Words and Pictures

• See Chapter 5 in

A.Turnell and S.Essex Working with “Denied” child abuse: the Resolutions approach. OU press 2006

• And article in Context 97 June 2008• Hiles, Essex, Fox and Luger.

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Resolutions words and picturesHelping to create a coherent narrative about difficult events.

• What would you like me to make sure I cover this morning?

• Basic Principles and Techniques.• Brief exercise.• Recent experiences.• Questions?

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Entertaining multiple positions simultaneously,Process leading up to Words and Pics very important. See book Donna’s case Chapter 4.

Judge: He did it

Granma: I’m confused and worried

Mother: He’s my Husband, I don’t know what to think

Worker: She should leave him!

Dad: You’re sick peopleOut to destroy me

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The Benefit of the Words and Pictures Process

“Some adults who, despite having had very traumatic childhoodsabout which they can nevertheless tell coherent stories, are likely to have securely attached children…………One important therapeutic implication of this finding is thatit may be helpful, perhaps even transforming, to help the family to tell a more coherent story about its painful experiences,Including (traumatic events) its illnesses.”

John Byng-Hall “Toward a coherent story about illness and loss.”

in Multiple Voices 1997.

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‘Certain topics are so emotionally laden that some people seem to think that systemic ideas do not apply in such cases....’

Cecchin, Lane and Ray Irreverence 1992

We can be over or under organised by topics that emotionally overwhelm, how do we find a way that includes children and children’s voices.

IrreverenceIrreverence

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This light globe seems faulty

A key issue in Child Protection is how do we create openess about the concerns.

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This light globeStill seems faulty… …but now we’ve

installed a whole new lighting system!

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No Gratuitous opinions• Could we leave whether you did it or not to one side, up on

a shelf so to speak?

• If the dispute was easy to resolve I guess it would have happened by now.

• Current research indicates, I can understand from the research and literature why they are worried but i do hear what you are saying , I have made a note of it here.

• Don’t be tempted to give a definitive position.

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Words and Pictures

Explanations for children as to what has happened in their family and why they may not be living at home, using drawing, play people etc.

Undertaken with children and their parents and often with members of the support network present.

Words and Pictures are the bedrock in creating openess which leads the way to an agreed safety plan.

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DVD Case ExampleAlex and Kate Smith have two children, Jake 4 years and Chloe 8 months. Chloe is presented at hospital

having allegedly been dropped by Alex whilst in his sole care. Medical examination reveals linear bruising to

Chloe’s cheek, rib fractures of different ages and subdural haematomas, which the doctors think are non-accidental in origin. The family are not known to Social Services and the Health Visitor reports positively about

the parenting and care of the children until this time. Jake is placed in foster care and Chloe joins him when

she is allowed to leave hospital. Alex and Kate are allowed contact with the children five days per week

supervised by social workers. The matter is put before the Court which has to decide what should happen to

the children. Further assessments reveal no other concerns and both parents deny they have injured

Chloe.

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Genogram Alex and Kate.

Chloe Jake

Alex mark

Jim Sarah +Norman

Kate

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DVD case example Julia and Gerry

• A pre-school girl from Sunday School (Kelly), where Gerry helped as Leader, alleged that Gerry had sexually abused her. The matter was not taken to court but Social Services “substantiated” the allegations based on the detail of oral abuse in the girl’s report. As a result of this Social Services were concerned for the current and future safety of Gerry and Julia’s 3 year old daughter Emma. Julia’s sister Sharon and Julia’s mother have been helpful during the investigation. 12

Susie Essex Oct ober 2011

Julia and Gerry Genogram

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Sharon

Julia32Artist Community

Projects

36GerryFinancial Advisor

4Kelly CSA Allegation 3 Emma

Social Workers Church Nursery School Day Care

Sunday School Teacher

MGM+

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Words and Pics exercise

• In threes think of the DVD family with injured baby Chloe or little Emma.

• What might you expect someone to say to Jake about why he and his sister were going to Foster carers for a while?

• What might you expect someone to say to Emma about why Daddy is not at home?

( Think how you might use age appropriate language and some pictures)

• Who might explain to Jake/Emma, how might you help them explain? 14

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Exercise in 3’s

• In 3’s think what you might want children to know about the concerns.

• What might they already know and how?• Who would you want to talk to the children

about the concerns, workers, family member?• What would you want them to say, how much

or how little to get across the concerns?

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It isn’t easy.

• Children are often not asked what they make of what is happening.

• Children are often left out of discussions about what is happening and why.

• Adults are often at a loss about how much to say, or how little to say, and what words to use.

• By adults I include not just family members but also key professionals.

• If we have ideas about what to say how do we take family members /carers worries into account.

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Family Members Mother: Mari 24 Dual Heritage 2nd Generation Father: Ralph 32 White UK Jodie born Autumn 2006

Hospital age 1 month Apnoea attackage 6 weeks Apnoea attack and rashage 3 months rash possible Apnoea

Previous Child Death Boy Eli age 10 months in 2005 New Baby Due Easter 2008

Fictitious Case Example for Fictitious Case Example for Fabricated or Induced IllnessFabricated or Induced Illness

The Safety Network

Grandmother: dual heritage white UK and black British Great Uncle Frank and girlfriend Jo (Grandpa died 2005, white UK)Godmother: ConnieChurch friends: Pastor Mark and Cheryl etc….

