29034 Secure Accomm

Secure in the Knowledge

Perspectives on Practice in
Secure Accommodation

Edited by

Mark Smith

with

Bob Forrest, Phil Garland and Lynne Hunter

Scottish Institute for Residential Child Care
Glasgow School of Social Work
Universities of Strathclyde and Glasgow

May 2005

© the Authors
and the
Glasgow School of Social Work
Universities of Strathclyde and Glasgow
2005

ISBN – 1-900743-23-X

Not to be reproduced without permission
of the
University of Strathclyde
Glasgow

Acknowledgements

A reference group of stakeholders in this project met on a regular basis to consult
on its progress. This group comprised:

Graham Bell CEO, Kibble Education and Care Centre, Paisley
Stuart Bond Social Work Services Inspectorate, Scottish Executive
Debbie Clelland Scottish Executive
Bob Forrest SIRCC Associate
Paddy Hanrahan Principal, St Philip’s School Plains
Lynne Hunter SIRCC Research Assistant
Shona Kelly Acting Depute, Kerelaw School
Veronica McCall Depute Chief Executive, Rossie School
Fergus McNeill Senior Lecturer, Glasgow School of Social Work
Frank Phelan Principal, Edinburgh Secure Services
Margaret Sloan Acting Principal, Good Shepherd Centre
Mark Smith SIRCC Lecturer.

In addition to the reference group, we are grateful to those staff in residential
schools and secure units who read and commented on selections of the papers in
draft form.

We also acknowledge the contribution of those who read and commented on the
entire volume prior to publication:

Bill Duffy Principal, St Mary’s Kenmure
Andrew Kendrick Professor of Residential Child Care
Mike Laxton Phase 3 Consultancy

Thank you to Irene Stevens from SIRCC for appending training links to the various
papers, SIRCC Library staff who undertook the final proofreading and to Christine
Wilson, Senior Psychologist at Edinburgh City Council, for her comments and
contribution to Chapter 3.

We would also like to thank the young people from St Katharine’s Centre who
provided the art work for the front cover.

Secure in the Knowledge - Acknowledgements - May 2005

Contents

Contributors

Introduction Mark Smith

Chapter 1
Historical and policy context of secure accommodation Mark Smith
Bob Forrest
Fergus McNeill
& Neil McMillan

Chapter 2
Values and ethics in secure accommodation Mark Smith

Chapter 3
Theoretical perspectives Lynda Taylor

Chapter 4
Practice Papers

4.01 Introduction Mark Smith

4.02 Referral, screening and decision-making Bob Forrest

4.03: Admission Mark Smith

4.04: Assessment, care planning, programmes
and monitoring Phil Garland

4.05: Working in secure accommodation Mark Smith &
Margaret Sloan
4.06: Daily rhythms, rituals and routines Mark Smith

4.07: Prosocial modelling Chris Johnson

4.08: Activities Laura Steckley

4.09: Educational issues in secure accommodation Graham McPheat

4.10: Health issues in secure accommodation Graham McPheat

Secure in the Knowledge - Contents - May 2005 1

4.11: Mental health Ian Milligan

4.12: Working with boys and girls Mark Smith &
Laura Steckley

4.13: Sexuality Mark Smith

4.14: Self-harm Shannon A. Moore

4.15: Drugs Brian Wood

4.16: Offending Susan Batchelor &
Fergus McNeill

4.17: Sexual offending and sexual vulnerability Mark Smith

4.18: Risk assessment Mark Smith,
Fergus McNeill &
Susan Batchelor

4.19: Safe care Mark Smith

4.20: Children’s rights Richard Mitchell

4.21: Partnership with families Maura Daly

4.22: Life story work Maura Daly

4.23: Managing behaviour Laura Steckley

4.24: Learning disabilities Irene Stevens

4.25: Secure accommodation in the continuum of care Graham Bell &
Mark Smith

4.26: Exits and mobility Chris Johnson

4.27: Throughcare and aftercare Alison Caulfield-Dow

Glossary

References

Resources on secure accommodation

Secure in the Knowledge - Contents - May 2005 2

Contributors

Editor

Mark Smith – worked for almost 20 years in residential schools, close support units
and latterly in secure accommodation where he was Principal for
Secure Services in Edinburgh. In 2000 he moved to his present post
as lecturer and course director of the MSc in Advanced Residential
Child Care at The University of Strathclyde, now part of the Glasgow
School of Social Work. He has published work on a range of issues
relating to residential child care and is a regular contributor to cyc-
online, the monthly journal of the international child and youth care
network. He has particular interests around youth justice, leadership
and masculinity in care settings.

The Editorial Team

Bob Forrest – held various posts in five different secure units north and south of the
border since 1971. Since leaving Kerelaw after 14 years as Head, he
has continued his involvement in residential/secure care as
development manager for EUROARC, a European research network
on residential child care and as a consultant to organisations in the
independent sector. He was involved in drafting the legislation on
secure accommodation in the early 1980s and the Code of Practice,
1985.

Phil Garland – worked in children’s units and close support units in Edinburgh. He
was first manager of Guthrie unit, the secure wing in St Katharine’s
Centre. He moved to Ireland in the mid 1990s, where he worked as
social worker, team leader and child care manager in the Northern
Area Health Board. He is currently Director of Child Protection for the
Archdiocese of Dublin.

Lynne Hunter – works as a research assistant for the Scottish Institute for
Residential Child Care on a number of residential child care projects.
She has a BA in Psychology and an MSc in Psychological Research
Methods.

Secure in the Knowledge - Contributors - May 2005 1

Contributors

Susan Batchelor – is researching her PhD in the Department of Sociology,
Anthropology and Applied Social Sciences at Glasgow University.
Her research topic is young women who have committed violent
offences. She has worked as a researcher on a range of projects
relating to young people and crime, and teaches on the Open
University module D864: Youth Justice, Penality and Social Control.
Susan has also been a Befriender for Barnados and is a Children’s
Panel Member for the City of Glasgow.

Graham Bell – is CEO at Kibble Education and Care Centre, Paisley. He has
worked in different residential child care settings, including secure
accommodation. In his current post at Kibble he has led a number of
research and staff development initiatives.

Alison Caulfield-Dow – worked as a residential care worker in local authority
children’s units and at Kibble Education and Care Centre, where she
became involved in various international research and practice
development projects. For the past four years she has been National
Co-coordinator at the Scottish Throughcare and Aftercare Forum and
has been involved in national policy and practice developments for
young people leaving care.

Maura Daly – worked in a children’s home and residential school before moving to
a children and families social work post. She is currently a Scottish
Social Services Council (SSSC) funded practice teacher at Family
Service Unit Scotland and contributes to social work teaching at
Edinburgh University. She has a particular interest in direct practice
with children and their families.

Chris Johnson – worked in a psychiatric unit before taking up a post at Aycliffe
School in Co. Durham, where he worked mostly in the secure unit. He
moved to Kerelaw in 1982 as Depute and was responsible for
opening the secure unit there.

Neil McMillan – originally qualifying as a social worker, he worked with children and
young people for ten years before becoming involved in social work
training and research. He has held research posts in Scottish
universities, published in the areas of residential child care and
conducted child care training and research throughout mainland
China, Europe and east and central Africa. He is currently employed
in a development post at Kibble Education and Care Centre.

Fergus McNeill – took up a post as Lecturer in Social Work at the University of
Glasgow in 1998. Before this, he worked as a criminal justice social
worker in the east end of Glasgow for five years. His research and
publications have addressed a variety of issues in probation and
youth justice. He is now senior lecturer at the Glasgow School of
Social Work, a joint initiative of the Universities of Glasgow and
Strathclyde.


Graham McPheat – trained as a teacher before moving into residential child care,
where he worked in close support and children’s home settings,
latterly as unit manager. He now teaches residential child care at the
Glasgow School of Social Work.

Ian Milligan – was a practitioner and manager in residential child care settings
before moving to teach in further education. Since 2000 he has been
a SIRCC funded lecturer at the Glasgow School of Social Work,
where he has responsibility for policy and training. He has particular
interests in the mental health needs of looked after children.

Richard Mitchell – has extensive practice experience in child and youth care
settings in Canada. He recently completed a PhD at the University of
Stirling looking at the impact of the United Nations Convention on the
Rights of the Child. He was research assistant on residential child
care projects at the University of Strathclyde. Currently, Richard is an
Assistant Professor in the Child and Youth Studies Department at
Brock University in Ontario, Canada.

Shannon Moore – worked in child and youth services across mental health,
education and justice systems for more than 15 years. After
completing her PhD in Counseling Psychology in Canada (2003) she
joined the Scottish Institute for Residential Child Care as a research
assistant at the University of Strathclyde and lecturer at Langside
College. Shannon also consulted in the area of child and youth
mental health in Scotland and England before returning to Canada in
2004. She is currently a lecturer at Brock University in Ontario,
Canada.

Margaret Sloan – is Depute Principal at the Good Shepherd Centre, which is
developing a new secure unit for girls. Before that she worked in
both the open and secure wings of Kerelaw School for 11 years.

Laura Steckley – has lecturer and research assistant posts at the Glasgow School
of Social Work where she teaches on the MSc in Advanced
Residential Child Care and on undergraduate programmes. She is
completing her MSc dissertation on the therapeutic role of the football
team in a residential school. She has practice, training and
management experience from working in a residential school in
Scotland and in treatment centres in the US.

Irene Stevens – has worked in a variety of residential settings. Just prior to joining
SIRCC in 2000, she was a unit manager in a secure unit. She is
currently based at the National Office of SIRCC and has responsibility
for the delivery of a number of short courses, as well as looking at
links between all of SIRCC’s provision. She is an external moderator
for SQA and verifies the care SVQs. She has written two Higher
National Units on secure care and an open learning pack to support
one of the units.


Lynda Taylor – has experience as a youth worker and children and families social
worker. For the past ten years she has managed Pentland View
Close Support unit in Edinburgh, where she has developed
approaches to practice based around attachment theory.

Brian Wood – worked in a drugs rehabilitation project before undertaking social
work training. On qualifying he worked as an RCO and later secure
unit manager at St Katharine’s Centre in Edinburgh. He is currently
project manager in a family centre in Finglas, Dublin, run by
Barnados.

These papers reflect the personal views of the authors and not necessarily those of
the organisations they represent.


Introduction
Mark Smith

Background
In 2002 The Scottish Executive announced an expansion and re-configuration of
secure accommodation services for young people – from 96 to a proposed 125
beds.

The expansion of the secure estate is taking place at a point when agencies across
Scotland have to prepare to meet the requirements of the Scottish Social Services
Council’s (SSSC’s) qualifications framework which demands that all workers in
residential child care hold a recognised qualification by 2008/9. Agencies charged to
develop new secure services are faced with the need to qualify their existing
workforces and significant numbers of additional staff.

The Scottish Executive approached The Scottish Institute for Residential Child Care
(SIRCC) with a request to develop a corpus of practice literature around themes
relevant to working in secure accommodation to support these agencies.

Developing the papers
It was recognised that if this initiative were to have any significant impact on practice
in secure accommodation and ultimately on the experiences of the children and
young people placed there, it needed to be informed by the views and experiences
of those who work in the sector. A number of preliminary meetings were held with
providers of secure accommodation who were asked to nominate representatives to
a steering group which would help produce the papers that make up this volume.
The project was co-ordinated by SIRCC staff, one lecturer and two associates, all of
whom have management experience in secure accommodation. This group
produced a number of the papers, supported practitioners in writing others and
undertook an editorial role for the project. Research and administrative support was
provided through the services of a research assistant and the SIRCC library staff

Secure in the Knowledge - Introduction - May 2005 1

Content and format
Secure accommodation does not exist in a policy vacuum. Staff working in the
sector should be able to locate what they do within an understanding of the
development of secure accommodation as a mode of intervention with young
people. The first chapter of this volume traces the history of secure accommodation
and the policy trends that have informed the way it has developed.

A number of tensions and ethical dilemmas are inherent in any setting in which
children and young people are deprived of their liberty. The second chapter
considers the importance of practice being underpinned by an appropriate values
framework. It is only through continually revisiting, contesting and reconstructing
beliefs and assumptions that secure accommodation can become a dynamic and
powerful way of intervening in and changing the lives of children and young people
for the better. The chapter goes on to examine the importance of relationships within
a values context.

Work with children in residential care has been influenced by a number of
theoretical orientations, ranging from psycho-dynamic through behavioural, social
learning and developmental theories to the current fashion for cognitive
behaviourism. Staff on the ground can be left to draw on little bits of theory without
necessarily understanding much about where it comes from or what it says about
children, their behaviour and how we might best respond to them. The third chapter
offers a brief overview of some theoretical approaches that may be useful in helping
staff locate and think more deeply about what they do.

Staff are encouraged to reflect on their own workplaces against the historical, values
and theoretical understandings gained from these three sections, the focus of which
are primarily information giving. The next chapter moves to an applied practice
focus. It is arranged along a timeline of pre-admission, stay in care and through and
after care. The stay in care section inevitably accounts for the bulk of this chapter.
Each of the practice papers provides a context to the topic under discussion,
drawing on relevant literature on the area. It goes on to introduce some implications
for practice. Interventions though do not proceed along tram lines. What happens in
specific programmed interventions will affect and be affected by what happens in
the lifespace. Issues of anger management might (or might not) be related to
struggles over sexual identity, issues of self harm or to past abuse. These are the
kind of complex interplays that practitioners have to try to make sense of on a daily
basis. We have tried to draw some of these possible links as we have gone along.
Practitioners will themselves identify additional and more intricate ones. The ability
to make connections and not to think along tram lines is indicative of good learning.

Secure accommodation is a unique environment. It reflects many of the dynamics of
any organisation, compounded and lent a particular flavour by the enclosed and
intense nature of the setting. The fifth chapter considers some of the wider
organisational factors that impact life in secure accommodation.

The assumptions behind our thinking
Secure accommodation is a contentious area of practice. Frequently politicians, the
media and many professionals choose to portray it as providing for offenders within
a criminal justice framework. Whilst it does in some circumstances fulfil such a role,


these papers proceed from a basis of secure accommodation being located
primarily within the wider welfare model which frames Scottish approaches to
children and young people. Youth offending and how best to respond to this will be
covered in some of these papers but within a ‘whole child’ context. Similarly, secure
accommodation as a mode of intervention is located within the wider continuum of
services for children and young people.

The programme of expansion and investment in the secure estate and the
heightened political interest in this area (of which this volume is a product), offers
opportunities to develop approaches to secure accommodation that can make a real
difference to the lives of some of Scotland’s most disadvantaged young people.
Physical surroundings will be state of the art. Initiatives around ensuring appropriate
health provision and boosting expectations of educational achievement create
opportunities for secure accommodation to move significantly beyond simple
containment and keeping young people safe.

However, physical surroundings and levels of investment are only part of the
equation. Of greater importance is the quality and commitment of staff who lead and
work in secure accommodation. Ultimately they are the ones who are going to make
a difference to the lives of young people.

There are no procedures manuals or sets of standards that, on their own, can bring
about this outcome. There is no pixie dust that sprinkled in proper measure will turn
around recalcitrant youth. The only thing likely to do this in any long term and
meaningful way is the strength of the relationships young people build up with the
adults around them, the skills of these adults in using themselves for the benefit of
young people and the message given to young people that they are worthwhile,
redeemable and that they have hope of different and better futures.

Themes, around the importance of work being located in an appropriate value base,
the centrality of human relationships and a spirit of optimism, underpin our beliefs in
writing this volume. If these themes are to be translated into practice, staff working
in secure accommodation need to have fire in their bellies - they need to believe that
what they are doing is worthwhile and that they can make a difference.

Fire in the belly can be easily extinguished, however, in unsupportive work
environments. It needs to be nurtured and stoked by those who have management
and leadership responsibilities for secure accommodation. If young people are to
feel valued, staff need to feel similarly valued, stimulated and challenged. Staff
teams have a responsibility to themselves and to the service to stoke those fires.
We hope that this volume will provide some of the stimulation needed for this.

Using this volume

Staff who work in secure accommodation will come from a variety of backgrounds
and life experiences. Some will be degree educated and will have existing
professional qualifications. However, they are unlikely to have been exposed to any
training specifically on secure accommodation. Others may not have an academic
background but relevant experience. These papers hopefully have something of
interest for all of them.


There are practical, emotional and intellectual dimensions to working in secure
accommodation, or indeed any residential child care setting. We have tried to strike
an appropriate balance in our coverage of these areas.

The papers are written in such a way as to resonate with the everyday practice of
those working in secure accommodation. They reflect the experience of current and
past practitioners. They are also underpinned by the available literature on secure
accommodation and on residential child care more generally. Reflective questions
prompt practitioners to link theoretical knowledge to their own settings and their own
practice. Those who wish to extend their thinking around particular areas of practice
are pointed towards further reading. Links are also provided directing readers
towards how this material may be used to support vocational training frameworks. It
is intended too that many of the papers will prove to be useful tools in the
supervisory process and in team discussions.

Working in secure accommodation presents practitioners with a range of judgement
calls that have to be made on a shift by shift basis. Social care values such as
privacy or confidentiality cannot be absolute in such settings (and arguably in any
social care setting). They become dilemmas that need to be negotiated according to
the particular circumstances of a situation. This requires critical thinkers or reflective
practitioners. Both critical thinking and reflective practice require a context.
Practitioners need to be able to reflect on relevant content; otherwise their reflection
becomes introspective and not particularly useful. It is hoped that these papers will
provide content that links theory to practice experience, encouraging them to ask
questions of that experience and thereby extending their understanding of their
work. The most effective learning is collaborative. It happens best when undertaken
alongside others. So although these papers will hopefully have a role in helping
individuals work towards relevant qualifications, they will achieve their optimum
effect if used to involve staff teams and groups in discussing and debating particular
areas of practice. That way lies the possibility of developing learning organisations
and cultures. In learning organisations the impetus for learning and practice
development comes from a ‘bottom up’ curiosity and desire for knowledge.

The intention of this volume is not to supplant units’ existing policies and procedures
or to provide them with ‘off the shelf’ versions. Developing policies and procedures
is a task that lies with units themselves and these will reflect the different histories,
remits, philosophies and indeed physical layouts of units. Hopefully this volume will
provide a resource they can draw upon in the preparation of unit specific
documentation.

One suggestion is that units might take particular themes and develop approaches
around these to suit their own particular circumstances. There may be some merit in
taking some of the discussion and the practice development beyond the walls of
individual units, so that those working in secure accommodation develop a
community of practice around this area of work. We envisage also that the volume
will have a currency beyond secure accommodation. Many of the principles and
much of the content will have a resonance across residential child care and we
would hope that it proves useful to practitioners wherever they work.

