Practice Guidance

Working with Hostile Families

Contents

1. Introduction

1.1 Hostility, intimidation and the threat of violence or actual violence are frequently experienced by professionals in the caring professions. They can all limit the worker’s ability to assess risk and to take any actions required to protect the child. How professionals have dealt, or not dealt appropriately, with hostility from parents/carers, has been a key feature in numerous high profile serious case reviews. The purpose of this guidance is to offer advice to professionals confronted by hostile parents and carers.

1.2 Keeping yourself safe is a crucial factor in being able to focus on the child’s needs. A key principle of this document is that recognising the impact of hostility and intimidation on yourself and others and taking account of this is vital.

1.3There are some key principles which help to manage such work effectively:

recognising impact on self
keeping safe - agency responsibility/personal responsibility
collaborative working between agencies

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2. Making Sense of Angry Responses

2.1 An accurate assessment of the reasons for the hostility and the actual level of risk involved is critical both for your personal safety and also to ensure that the risks to the child can be accurately assessed.

2.2 There are many ways of behaving in a manner which can be threatening. They include:

physical violence
shouting
swearing
throwing things
using intimidating or derogatory language
using written threats
the deliberate use of silence
using domineering body language
using dogs or other animals as a threat, which sometimes can be a veiled threat
racial abuse

2.3 Threats can be covert or implied as well as obvious. In order to make sense of what is going on in any uncomfortable exchange with a parent/carer, you need to ask yourself the following questions:

Is this anger, as opposed to hostility?
Might you have aggravated the situation by either getting angry yourself or by being patronising or dismissive?
Is it a response to frustration, either related or unrelated to your visit?
does the person need to complain, possibly with reason?
Is the behaviour deliberately threatening/obstructive/abusive?
Is the parent/carer aware of the impact he/she is having on you?
Is he/she so used to aggression that they don't appreciate the impact of their behaviour?
Is this normal behaviour for this person?
Is your discomfort disproportionate to what has been said or done?
Are you taking this personally in a situation where hostility is aimed at your organisation?
Is your judgement affected by fears for your own safety?

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3. The Personal Impact on Workers.

3.1 Working with hostile and violent families places workers under a great deal of stress. This can have physical consequences such as sleep disturbance, shock and distress. It can have emotional and psychological consequences such as loss of confidence and self-esteem. It can have consequences for practice such as hostage behaviour.

3.2 The impact on workers of experiencing violence and hostility can be significant and can be expressed in many different ways, for example:

Fear
Shock
Surprise
Distress
Numbness
Denial
Embarrassment
Anger
Self-doubt
Loss of self-esteem and of personal and/or professional confidence
Sleep and dream disturbance
Hypervigilance
Preoccupation with the event, or related events
Repetitive stressful thoughts, images and emotions
A sense of helplessness
Stress related illness such as depression

3.3 Factors which are known to increase the impact on workers include the following.

3.4 Previous traumatic experiences, both in your professional and personal life, can be revived and heighten the fears.

3.5 Regularly working in situations where violence/threats are pervasive:

Workers in these situations can develop an adrenalin-led response which may over or underplay the threat.

3.6 Hostage-like responses: When faced with significant fears for their own safety, workers may develop a ‘hostage-like’ response. This is characterised by accommodating, appeasing or identifying with the ‘hostage-taker’ to keep safe.

3.7 Threats that extend to the worker’s life outside of work can be particularly unnerving.

3.8 Stereotypical assumptions about the higher levels of risk from men than from women and that male workers are less likely to be intimidated: False assumptions decrease the chances of recognition and support, e.g. male workers may find it more difficult to admit to being afraid; colleagues and managers may not recognise their need for emotional support. This may be particularly so if the perpetrator of the violence is a woman. Additionally male workers may be expected to carry a caseload that includes a disproportionate number of threatening service users.

3.9 Lack of appropriate support and a culture of denial or minimising of violent episodes as 'part of the job' can lead to the under reporting of violent or threatening incidents and to more intense symptoms as the worker feels obliged to deal with it alone.