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Words and Pictures for Jodi - 1

In 2006, in the Winter, Jodi had a rash on her face.The doctor came to see Jodi.Grandma Sophie was there, as Mum had called her because they were so worried about Jodi.

The doctor gave Mum and Dad a letter, saying ‘Please take Jodi to Hospital.’

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Jodi went to the Hospital. Mummy told them Jodi seemed a bit floppy in the night. The doctors said ‘The rash might be a virus, but weneed to check.’

Jodi stayed in Hospital.

Words and Pictures for Jodi - 2

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The doctors were worried as this was the third time in 3 monthsthat Jodi had come to Hospital since she was born.

The doctors talked to another doctor…..they thought the rash might be because someone had stopped Jodie breathing but they couldn’t be sure.

…..then they talked to Social Services and other people.

Words and Pictures for Jodi - 3

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There was a big meeting - a Case Conference.

The doctor said ‘We are very worried about Jodi’s rash. We think she might havebeen hurt’

The Case Conference decided to ask another doctorin London to see Jodi.

Words and Pictures for Jodi - 4

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In London, Mummy and Daddy said Jodi had one rash and had been to hospital lots because she was ill.The doctors seemed to say different things. Everyone was very worried.

The Social Worker said this is confusing and worrying. I have to make sure Jodi is safe .We need a Judge to help sort it out. The Judge said she thought Jodi had been hurt when mummy was looking after her.She said she had to be sure Jodi would not be hurt again.

Words and Pictures for Jodi - 5

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DVD clip Words and Pics

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Words and Pictures Processin outline

• Explain the process to parents and their key advisors. ( Explore these same issues with the other parent, kinship ( Explore these same issues with the other parent, kinship

system, and significant adults in the system, and significant adults in the child’s life)child’s life)

Offer a first draft of the explanation to parents Offer a first draft of the explanation to parents and advisors, and if possible network system.and advisors, and if possible network system.

Edit refine and agree the final version with Edit refine and agree the final version with parents advisors and social services. (CYPS). parents advisors and social services. (CYPS). (Pictures agreed either what will be drawn or (Pictures agreed either what will be drawn or done as part of the draft.)done as part of the draft.)

Provide the explanation using the words and pics Provide the explanation using the words and pics document to the children preferably with document to the children preferably with network members. network members. 24

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Questions for Words and Pictures

What do you think Sharni makes of what is happening?

What makes you think she thinks that?

What questions has she asked?

What difference would it make if she knew a bit more about what has been happening?

What might she have overheard?

What does she think happened to Asha, why does she think she is staying with grandma?

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Words and Pics storyboard First part Keep Checking

• 1.1. Begin by briefing statutory child Begin by briefing statutory child protection workers on the process and obtain protection workers on the process and obtain their permission and endorsement to their permission and endorsement to undertake the process and commitment to use undertake the process and commitment to use the words and pictures within the looked-the words and pictures within the looked-after/child protection system .after/child protection system .

3. Explore these same issues with the other parent, 3. Explore these same issues with the other parent, kinship kinship system, and significant adults in the system, and significant adults in the child’s life.child’s life.

2.2. Check with the parent or parents about the problem Check with the parent or parents about the problem (e.g., mental health problem; severe illness; child (e.g., mental health problem; severe illness; child protection concerns; drug or alcohol misuse) regarding protection concerns; drug or alcohol misuse) regarding from their point of view what would be most helpful for from their point of view what would be most helpful for their children to understand about the situation. their children to understand about the situation.

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Second part, First Draft.• 4. Explore with child/children what they make of what is

happening, what they already think and know, and what they are concerned about. ( Depending on the circumstances include a parent, or both parents and a supporter or children’s current carers/ trusted adult from the kinship system. For teenagers have a separate session to talk through what would work best for them.)

• 5. Draft the explanation utilising the families own language and ways of expressing concerns wherever possible bearing in mind the family’s race culture and religion. Link all the above to any worries about the children at home, at school, with peers ie how the child might be expressing some of the worries and their confusions.

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Second part cond.• 5cond.. The explanation should be balanced and not solely

focused on the concerns/ negative. The explanation should be framed with a neutral or affirmative beginning and a positive end. The explanation should include meaningful positive events or aspects of the child’s life that fit and add to the overall story.

• 6. Present the first draft to the parents. Develop and refine the Words ( and Pictures if drafted), so that they are comfortable with the draft and the explanation reflects what they have agreed the child should know.

• 7 Once the parents take ownership of the explanation, the next task is to ensure that the explanation captures everything the statutory agency wants the child to know.

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Third Part.Making sure everyone is on the same page

• 8. Provide the explanation to child/children with their parents, extended family, carers and social service workers present. Set Context, use traffic lights, think carefully about teenagers.

• 9. Ensure that all other significant extended family members and adults in the child’s life have seen the explanation and will draw upon it when they need to talk to the child about the problems, their parents difficulties or why they are in care.

Remember no-one finds it easy to know what to say, or how much, this document forms the basis of all the work. If there are new concerns or more positive information comes to light, this can be added or included as sessions take place.29

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Words and Pics Basic Structure1. Title to be clear what this is about,

2. Start Pic sets the Context, neutral not too worrying,

3. Who is worried,

4. What are they worried about, clear about what the worries are this might be the only chance to let everyone in the system know the concerns,

5. Who is trying to help and move things forward,

6. End all working together. Positive picture and future focussed

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