision should enable and foster reflective thinking. Effective supervision should
provide a child protection frontline worker a space to reflect their practice, thus enabling more
effective working with resistant families.
Although evidence is available of the importance of communication skills in child protection practice
with resistant families, this is largely based on research among professionals. No relevant research
was found that explored parents’ or children’s perspectives. Another limitation in this research is the
lack of clarity in terminology used to describe resistance or avoidance behaviour. Therefore, a
pragmatic decision was made to include evidence that discusses working with families that are
difficult to engage with child protection interventions.
Despite the numerous limitations in this evidence summary, evidence emerged that currently
individual variation in communication skills is considerable. Available evidence indicates that
professionals would benefit from enhanced communication skill training that would include use of
open question, reflection, and empathetic listening in context of child protection. Further,
professionals need access to effective supervision that enables reflective practice and constructive
dialogue with their supervisor.
7. Conclusions
o
o
o
o
o
o
Terminology used in research discussing families displaying avoidance behaviour in context
of child protection interventions is varied.
Available research emphasises professionals’ view point.
Parental shame, ambivalence, and confidence are factors contributing to development
resistance.
Resistance behaviours do not exist only within a client involved in child protection
procedures, but can be created by communication between a professional and families.
Professionals involved in child protection issues have a tendency to use confrontational nonlistening communication style with parents.
Un-empathetic and confrontational communication style can promote non-cooperation and
avoidance behaviours among parents. However, using confrontational communication style
may be seen as an assurance that a professional will not be accused of colluding with
families.
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o
o
o
Achieving good communication with families reluctant to engage is challenging.
Nevertheless, effectiveness of communications during child protection interventions could
be improved by more frequent use of open questions, reflection, and empathetic listening.
Motivational Interviewing (MI) is suggested as a possible technique to enhance
communication skills. However, as MI is more commonly used in counselling, there is a risk
of losing the focus on child and become parent orientated. Therefore, effective use of MI in
child protection context would require child protection context specific MI training.
Frontline professionals working with families resisting child protection interventions would
benefit from effective supervision. Supervision should provide a child protection frontline
worker a space reflect their practice, thus enabling more effective working with resistant
families.
References
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Forrester D, Kershaw S, Moss H, Hughes L. Communication skills in child protection: how do social workers talk to
parents? Child Fam Soc Work. 2008;13:41–51.
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Forrester D, McCambridge J, Waissbein C, Rollnick S. How do Child and Family Social Workers Talk to Parents
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