Like any exposition of knowledge, this volume is a snapshot of where we are in time
and place. There is no universal ‘best practice.’ What we consider to be best
practice today is unlikely to be considered so by tomorrow’s practitioners. This


volume then is not definitive. There may be areas of practice not already included
that would benefit from being so at some future point. It is likely too that what is
currently written will need to be updated sooner or later.

As already indicated, practice in secure accommodation is dynamic. The loose-leaf
format lends itself to the updating and addition of new papers so that what is written
here continues to reflect the changing landscape of secure accommodation in
Scotland. The various sections are colour coded and arranged in a loose leaf folder,
allowing staff and staff groups to work their way through the papers or to identify
and work around particular ones. The material will also be available on-line on the
SIRCC website.

Running alongside the development of the volume and informed by it, the Scottish
Qualifications Authority (SQA) have produced two Higher National units on secure
care:

• SQA DMOF34 Caring for young people in secure settings

• SQA DMOG35 Supporting and managing provisions in secure care setting.

Together, these initiatives form an integrated educational package for those working
in secure accommodation.


Historical and policy context of
Chapter 1 secure accommodation
Mark Smith, Bob Forrest, Fergus McNeill &
Neil McMillan

..seek to prevent that there may be no occasion to punish.
(Dr Thomas Guthrie)

Introduction
Secure accommodation cannot be properly understood except through reference to
the way in which history and social policy have shaped the development of services.
This chapter charts the history of secure accommodation through its origins in the
approved and List D Schools. It will outline the legal context that frames the use of
secure accommodation. Social, political and demographic trends and how these
impact on the demand for secure care are identified. Readers are encouraged to
consider their own workplaces within wider historical, policy and legal contexts.

1.1 Historical background

Throughout history children and young people have been a source of social and
political concern. This chapter charts some important themes and milestones in
Scottish approaches to dealing with them. It takes as its starting point the processes
of industrialisation and urbanisation which occurred around the middle of the 19th
century. During this period new centres of population grew up around developing
industries. The emerging towns and cities attracted a flood of new city dwellers from
the countryside. Initially children were treated as economic units of production
alongside their parents and were forced to work in mills and factories to supplement
family incomes. Ironically, some of the social reforms of the early 19th century, such
as the Factory Acts, which prevented the employment of children below a certain
age, cut off any legitimate means for them to earn a living. Many were forced to do
so in other ways through recourse to begging, crime or street theatre. Children as
young as five could be imprisoned alongside adults when their actions were deemed
to be criminal. The problems caused by this growing army of displaced, and vagrant
children ('Street Arabs' as they were called) exercised the minds of social reformers
of the day.

Secure in the Knowledge - Chapter 1 - May 2005 1

The ‘Ragged’ schools

The Scottish response to the problems experienced and presented by the displaced
child on the street was in many respects an innovative and enlightened one. It drew
upon traditions of education and social welfare that had their roots in the
Reformation, which saw parishes assume responsibility for education and social
welfare provision. Industrialisation happened simultaneously with a breakdown of
the parish system. A group of Church of Scotland ministers sought to ensure the
continuance of a religious tradition in the new cities. The resultant movement led to
the Disruption of the Church of Scotland in 1843. The Disruption saw the
evangelical wing, led by Thomas Chalmers, often regarded as the father of Scottish
social work, break away from what was perceived to be an increasingly comfortable
and complacent established Kirk to form the Free Church. The mission of the
evangelical movement was to bring a Christian presence into the developing centres
of population. A practical realisation of this philosophy was the opening of the first
industrial feeding school in Aberdeen in 1841, under the patronage of Sheriff
Watson. The school sought ‘to feed, train in work habits and give basic education’ to
the children who attended. The industrial feeding or ‘ragged’ schools were
characterised by an aversion to institutional care in Scotland. They stressed a
preventative as opposed to a punitive philosophy. This was encapsulated in the
exhortations of Dr Thomas Guthrie, a pioneer of the movement to ‘seek to prevent
that there may be no occasion to punish.’

Guthrie promoted the cause of the ragged schools through three national ‘Pleas’.
The movement was a remarkable success with schools being established in every
city and most sizeable towns within months of his First Plea. Alongside the voluntary
principle went a commitment to day schools, which sought to strengthen rather than
weaken family links. Such beliefs challenge present day assumptions of the child as
merely a victim of abusive family influences, by stressing a more interactive
relationship and attempting to use the child as a positive influence upon the family to
which he or she returned each evening. Children unable to return to their families in
the evening were boarded out to what would now be called foster carers or
occasionally offered respite accommodation on school premises. Proponents of the
ragged schools were opposed to a ‘hospital’ model of care, which involved removing
children from their families into large institutions such as workhouses.

The ideas of the ragged school pioneers differed significantly from prevailing English
approaches to delinquency, which were based around a workhouse model. They
differed too in their emphasis on the importance of education. Whilst education was
considered to be a positive force contributing to social cohesion in Scotland, the
English tradition considered the education of the working classes as encouraging of
sedition.

The response to delinquency offered by the ragged schools seems to have met with
remarkable success. By the early 1850s, Governor Smith of Edinburgh Prisons
reported that, whereas in 1847 more than 5% of the prisoners in Calton Jail were
under 14, by 1851 this had fallen to less than 1%. He went on to assert his belief
that the ragged industrial schools had been principally responsible for this fall. The
success of the approach supported Guthrie’s belief that it was better to pay for the
education of the child than the imprisonment of the adult in later life.


Acts of Parliament passed in 1854 secured state funding for the ragged schools;
however, subsequent Acts of 1861 and 1865 ensured that funding applied only to
children committed to the schools through the Courts. As such the legislation
sounded the death knell for Watson’s and Guthrie's peculiarly Scottish conception of
the industrial feeding school, through superimposing the prevailing English
reformatory and industrial school model under the direction of the Home Office.
Nevertheless, an interesting insight into the durability of underpinning Scottish
beliefs is provided in a government report from 1896, which states that, ‘Scotch
reformatories are not looked upon with public favour on account of the aversion felt
by the Scotch people to the imprisonment of children’ (quoted in Seed, 1974,
p. 326).

In summary, the key features of the Scottish tradition were: the need to cater for
children’s physical needs; the importance of education; prevention rather than cure;
a focus on needs rather than deeds; the voluntary nature of provision; the
preference for day provision which maintained family ties; structure and discipline.

The rescue period
The second half of the nineteenth century has become known as the ‘rescue period’
in social welfare provision. In contrast to Guthrie's and Watson’s visions of family
oriented care, poor families came to be seen as a contaminating influence from
which children needed to be removed. This was the era of the large orphanage,
removed from public view and consciousness. One manifestation of the ‘rescue’
philosophy was the forced (or indeed voluntary) emigration of children to the
Colonies in pursuit of a better life. Large charities were foremost in the orphanage
movement, Quarriers and Aberlour being the most obvious examples. Many reform
or industrial schools operated their own assisted passage schemes. Boarding out
(fostering) was still common but, in line with the rescue philosophy, children were
sent further afield, often to isolated farms or crofts throughout Scotland. Those who
offended could be committed by the courts to reformatory schools (the successors
to the ‘ragged’ schools).

Psychoanalytic influences
The emergence of the psychoanalytic movement in the early twentieth century (see
chapter 3) led to a questioning of some of traditional and authoritarian ways of
responding to children. This led to some interesting experiments in child rearing and
education. Perhaps the best known of these are Summerhill, established in England
by a Scot, A.S. Neil, and Kilquhanity in the south-west of Scotland, established by
John and Morag Aitkenhead. These schools, known as ‘free schools’ sought to
allow children to develop free from the constraints of adult or societal oppression.
Whilst the ideas behind Summerhill and Kilquhanity remained minority ones, the
influence of Freudian psychology was also apparent in the growth of the child
guidance movement, which emphasised the importance of working with children in
the context of their family relationships. In keeping with Scotland’s educational
tradition, the child guidance movement was rooted within the field of educational
psychology. The large children’s home or children’s village, however, remained the
most common response to children who were deemed unable to live at home.


Reflective Questions

• What is the history of your unit?
• What period/phase in the development of secure accommodation services
does it reflect? (In older establishments some interesting material may be
available in old documents such as admissions books).

1.2 Legislation

The UK Children Act 1908 brought together and tidied up previous legislation
relating to children. The Children and Young Person’s (Scotland) Act 1937
established separate juvenile courts, which were required in their proceedings to
have regard to the welfare of the child. Essentially, this piece of legislation marks
the formal embodiment of the ‘welfare’ principle, which has been central to
subsequent child care philosophy and regulation. Following the 1937 Act Remand
and Reform schools were brought together under the term Approved School. The
distinction within the 1908 Act between those children who had offended and those
in need of care and protection was removed, and approved schools admitted both
categories of child. Approved Schools were funded by the Scottish Office.

The Clyde Committee, reported in 1946, in response to concerns about the welfare
of children in foster care. It also criticised large scale institutional living and
proposed that provision for children should be provided in smaller units, located
nearer to centres of population. Clyde was influenced by some of the thinking of the
child guidance movement and proposed the family as the preferred unit of care.
Substitute care was to be modelled on family life. This resulted in the development
of the family group home model, whereby groups of children were looked after by
‘auntie’ and ‘uncle’ figures, ostensibly modelling the experience on family living.
Family group homes were set up throughout Scotland in the 1960s and 70s and
were the preferred model of providing community based residential care for children.
The family group model was replicated in many List D Schools with the
housemaster/housemother system.

Kilbrandon and the Social Work (Scotland) Act 1968
A watershed in Scottish welfare provision came with the publication of The
Kilbrandon Report in 1964. This reaffirmed a ‘welfare’ as opposed to a ‘justice’
model of dealing with young people. The preferred approach was to be education….
'in its widest sense.' Kilbrandon proposed the establishment of Social Education
Departments to oversee his proposed developments. These ideas were developed
by the emerging social work lobby and taken forward in a white paper, Social Work


and the Community (1966), thereafter becoming law in The Social Work (Scotland)
Act (1968). The 1968 Act established professional social work, rather than the social
education departments envisaged by Kilbrandon and located provision for children
and young people within the new generically structured departments. The Social
Work (Scotland) Act heralded the introduction of the Children’s Hearing system.

The Hearing system involves a panel of three trained lay volunteers. A key figure in
the Hearing system is the Reporter. S/he is the administrative officer who ensures
that Panels operate within their legal remit. The Reporter’s principal function is to
decide, on the basis of reports provided by social workers, whether a child may be
in need of compulsory measures of care. If so, they convene a Hearing which will
discuss the full circumstances of a case before reaching a decision in the 'best
interests of the child'. The 'best interests' test means that any disposal made by a
children's hearing has to be justified on the grounds of what is best for that individual
child in their particular circumstances. The child and their parents ought to be full
participants in this decision-making process.

A Children’s Hearing has the legal status of tribunal and may only proceed if the
child and their parents agree with the grounds of referral. If they do not agree, the
case can be referred to a Sheriff for proof. Similarly, if a young person or their
parents disagree with the decision of a Panel, they can appeal to the Sheriff.

Children can be referred to the Children’s Panel on a range of different grounds,
only one of which involves offending, the others reflecting their need for welfare or
protection. Philosophically the system works on the same assumptions which
characterised earlier approaches, namely that the underlying needs of those who
offend and those in need of care and protection are essentially similar.

Having considered the circumstances of a case there are a number of possible
disposals open to panel members. They can impose a supervision requirement
(through which a child becomes legally 'looked after'). Being 'looked after' can, at its
least intrusive, involve supervision by a social worker whilst the young person
remained at home; however, hearings can also set a condition that attaches a place
of residence to the supervision requirement. In such cases young people become
‘looked after and accommodated.’ This particular terminology was introduced
following the passage of the Children (Scotland) Act 1995. The Children (Scotland)
Act also saw the administration of children's hearings move away from local
authority control to become centralised under the Scottish Children’s Reporter
Administration (SCRA).

If particular legal criteria are met (see section on secure legislation), hearings can
authorise placement in secure accommodation. Increasingly, other measures are
becoming available to panel members under the Scottish Executive's Intensive
Support and Management Service (ISMS). One such option for those young people
deemed to meet secure criteria (and as a direct alternative to placement in security)
is the use of electronic tagging.

Residential schools after the 1968 Act
The Social Work (Scotland) Act had envisaged the integration of child care provision
to ensure a coordinated approach to placements. It failed however to locate List D


schools, as they became known (simply due to being on an administrative list under
the heading ‘D’), within the local government structures, but maintained them as a
separately managed service within the Social Work Services Group of the Scottish
Education Department. One of the advantages of this centralised structure was the
development of the List D Schools psychological service which saw psychologists
attached to all of the schools from the early 1970’s. The psychological service was
responsible for a body of progressive thinking around child development and child
care generally.

In 1986, following a review, central government withdrew funding from the List D
Schools and essentially devolved responsibility for them to the user local authorities.
A number of schools closed around this time. Others entered into user agreements
with particular local authorities. The break-up of local government in the mid 1990s
led to further adjustments to the landscape as far as residential schools were
concerned, as the new smaller local authorities were unable to sustain sole user
arrangements with particular schools. This has resulted in schools selling beds in an
open market to a range of local authorities. This reflects a wider trend in the way in
which care is delivered in Scotland, with local authorities increasingly purchasing
services from voluntary or charitable providers rather than providing and managing
these services directly.

History and development of secure accommodation in Scotland
In the late 1950s, Chief Constables expressed concerns about the perceived
number of absconders from Approved Schools. In response to this and a riot at one
school, the Scottish Office offered building capital to any school prepared to run a
secure unit for the more recalcitrant youngsters. Rossie School, near Montrose,
eventually agreed to this and the first secure unit in Scotland (and indeed in the UK)
opened there in 1962 for 25 boys.

Over the next 40 years the number of secure beds increased significantly – doubling
in the 1970s, trebling in the 1980s and quadrupling in the 1990s. Numbers currently
stand at 96 for a mix of boys and girls. Eighty of these places are in the large units
of Rossie, St Mary's Kenmure (1975), Kerelaw (1983) and the remaining 16 in the
Edinburgh secure services, St Katharine’s (1994) and Howdenhall (1983 - rebuilt
2004), and The Elms (2000) in Dundee.

It was only after the mid 1970s that girls were admitted to secure care. The first unit
to include girls was St Mary’s, Kenmure. All other units subsequently followed. For a
few years in the 1980s and 1990s, some assessment centres operated small suites
of secure rooms (10 beds in all) but approval for the use of these was discontinued
over time. During the 1970s and 1980s, paralleling the increase in secure
accommodation, there was a steady reduction in open beds within the List D
System with the closure of 16 schools, 62% of the total Scottish system.

Secure legislation
Prior to 1983 there was no specific legislation controlling the admission of young
people to secure care (except for those young people convicted of serious offences
through the criminal courts and placed in security by the Secretary of State). A


Children’s Hearing could make a Residential Order naming a particular school which
had a secure unit, but it was up to the Head of Establishment to decide whether to
place the young person in the open or secure setting. In principle this meant that if a
young person in Kenmure, Kerelaw or Rossie open settings proved particularly
difficult he could be simply transferred to security without reference to any other
authority.

In practice, the general rule was that a young person had to have had at least two
previous placements in other List D Schools and had to be recommended by a
consultant psychologist/psychiatrist before he/she would be considered for a secure
placement. The Head of Establishment sought advice from a screening group,
which included psychological and psychiatric representatives, as to the
appropriateness of secure care for a young person. The Heads of the three large
units (which provided almost 90% of all secure beds in Scotland) met regularly
between themselves and the Scottish Office to review the overall secure situation.
They felt that there should be consistent criteria applied to young people across the
country for placement in security. Also in the early 1980s, prompted by concerns
that Scotland might be in breach of the European Convention on Human Rights –
that a person can only be deprived of their liberty after due process of law – the
Scottish Office consulted around the behavioural criteria and procedures that might
apply to placement in secure accommodation. The subsequent legislation was
appended to the Health and Social Services and Social Security Adjudications Act
(HASSASSAA) 1983 and came into effect on 1st February 1984.

The criteria laid down in the act were that:
a) he (sic) has a history of absconding and he is likely to abscond
unless he is kept in secure accommodation and if he absconds, it
is likely that his physical, mental or moral welfare will be at risk:
or
b) he is likely to injure himself or other persons unless he is kept in
secure accommodation.
The legislation was fleshed out in a Code of Practice issued by the Social Work
Services Group (SWSG, 1985) on behalf of the Secretary of State for Scotland. In
section 3.5 the Code stated that:
the use of secure accommodation for children is seen as an exceptional
measure:
only those children who genuinely need secure accommodation are placed
and kept there;
where it proves necessary to use this type of accommodation, the length of
time during which any child stays in it is restricted to the minimum necessary
to meet the child’s particular needs; and
the use of secure accommodation is seen in the context of an appropriate
child care framework which is fully consistent with the ‘welfare principle’
contained in sections 20 and 43(1) of the Social Work (Scotland) Act 1968
(The welfare principle demands that placement in secure accommodation be
justified through reference to the best interests of the child).


The HASSASSAA legislation as well as introducing legal criteria that had to be met
before a young person could be placed in secure accommodation also required that
units providing secure accommodation be registered and inspected by the Scottish
Office.

If a Children’s Hearing deemed that a young person satisfied the above criteria, it
could authorise the use of secure accommodation under Section 58 of the Social
Work (Scotland) Act (as amended by HASSASSAA 1983). The young person could
only be admitted to security if the Director of Social Work and Head of
Establishment considered it to be in the child’s best interests. In effect this tripartite
arrangement ensured that a young person could only be placed in secure
accommodation with the agreement of three independent parties – the Children’s
Hearing, Director of Social Work and Head of Establishment. The system was
designed to restrict usage and to ensure that appropriate checks and balances were
attached to the decision to deprive a young person of their liberty.

In practice, secure accommodation was regarded as part of the continuum of care
and a young person with a secure authorisation was often placed in an open setting
with an option of moving into security if deemed necessary; however, within two
years of the legislation coming into effect, the open schools at Rossie and Kenmure
St Mary’s closed leaving them as ‘stand alone’ secure units. They retained a few
hostel places for young people leaving security – not as a precursor to security.
Only Kerelaw of the larger units retained the open/secure option. A significant
proportion of those young people admitted to the open school were subject to
secure authorisation.