3.10 Violence and abuse can strike at the very core of a person's identity and self-image, particularly if it is in relation to a person's race, sexuality,disability or gender. If the worker already feels isolated in their workplace due to any of these issues, the impact may be particularly acute and it may be more difficult to access appropriate support.

3.11 A key message in this document therefore is be aware that the impact of stressful events on you can:

limit what you can allow yourself to believe
make you feel responsible for allowing the violence to take place
lead to adaptive behaviour which is unconsciously ‘hostage-like’
have an impact on your assessment or judgement
result in a number of distressing symptoms as listed above

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4. Agency Responsibility and Support

4.1 All agencies have a duty of care, as stated in the Health and Safety at Work Act (Section 2).

4.2 Each agency should have a supervision or support system in place that is accessible to the practitioner and reflects practice needs. This supervision or support system should look at any difficulties being experienced by workers or anticipated by them in working with families and should address the impact on the worker and the impact on the work with the family.

4.3 There may be occasions when support for the worker is required immediately.

4.4 Managers must encourage a culture of openness, where their staff are aware of the support available within the team and aware of the welfare services available to them within their agency. Managers must ensure that their staff members feel comfortable in asking for this support when they need it.

4.5 Workers must feel safe to admit their concerns knowing that these will be taken seriously and acted upon without reflecting negatively on their ability or professionalism. Each agency should have a system in place to ensure that workers know what action to take if they feel that their concerns are not taken sufficiently seriously.

4.6 The practitioner should prepare for these discussions and should bring case records relating to any violence/threats made. Managers will not know about the concerns unless the practitioner reports them. By the same token, managers should be aware of the high incidence of under reporting of threat and violence and should encourage discussion of this as a potential problem. A worker who feels threatened may need to ask that a manager or colleague accompany them to make a joint visit.

4.7 Discussion should examine whether the behaviour of the service user is preventing work being effectively carried out. It should focus on the risk factors for the child within a hostile or violent family and on the effects on the child of living in that hostile or aggressive environment.

4.8 An agreed action plan should be drawn up detailing how any identified risk can be managed or reduced. This should be clearly recorded in the supervision notes. The action plan should be agreed prior to a visit taking place.

4.9 Group supervision or team discussions can be particularly useful to share the problem and debate options and responsibilities.

4.10 Files and computer records should clearly indicate the risks to workers.

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5. Impact on the Assessment of Children/Families

5.1 Accurate information and a clear understanding of what is happening to a child within their family and community is vital to any assessment. The usual and most effective way to achieve this is by engaging parents and children in the process of assessment, reaching a shared view of what needs to change and what support is needed, and jointly planning.

5.2 Engaging with a parent/carer who is violent and/or intimidating is obviously more difficult. The behaviour may be deliberately used to keep professionals at bay - or can have the effect of keeping professionals at bay. There may be practical restrictions to the ordinary tools of assessment e.g. observing the child in their own home. The usual sources of information/alternative perceptions, other workers and other family members, may also be kept at bay.

5.3 It is important to explicitly work out and record what areas of assessment are difficult to achieve and why.

Factors which stem from the impact on the worker

5.4 Some coping strategies developed by workers obstruct engagement with the family.

Seeing each situation as a potential threat and developing a ‘fight’ respons, becoming over-challenging, thus increasing the tension between him or herself and the family. This may protect the worker physically and emotionally but can lead to that worker becoming desensitised to the child's pain and to the levels of violence within the home. As a result of this the harm to the child can be underestimated.
Colluding with parents/carers by accommodating and appeasing them in order to avoid provoking a reaction.
Becoming hyper alert to the personal threat so that the worker becomes less able to listen accurately to what the adult is saying or distracted from observing important responses of the child or interactions between the child and adults.
‘Filtering out’ negative information or minimising the extent and impact of the child's experiences in order to avoid having to challenge. At it's extreme, this can result in workers avoiding making difficult visits or avoiding meeting with those adults in their home, losing important information about the home environment.
Feeling helpless/paralysed by the dilemma of deciding whether to ‘go in heavy’ or ‘back off’. This may be either when faced with escalating concerns about a child or when the hostile barrier between the family and outside means that evidence about the child's situation appears minimal.

