Reflections on challenging behaviour and social work
By Michael Balkow, Lecturer in Social and Community Studies, College of Health, Psychology and Social Care
My two main areas of experience in social work began in child protection services, followed by children with disabilities teams. Challenging behaviour had a part to play in the former, but usually the greatest challenges were from the parents, either through resistance, disguised or non-compliance and simply lacking the ability to make the significant behaviour changes to provide their children with a safe stable home life. Moving into children with disabilities services, some of these parental challenges remained, however a new element of safeguarding became more common – that of children with challenging behaviour, sometimes extreme and violent, making them one of the main risk factors within the family home. Some children would attack their parents and siblings, damage the home, putting a huge strain on the resources and resilience of parents and carers. The dynamic of parents being scared of their own children, often seemed like a complete reversal of my previous child protection work.
Services to support these more extreme cases were often problematic. Mental health services like CAMHS would often quickly rule out types of therapies for these children, due to their cognitive ability, medication was sometimes used as a calming mechanism, but often had limited success with resistance coming in equal measure from parents and doctors to avoid medicalising the problem. One of the key services in supporting these families was respite, either via support workers taking these young people out into the community, or the much sought after overnight respite, giving parents a full break from the relentless caring responsibilities. Long waiting lists were typical for overnight respite, which would increase following emergency admissions when foster carers or other children’s residential homes were full. This lack of respite would then push families even closer to breaking point, increasing the likelihood of more children going into care, putting even more pressure on the already stretched system. Specialist schools were often dedicated and worked hard to give these young people access to education, and all else that this entails – socialisation, friendships and another key part of respite, those few hours where other people were safely supporting their children.
Meeting the threshold of significant harm in some of these cases was a contentious area, attempting to argue that a child is at risk of significant harm, when more likely the parents were the ones at risk. Beyond parental control was often the most suitable threshold category, but still carries with it a sense of failure on behalf of the parents, made difficult to contend with, when to me, they were some of the hardest working parents I knew – more dedicated than all the services around them, providing around the clock care, love and attention for children with incredibly complex needs, without much thanks and often only met with aggression or violence.