From the outset there was some tension around what was perceived as the limited
authority of Children’s Hearings. Some panel members wanted the power to require
a young person to be placed in secure care rather than merely authorising it. In
1984 the Government tried to introduce legislation giving such power to the
Children’s Hearing in the Miscellaneous Provisions (Scotland) Bill 1984, but after its
second reading in the Commons, the Minister responsible withdrew it following
opposition. Had such legislation been enacted it is likely that many more secure
beds would have had to be provided.

The HASSASSAA (1983) legislation did not stipulate a minimum age below which a
young person could not be admitted to secure care since until then no child under
the age of 12 had ever been admitted. However, the age of legal responsibility in
Scotland remains as low as eight. Children as young as this can and have been
placed in secure accommodation on both offence and non-offence grounds.

The Children (Scotland) Act 1995
The Children (Scotland) Act 1995, which replaced the 1968 Act in relation to social
work with children, introduced a concern for the interests of the wider community
rather than just the individual child to the Hearing system. However, it left the legal
framework for secure accommodation unchanged apart from a slight change in
wording around the absconding criteria, from 'having a history' to 'having previously
absconded'. The criteria relating to the use of secure accommodation were
incorporated in the Children (Scotland) Act 1995, section 70(10) and could be
invoked under a warrant to detain a child or as a condition of a supervision


requirement. The Regulations concerning secure care were updated and again
repeated the focus on the child’s needs:
‘Secure placements once made, should only be for so long as it is
in the best interests of the child.’
(The Children (Scotland) Act 1995 Guidance, Volume 2, ch.6:4)

The inclusion of the 'best interests' test, the cornerstone of Scottish approaches to
children, locates the criteria within a welfare frame, recognising that decisions
should be made on the basis of needs rather than deeds. The welfare principle
remains paramount in law today and is, if anything, strengthened by the overarching
principles of the 1995 Children (Scotland) Act; namely that the interests of the child
are paramount; the views of the child are taken into account, where reasonably
practical; and that any supervision requirement should be made only if it is
considered better to do so than not to do so (the 'no order principle') (Children
(Scotland) Act 1995: 17(3)).

Routes into secure accommodation
Placement through Children’s Hearings
Young people can be admitted to secure accommodation through a variety of
routes. They can be authorised to stay in security by virtue of a supervision
requirement naming a particular secure unit. Unlike normal supervision orders which
only require to be reviewed annually, secure authorisations, in line with the
imperative to use secure accommodation for the shortest possible time, need to be
reviewed every three months.

Young people can also be authorised to stay in secure accommodation on a warrant
from a children’s panel (see the Children (Scotland) Act 1995 and the regulations
attaching to this). Panel members may be likely to use a warrant in cases where
they do not have the full facts of a case at their disposal. Warrants last a maximum
of 22 days and should allow time for the preparation of reports which will allow panel
members to reach a substantive decision on a case. Warrants do not require a
young person to be placed in a particular establishment.

In emergency situations young people can be held in security in cases where the
Chief Social Work Officer and the Head of a Secure Establishment agree that legal
criteria are met and there is a need for this level of intervention. This type of
admission is sometimes termed ‘by administrative process.’ It is used in emergency
situations where there is serious and immediate risk to self or others or perhaps in
situations where a young person has been awaiting a secure placement and one
becomes available. Placements through this route need to be considered by a
Children’s Hearing within 72 hours of being made. At this point a Hearing, assuming
it agrees on the need for security, is likely to issue a warrant (or possibly make a
supervision requirement), allowing the young person to remain in secure
accommodation.

Placement through a criminal justice route
Whilst most (two thirds) placements in secure accommodation are made through a
Children’s Hearing there is provision under the Criminal Procedure (Scotland) Act
1995 for juveniles to be placed in secure accommodation through a criminal justice


route. Children awaiting trial can be held in secure accommodation on remand
Section 51 (1) allows a court to remand children under 16 years to the care of the
local authority and this may (although need not be) be in secure accommodation.
Remands are generally for an initial seven days and may extend to 110 days. The
Courts deal with more serious offences involving juveniles under solemn procedure.
Children convicted of murder may be sentenced under section 205 of the 1995 Act
and which carries a mandatory life sentence. Those convicted of other cases heard
on indictment, under section 208 will receive a determinate length of sentence.

Young people convicted of an offence under summary procedure may be sentenced
to residential accommodation under Section 44(1) of the Act for a period of up to a
year, although they can only be kept in secure accommodation if the legal criteria
within the Children (Scotland) Act 1995 are met. Again, this decision is taken by the
Chief Social Work Officer and Head of Establishment. They serve a maximum of
half sentence and may be released within that period on the decision of a review
held by the local authority. Interestingly, after sentence has been passed,
responsibility for such cases passes to the local authority and youngsters held under
section 44 are to be treated as though subject to supervision requirement, with all
this implies in terms of being granted time out of security. Again, the welfare
principle is paramount.

For all placements in secure accommodation other than those sentenced and those
remanded under Part V s.51 (1)(a)(i) (Criminal Procedure (Scotland) Act 1995) and
under Part II s.66 of the Children (Scotland) Act 1995, legislation is permissive and
its thrust is to limit the length of time a youngster is held in secure conditions. Both
the original guidance issued by the Scottish Office (SWSG, 1985) and A Secure
Remedy (SWSI, 1996), a review conducted by the Chief Social Work Inspector in
1996, emphasise the need for units to operate in accordance with quality child care
standards. A Secure Remedy draws on the UN Convention on the Rights of the
Child, re-stating that:

It should only be used as a measure of the last resort and for the shortest
appropriate period of time. (p. 5)

Young people can also be placed in penal establishments by the court if they are
deemed ‘unruly’. In such cases they do not have to satisfy the behavioural criteria
laid down in the HASSASSAA legislation. Young people in this category are placed
in Young Offenders Institutions.


• Chart the legislation governing the admission and stay in secure care of a
young person you are working with.
• Are some young people placed through a different route? What legislation
governs their placement?


Societal factors affecting secure
1.3
accommodation

The use of secure accommodation for children and young people reflects prevailing
social trends and problems. This section considers the impact of poverty and
misuse of drugs. It will examine the social backgrounds of the young people referred
to the Hearings system. The issue of youth offending will be covered in a separate
paper (4.16).

The latest estimate of Scotland's population (for 30 June 2003) is 5,057,400.
Children aged 15 and under accounted for 19 per cent of the population. The
general demographic trend sees Scotland's population falling as a result of lower
birth rates and net emigration.

Poverty
Poverty continues to cast a shadow on the lives of children and families in Scotland.
The literature on poverty differentiates between absolute poverty and relative
poverty. Absolute poverty is where individuals or families do not have sufficient
resources to access the bare essentials of life such as food, clothing and shelter.
State benefits are designed to prevent absolute poverty although there may, for a
variety of reasons, be times when people do experience situations when they do not
have enough money to get by on a day to day basis.

Relative poverty is a far more common experience, as some of the figures below
indicate. Relative poverty is a state where individuals and families cannot access
what would be considered to be a reasonable standard of living in the society they
live in. They may not be starving, but they cannot enjoy the comforts that most
people can take for granted - things like being able to organise a birthday party for
their children or going out to the cinema or for an occasional meal out. Not being
able to do things like this can lead to a grinding existence. People who experience
this kind of existence may turn to drink or drugs to alleviate the lack of stimulus or
meaning in their lives.

The present government has set targets to reduce levels of child poverty and recent
figures suggest they are making some inroads in this regard. However the gap
between rich and poor continues to increase and this has implications. Poverty and
the unequal distribution of wealth in society contribute to social exclusion. People
who cannot access some of the finer things in life are unlikely to buy into the values
of that society. Bringing up children in such circumstances can become a drudge for
parents. Children brought up in such environments are likely to lack the kind of
stimuli they need to consider alternative lifestyles for themselves.

Sharp local concentrations exist in the geographical spread of poverty. Glasgow,
overwhelmingly has the highest concentration of deprived areas in Scotland,
accounting for more than half (57%) of the worst 10% of postcode areas. Recent
research by Sheffield University found that 41% of Glasgow households were living
in poverty, the city was suffering population decline and unskilled worker numbers
were up (Dorling & Thomas, 2004).


There are then significant socio-economic factors affecting the experiences of
children and families growing up in Scotland. The kind of behaviours which lead
children and young people into lives of crime or exploitation need to take this wider
context into account.

Misuse of drugs and alcohol
The use of drugs introduces particular dimensions and difficulties to working with
children and young people in Scotland today. Drugs will affect the lives of many if
not most young people in secure accommodation either directly or through family
involvement. Amendments to legislation to include specific grounds for referral
within the Children’s Hearing system are indicative of the trends in drug use by
children in Scotland and a heightened awareness of such trends. For example,
although not a criminal offence, growing concern about misuse of volatile
substances by children and young people through the early 1980s saw the
introduction of the Solvent Abuse (Scotland) Act 1983 which then led to solvent
abuse becoming a specific ground of referral. Similarly, a growing trend in the abuse
of drugs and alcohol by children and young people saw this become a ground for
referral in 1995 when the Children (Scotland) Act was introduced.

Grounds for referral for solvent abuse have dropped considerably over the years.
This may be more of a reflection of the growing trend in the availability and misuse
of other drugs and the abuse of solvents becoming less fashionable or acceptable
within youth culture. Statistics on misuse of alcohol and drugs have only been
collected by the Scottish Children’s Reporters Administration since 1997 although in
this short period there has been a steady rise in the number of referrals on this
ground. The figure rose more than threefold between 1997/98 and 2001/02 from
553 alleged referrals. Nevertheless, referrals on grounds of alcohol, drugs and
volatile substance misuse particularly remain relatively low when compared with
other referrals.

The Scottish Schools Survey (2004), a self-reporting study examining the drug,
alcohol and tobacco consumption of pupils aged 12-15 across Scottish schools,
stated that 20% of 13 year olds and 43% of 15 year olds reported that they had
drunk alcohol in the week before the survey. Seven percent of 13 year olds and
20% of 15 year olds reported that they had used drugs in the month before the
survey.

Cannabis was the drug most frequently reported as having been used. Boys were
more likely than girls to have used drugs and many more pupils have been offered
drugs than have ever tried them. More than a third had been offered one or more
drugs, and again, boys were slightly more likely to have been offered them than
girls. Unsurprisingly the likelihood of ever having used drugs was found to increase
sharply with age.

Whilst the issue of drugs evokes considerable public anxiety and confronts staff in
secure accommodation with particular problems, the impact of alcohol remains
perhaps a more common concern. Alcohol abuse is implicated in a range of the
difficulties that bring young people into secure accommodation, again either directly
or as a result of family histories of alcohol abuse.


Smoking, drinking and drug use were all found to be highly interrelated behaviours.
Pupils who smoked were more likely to drink and vice versa. Similarly, pupils who
drank or smoked were more likely to take drugs. Social characteristics were also
significant with drug use and smoking more prevalent amongst those in relatively
disadvantaged groups such as those taking free school meals and those in lower
socio-economic groups.

Children referred to Children's Hearings
The rationale for an integrated system dealing with both children and young people
who offend and those in need of care and protection is that they are considered to
have much in common in that the roots of their difficulties often stem from broadly
similar experiences of disadvantage and social adversity. Studies, such as the youth
transitions study being undertaken by Professor David Smith at Edinburgh
University, support this assumption (see website listed in references).

Around 40,000 children are referred to the Reporter to the Children's Panel each
year. Those referred experience high levels of social adversity. In 2003 the
Children's Reporter's Administration conducted a small scale study on the case files
of those children referred in three different geographical areas (SCRA, 2004). The
main findings of the study were:

Almost half of children had physical and/or mental health problems.
58% had social, behavioural or emotional difficulties.
33% had experienced physical, sexual or emotional abuse.
37% had been neglected or diagnosed with failure to thrive.
36% of their parents/carers had mental health problems.
43% of children had experience of domestic abuse in their homes.
39% of parents/carers abused alcohol.
35% of parents/carers misused drugs.

Children in all three areas studied experienced these problems despite different
levels of affluence and deprivation.

The vast majority of young people in the Children's Hearing System because of their
offending live in poor economic and social circumstances and the most persistent
offenders have the highest levels of social adversity. Children who end up in secure
accommodation are likely to have experienced a range of personal and family
problems which have contributed to their placements there. The behaviours of
children and young people therefore need to be understood in the context of their
social circumstances, and the regimes in secure units need to recognise and seek
to address the multiplicity of these social problems.

Over the period of its existence, the emphasis of referrals to the Reporter has
changed. Whilst there has been some increase in the number of referrals on offence
grounds over the past ten years, referrals on care and protection grounds have
almost doubled over the same period. It is considered that the steep rise in
protection referrals reflects the impact both of drug abuse and changed professional
attitudes in the reporting of domestic violence as well as a wider interpretation by
society of what constitutes lack of parental care, child abuse and neglect.



• What social issues face the young people you work with and their families?
• How might these have contributed to the young person’s placement in secure
accommodation?

1.4 Developments in residential child care

The early 1990s witnessed the uncovering of a number of abuse scandals in
residential child care. These spawned a number of Inquiry reports, primarily in
England. The major policy document in Scotland was the 'Skinner Report' Another
Kind of Home, (SWSI, 1992), a wide ranging review of residential child care. The
report discussed the purpose and role of residential care in general terms, and then
proposed a set of fundamental principles to provide a framework within which
relevant standards for evaluating the quality of care could be developed. The
'Skinner Principles', have provided a backdrop to any developments in residential
child care in Scotland since their publication. The eight principles are;

• Individuality and development
• Rights and responsibilities
• Good basic care
• Education
• Health
• Partnership with parents
• Child centred collaboration
• A feeling of safety

The report also reviewed historical changes in the nature of residential care: how it
had shrunk as a proportion of total numbers of children and young people in the
care system, and how the average age of children and young people in residential
care had increased to the point that the vast majority of children cared for in
residential settings were now adolescents.

It went on to tackle issues of training and qualifications and of management,
planning and inspection, again making a series of recommendations, including
targets for numbers of qualified staff. It recommended that child care agencies
should aim to achieve a position in which 30% of all residential child care staff and
90% of all senior residential child care staff held a Diploma in Social Work or
equivalent. In addition, 60% of residential child care staff were to be assessed as
competent at HNC/SVQ level 3. The Diploma in Social Work was at the time the


baseline professional qualification for practicing social workers. It has recently been
replaced by an honours degree. One of Skinner's recommendations led to the
establishment of the Centre for Residential Child Care.

The Skinner Report was underpinned by three important research studies: a review
of the literature; an evaluation of statements of functions and objectives of children's
homes; and a questionnaire completed by officers in charge of children's homes in
Scotland.

The second significant Scottish report pertaining to residential child care in the
1990's was the Children's Safeguards Review (Kent, 1997). This made a number of
recommendations for improvements to children's safety, and for staff recruitment
and training, and carried out a major literature review. Among other things it
tentatively explored the possibility of developing training along the lines of a
European 'social pedagogy' model, but this has not been followed up. One of Kent's
recommendations envisaged the development of a centre of excellence in various
aspects of residential child care education and development. This recommendation
resulted in the establishment of The Scottish Institute for Residential Child Care
(SIRCC), which built on and developed the role of the Centre for Residential Child
Care.

1.5 Recent policy trends

Recent years have seen the establishment of two new statutory bodies with a role in
residential child care. The Scottish Social Services Council (SSSC) is responsible
for the registration of individual workers. All those who work in the social care field
will have to be registered with the SSSC and to hold specified qualifications deemed
appropriate to the task. The Council's qualifications framework has set minimum
registration requirements for residential child care workers at HNC (in any discipline)
and SVQ (level 3). Skinner's targets to qualify a proportion of the workforce up to the
level required for other areas of professional social work have been dropped.

Residential child care staff have to meet the requirements for registration with the
Council by 2008/9 if they are to be employed or to continue in employment. As well
as maintaining a register the Council regulates professional and vocational
education and publishes codes of conduct for all staff. It has the power to de-
register staff for breaches of the codes of conduct. In addition to the Council’s
powers to de-register staff, the government has set up a consultancy index, which
will contain information about staff considered unsuitable to work with children.
Organisations are required to check with the index before employing anyone to work
with children even in a voluntary capacity.

The Scottish Commission for the Regulation of Care (the Care Commission) has
responsibility for registering and inspecting all residential child care units whether
provided by local authorities or other agencies. Secure accommodation, which has
until now been inspected by SWSI, is now also the responsibility of the Commission


(and Her Majesty's Inspectors of Education - HMIE). Inspections take place against
a framework of national standards (although these do not specifically relate to
secure accommodation). The Commission has powers of enforcement including the
right to impose conditions on registration, report cases to the procurator fiscal and to
de-register services, including emergency de-registration if necessary.

The establishment of the SSSC and SCRC are consistent with government priorities
to improve standards in the workforce and improve protection for social service
users. Other priorities include improving partnership and improving service delivery
and efficiency.

The partnership strand in the government's priorities acknowledges that people's
needs are often complex and cannot be met by any one professional group.
Services therefore have to cross professional boundaries in order to meet the range
of these needs. In secure accommodation for instance, young people may have
general health needs, mental health difficulties, a drugs problem and particular
family problems (which will be covered in more detail in chapter 4), all of which need
to be addressed to help them move forward. The government's aim is that the
different services responsible for these services work together in a 'joined up' way to
provide them as seamlessly as possible. This policy aim is underpinned by
particular policy initiatives:

Joint Future brings together health and social services;

For Scotland's Children draws together education and social work for children and
young people;

Youth Justice Strategy Groups set up in every local authority bring together social
work, housing, the police and the Reporter to the Children's Panel amongst others
to address issues of youth crime and disorder.

The final strand, that of improving service delivery and efficiency, aims to bring all
services up to the standard of the best. The 'best value' reviews which social work
services are obliged to undertake, and the focus on targets and outcome measures
are all part of this drive towards improving service delivery.

1.6 Recent trends in criminal justice

In post-devolution Scotland, policy developments in the field of youth justice have
been rapid. Recent trends see a challenge to the general consensus that has
existed to this point around the appropriateness of a 'welfare' based approach to
working with young offenders.

In order to understand recent developments around secure accommodation it is
helpful to know a bit about trends in criminal justice. Put simply, in the 1970s and
1980s there was a sense amongst those working in the field that offending did not
respond particularly well to social work intervention. A catchphrase at that time was


'nothing works,' essentially suggesting that doing nothing might be the best
approach to work with offenders. Most would grow out of their offending, some
would not.