5.5 When considering what the child is experiencing, many of the above may be equally relevant; the child may:

be coping with their situation with hostage-like behaviour
have become de-sensitised to violence
have learnt to appease and minimise
be simply too frightened to tell

5.6 In order to assess how far the hostility of the parents/carers is taking a toll on your assessment of the child, ask yourself some of these questions:

are you colluding with the parents/carers by avoiding conflict, e.g., focussing on less contentious issues such as benefits/housing, avoiding asking to look round the house, see how much food is available, etc. or, crucially, not asking to see the child alone?
are you changing your behaviour to avoid conflict?
are you filtering out negative information, or minimising?
are you afraid to confront family members about your concerns?
what message are you giving this family if you don't challenge?
are you relieved when there is no answer at the door?
are you relieved when you get back out of the door?
did you say, ask and do what you would usually say, ask and do when making a visit or assessment?
have you seen the key people?
is this a case of domestic violence by a man but you only work with the woman?
is the child keeping 'safe' by not telling you things?
has the child learned to appease and minimise?
is the child blaming him or herself?
what might the child have been feeling as the door closed behind you?

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6. Keeping Yourself Safe

6.1 You have a responsibility to plan for your own safety just as your agency has the responsibility for trying to ensure your safety. Workers should consult with their line manager to draw up plans to protect their safety. Consider the following questions:

are my colleagues/line manager aware of where I am going and when I should be back? do they know that I am particularly at risk during this visit?
is my car likely to be targeted/followed? If yes, it may be better to go by taxi and have that taxi wait outside the house.
do I have a mobile phone or some other means of summoning help?
could this visit be arranged at a neutral venue?
why am I doing this visit at the end of the day when it's dark and everyone else has gone home? Risky visits should be undertaken in daylight whenever possible.
does my manager know my mobile phone number and network, my car registration number and my home address and phone number?
do my family members know how to contact someone from work if I don't come home when expected?
have I taken basic precautions for my family such as being ex-directory at home and having my name removed from the public section of the electoral register?
have I accessed personal safety training?
is it possible for me to continue to work effectively with this family? if threats and violence have become a significant issue for a worker, their line manager should consider whether he or she should be released from the case and another worker allocated. In exceptional circumstances it may be necessary to transfer the case to another team or district.

6.2 Finally, a few don'ts:

don't take it personally
don't get angry yourself
don't be too reasonable and understanding
don't assume you can deal with it and then fail to get out
don't think that you don't need strategies or support
don't assume it's your fault and that if you had said or done something differently it wouldn't have happened

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7. Impact on Multi-Agency Work

7.1 Sometimes parents/carers are hostile to all agencies. Unless this is recognised and managed on an inter-agency basis the results can be as follows:

everyone 'backs off', leaving the child unprotected
the family is 'punished' by withholding of services as everyone 'sees it as a fight'. This is at the expense of assessing and resolving the situation for the child
there is a divide between those who want to appease and those who want to oppose - or everyone colludes

7.2 When parents/carers are only hostile to some individuals/agencies or where individuals become targets of intimidation intermittently, the risk to good inter-agency collaboration is probably at its greatest. Any pre-existing tensions between agencies and individuals, or misunderstandings about different roles are likely to surface. The risks are of splitting between the agencies/individuals, with tensions and disagreement taking the focus from the child.

individuals or agencies blame each other, and collude with the family
those not feeling under threat can find themselves taking sole responsibility which can ultimately increase the risk to themselves
those feeling under threat may feel that it is personal
there is no unified and consistent plan

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8. Ensuring Effective Multi-Agency Working

8.1 Any agency faced with incidents of threat, hostility or violence should routinely consider the potential implications for any other agency involved with the family as well as for its own staff.

8.2 Other agencies known to be working with a hostile family should be alerted to the potential dangers to their workers.