Over the 1990s a literature developed that indicated that some types of intervention
were in fact more effective than others in helping offenders turn round their
behaviours. The professional focus turned to ‘What Works?’ This is a phrase that
has characterised criminal justice social work ever since. It is linked with a political
push towards ‘evidence-led practice’ where interventions are evaluated as to their
effectiveness. A manifestation of this wider trend is the proliferation of programmes
aimed at tackling offending behaviour. There is a drive to have programmes
‘accredited’ in order to identify those for which there is some evidence of
effectiveness. Current thinking seems to favour cognitive behaviour based
programmes as being the most successful, although there are question marks
around whether much of the population of secure accommodation has the
intellectual, emotional or developmental capacity to make best use of such
programmes. The effectiveness of such approaches in isolation of the wider care
experience is also questionable. Most of the 'What Works' focus was on adult
offenders. Youth offending, for the most part, continued to be dealt with in children's
hearings and approaches reflected the welfare underpinnings of this system.

The first intimation of a change in direction in youth justice came in 1999 when the
Scottish Cabinet set up an Advisory Group on Youth Crime with a remit to:
assess the extent and effectiveness of options currently available
to Children’s Hearings and Courts in cases involving persistent
offenders, and look at the scope for improving the range and
availability of options aimed at addressing the actions of persistent
young offenders

The Advisory Group’s report reflected a focus on how best to respond to those
already involved in persistent offending. One of the key issues identified concerned
responses to 14-18 year olds. It was felt that the gap between the welfare-oriented
children's hearing system and the adult criminal justice system was too stark, yet
young people could move between the two almost overnight. The report sought to
mediate some of these contrasts, advocating that:
the system should promote the responsibility of the community for
the young people it produces, support community safety and
recognise the rights of the young person to the due process of law.

The report concluded that:
there needs to be a unified approach at the practical level,
combining care and protection with the public’s concerns over the
need to address offending behaviour.

The Advisory Group, whilst acknowledging the political concern with addressing
offending, did retain some of the broad principles of the Scottish system. Its findings
were located within a broader discourse of effective intervention which struggled to
look beyond individuals and families for both the ‘causes’ and ‘cures’ of persistent
offending.


A change in direction came in June 2002, when The Executive’s ‘10 Point Action
Plan on Youth Crime’ was published (Scottish Executive, 2002a). It included new
measures to tackle persistent offending: a pilot of a specialist Children’s Hearings to
fast-track persistent offenders under 16; a youth courts feasibility project for
persistent offenders aged 16 and 17 (with flexibility to deal with 15 year olds); and a
review of the scope for imposing Restriction of Liberty Orders, Anti-Social Behaviour
Orders and Community Service Orders on persistent young offenders. The Plan
also announced proposals to develop national standards for youth justice, to
promote parental responsibility and to consider increasing the number of available
places in secure accommodation. When the National Standards were subsequently
issued in December 2002, they set as the national target for Youth Justice Services
to reduce the number of persistent offenders by 10 per cent by 2006. Objective 5
within the National Standards deals specifically with secure accommodation. It is to
‘target the use of secure accommodation appropriately and ensure it is effective in
reducing offending behaviour’. This standard requires that records are kept in
relation to numbers of secure authorisations made and numbers of authorisations
made but not implemented by the chief social work officer or principal of a secure
unit. These figures are to be made available to appropriate agencies and
communities.

Provisions of this standard which affect practitioners are:
All relevant background information, including the ASSET/YLS-
CMI assessment (see paper 4.18), held on the young person
should be passed by the young person’s caseworker to the secure
unit within two working days of admission. Information that may
indicate concerns about risk of harm either to self or to others
should be passed on immediately.
The young person should have a named caseworker from within
their home authority with whom the secure unit maintains regular
contact and who is responsible for developing the aftercare plan
for the young person.
An action plan detailing the objectives for the care of the young
person while in secure, including educational provision and a
health assessment, should be completed by secure staff, within
ten days of their entry into the unit.
The individual’s plan should be reviewed at least monthly by the
unit, the named caseworker, the young person and their
parent/advocate. (see paper 4.04)
Other provisions within this standard relate to aftercare
arrangements (see paper 4.27)

The passage of the Antisocial Behaviour etc. (Scotland) Act (2004) underlines the
Executive’s commitment to driving forward their agenda on youth crime.


1.7 The expansion of the secure estate

The expansion of the secure estate needs to be understood against the backdrop of
the above changes in thinking around criminal justice and particularly around youth
crime and disorder. In March 2003, the Scottish Executive announced an increase
in the number of beds to 125 by 2007. Following the recent announcement about
the imminent closure of Kerelaw, the proposed configuration of places is:
Good Shepherd (Bishopton) 18
Howdenhall (Edinburgh) 5
Kibble (Paisley) 18
Rossie (Montrose) 18
St Katharine’s (Edinburgh) 7
St Mary’s Kenmure (Bishopriggs) 31
St Philip’s (Airdrie) 24
The Elms (Dundee) 4
Total 125
Of these, 13% will be owned and managed by local authorities and 87% by the
charitable/not for profit sector. The agencies providing the service have long
traditions in residential child care. Unlike in England where young people can be
locked up in local authority secure units, secure training centres or in the prison
system, there remains a discernible system of secure accommodation in Scotland.
This offers opportunities to develop practice through dialogue among providers.

Trends in the use of secure accommodation
In relative terms Scotland places more children in secure accommodation than
England and Wales, although the comparison is not a direct one due to the different
ways secure accommodation has developed in the two countries. Nevertheless,
even taking these differences into account, Scotland has a higher proportion of
juveniles in secure accommodation.
Demand for secure accommodation has remained fairly static since the late 1990s.
Within this general picture there have been some changes in patterns of admission.
Admission of boys aged 14 and 15 increased by over 50%, whilst admissions
through the Courts as opposed to the Hearing system have more than doubled.
Admission of children direct from the family home rather than from other parts of the
care system has also doubled.
Children are staying for longer in secure accommodation rather than more of them
needing this type of care. There is an increasing gap between the length of time
between release and readmission in those cases where young people have to be
re-secured. This suggests that secure units are taking fewer risks in moving children
on from secure accommodation. The longer stay in security may also be linked to
the proliferation of programmes targeting particular patterns of behaviour, such as
sexual aggression.


There are considerable geographical differences in the use of secure
accommodation, with some authorities using significantly more places than others.
Some of this difference might indicate variations in social composition and social
problems between areas, but they also reflect different policies and practices.
Research (Harris & Timms, 1993) suggests that one of the biggest determinants of
the use of secure accommodation is accessibility to a secure unit. Thus, authorities
that manage secure accommodation or have ready access to beds are likely to be
the biggest users. Authorities that do not have such access may be forced to think
more creatively about how they support young people without the use of secure
accommodation.
Secure accommodation is a costly resource. The average weekly cost in 2002/2003
was £2,750 per young person.

Implications for secure accommodation
Recent changes in the political profile of secure accommodation shift its emphasis
from primarily a welfare focus to one where there are increased expectations to
address offending behaviour very directly. In such a climate units may feel under
pressure to be seen to be doing something about ‘offending behaviour’ rather than
dealing with the whole child or young person. There is an inevitable pressure to
respond to what they believe referring agencies such as local authorities and the
Scottish Executive want. The perceived demands of the marketplace can drive the
type of service offered.
Yet secure accommodation continues to operate within what is essentially a welfare-
oriented system. It can be argued to occupy a complex and potentially contradictory
space in provision for children and young people. As a mode of intervention it has
been characterised as operating ‘Between hospital and prison or thereabouts’ as the
subtitle of Harris and Timms (1993) suggests.
Once a child is admitted to secure accommodation particular priorities become
apparent. The SWSI over recent years inspected secure units against the
framework of Skinner’s Principles, which are broad and require a comprehensive
approach to children's needs. Over the past decade, inspectors have pushed
agendas which emphasise the importance of a broad educational curriculum along
the lines of that on offer in mainstream schools. They also stress the importance of
addressing the health (including mental health – see relevant papers in chapter 4)
needs of those young people placed in security. Another focus is on improved
assessment and programmes of intervention.

A role for secure accommodation
In this potentially confusing space practitioners might find it helpful to think of secure
accommodation within a wider conceptual frame.
Fulcher and Ainsworth (1985) identify four societal resource systems within which
group care facilities are located; health care, education, social welfare and criminal
justice. The purpose of each of these systems is respectively to treat, teach, nurture
and control. ‘All of these systems’ they argue, ‘embody value preferences,
organisational features and occupational characteristics that reflect these purposes
(p. 6).’ They go on to say that:


..any group care centre has in various ways to incorporate aspects
of treatment, teaching, nurturance and control according to the
specific needs of children referred there. Yet experience has
shown that the ethos of most group care centres is heavily
dominated by the single yet simplistic purpose that underpins the
resource system sponsoring a centre. This often results in the
overall developmental needs of children being overwhelmed by a
single purpose, which although important, is an incomplete
response at best. (p. 7)
They continue:
It is worth noting, however, that facilities which seek to transcend
or overlap boundaries, and in that respect respond to a broader
conception of children's developmental needs, are invariably the
most controversial programmes. Public debate frequently
surrounds the operation of these programmes, with strong
pressure being exerted from many sources for these group care
services to concentrate on a single purpose rather than operating
from a multi-purpose orientation. (p. 8)

Secure accommodation by its nature overlaps boundaries. It is expected to meet a
broad range of children's developmental needs. As such it is likely to be a
controversial area of practice. Given this complexity of task and competing public
perceptions about its role, staff who work in secure accommodation may feel they
are pulled in different directions. Their difficulty is compounded by the fact that the
time a young person spends in secure accommodation is limited (other than for
those placed under sections 205 or 208). The period to be spent in security will
determine what can be done in this time. It may be worth considering what can be
done realistically within limited time-scales.
The primary task of secure accommodation is to bring some order and control to
young people whose lives have been out of control. This is done through the
physical confines of the building but also through the rhythms and routines of care
(see paper 4.06) and through exposure to caring and authoritative adults. The
establishment of these relationships are critical and, even if only short term, they
may act as templates for future relationships. The next task is to get some sense of
where young people are coming from, what are some of the defining features of their
lives and where they might move onto from secure accommodation (see paper
4.04). There is then a role to address specific problems. Some of this may involve a
'first-aid' type role such as ensuring appropriate medical and dental treatment. other
aspects of intervention may involve pieces of work around specific difficulties such
as offending, self-harm or drugs/alcohol misuse.
None of this work however should take place in a vacuum. Staff need to keep an eye
on the next move, and to build in family and community links so that any progress
made in secure accommodation can be carried through beyond placement. A
number of agencies can complement the work done in secure accommodation.
Increased concern over youth justice for instance has brought with it a number of
initiatives aimed at supporting young people who offend. Agencies such as SACRO
and Includem may have a role to play in providing a continuum of provision and
support to young people before during and after their stay in secure accommodation.



• Look out some inspection reports from your unit (or, if none are available, from
other secure units. These are public documents and are available on-line).
What are some of the main issues inspectors identify?

Conclusion
This chapter has attempted to locate secure accommodation within historical and
policy contexts. Some key themes which should be borne in mind when considering
practice in secure accommodation are:
• the use of secure accommodation involves the deprivation of an
individual’s liberty. This is a serious step that should only be taken
within exceptional circumstances and for the shortest possible
time.
• secure accommodation needs to operate in the best interests of
the child where ‘needs rather than deeds’ are paramount.
• secure accommodation should be considered within the wider
context of families and communities.
• secure accommodation needs to have regard for the ‘whole child’.
As subsequent papers in this volume suggest, addressing
community interests such as reducing offending requires such a
broad focus on the child within this wider social context.

Training links
HNC in Social Care:
HN unit Caring for young people in secure care settings: outcome one (optional
unit).

Further reading

Furnivall, J., Macquarrie, A. & Smith, M. (unpublished). A review of residential child
care in Scotland. Glasgow: Scottish Institute for Residential Child Care. As the title
suggests, this provides a review of residential child care in Scotland, identifying
salient policy developments and the implications of these.

McGhee, J., Mellon, M. & Whyte, B. (2005). Meeting needs addressing deeds –
working with young people who offend. NCH Scotland. A good account of working
with young people who offend drawing on the principles of the Kilbrandon Report.

McNeill, F. & Batchelor, S. (2004). Persistent offending by young people: developing
practice issues in community and criminal justice, Monograph 3. London: National
Association of Probation Officers. A comprehensive outline of a range of issues,


such as risk assessment and restorative justice, that are central to current debate
on youth justice.

Scottish Schools Adolescent Lifestyle and Substance Use Survey 2004 Interim
Report (October 2004). A survey undertaken by the Child and Adolescent Health
Research Unit (CAHRU), The University of Edinburgh, commissioned by the
Information Services Division of NHS National Services Scotland on behalf of the
Scottish Executive.

Seed, P. (1974). Should any child be placed in care? The forgotten great debate
1841-74. British Journal of Social Work, 3, 3, 321-330. Provides a fascinating
account of the ideas behind the Aberdeen Feeding Schools.

Smith, M. (2002). Stands Scotland where it did? Perspectives and possibilities for
child and youth care. CYC-Online. Issue 47 Dec 2002, www.cyc-net.org/cyc-online/
cycol-1202-smith-scotland.html

Smith, M. & Milligan, I. (2005). The expansion of secure care places in Scotland: in
the best interests of the child? Youth Justice, 4(3), 178-191.

Websites
http://www.childrens-hearings.co.uk (provides some background to the Hearing
system and its workings).

http://www.law.ed.ac.uk/cls/esytc/aboutthestudy.htm (the website of the youth
transitions study, which gives access to the developing body of work being
undertaken by the team - a useful source for those wanting to understand
contemporary youth issues in Scotland).

The Scottish Parliament's Justice 2 committee's report on youth justice will be
available shortly on their website:
www.scottish.parliament.uk/business/committees/justice2/index.htm


Values and ethics in secure
Chapter 2 accommodation
Mark Smith

Care is a practice rather than a set of rules and principles… It involves both particular acts of
caring and a ‘general habit of mind’ to care that should inform all aspects of a practitioner’s
moral life.
(Joan Tronto, 1994, p. 127)

Introduction
Secure accommodation as a field of practice sits at the interface of different
resource systems. It is expected to treat, teach, nurture and control. At different
points, the emphasis will fall down more on one side than the others. Those who
work in secure accommodation and those who take an interest in it might have
different perspectives as to what its primary purpose might be. Ultimately, many of
these differences come down to differences in values. This chapter will consider
some fundamental questions around the nature of childhood, the nature of care,
values and ethics, and an ethic of care.

If values are fundamental to care so too are relationships. Change and growth occur
when human beings interact with one another in ways that are mutually beneficial
and growth-enhancing. Residential child care can be a medium for growth, not only
for the young people who live there, but also for the staff who work there.
Relationships need to be played out in an ethical context.

If values and relationships are central to practice in residential child care it becomes
essential that staff who work in this field are given the opportunity to examine values
and to explore the nature of the personal and professional relationship. These are
vast areas, taking us into the realms of philosophy. They are areas of practice that
are underdeveloped in residential child care in this country. This chapter merely
skims the surface, but also it is hoped offers some perspectives that might prompt
discussion in teams and further reading by individuals.


2.1 What is childhood? Constructing children

Childhood does not exist; we create it as a society, as a public subject. It is a social, political
and historical construction.
(Rinaldi, 1999, cited in Moss & Petrie, 2002, p. 55)

Some of the first questions we need to address may at first reading seem silly. We
probably think that what we mean when we use terms such as children and
childhood is self-evident. But is it? We have seen in Chapter 1 that in early Victorian
times, five-year-olds could be sent out to work or even imprisoned alongside adults.
Why do we not do so today? In fact we have gradually extended the period we know
as childhood through policies such as the raising of the school leaving age. Our
understandings of children and of childhood have changed. We have come to see
them less as economic units or as morally rational and responsible beings and more
in need of adult care, protection and guidance. Why?

Other than physical immaturity there are few tangible characteristics that mark
children or childhood out as a discrete stage of human development (and even
physical development can be extremely variable). In most respects we create
children and childhood by the ways in which we have come to understand them
historically, culturally, socially and politically. They become defined by the kind of
beliefs and assumptions we make about them and by the kind of policies that follow
from these. This way of thinking is called social constructionism.

In present day society we construct children in a number of different, sometimes
contradictory ways. It is important that we understand how we do so as this will
determine how we think about them, the kind of services we put in place for them
and the kind of relationships we enter into with them.

Constructing the child as villain
As was noted in Chapter 1 there has been a hardening of political and public
attitudes in recent years towards young people who offend. We are faced with story
after story in the media about youth crime and ‘ned’ culture. It can be an easy step
to demand that something be done to counter such behaviours. Indeed, there have
been a number of policy developments designed to allay such public concerns, one
of these being to increase the number of places in secure accommodation. Others
include the provisions of the Anti-Social Behaviour Act (2004). Proponents of such
legislation argue that it is about making people and communities safer. Critics claim
that such correctional measures risk demonising young people. Staff working in
secure accommodation are not inured to these wider social and policy debates. In
practice they are manifest in increasing demands to be seen to address offending
behaviour more directly than in the past. In such a climate, care has to be taken that
the regime in units does not become overly correctional or punitive.


Constructing the child as victim
Criteria for secure accommodation draw in not just those who offend, but also those
deemed to be vulnerable and needing protection. Over the past 20 to 30 years, child
protection has been the dominant professional concern in work with children and
families. Just as we are faced with a media barrage over the need to stamp down on
youth crime, we are also confronted with newspaper stories or policy initiatives
which seek to protect children. Consider the concern generated over child abuse,
the measures put in place to tighten the vetting of those who have access to
children, or the ongoing debate about the appropriateness or otherwise of smacking
children. Such measures speak of constructions of childhood which see children as
vulnerable and needing protection from predatory or abusive adults.

The child abuse discourse also proceeds from a position of children being
traumatised by the effects of past experience. Most of the children who are placed in
secure accommodation have experienced a range of life experiences that might
result in trauma. Past trauma can indeed have a fundamental impact on current
functioning. Such an orientation can push staff in the direction of wanting to counsel
young people to try to get to the root of their difficulties. A risk in such situations is
that staff are insufficiently knowledgeable or skilled in such interventions and may
do as much harm as good. They may also underestimate the resilience of many
young people (see chapter 3).

Both of the above constructions of childhood place adults in positions of power over
young people. In the former case, that power derives from an urge to control; in the
latter from a desire to protect, which again makes assumptions about the superior
knowledge of adults in determining what is right and wrong for children.

The child with rights
There has been an increasing awareness and emphasis on children’s rights over
the past two decades. Elsewhere in this series of papers (paper 4.20) we outline the
background to, and implications of, adopting a rights perspective in secure units.

At this stage it is worth reflecting on how a rights perspective might lead to young
people being constructed in different ways. If rights are considered only legally
rather than within broader moral and ethical frameworks, there is a risk that society’s
responsibilities to young people become limited to ensuring that a due process of
law is followed in any decision to place them in secure accommodation. An example
of this might be the fact that young people now have legal representation built in to
the decision to place them in secure accommodation. This has not led to fewer such
placements or to children’s rights being interpreted or addressed beyond ensuring
that the legal process was properly followed.

Within a predominantly legal frame of reference, if young people have rights they
are also deemed to have responsibilities. Some commentators (e.g. Goldson, 2002)
argue that we currently ‘responsibilise’ and ’adulterise’ young people too readily
without taking into account their particular status or needs as children. We can
impose too great a responsibility and rationality upon them. This way of thinking can
be argued to have contributed to the increased use of secure accommodation and
custody over recent years.


The child with agency
The constructions identified above position children and young people in relation to
adult systems and adult ways of thinking. Adults within such interpretive frames are
called on to control, protect or safeguard the rights of young people. Recent writing
(Moss & Petrie, 2002) suggests that we need to re-examine the ways in which we
think about children and childhood and about the kind of relationships we have with
them. Such writers suggest that children have ‘agency’; a status and certain natural
rights that accrue to them as children, not just as ‘becoming’ adults.

Adopting such an approach to children and childhood has implications for the way
adults work with them and ‘are’ with them. The power differential becomes less
pronounced and adults and children enter into relationships in which they can both
grow and develop. Such an orientation to practice requires that rather than one
party (the adult) being cast in the expert role, both parties strive to enter into some
shared rhythm or way of being together. They construct common meaning and
understanding within that developing relationship.

None of this detracts from the need for adults to impart their own wisdom to young
people or to impose appropriate authority when required. It does, however, mean
that adults operate with a greater humility than is sometimes the case, accepting
that they, as much as the young person, can grow and change through their shared
relationship. It also requires that units and agencies operate similar standards and
expectations of behaviour for both adults and young people.

Generally, a co-constructivist approach (whereby adult and young person together
construct meaning from their relationship) calls for different ways of thinking about
children and childhood. It means we need to start enjoying and celebrating children
rather than fearing and seeking to control them. Once we can do this control issues
start to take care of themselves to a far greater extent.

The whole child
Of course, any meaningful approach to working with young people has to take into
account all of the above dimensions and to acknowledge the overlap between them.
Villains are as often as not also victims. All young people have certain rights and
responsibilities appropriate to their age and stage and they all ought to be
recognised as having ‘agency’ - that ability to exert some control over their own lives
and their own decision making. This is what Kilbrandon (see Chapter 1) had in mind
when he spoke of the need for a whole child approach. We cannot
compartmentalise young people. We need to see them and to respond to them in
their entirety.


• What is the dominant construction of children and childhood in your unit?
• Can you think of any examples of practice that back up your answer?


2.2 What is care?

Having cast some doubt upon whether terms such as children and childhood are
straightforward, let us now turn our attention to what constitutes care. Just as our
understandings of children and childhood reflect different historical and cultural
assumptions, so too do our understandings of the concept of care. Cameron
(drawing on predominantly English legislation) tells us that over the past century or
so our understanding of care:
..has come to equate with ‘welfare’ and the scope of care has
widened from food and shelter (1908) to maintenance,
accommodation and proper development (1948) and finally to
include at least a partial sense of the child and their family as co-
participants in care through, the ‘wishes and feelings’ and
‘partnership’ dimensions of the welfare principle in the Children Act
1989.
(Cameron, 2003, p. 90)

So our understanding of what care means has shifted over the years. This, perhaps,
calls us to question and keep under review the prominence we afford to particular
aspects of the task at any one time. Current ‘best practice’ reflects only current
dominant concerns and understandings, which are located historically and culturally.

Cameron goes on to say that the assumptions that frame the management of care
services have also changed, moving away from a faith in professional judgement
and expertise towards a greater focus on the managerial role and on target setting.
She cautions that target setting approaches ‘potentially reduce public care to
addressing these targets rather than an holistic care relationship with a young
person’ (Cameron, 2003, p. 91). This is something to be aware of, for it impacts
significantly on what we consider care to be. Is it a set of instrumental tasks or is
there an emotional, affective dimension to it?

Care: A technical or adaptive task?
Staff in residential child care settings, as in any other walk of life, will have their own
views of what constitutes the right way to raise children. Some of these views will
reflect their own personal, family or religious values and beliefs. If staff were brought
up believing that children should be seen and not heard, this will have a bearing on
the way they approach the children and young people they work with, They may
accept or reject such approaches and either reinforce or challenge them in practice.

If staff believe that children should be allowed to experiment and make mistakes
free of adult control, that value too will impact on their work. The likelihood is that
every unit will include staff who hold very different but strongly held views about how
best to bring up children and about the nature and purpose of secure
accommodation. This can lead to a number of tensions and possible conflicts in staff
teams.

Roger Kent (1997) cautions that 'belt and braces don't make good trousers'. This
statement expresses a fairly basic truth about residential child care. Good quality,


growth-enhancing care does not come out of house rules, procedures manuals or
quality standards. These all have their place, but only as props to something deeper
and more diffuse. That which is deeper might be thought of in terms such as ethos,
culture, shared values or social climate.

In some ways it is what a place feels like rather than what it looks like in the
brochure. That which is more diffuse entails that there is no practice manual that if
followed necessarily leads to a good care experience. To believe that it might
misrepresents care as a technical task, akin to servicing a car. Heifetz, a writer on
leadership, distinguishes between technical and adaptive tasks (Heifetz, 1994).
Technical tasks or problems require technical solutions. Adaptive tasks or problems
require adaptive solutions. They involve the negotiation of a range of value conflicts.

Child care is an adaptive task, involving and demanding the negotiation of a series
of value conflicts. Secure care, because it involves the extreme step of depriving
young people of their liberty, especially requires that issues around values are kept
to the fore.

Values are rarely absolute but need to be continually examined and negotiated.
Consider what can be postulated as social care values, such as privacy or
confidentiality. In secure accommodation these become dilemmas. There are times
when privacy cannot be guaranteed. There may be times when intrusive practices
such as searching are required. There may be information that cannot be kept
confidential if it risks harming an individual. In situations such as these staff need to
find some acceptable compromise which, as much as possible, preserves human
rights and dignity.


• Think of a time you have experienced care. What did it feel like?
• What kind of care is offered to the young people in your unit?

2.3 What are values and ethics?

The whole area of values and ethics is somewhere practitioners rarely go in any
depth. Yet values are central to just about everything we do. Care, above all, is a
moral and ethical endeavour. So what do these terms mean?

Values tend to reflect our own belief systems and as such have a personal
dimension to them. I may believe, for instance, that abortion is wrong. Someone
else with equal conviction might believe that a woman has a right to choose. These
are our respective value positions.


Morality is the wider philosophical concern about what is right and good.

Ethics, according to Ricks and Bellefeuille (2003) refer to ‘a set of moral principles to
live by.’ They go further and define professional ethics as ‘those principles for
professional conduct that are used to guide practitioners in making ethical choices.’
(p.119)

Ethics are increasingly brought together in professional codes or codes of conduct.
The obvious example of this is the Scottish Social Services Council’s Code of
Conduct, by which all those registered to work in social care settings in Scotland are
bound.

However, codes of ethics themselves make certain assumptions about the nature of
ethics. Are ethics universal, rational and legal or are they more contextual, intuitive
and compassionate? Some feminist writers suggest that the former approach
represents a particularly male approach to ethics whereas women would tend
towards the latter.

Practitioners need to be aware that codes of ethics don’t provide the answers to
many of the moral dilemmas they face in practice. There will be occasions when
individual workers or teams will need to take responsibility for ethical decisions,
rather than relying on universal codes to give then clear-cut answers. Think for
example of a 16-year-old girl who is self-harming. She has a gaping wound that
needs stitched, yet she is refusing to comply with medical treatment. In such
situations, legal, medical, moral and personal values systems may all conflict.
Practitioners have to find ways through such dilemmas with both feet grounded in
the real world and to make complex judgements based around what they feel is the
right thing to do in the particular circumstances. As Ricks and Bellefeuille (2003)
argue

...codified rules of what to do in particular cases and cases of like
kind, gets us off the hook of moral endeavor... Adherence to
codified rules does not necessarily require self-awareness or
accountability for taking a moral stance. It simply requires learning
the rules and following them, whereupon we may fall prey to being
lulled to sleep as we methodically attempt to capture similarities
across cases and avoid the unique complexities of the situation at
hand. (p. 121)

An ethic of care
Having considered what is care and what are values and ethics the question arises:
is there an ethic of care?

Joan Tronto, a feminist writer, suggests that there is. Caring according to Tronto is
‘everything that we do to maintain, continue and repair our ‘world’ so we can live in it
as well as possible.’ (Cited in Moss & Petrie, 2002, p. 103). An ethic of care, she
goes on to say, is ‘a practice rather than a set of rules and principles...It involves
particular acts of caring and a ‘general habit of mind’ to care that should inform all
aspects of moral life.’ (p. 127)


Care as a ‘general habit of mind’ is something young people will recognise. They
know the staff who follow the rule book and those who make authentic caring
connections with them. Some of the elements of care are summed up in the social
pedagogic tradition which frames service delivery in most European countries. Care
in that tradition is something offered with head, hand and heart. It requires staff to
think about the job, to have practical skills to bring to it and to be driven by an
emotional commitment to those being cared for.


• Think of a situation you have had to deal with that involved possible moral
conflicts. What were these?
• How was the situation resolved and why was it resolved in that particular way?

2.4 The personal relationship

...Amazing, brilliant - they don't tell you what to do. They'll give you choices. They take you
up to the shop in their own car - they don't need to do that, they do that 'cause they like you.
You've got a good relationship with them.
(boy in residential school, Smith, McKay and Chakrabarti, 2004, p. 91)

Secure accommodation is about creating opportunities for young people to change
and contexts within which they can do so. For that to happen there is one central
ingredient; the quality of the adults who work in a place. We can be seduced into
thinking that there are all sorts of fancy interventions out there that we can use to
turn young people around. The reality is that it is the singer not the song that is
important in helping young people change. Nicholson and Artz (2003) cite research
by Clark (2001), which looked into 40 years of psychotherapy outcomes. It
concludes:

relationship factors (the strength of the alliance that develops
between the youth and the worker, built upon perceived empathy,
acceptance, warmth, trust and self-expression and defined by the
youth as a helpful connection) and the ability of workers to work
positively with the clients’ ways of understanding themselves and
others, account for 70% of behaviour change (Clark, 2001). Two
other factors, hope and expectancy that change will occur, account
for 15% of behaviour change (and also depend on a positive
relationship between worker and youth); while intervention model
and technique account for only 15%. Fundamental to any


prevention or intervention that has a chance of success, is a strong
positive relationship.
(Nicholson & Artz, 2003, pp. 41-42)

The importance of relationship is particularly pronounced in residential child care,
which is perhaps unique amongst professions in placing the personal qualities of
adults at the forefront of the entire business. While it would be desirable for teachers
and doctors, for instance, to build relationships with those they teach or treat,
ultimately teaching and treating are the primary tasks. In care settings the primary
task is building appropriate relationships and using these to help young people in
care to change their ways. Care is what Jack Phelan (2001) calls a ‘self in action’
task.

Some principles of a child and youth care (CYC) approach to practice support this
assertion. This North American approach is about ‘being with rather than doing to.’
or as Garfat (1999) says about ‘hanging out and hanging in.’ Very often there’s no
need to be doing anything that seems vaguely professional with young people. Just
being there, hanging out, chatting, joining in with whatever they’re doing, initiating
particular activities perhaps; all of these everyday occurrences provide opportunities
for adults to interact with and influence young people. But they also need to ‘hang in’
when the going gets tough; especially perhaps in secure accommodation where
there is no easy next move.

To be able to ‘hang in’ with difficult young people demands certain personal qualities
of staff. First and foremost they need to have a good sense of who they are and they
need to be able to present this confidently to young people; they need to be
authoritative without being authoritarian. With suitably confident and committed staff,
authority comes from within rather than through recourse to sets of rules. That is not
to say that rules are not important or necessary. They are, to set the norms of
behaviour in a unit. With individual young people, tight adherence to externally
imposed rules might be required in the early stages of placement, but as
relationships develop, compliance becomes more internalised and based on mutual
respect rather than on the rule book. (see paper 4.06 for further elaboration of these
points).

Self in action - Characteristics of the effective child and youth care
intervention
So what do we know about what is involved in effective professional relationships?
Garfat (1998) explored workers and young peoples' views of what was meaningful in
their experience of particular lifespace interventions. He identifies several themes in
his study of what constitutes an effective intervention. These include adults having a
high degree of care for and commitment to the young people they work with, high
levels of self-confidence and responsibility, and a general and immediate awareness
of themselves.

Good workers also possess an awareness of the wider context, an understanding of
the individual young person with whom they are intervening, and an intimate
familiarity with the issues or situations facing that young person. The latter in
particular seems to be promoted by the ongoing process of sharing and working
together in the lifespace. Child and youth care workers’ ability to prepare for an


intervention and connect with the individual young person in a manner that 'fits' was
also identified as important.

Effective interventions were related to the immediate circumstance and/or
experience of each young person; they enabled them to see their responsibility
related to their situations, and challenged their perceptions and expectations.
Finally, a young person’s experience of continuity in the relationship with the worker
emerged as a theme in the study.

The importance of the relationship in working with young offenders
Similar themes can be detected in the literature on working with young offenders.
Trends in working with offenders and, by extension, young offenders over the past
decade or so have seen an emphasis on the use of particular (generally cognitive
behaviour based - see chapter 3) programmes aimed at tackling offending
behaviour. This can have the effect of understating and undervaluing the centrality
of the personal relationship in such work.

Recent writing in this area (Batchelor & McNeill, 2004) brings the personal
relationship to the foreground in any change effort with young offenders. Focusing
on the views of those who desist from, rather than those who persist in, offending
suggests that the decision to desist is generated by the personal and professional
commitment of the workers involved with them. Worker qualities such as
reasonableness, fairness and encouragement convey a sense of genuine concern
for them and their worth. The message that they are redeemable and able to take
their lives in more positive directions is crucial to a young person’s decision to stop
offending. Valued relationships with workers encourage a personal loyalty and
sense of accountability in supporting young peoples’ efforts to change. A central
task of the worker is to support and nurture this intrinsic motivation to change rather
than to seek recourse to external consequences.

Young people who offend do so for a range of personal and social reasons. Most
often they have been damaged in some way by past relationships. Part of their
healing and part of their ability to move on from offending (which is a symptom of
damaged relationships) is to encounter and to develop relationships that help repair
these experiences. Repairing damaged relationships and experiencing new types of
relationship in personal and professional capacities is central to the decision to
move away from offending.

The type of worker qualities and behaviours implicated in young peoples’ decisions
to move away from offending are those associated with a pro-social approach (see
paper 4.07). They may be summed up thus:
Relationship skills are essential to achieving positive outcomes
and these involve the worker being open and honest, empathetic,
able to challenge rationalisations, non-blaming, optimistic, able to
articulate the client’s and family members’ feelings and problems,
using appropriate self-disclosure and humour. (HMSO, 1995;
Shulman, 1991; Trotter, 1999).
(Batchelor & McNeill, 2005, p. 171)


Close enough?

Because of the abuses that have come to light in recent years in residential child
care, there has been a tendency for organisations providing care to shy away from
close personal relationships between staff and young people. As Kent (1997) points
out, the consequences of such an approach can lead to sterile care environments
that may be equally abusive in terms of their impact on children and young people.

To try to deny close emotional relationships between staff and young people flies in
the face of human nature. Attachment theory (Howe, 1995) tells us that human
beings are drawn to one another. Connections between particular adults and
particular children will happen regardless and in the vast majority of cases have
positive outcomes for those involved.

The CYC relationship is essentially and perhaps inevitably an affective, relationally
centred one. The most powerful moments in CYC are when a personal connection
is made between a worker and youth. One of the most commonly referred to
quotations in CYC practice is that ‘every kid needs at least one adult who's crazy
about him’ (Bronfenbrenner, 1977, p. 5). And while it might be hard to admit, in this
climate, that we're crazy about any kid, the reality is that there are kids who will pull
on our heartstrings in all sorts of powerful and personal ways. It is not
unprofessional to acknowledge this. Indeed, it is central to our professional task. It is
what we use to bring about change.

Relationships, however, cannot afford to be indiscriminate. They need to be
purposeful in residential child care settings. The need to be seen as the vehicle
through which care planning goals are achieved. Fewster (1990) has suggested that
‘the personalized relationship continues to be the greatest challenge in professional
child and youth care’ (p. 26). He refers to the difficulty that child and youth care
workers sometimes seem to have in developing a relationship with a young person
in which the experience of intimacy and connectedness can be present, while
appropriate boundaries are maintained. However, he goes on to say that in the
absence of relationship, the child and youth care worker’s ability to affect a youth’s
values, beliefs, attitudes, or behaviours is seen as extremely limited.

This takes us back to the need for an ethical approach to practice. Ricks and
Bellefeuille (2003), citing Blum (1994), argue that ethics have to be constructed in
relation to individual workers, to ‘self.’ The ethical and moral involves:

getting oneself to attend to the reality of individual other
persons....while not allowing one’s own needs, biases, fantasies
(conscious or unconscious) and desires regarding the other
persons to get in the way of appreciating his or her own particular
needs and situation.
(Ricks & Bellefeuille, 2003, p. 120)

Ethics according to such a formulation do not deny the complex range of human
emotions that can be present in care relationships but requires that workers are
aware of these and are able to make informed moral decisions to concentrate on the
needs of the person being cared for.


To ensure that relationships between workers and young people remain appropriate
and purposeful requires two things. At an individual level workers need to be self-
aware and to reflect on what is going on for them in relationships and where the
balance of power lies within them. This requires a journey inwards to consider areas
of our own need and motivation in particular situations. It also demands that the
whole area of personal relationship is discussed in supervision and within the wider
staff team to ensure that personal and professional relationships are open,
understood and supported.


• Think of a close relationship that you have with a particular young person. What
contributes to that feeling of closeness?
• How do you use the strength of this relationship to achieve care planning
goals?
• What is your own agency's policy or position on the nature of relationships
between staff and young people?