8.3 Regular inter-agency communication, clear mutual expectations and attitudes of mutual respect and trust are the core of inter-agency working. When working with hostile or violent parents or carers, the need for very good inter-agency collaboration and trust is paramount and is also likely to be put under greatest pressure. It becomes particularly important that everyone is:

aware of the impact of hostility on their own response and that of others and respecting of the concerns of others
alert to the need to keep each other safe
actively supportive of each other and aware of the differing problems which different agencies have in working within these sorts of circumstances
open and honest when disagreeing
aware of the risks of collusion and of the targeting of specific professions/agencies

8.4 It is not possible to protect a child, make a proper assessment of the home situation or do what is right for the child if you are frightened or at risk yourself and so the following strategies, suggestions and questions should be considered:

you need to establish good, clear communication with families if you are to elicit their views, recognise their efforts and strengths and make it clear what is required of them. Positive strategies that have worked in the past may form a basis on which to build. If the family put forward blocks or resistance this should be quickly identified and shared with the family and/or your manager
clear records should be maintained, including records on supervision and the agreed action plan. Records should detail not only what was said or what happened but also how the worker felt
are the family members clear about why we are taking a particular course of action or why they are not being invited to attend meetings?

At the point of child protection enquiries

8.5 There are reasonable uncertainties and need for care when considering disclosing personal information about an adult. Concerns about the repercussions from someone who can be hostile and intimidating can become an added deterrent to sharing information. However, information sharing is pivotal, and being explicit about experiences of confronting hostility/intimidation or violence should be standard practice.

8.6 If you would answer yes to any of the following questions you should raise them during child protection enquiries:

do you have previous experience of an adult linked to the child being hostile, intimidating, threatening or actually violent?
is this in specific circumstances? e.g. drink related/linked to intermittent mental health problems?
are you intimidated/fearful of the adult?
if so, how have you managed your own response prior to the present child protection issue arising? (You may have been less than honest/avoided conflict.)
are you now in a position where you will have to acknowledge concerns for the first time? and are you fearful how they will respond to you?
would you want to be made aware of these concerns?

8.7 Workers in different settings have different thresholds for concern and different experiences of having to confront difficult behaviour. It is vital that the differing risks and pressures are acknowledged and supported.

Child protection conferences and core groups

8.8 Avoiding people who are hostile is a normal human response. It is very damaging to effective inter-agency work under child protection plans, which depends on proactive engagement by all professionals with the family.

8.9 Collusion and splitting between agencies will be reduced by:

clear agreements, known to all agencies and to the family, detailing each worker's role and the tasks to be undertaken by them
full participation at regular Core Group Meetings and at Child Protection Conferences: all agencies owning the concerns for the child rather than leaving it to a few to avoid wrath

Opportunities to communicate confidentially

8.10 Although it is important to remain open with the family as far as possible, this should not be at the expense of being able to share real concerns about intimidation and threat of violence. In exceptional circumstances it may be helpful to consider 'professionals only' meetings.

8.11 Options to consider are:

using the exclusion criteria for Child Protection Conferences if the quality of information shared is likely to be impaired by the presence of threatening adults
holding a meeting of the agencies involved to share concerns, information and strategies and to draw up an effective work plan which clearly shares decision-making and responsibilities
holding a meeting to draw up an explicit risk reduction plan for workers
in extreme situations, instituting repeat meetings explicitly to review the risks to workers and to put strategies in place to reduce these risks
joint visits with police, colleagues or workers from other agencies
if workers have experienced a frightening event, debriefing with other agencies can be helpful

8.12 If such meetings are held, it is important to ensure that the threat of risk is not exaggerated by 'group-think' and there must always be an explicit plan made of what/how/when to share what has gone on with the family. Secret discussions are unlikely to remain secret, and the aim should always be to empower the core group to become more able to be direct and assertive with the family without compromising their own safety.

8.13 Although working with hostile families can be particularly challenging, remember that hostile feelings can change; and families frequently respond to assertive, positive work, where they are treated with respect.

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