2.5 Shared values: a unifying vision

The emphasis in residential child care in recent years on the importance of the
individual and the need to respond to individual needs is entirely proper. However,
individual needs exist and are met in social contexts. The primary social context in
secure accommodation is the lifespace, the immediate setting as shared and
experienced by staff who live and work there. Together, those who inhabit this
lifespace form a community. Any community needs to be grounded in a set of
common values and beliefs.

Given that both staff and young people enter into this community with a whole range
of different assumptions and experiences around fundamental questions about the
nature of care and the purpose of relationships, there is a need to develop and
adopt some shared values that set out a common purpose. If they are to have any
real meaning and are to be acted out in practice rather than just stated, values need
to be both aspirational and inspirational.

The head of an establishment has to set the tone in terms of living and modelling a
unit’s values, but they need to be owned and lived at every level in a staff team.
Staff need to buy into an agency’s vision and to feel they can make a difference
through living this vision. The vision and the belief that they can make a difference is
what keeps people going beyond the everyday pressures and grind of residential
child care.


An agency’s preferred approach to working with children should be set out in its
Statement of Functions and Objectives. It may be encapsulated in a mission or
vision statement. A unit’s stated vision will help shape the nature of the provision it
offers. A vision needs to be ‘lived’ rather than just stated on paper. For this to
happen, staff need to feel involved in the development of the vision and to feel that it
encompasses their hopes and beliefs about the job. Once established, an
appropriate vision can become a touchstone against which staff can frame and
justify their practice. All their actions should be geared towards realising that vision.
It is the road map that tells them where they’re hoping to go and how they’re going
to get there.

Any vision has to be dynamic. It has to be continually discussed and tailored to
address changing circumstances. This is particularly important, as constructions of
what is appropriate or acceptable in work with children and young people vary over
time. What might be one generation’s ‘best practice’ may be thought of as abuse by
the next.

Agencies need to make time for staff to develop and to touch base with their vision
and their shared values. This may involve periodic away days or regular discussion
of values in staff meetings. This can be time consuming but it is essential in making
sure that staff pull together in the same general direction. The alternative to
discussing and locating practice in a set of shared values leads to continual
bickering and differences of opinion in staff teams around central issues such as
care and control. In the absence of commonly understood shared values,
individuals’ values and beliefs come to the fore. It is important too that young people
feel they are part of something bigger than the sum of the individual parts of an
organisation; part of a community that can meet their emotional needs for affection
and affirmation.

A staff view that ‘we care about you too much to let you do this’ is
an excellent foundation of a positive milieu and once accepted as
genuine can be far more powerful in bringing about change than a
formal treatment strategy.
(Elliott & Place, 1998)

Values statements ought to become the touchstone against which everyday actions
are articulated and judged. An example of one school’s (St Philip’s) value statement
is appended to this chapter and encapsulates the particular value position that
underpins these. The essence of St Philip’s approach is to create a community
where both young people and the adults who work with them grow through their
daily sharing of the lifespace.

Similar sentiments are captured in some of the principles of social pedagogic
approaches (the predominant approach in European countries) to practice. These
principles are identified by Petrie (2004) as:
• a focus on the child as a whole person, and support for the child’s
overall development;
• the practitioner seeing herself/himself as a person, in relationship
with the child or young person;


• while they are together, children and staff are seen as inhabiting
the same lifespace, not as existing in separate hierarchical
domains;
• as professionals [staff] are encouraged to reflect on their practice
and to apply both theoretical understandings and self-knowledge
to their work...;
• [staff] are also practical; their training prepares them to share in
many aspects of children’s daily lives...such as making music or
building kites;
• ...children’s associative life is seen as an important resource:
workers should foster and make use of the group;
• pedagogy is built on an understanding of children’s rights that is
not limited to procedural matters or legislative requirements;
• is based on ...an emphasis on team work and on valuing the
contributions of others in the task of bringing up children: other
professionals, members of the local community and, especially,
parents.
(adapted from Petrie, 2004, pp. 3-4)


• How does your organisation describe its value base?
• How often do you come together as a staff team to discuss issues around
values?

Conclusion
This chapter starts from the premise that care is, above all, about values and ethics.
How we think about young people and how we think about care will determine the
kind of care experience a unit offers. Practitioners need to be able to explore their
own values and to locate these within an understood agency framework. Such value
based frameworks provide the backdrop against which important everyday policy
and practice decisions should be made.

Values are translated and played out in the kind of relationships we develop with
young people and with colleagues. For these to be positive and growth enhancing
requires that individual practitioners are appropriately self-aware and reflective and
that agencies provide them with opportunities, through supervision and other
support structures to enter into discussions around values and ethics.


Training Links
SVQ:
Unit O2 Promote individual’s equality, diversity and rights (mandatory unit in the
SVQ level 3 qualification Caring for children and young people)

In the revised SVQ Health and Social Care (Children and Young People) awards at
level 3 and level 4, there is a values statement in every unit, indicating what must be
met. This chapter would be applicable to the whole of these awards.

HNC in Social Care:
HN unit Caring for young people in secure care settings: outcome one (optional unit)

Further reading
Those interested in the ideas outlined in this chapter might want to read:
Tronto, J. (1994). Moral boundaries: a political argument for an ethic of care. New
York: Routledge, Chapman & Hall Inc.
Moss, P. & Petrie, P. (2002). From children's services to children's spaces.
London: Routledge/ Falmer.
(neither of the above are easy reads but are stimulating with a bit of perseverance)
Brannan, J. & Moss, P. (2003). Rethinking children's care. Buckingham: Open
University Press.
An easily accessible way into ideas around social constructions of childhood is
provided in:
Stainton, R. (2001). Constructing childhood, constructing child concern. In P. Foley,
J. Roche & S. Tucker (Eds.), Children in society: contemporary theory, policy and
practice. New York: Palgrave, Open University.
A chapter on ethics from a child and youth care perspective is available in:
Ricks, F. & Bellefeuille, G. (2003). Knowing: the critical error of ethics in family work.
In T. Garfat (Ed.), A child and youth care approach to working with families. New
York: Haworth.
Ideas around child and youth care principles can be found by typing in relevant
words or phrases into the search facility on cyc-net.org. Gerry Fewster writes well
on the use of self in work with young people.


Appendix 1
(Taken from ‘The Essence of St Philip’s’)

Shared Values
In a community such as St. Philip’s that thrives on a set of shared values, leadership
should be visible everywhere. The power of inspiring values, not just stated but
acted out, makes leadership possible at every level of engagement.
1. We believe that, as a Christian community, every person should be respected,
recognised as having a unique worth and treated with dignity.
2. We believe in the importance of acting with integrity and in a spirit of truth and
consistency, honouring our commitments to children, families and fellow
professionals.
3. We believe in the importance of treating people fairly and in the value of
routinely questioning the relative fairness of alternative courses of action. This
does not mean that everyone is treated in exactly the same way, but instead is
treated fairly given the appropriate situation.
4. We believe in the healing power of affirmation.
5. We believe in the importance of mutual appraisal within our community.
6. We believe that we have a responsibility to shine a light on good practice and
to enquire into practice which is incongruent with agreed standards.
7. We believe that by working together collectively the community creates an
‘Archetypal Adult’ who is fairer, more just, more understanding, more sensitive
and more tolerant than any individual can be.
8. We believe that adults should strive to understand the true meaning of what
children communicate to us.
9. We believe in the importance of viewing children positively.
10. We believe that our systems of dealing with challenging behaviour are neutral,
objective and non –punitive.
11. We believe that consequences should be child-sized and not reflective of adult
antagonism or spite.
12. We believe that children should be protected from behaviour that models
bullying or arbitrary imposition by adults.
13. We believe young people have important rights that should be acknowledged,
promoted and respected.
14. We believe in the importance of everyone developing a growing sense of
responsibility for the choices they make and the actions they take.
15. We believe that all children wish to make progress in school, make friends and
have fun.
16. We believe that a sense of enjoyment, complemented by appropriate humour,
can contribute to a healthy working and living environment.


Theoretical perspectives
Chapter 3
Lynda Taylor

Theories – whether in the form of academic, political or professional ideas, or offered in the
guise of ‘common sense’ – shape our understandings and govern our actions, whether we
recognise this or not.....
(Moss & Petrie, 2002, p. 17)

Introduction

This chapter sets out the need for theory in work with young people in secure
accommodation. It begins with a discussion of adolescent development and goes on
to consider some of the theories that may help cast light on practice. Inevitably,
coverage of the various theories is selective and brief. Practitioners who wish to
develop their understanding in any area are pointed in the direction of some further
reading.

Making the links

Throughout this chapter you are invited to think about a particular child and how
each of the theories discussed might help you understand them better.

Overview
Theory does not always get a good press among workers in residential child care.
That may be understandable. Many of the theories taught have not always reflected
practice experience. Good theory ought to be grounded in and illuminate the
everyday experience of those who do the job. Having acknowledged that theory has
not always served us well, it is all around us nevertheless. Even those who would
run a mile from theory and claim to approach their work from a pragmatic or
‘common sense’ perspective, draw on bits of theory all the time. They might talk of
Freudian slips or of the need for consequences to behaviours, or they may use
programmes or worksheets to address particular behaviours. All of these are based
on theoretical understandings of some sort. The trouble is that practitioners often do
not recognise this. At one level this devalues some of the very good practice that
goes on in units, because practitioners do not have the concepts or the language to
explain what they are doing. On the other hand, attempts to apply ill-understood
theory to residential child care settings can be at best useless and at worst


dangerous. It is important then that staff who work in secure accommodation and in
residential child care more generally have some idea of some of the main bodies of
theory that have had a bearing on and still influence practice.

Theories from a range of academic disciplines including sociology, criminology,
anthropology, social policy and education can be used as lenses through which to
seek to understand secure accommodation. This chapter limits itself to a
consideration of some of the main psychological theories. Most psychological
theories can be thought of as trying to explain the linkage between thinking, feeling
and behaving. They differ in the importance they attach to each dimension.
Theoretical models inevitably influence the assumptions made by practitioners
about behaviours and how to respond to them. As such, they influence the type of
regime that operates in a centre and, through that, daily practice.

Theories are only ever provisional. There is no theory that is going to provide all of
the answers that practitioners in secure accommodation might want. Neither are
theories value free. Prevailing theoretical perspectives are likely to reflect dominant
political and professional value preferences, beliefs and assumptions about how
people change. Do they change through the use of psychologically rigorous
programmes? Or do they change through the power of personal and professional
relationships? Consider the old saying about a glass being seen as either half-
empty or half-full. How we view the glass will, in many respects, say something
about our approach to life. Similarly, when we look at young people, do we see their
problems or do we see their strengths and potential? That will influence (or be
influenced by) our preferred theoretical orientation and hence the way we approach
our work with them.

Because theories are not value free, practitioners need to understand and be able to
question them. They need to be able to use what makes sense in their own
workplace to help them put together some of the pieces of the jigsaw that is their
everyday experience. That way they can start to build up parts of the bigger picture,
whilst recognising that this will never be entirely complete or clear.

A simple developmental model
Before we go on to consider particular theories, it is worth thinking in general terms
about how people grow and develop. Children, from birth, have a range of physical,
social and emotional needs. If these needs are met they are likely to grow and
develop into healthy and autonomous adults. If these are not met or are distorted in
some way through abuse, trauma or other experiences of adversity, we might
expect them to face some difficulty as they progress through life. A very accessible
model of how children grow and develop is provided by Mia Kellmer-Pringle in her
book, The Needs of Children. She identifies children as having four basic needs:
• love and security
• new experiences
• praise and recognition
• responsibility.


If these needs are appropriately met as children grow up then their passage to
adulthood should be relatively uncomplicated. It might be useful to consider the
extent to which young people in secure accommodation have had these needs met
in their past and indeed in their current experience of care.

3.1 Adolescent development

Introduction
Most of those placed in secure accommodation are teenagers. To work with them it
is essential to understand something about the nature of adolescence and the
processes involved in this developmental stage. Adolescence involves a gradual
transformation from child to adult. The precise nature of adolescence is dictated by
the culture in which the transition is undertaken. Generally, in western society, this
process is protracted and multi-dimensional. In more traditional societies, rites of
passage ceremonies mark this transition in far more formal and tangible ways.

There is a series of challenges to be confronted in making this transition: biological,
cognitive, psycho-social and moral/spiritual. When an individual is unable to deal
with these challenges successfully there are likely to be unhelpful psychological,
emotional and behavioural consequences. It is vital therefore, for adults who are
working with adolescents through these transitions to understand how the changes
affect the individual.

Biological change
The biological challenge in adolescence involves physiological, sexual and
emotional change.

Physiological changes, such as girls developing breasts or boys' voices breaking,
happen at different ages and rates for different young people. Therefore, it is very
common for young people to feel awkward and self conscious about their
appearance and to suffer from low self esteem as a result.

During adolescence there are increases in the production of sex hormones which
trigger an increase in sexual arousal and desire in both males and females. These
changes can be very uncomfortable for the adolescent as they confront them with
issues of personal sexuality and sexual identity. This rise in sex hormones along
with the other changes that are happening to the young person may affect the
young person’s emotional state.

Cognitive change
Adolescence is also a time when significant cognitive (thinking) changes are taking
place. These were identified by Piaget, a Swiss psychologist, who talks about the
transition made by adolescents from ‘concrete operations’ to ‘formal operations.’


The adolescent moves from seeing things in black and white, 'concrete' terms and
begins to deal with more abstract concepts and ideas. This is likely to encourage
them to try out new situations and learn through success and failure. The
broadening of thinking abilities includes being able to think about how one is
perceived by others. This results in a heightened level of self-consciousness for
many adolescents.

Adolescent thinking is often egocentric (self-centred). They may at times feel all-
powerful and that they cannot be hurt. This can be risky as they may engage in
extreme risk taking behaviour because they believe they are invincible. Typical
examples of this would be drinking, taking drugs, joyriding or having unprotected
sex.

While Piaget considers that there are set stages of cognitive development,
Vygotsky, a Russian psychologist, argues that cognitive development is first of all a
social process that an individual then internalises. A second aspect of Vygotsky's
theory is the idea that cognitive development takes place as children move towards
their 'zone of proximal development' (ZPD), the next stage in their psychological
development. The ZPD is achieved through engaging in social behavior and
depends upon full social interaction. Skills are best developed with adult guidance or
peer collaboration. This way of thinking has important implications for residential
child care as it highlights the importance of the social environment in developing
young people's cognitive skills.

Identity formation
Biological and cognitive changes at adolescence trigger a major psychological
challenge. The young person needs to form a new identity as he/she is no longer a
child. Although the search for identity can be a lifelong process, the transition from
child to adult means that it is most pronounced during adolescence. The 'Who am
I?' question is a central one. The best-known writer on adolescent identity formation
is Erik Erikson (1995).

The adolescent is less joined to parents and family and moves into a separate
space increasing his/her capacity to function as a member of adult society. This is
called individuation. It is a complex process which sometimes leads to adolescents
being marginalised and living with the consequences of being less valued by others.
This is because adults often struggle with adolescent behaviour and perceive the
adolescent’s quest for autonomy as rebellious. This process is necessary however,
if the adolescent is to go on to become an autonomous adult. Adolescents must
make and follow through their own decisions, live by their own set of principles of
right and wrong, and become less emotionally dependent on parents.

A sense of uniqueness is an essential part of the process of becoming a separate
individual in adulthood. This can however, also make it difficult for adolescents to
believe that anyone understands them and they may become overly dramatic in
describing things that are upsetting to them as they believe no one else has ever
experienced similar feelings and emotions.

It is not surprising that this continual adjustment biologically, cognitively and
psychologically is very stressful. Adolescence is characterised by an intensity of


emotional response. Feelings of shame and embarrassment may be powerful and
frequent. Subsequently, adolescents develop strong psychological defence
mechanisms, such as denial, regression and projection to deal with these feelings.
These can explain some of the seemingly inappropriate behaviour found in
adolescents.

No longer perceived as children, there are further challenges for adolescents arising
from changing expectations from society, parents and peers. There are strong social
expectations. The list below from Havighurst (1951) is an example of how daunting
the expectations are:

• Accepting one's physique and sexual role

• Establishing new peer relationships with both sexes

• Achieving emotional independence from parents

• Selecting and preparing for an occupation

• Developing intellectual skills and concepts necessary for civic

competence

• Achieving assurance of economic independence

• Acquiring socially responsible behaviour patterns

• Preparing for relationships and family life

• Building conscious values that are harmonious with one's
environment.

The adolescent is dealing with many new challenges and changes and is unlikely to
focus on tasks such as the above without making mistakes. Some adolescents may
be so overwhelmed by society’s demands that they get involved in delinquent
behaviour and look for their sense of belonging with like-minded individuals.
Children in families that exist in difficult and stressful social situations are more likely
to find adolescence difficult.

Peer relationships are very important in adolescence. They help teenagers to
explore and develop their own identity. Close friendships help young people with the
process of developing an individual identity separate from that of a child in a family.
On the other hand, these relationships can be so influential that peer groups can
increase antisocial behaviour in a young person caught up in the wrong crowd.

An important challenge for adolescents is to maintain positive relationships with their
parents while achieving their developmental goals, a major one of which is to
separate and detach from their parents. This is very complex and can cause a lot of
conflict. Many parents feel rejected and dismayed at the adolescent’s withdrawal,
not understanding that this is a central part of their development. The parent’s
disapproval or rejection will make it even more difficult for the adolescent to achieve
their developmental goals. It can be important for adolescents to have access to


adults other than their parents. Boys especially benefit from supportive relationships
with male mentors.

Moral development
During adolescence the young person is also challenged by a wide range of moral
decisions. Kohlberg (1984) is the main writer on moral development. Like Piaget, he
sees morality developing in stages. The stage of morality most commonly
encountered in adolescence is post-conventional morality, where the individual
develops a sense of human rights and starts to develop a conscience. At this stage
adolescents also develop clear ideas about what they believe in and what they are
prepared to stand for. No longer does the individual act merely out of fear or the
need for approval.

However, different rates of cognitive and emotional development mean that there
are differences in how this stage is translated for each individual. For example,
some young people advocate for specific values and violate them at the same time.
Some adolescents might not even reach the post-conventional morality stage at all
and continue to operate at a level where morality is tied up with rewards or with not
‘getting caught’.

Conclusion
Adolescence is a time of change and crisis which, if appropriate supports are in
place will be managed without too much difficulty by most teenagers. A useful
perspective on adolescence is offered by John Coleman in what he describes as
focal theory (Coleman & Hendry, 1999). He suggests that if the various changes
expected of adolescents are appropriately sequenced and take place in a supportive
environment, most teenagers cope with the stage without too much difficulty.
For others, however (especially perhaps those placed in secure accommodation), it
can present the possibility of undesirable psychological, social and emotional
consequences. The expectation of a successful transition from childhood to
adulthood in the face of many biological, psychological and social challenges can
often prove overwhelming.

Suggested reading
Coleman, J. & Hendry, L. (1999). The nature of adolescence (3rd ed.). London:
Routledge. Provides a good readable overview of different theories of adolescence
and proposes focal theory as a way of understanding the stage.

Bee, H. & Boyd, D. (2002). Lifespan development. Boston: Allyn and Bacon. A good
text on developmental psychology. .


3.2 Psychodynamic theory

Introduction

Psychodynamic thinking is commonly associated with the work of Sigmund Freud in
the 1920s. Although the original description is complex and can be difficult to grasp,
many ideas that are taken for granted in social work today derive from Freud and his
immediate followers who were influential in shaping the early conceptual
underpinnings of social work.

Freud’s thinking has been developed extensively by later writers and it is no longer
possible to point to a single body of theory, although all approaches share certain
common assumptions as outlined below. One of the major changes has been the
shift away from the language of ‘drives’ and ‘instincts’ towards a focus on
relationships and the way in which a sense of self evolves and is maintained.
Important figures include Melanie Klein and W R D Fairbairn, an Edinburgh-based
psychoanalyst whose work was promoted by J D Sutherland, another Scot.

Psychoanalytic thought can be complex, but nevertheless, some of its language and
assumptions influence practice today and it can provide practitioners with some
valuable insights.

Outline of theory
Psychodynamic approaches stress the importance of experiences in babyhood and
early childhood for later development, suggesting that patterns of relating tend to
persist and to be repeated with significant others. The theory holds that behaviour is
influenced not only by conscious feelings, wishes and ideas but also by those of
which the individual is unaware (‘the unconscious’).

It is concerned also with the ways in which people defend themselves against
experiencing too much anxiety or emotional pain, often using other people in the
process, e.g. by ‘projecting’ on to others what is too difficult for them to hold inside.

It is an approach which looks beneath the surface of what is presented and tries to
understand the ‘inner world’ of feelings and beliefs, including the fantasies which the
small child develops in an attempt to make sense of his or her experience at a time
when thought processes are immature. Being unconscious, such fantasies often live
on into adulthood.

Psychodynamic approaches complement attachment theory (see later in this
chapter) in teaching us that children who have been neglected, rejected or abused
operate from an inner world which is often in greater turmoil than the outside world.
Staff working with children and young people need to pay careful attention to their
histories, not just those that are objectively recorded but also to the meaning young
people make of these.

The concept of ‘containment,’ of particular relevance to residential child care, has
been discussed by Wilfred Bion (1990), and the closely related idea of ‘the holding


environment’ by Donald Winnicott (1960). In normal development a child’s most
primitive thoughts and anxieties are contained by being understood by their
caregivers and this is how the child learns to trust. If this containment function does
not happen because of a lack of response, the child is left feeling he/she cannot be
understood or cannot rely on anyone. If the caregiver adds their own distress to the
baby’s distress a downward spiral is triggered. Uncontained distress is projected
outwards through behaviours. If a healthy containment process is not achieved by
adolescence, dangerous risk-taking behaviours may ensue because of the strong
need to find identity at this developmental stage. The role of the psychoanalyst is to
help people understand where, within themselves, their feelings and behaviours are
coming from.

Implications for practice
From a psychodynamic perspective, the priority for a child care worker is to try to
promote and model responsive, honest and authoritative management and to foster
supportive relationships between adults and children. The aim of the worker is to
create insightful and benign containment at an organisational level that is strong
enough to withstand powerful negative projections of uncontained children and to
give them tools to establish good and intimate relationships in their adult lives.

Psychodynamic views of group and organisational processes
Individual psychodynamics are further complicated by the group dimension. William
Bion takes the concept of containment beyond the individual to group and
institutional processes. In this situation, a staff group lacking understanding of an
adolescent’s ‘stuckness’ could easily respond in a way that would heighten their
feelings of helplessness and trigger acting out behaviour.

Bion also wrote about a spectrum of unconscious group processes. He describes
groups sometimes working unconsciously in ways which subvert their therapeutic
intent or task. They become anti-task (see paper 5.03). Although at first they may
seem to be behaving acceptably, when this is compared to what they should be
doing therapeutically, it becomes apparent that they are in the throes of a more
primitive process. Bion says this can manifest itself in a variety of unhelpful ways.

Bion’s other major insight into group functioning is his belief that the group should
be viewed as a whole and not as a collection of individuals. Therefore, an
adolescent who vandalises the unit should be managed as representing vandalism
on behalf of the entire group. This view arises from the belief that there will be a
complex network of projective processes at work in group situation. If you treat it as
a group process then you will address the entire process including the perpetrator. If
you focus on the perpetrator, everyone else is able to disown the parts of
themselves projected onto him/her and the process is likely to continue unabated.

Psychoanalytic theory is a complex way of looking at individual and group
functioning and is often avoided by residential workers. It requires staff training,
supervision and space to help them acknowledge how troubled and distressed
young people really make them feel. It is constructive to help workers to recognise
that their sometimes angry, helpless and terrified feelings are not failures in


themselves but important communications about the young person. Staff groups can
be helped to function better by reflecting on their own feelings and behaviour and
how easily these can mirror young peoples' behaviour.

Troubled young people are very perceptive of the quality of relating that significant
adults display. When adults are prepared to discuss and examine the feelings they
are caught up in, they gain a better grasp of the young people’s problems. Working
from a group dynamic perspective such as that described above was central to the
work of many therapeutic communities, which were fairly common in England
(although less so in Scotland) over the course of the 1970s and 80s. Such
approaches have fallen out of favour in recent years but, nevertheless, can provide
valuable insights into the way a unit operates.

Anton Obholzer (1995) writes about organisations from a combination of
psychodynamic and systems perspectives. Some guidelines set out by him, relevant
to residential settings are:
There needs to be clarity of task. Without this it is impossible for
staff to assess whether they are moving in the right direction. This
is particularly important when working with adolescents, as
confusion is an innate part of the young people process. If staff
clarity is lacking it can lead to confusion of the entire institution and
acting out (among young people and staff) that can threaten the
whole enterprise.
There needs to be clarity of structure, authority, roles and
boundaries. Young people need to find their own authority and
learn how to relate to authority figures. Young people in a unit are
likely to bring confusion in this area of functioning to the fore and
need staff to model clarity about such matters.
Staff need training in the field of group and institutional processes.
Young people have a great capacity to root out any personal or
institutional weakness. This often takes the form of attempting to
split the coherence of the staff group. Staff who have insight into
their own vulnerabilities are less open to adolescent attack which
is often of a personal nature. Staff who master themselves in this
way can act as role models for the adolescents who are
negotiating similar issues of identity, authority etc.
There needs to be an awareness of the risk to staff and young
people arising from the nature of the work in which they are
engaged. Institutions develop ways of functioning that are
sometimes more influenced by the need for staff to protect
themselves than by work-oriented considerations. Outside
consultation can bring a different and useful perspective to the
work of a unit.

Conclusion
The complexity of Freudian language and the fact that his work was focussed on the
individual created the belief that the ‘real work’ done with young people in residential
child care was done by the expert therapist, with residential workers concentrating


on primary care tasks (see paper 4.06). However, there is growing recognition that
residential units should themselves be essentially therapeutic, as they are
environments to promote personal change and growth. As residential workers are
the key players in this process, an understanding of the psychodynamic approach
can be enriching.

Beyond its scope to offer individual insight, it is also invaluable in understanding the
dynamics that exist in any residential setting. Dysfunctional group dynamics are
corrosive. Without understanding the complexity of these, many organisations seek
to deal with only the symptoms rather than addressing where these might be arising
from. The use of an external consultant can be helpful in this process.

Suggested reading
A good overview of psychodynamic theory is available on-line at
http://216.239.59.104/search?q=cache:KjBHK6_2VEAJ:www.intl.elsevierhealth.
com/e-books/pdf/194.pdf+gita+ingram+attachment&hl=en

The literature on group processes tends to be rather complex. For relevance to
residential child care, I would suggest:
Bion, W. R. (1984). Learning from experience. London: Karnac Books.
Bion, W. R. (1990). Experience in groups. London: Routledge.
Obholzer, A. & Zagier Roberts, V. (1993). The unconscious at work. London:
Routledge.

3.3 Behavioural theories

Introduction
Behavioural theories are associated, historically, with the work of Skinner (Skinner,
1969). They were important in secure accommodation and in residential child care
more generally in the 1970s (see paper 4.07). They are still influential in many of the
assumptions that underpin practice (such as the need for consequences to
behaviours), even if staff are not always aware of the theory behind them.

Background
The basic assumption of behavioural theories is that maladaptive behaviours are
learned and therefore can be unlearned. In addition it is believed that new and more
adaptive behaviours can be learned. The notion of operant conditioning is crucial. Its
premise is that behaviour can be controlled by its consequences. Acceptable
behaviours are rewarded and thereby reinforced. Unacceptable behaviours are
eliminated because they are followed by punishment. Punishment has not been
found to be particularly effective in changing behaviour however. Behaviourism in


this crudest form has been discredited for this reason and because it fails to
acknowledge the complexity of human behaviour. Workers in secure
accommodation will be aware that changing behaviour is not as clear cut as offering
rewards or sanctions.

Behaviour therapy
This is designed to target disabling, unproductive or maladaptive behaviours. Many
practitioners nowadays use a combination of cognitive therapy and behaviour
therapy.

Desensitisation is a technique that involves bringing a young person into contact
with the feared stimulus. Fears are faced gradually working from the least to the
most difficult. The young person must stay in the feared situation long enough to
learn that the bad things he fears will not happen. Practice and repetition are the
keys to success.

A second aspect of behaviour therapy is to schedule activities and pleasant events
because to change what a person does also changes how they feel. Young people
plan and record their activities each day and rate them for pleasure, mastery,
anxiety or competence. This demonstrates the relationship between mood and
activity.

Relaxation techniques are also important to help young people have control over
their symptoms, especially for young people with anxiety disorders. Likewise,
problem solving techniques are taught and encouraged as they can assist young
people in recognising the resources they have for dealing with problems. It can
enhance young people’s control over problems and equip them with ways of tackling
future problems.

Residential units in the 1970s and 80s that adopted behaviourist approaches based
their practice around operant conditioning principles. A number operated token
economy systems whereby young people had to earn points to gain access to
particular areas of a unit's programme, such as activities or even home leave.

Social learning theory
Criticisms of behaviourist theory led to the development of other psychological
theories. One of these was social learning theory, most often associated with the
work of Bandura (Bandura, 1977). Bandura believed that behaviour can be learned
by observing and imitating other people. Suitable adults (and peers) were required
to model social behaviour in the belief that it would be replicated. Given the nature
of residential child care and the opportunities for appropriate modelling of
behaviours, we can see how social learning theory has been important in informing
practice in this field (see paper 4.07).

Cognitive behaviourism
Cognitive behavioural approaches represent another development from classic
behavioural theory. Cognitive behavioural therapy focuses on the links between


thoughts, feelings and behaviour, arguing that a change in one area can lead to
changes in the other two. It is based on a cognitive model of emotion. This dictates
that it is not simply what happens to you that causes your reactions. Rather, it is the
meaning that is attached to an experience that leads a person to feel and behave in
certain ways.

This way of working with young people is usually brief and time-limited, encouraging
the development of independent self-help skills. Unlike psychodynamic approaches
it does not dwell on the origins of psychological difficulty. It is problem-oriented and
focuses on presenting circumstances which serve to maintain difficulties.

Within a cognitive model of emotion, different people will process situations
differently and the way in which they do may offer valuable information about their
behaviour. Kendall (2000) uses the example of stepping in dog poo to illustrate this:
• Some people may react with immediate social embarrassment.
This reaction often characterises anxious people.
• Some people might become self-denigrating for stepping in it.
This may characterise depression.
• Some might dwell on who was responsible for leaving it. This may
lead to an angry response.

Due to the wide variation in personal responses to particular triggers, assessment is
essential to a cognitive behavioural approach. This can be done by behavioural
interviewing, self-monitoring, self-report questionnaires or interviews and direct
observation of the problem.

Cognitive therapy
This is designed to target unhelpful or irrational beliefs, attitudes or thoughts.
Examples of these are:
• I must be loved and approved of at all times
• Things must always go right
• I must be competent at everything
• Life should always treat me fairly.

Cognitive therapy involves the identification of unhelpful, negative thoughts or
beliefs. Distortions in thinking patterns are detected then challenged by questions
such as:
• What is the evidence for the thought?
• Is there an alternative, more helpful way of thinking?
Through such techniques, the young person is helped to develop a more adaptive
and positive way of thinking.

When using such behavioural or cognitive techniques with young people the
psychological, cognitive and emotional development of the young person is
important. The family of the young person should be involved if possible and the


work should be made child-friendly by using age-appropriate language, worksheets,
art, cartoons, role plays, etc.

As noted, behavioural principles influenced practice in residential work in the 1970s
and 80s. However, over the history of residential work there has been a degree of
resistance to these, partly because most of the influence is from a psychodynamic
orientation. Within that tradition the focus has been in the environmental origins of
disturbance. This has meant that the most valued interventions with young people
have been those that happen in the lifespace or as part of group process.

However, there is increasing recognition that group living can be used
therapeutically and at the same time contain individualised treatment. Such
programmes are increasingly being applied in criminal justice settings and in secure
units to address a wide range of behaviours, one particular area being the treatment
of adolescent sex offenders (see paper 4.17). Anger management and cognitive
skills programmes also draw on such approaches.

In cognitive behavioural programmes offenders are taught to re-evaluate their
attitudes to victims and offending and are provided with behavioural control
techniques to help them avoid further offending. Treatment programmes cover
cycles of offending, relationships and attachment, self management and
interpersonal skills. They challenge an abuser’s reluctance to accept responsibility
for their behaviour and look at the role of fantasy and victim empathy. They also
include strategies for relapse prevention and lifestyle changes.

Within residential child care, the challenge is to combine a therapeutic environment
which, while accepting the child no matter what he does, encourages and promotes
appropriate behaviour.

Conclusion
Few people would nowadays subscribe to classical behaviourist theory. Human
behaviour is too complicated for that. However, practitioners will be able to identify
the remnants of behaviourism in many of the assumptions made and practices in
secure accommodation. Developments from behaviourism have been important in
shaping the development of residential care and cognitive behavioural approaches
in particular are currently influential.

Suggested reading
Cigno, K. (2002). Cognitive behavioural practice. In R. Adams, L. Dominelli & M.
Payne (Eds.), Social work: themes, issues and critical debates (pp. 180-190).
Basingstoke: Palgrave. Provides an overview of cognitive behavioural theory and
approaches.

Stevens, I. (2004). Cognitive-behavioural interventions for adolescents in residential
child care in Scotland: an examination of practice and lessons from research. Child
& Family Social Work, 9(3), 237. Provides an overview of cognitive behavioural
approaches in residential child care in Scotland.


Descriptions of token economies/points systems etc. in particular can be found
using the search facility on cyc-net.org. Karen Vander Ven is a particular critic of
such approaches.

3.4 Systems Theories

Introduction
Systems approaches are based on the premise that the way young people operate
is very much influenced by the systems in which they operate. When we plan
interventions it is vital to understand the significance of external influences and how
they interrelate to impact on the individual’s development (see paper 4.04).
Systems, or ecological approaches, help explain the interaction between individuals
and their immediate and wider environments.

Background
The seminal work on ecological perspectives of human development was by Uri
Bronfenbrenner, a social scientist, who also had a background in child care.
Bronfenbrenner categorised various external influences into different levels of
'systems'.

Microsystem
The microsystem is a developing person's immediate environment.
The nature of that environment will affect the experience of
growing up in it. Factors such as being born into a situation of
marital discord or having a very sick sibling will have particular
impacts on the developing child.
Mesosystem
The interrelation among two or more settings in which the
developing person actively participates is called the mesosystem.
An example of this could be a young person’s school and carer
failing to agree about what constitutes reasonable behaviour in the
young person. Another example could be the impact on the young
person’s care of their parent having a volatile relationship with their
social worker.
It is increasingly recognised in social work practice that wider
networks such as extended family and community can impact
powerfully on the individual. This is reflected in the recent
introduction of more holistic ways to approach individual problems,
such as family conferencing.
Exosystem
Factors which do not involve the developing person as an active
participant but affect him are called an exosystem. An example of


this could be social policy or law. The criteria for secure
accommodation, for instance, could have a very significant impact
on a young person’s life if they are behaving within these criteria.
Macrosystem
Bronfenbrenner's fourth system, the macrosystem, refers to
cultural or sub-cultural influences on an individual’s development.
An example of this might be racist attitudes prevalent in British
society. A young black person trying to reach developmental goals
amidst such attitudes is likely to be adversely affected. Another
example might be current political and public attitudes to young
people and the impact of these on policy development.
One way to understand these systems is in the image of a Russian doll a series of
dolls nested within each other. Each doll can be understood as an entity in itself but
interrelates with the others to constitute the ‘whole doll.’ When care planning for
young people it is important that each layer is carefully considered and addressed.

Cultural safety

Bronfenbrenner’s model emphasises the importance of social and cultural identity in
development. This links to the concept of cultural safety (see paper 4.19). This is
described as:

…that state of being in which the child knows emotionally that his
personal well-being, as well as social and cultural frames of
reference are acknowledged, even if not fully understood.
Furthermore, he is given active reason to feel hopeful that his
needs and those of family members will be accorded dignity and
respect.
(Fulcher, 1998)

Family systems
By far the most important factor for most young people in care will be how they feel
in relation to their biological families. In spite of their separation, a young person in
care is likely to have a profound bond with their family (see paper 4.21). For most
adolescents’ well-being, it is vital that they have a sense of mattering to their
parents.

Attachment theory shows us that the experience of receiving poor quality care does
not necessarily lessen dependence on the caregiver. Where a child's attachment
experience is deficient the child's instinct may still be to cling to them. Young people
who have been abused and maltreated may even want to cling on to the person
who has upset and frightened them.

There is also overwhelming evidence that the biological family is where most people
gravitate to when they leave care. Research indicates that 87% of children in care
eventually return to their families (Bullock, Little & Millham, 1993). There is also


evidence that family contact improves a young person’s chance of returning home
from care. Contact with family may help prevent a young person’s isolation in care
and counter the risks of marginalisation from social networks in adulthood.

It is very important for young people in care to know that they are cared about even
if they can’t be cared for. There is a vast therapeutic potential for young people
when residential workers try to work in partnership with parents (see paper 4.21).
Some young people may need parental permission before they can do well in
residential care as they will fear that any commitment to their placement or carers
might be interpreted by their parents as an act of disloyalty or betrayal. The potential
for this working together might be greater in residential than in foster care because
biological parents are less likely to feel direct rivalry with residential workers.

There are other reasons for working closely with parents. Biological parents may
know their child well and be able to offer useful information to residential workers.
Identity issues can be very problematic for young people in care and contact with
family can provide some clarity about who they are. It can also help clarify the real
reasons for the child being in care and the meanings attached to this.
Understanding this can help children put aside a belief that it is because they are
bad or unlovable.

Workers can help parents to provide an explanation to the children which will help
them build a coherent story about what has happened to them (see paper 4.22). It is
very important that young people know when their parents make mistakes. Young
people are entitled to know their story and be allowed to talk about it and express
their feelings about it. When this happens, they are less likely to suffer from pent-up
anger and resentment.

For the same kind of reasons, contact with siblings while in care can be very
important. Siblings may develop special bonds which can offer vital attachment
opportunities in the absence of adequate parental care. It is also important to
nurture sibling relationships because they may provide a key source of social
support in adulthood. Many young people in care lack such social support from
other sources in adult life. There is evidence that children's placements in foster
families have lower breakdown rates when siblings are placed together (Berridge &
Cleaver, 1987).

Wider networks
As we see in paper 4.21 the term ‘family’ can be a broad one. Those who are
important to a young person need not be their biological family (although some
understanding of this is important in terms of identity formation). Wider social
networks, from grandparents, aunts and uncles, teachers, youth club leaders and, of
course, staff in residential child care, may all be significant within a young person's
wider circle of influence.

Conclusion
Workers should be knowledgeable about young people’s wider social systems to
help them understand the young person’s particular way of seeing the world.


Workers should also be aware of how their own family histories and cultural beliefs
might influence their response to particular behaviours. If workers have a well
developed sense of their own histories and those of others, they will be able to
structure their interventions in a skilled way, making optimum use of the therapeutic
opportunities in the life space.

Suggested reading
Bronfenbrenner, U. (1989). Ecological systems theory. Annals of Child
Development, 6, 187-260.

Gilligan, R. (2001). Working with social networks: key resources in helping children
at risk. In M. Hill (Ed.), Effective ways of working with children and their families.
London: JKP. Identifies the importance of wider support networks to young people.

Payne, M. (1997). Modern social work theory. Basingstoke: Palgrave Macmillan.
Chapter 6: Systems and Ecological Perspective.

A nice one-page account of Bronfenbrenner's principles of human development is
provided at www.cyc-net.org/today2000/today000707.html

For further reading around the importance of family see paper 4.21.

3.5 Attachment theory

Introduction
John Bowlby (1969) was the first to conceptualise attachment as a fundamental
human need. In Bowlby’s early work an infant’s mother was considered to be the
primary attachment figure. In subsequent work, Bowlby and other researchers
developed thinking on attachment and broadened it from this initial focus on the
mother.

Attachment theory is very important in work with troubled young people as it can
help us to understand the meaning and function of violence, aggression and other
difficult behaviours in terms of attempts to gain a sense of security through
relationships. In any climate that seeks compensatory rather than controlling
strategies in work with young people, attachment theory is at the core.

Outline of theory
Attachment starts from the need in young children for physical closeness to their
main caregivers when they are upset or scared and leads to the formation of bonds
of affection that endure over time.


At the heart of attachment theory is the idea of the ‘arousal-relaxation’ cycle. This
describes an essential interaction where the baby communicates its distress or
discomfort by crying and subsequently gets a comforting response from the
caregiver. Meeting this need is the basis of the experience of the trust and security
and of the child’s capacity to regulate his/her own emotions.

The next stage in attachment theory is the ‘positive interaction cycle’ where the
caregiver initiates interaction with the child, which elicits a positive response. From
this interaction, the child’s self-esteem and self-worth are established. These early
and repeated experiences with our caregivers set a foundation for our internal
working models of self, others and relationships between self and others. They
provide us with our belief about whether we possess qualities that attract caregiving
and whether we believe in the capacity of attachment figures to provide us with
nurture and protection. (see also Maier’s ideas in The Core of Care, outlined later in
this chapter and in paper 4.06).

The Canadian psychologist, Mary Ainsworth (1978), observed the reactions of
young children when separated briefly from their caregivers and when reunited with
them and concluded that the presence of the caregiver functioned as a ‘secure
base’ which gave the child confidence to explore his or her environment. She also
identified three different patterns of attachment which appeared to be linked to the
way their main carer responded to and engaged with the child.

Secure

Insecure - avoidant

Insecure – ambivalent

A fourth pattern, insecure – disorganized was added by Main and Solomon in 1986.
The kinds of behaviour associated with each pattern have been studied and
described (see Daniel, Wassell & Gilligan, 1999a).

Attachment problems
Rutter (1995) writes about the likely consequences of severed or disordered
attachments. Attachment theory tells us that troubled young people, like all
individuals, will attempt to engage with others in ways that are consistent with their
past experiences of care. As their past experiences have often been inconsistent,
characterised by neglect, abuse or abandonment, they have learned that
aggression, violence and emotional pain are integral elements of close
relationships. Therefore, such young people may develop aggressive approaches in
their attempts to force a response from their caregiver.

Insecure attachments undermine a child’s capacity to reflect on and integrate
experience. Such individuals have an inability to interpret the meaning of many
human interactions. They often resort to concrete solutions to interpersonal
problems, attempting to control their sense of themselves through physical
experiences such as substance misuse, physical violence and crime. If the
caregiver responds to these behaviours in a negative way, which they commonly do,


the young person will be confirmed in their belief about themselves as bad and
unlovable and are likely to perceive their caregivers as rejecting.

Application to practice
Many of the sanctions used in residential child care are ineffective because they are
based on traditional behaviourist theories which are often not fitting for troubled
young people. For example, many young people with attachment disorders may be
convinced that they deserve nothing. In such cases, reward and sanction systems
are futile. Likewise, some young people in care will feel no attachment to their
caregivers whatsoever. If they are told to go to their room as a sanction, this will
have no effect on future behaviour as they will experience relief at being separated
from the adult they do not trust.

It is important therefore to view attachment theory not simply as a way of
understanding behaviour but as a tool to formulate interventions which will help
young people compensate for disordered attachments and thus learn new ways of
relating to people which will help them make healthy relationships in the future.
These interventions must place the priority on developing and maintaining
relationships rather than focussing on control.

Working from an attachment perspective has wide implications for residential child
care. It means that staff have to work from the belief that the meaning of the
behaviour is more important than the behaviour itself. This requires a depth of
knowledge and training in how to recognise different manifestations of
developmental difficulties and to know how to use their observations to inform care
plans and ensure that individual developmental needs are being met.

Attachment theory has been applied in educational settings and can provide a
useful theoretical bridge between teachers and care workers. Recent research in
neuroscience has shown how early experiences of caregiving affect the
development of the young brain and influence cognitive and emotional processes.
For example, the psychotherapist Sue Gerhardt (2004) reports in her book that
researchers studying the brains of acutely neglected Romanian orphans found a
‘virtual black hole’ where the orbitofrontal cortex should have been. This is the part
of the brain that enables us to manage our emotions, to relate sensitively to other
people, to experience pleasure and to appreciate beauty. Such scientific findings
highlight the importance of past experience on current functioning. They also open
up possibilities around how to compensate for past deficits. How this might happen
has implications that may be used to inform residential child care practice.

Conclusion
Attachment theory is increasingly influential in residential child care. Young people
in care, almost invariably, have experienced difficulties in past attachments and
these are played out in their current functioning. Attachment theory can help
workers better understand possible roots of behaviour and thus intervene more
appropriately.


Suggested reading
Bowlby, J. (1988). A secure base: parent-child attachment and healthy human
development. London: Routledge. Provides a good accessible account of Bowlby's
thinking on attachment

Daniel, B., Wassell, S. & Gilligan, R. (1999a). Child development for childcare and
child protection workers. London: Jessica Kingsley. A good accessible read - again
strong on ideas of attachment.

Fahlberg, V. (2001). A child’s journey through placement. London: British
Association for Adoption and Fostering. This is a classic text for anyone working
with children and families. It is particularly good on issues of transition and identity.

Howe, D. (1995). Attachment theory for social work practice. London: Macmillan.
Provides a good overview of attachment theory for a social work audience.

Lanyado, M. (2000). Daring to try again: the hope and pain of forming new
attachments. A paper first given to the Annual Care and Treatment INSET Day of
the Charterhouse Group of Therapeutic Communities on 20th September 2000. The
Charterhouse Group of Therapeutic Communities. Retrieved 1st September 2004:
http://www.charterhousegroup.org.uk/daring-to-try.htm

3.6 Lifespace approaches

Introduction
Lifespace is the physical and emotional arena in which workers and young people
interact and thus influence behaviour through daily life experience. The main factor
distinguishing residential child care from any other kind of child and youth work is a
sharing of the lifespace with the people we work with. If workers think about this in a
creative and considered way it can provide the foundation for important therapeutic
interventions and give damaged young people a safe place to have new and
positive experiences which can change the way they think about themselves and
the way they project themselves to others.

Overview
Working in the lifespace requires the conscious use of everyday life events as they
occur for therapeutic purposes. The concept of lifespace does not attach exclusively
to any specific child care theory. It emerged from the work of Fritz Redl, a
psychoanalyst who used psychodynamic ideas and explored them in groupwork
settings as a way to change delinquent behaviour (Redl, 1965). Others drew on his
ideas and wrote about creating a therapeutic milieu. The best known of these is The
Other 23 Hours (Trieschman, Whittaker & Brendtro, 1969). Others have applied


models of human development or sociological, cultural or social learning theories
within a lifespace context (see also paper 4.06).

Whichever theory is applied to working in the lifespace, it is important to assess the
quality of the milieu (the overall environment), as it must be a place in which young
people can heal and grow. The quality of the milieu will be determined, not just by
the physical environment but also by the non-material, including the customs, rules,
beliefs, attitudes, exercise of authority, social structure and history.

Implications for practice
In order to provide these experiences, workers need to focus on understanding
behaviour. For example, abused children have usually been betrayed by adults they
trusted. Therefore, it is likely that on the point of forming an attachment with a
caregiver they will exhibit rejecting behaviour which will stem from a deep fear of
trusting. They will need to be treated with patience, acceptance and understanding;
to be allowed to react to their terror and then come back to learn that the
relationship will not exploit their trust. This may need to happen repeatedly before
the young person can trust.

The central characteristic of a therapeutic milieu is that it must be able to provide
developmental care. Henry Maier wrote the seminal paper on what the components
of this should be. The paper is called, The Core of Care: Essential Ingredients for
the Development of Children at Home and Away from Home (1979). (See also
paper 4.06).

Maier writes of seven vital components in the core of care:

Bodily Comfort
As a child’s bodily comforts are met, they feel treated with care.
Throughout life a sense of well-being and care is experienced
when one’s body is free of stress. The experience of discomfort
makes people feel unwelcome, worthless and isolated. Young
people need to have private spaces that are unconditional.

Differentiations
Individual children all have different temperaments. This requires
that caregivers differentiate in the way they respond to them.
Temperamental differences impinge on development. Some young
people require bodily contact as part of close personal interactions
while others need some distance and rely on eye and marginal
body contacts.

Rhythmic Interactions
Rhythmic experiences promote feelings of belonging and
continuity. These can be simple things like walking, laughing or
clapping together. Playing ball games or bantering can also create
these rhythms. Rituals are the social counterpart to psychological
rhythmicity. Formal rituals might be the kind of things that happen
every fireworks night or on birthdays.


The Element of Predictability
To know what is likely to happen in the future lends a sense of
order and power to people's lives. Predictability can be
encouraged by engaging with young people in activities. The
young person accomplishing a new task requires recognition for
their mastery of this rather than an evaluation in terms of good and
bad.

Dependability
When repetition, rhythmicity and predictability are combined the
child will feel good and cared for because these experiences
establish a sense of certainty. The feeling of dependence creates
attachments and having a healthy attachment feels good.

Personalised Behavioural Training
It is only when a trusting relationship has been established with the
caregiver that effective behaviour training starts. This is because
behaviour is moulded largely by the caring person who the young
person perceives as being on his or her side.
Care for the Caregivers
It is essential that the caregivers are nurtured and given caring
support to enable them to transmit this quality of care to others.
Caregivers are enriched or limited as agents of care according to
the care they receive.

Using narratives
All young people who come to live in residential care come with a set story about
themselves. Given that their pasts have often been characterised by traumatic and
abusive experiences, they may well be distrustful and feel helpless about the future.
Some of our practice in residential child care, by constantly focusing on their
difficulties, can serve to 'stick' young people in negative stories of themselves. If
they can be helped to have trusting relationships in a safe environment then they
may dare to live in the present with greater optimism. The purposeful use of
activities can help them to reframe and re-tell their stories. Over time these stories
can change and they can begin to comprehend a new reality.

A therapeutic milieu is a place where people can be helped to change their story in
a very powerful but non-threatening way. The space needs to feel safe enough for
them to let go of the usual labels and social rules with which they surround and
protect themselves. These more positive experiences may have to happen
repeatedly before the person is able to change the story they believe.

The potential of using narrative approaches is being recognised in working with
young offenders to help them shift the ways in which they think about themselves
and to believe that they are redeemable. The quality of the helping relationships
available to them is fundamental to them being able to change their stories (McNeill,
2005).


Other traditions of practice
In Europe the idea of lifespace is pre-eminent in youth work as it fits with ideas of
social pedagogy, the preferred model of working with young people in most
European countries. Social pedagogy is more linked to ideas of social education
(education in its 'widest sense') than social work. It embraces a holistic approach to
working with young people and to their general 'upbringing.' It links well to the
concept of lifespace and the residential context as it focuses on merging tasks of
everyday life with longer-term goals of meeting young people’s emotional and
personal needs.

The development of residential child care in areas of North America and in Canada
in particular has been along similar lines, with people trained specifically as child
and youth care workers. Strands of their training are influenced by the Native
American philosophy that youth at risk can be corrected by nurturing the values of
belonging, mastery, independence and generosity. As with pedagogy, the focus is
on providing new experiences to promote growth and development rather than the
British tradition of the unitary practitioner assessing and attempting to treat
individual problems.

Increasingly in Scotland there is recognition that residential work merits a specialist
focus in relation to the education and training of workers. In child care in general,
there is a strong shift towards valuing strength-based and attachment-promoting
models of intervention. These two factors are bringing the concept of lifespace to
the centre of residential child care education.

Conclusion
The term lifespace is one that is not particularly well-known in Scotland or the UK. It
is central to other traditions of practice. Working in the lifespace is what workers in
residential child care do on a day by day basis. An understanding of lifespace allows
workers to locate their practice within a legitimate and sophisticated theoretical
framework.

Suggested reading
Maier, H. (1979). The core of care: essential ingredients for the development of
children at home and away from home. Child Care Quarterly, 8(4), 161-173.
For an account of the importance of narratives in work with young offenders see
Fergus McNeill's contributions to the 21st Century Social Work Review website
www.21csocialwork.org.uk.
Phelan, J. (1999). Experiments with experience. Journal of Child and Youth Care
Work, 14, 25-28. This short article provides a good way in to thinking about ideas
around helping young people re-tell the stories they have about themselves.
Smith, M. (forthcoming). Rethinking residential child care: a child and youth care
approach. In D. Crimmens & I. Milligan, Facing forward: residential child care in the
21st century. Lyme Regis: Russell House Publishing.
Trieschman, A., Whittaker, J. K. & Brendtro, L. (1969). The other 23 hours: child-
care work with emotionally disturbed children in a therapeutic milieu. New York:
Aldine de Guiter.


3.7 Resilience and strength-based interventions

Introduction
Resilience is the capacity an individual has to overcome adversity. As young people
in care are likely to encounter adversity on a large scale, their level of resilience is a
core indicator of how well they will do.

Traditionally, many coercive strategies have been employed for dealing with
troubled young people, including restraint and seclusion. This kind of response was
common to the disruptive behaviour arising from emotional and behavioural
difficulties and was seen as necessary to maintain safety, order and discipline.

With the recognition that these difficulties are usually caused by unmet needs, there
has been an impetus towards looking at strength-based alternatives to meet the
needs of our most challenging young people. There is an emerging view that it is
perhaps more important to understand the function of violence, aggression and
other troubling behaviours in the interactive process of relationships rather than
controlling the behaviours per se. This view is strengthened by a new, positive
psychology which says that young people have an innate capacity to compensate
for past deficits and to go on to reach their potentials (Benard, 2004).

Strength-based interventions in practice
For young people to thrive, basic physical needs must be met as well as needs for
attachment, achievement, autonomy and altruism. To help young people achieve
these, behavioural interventions must be driven by a focus on strength-building
rather than coercion. Strength-building interventions can be in the form of physical,
social and emotional support. Physical surroundings can convey powerful messages
to young people about themselves. Austere and ugly environments can be highly
distressing. Attractive and warm environments tell the people in it that they are of
value.

Children thrive in environments where they are free from the fear of physical
distress or harm. Young people can experience physical threat in environments that
are permissive or lackadaisical about bullying and attacks from peers. Although
physical restraint is officially only permissible as a last resort to ensure safety, it may
sometimes be the result of the mishandling of behavioural problems. Similarly,
seclusion imposes severe physical isolation and deprivation of stimulus. Such
sanctions impede optimal development and damage social bonds as young people
resist those who obstruct their needs.

Young people need to know that the adults who support them see beyond their
negative behaviours and offer them an unconditional positive regard. Blame,
rejection and threat interfere with the normal development of emotional resilience.
Incessant criticism creates a sense of inadequacy that interferes with the ability to
solve problems creatively. Young people have to feel they are trusted by the adults
who care for them before they can make a positive connection. Developing


resilience requires a sense of personal power and self-efficacy so that inner control
can be developed. Young people who are treated with respect and care learn to
believe in themselves and show respect to others.

Young people need social support to provide opportunities for belonging, mastery,
independence and generosity, the four pillars of resilience (Brendtro, Brokenleg &
Van Bockern, 1990). Young people who feel rejected may search for belonging in a
dysfunctional or distorted way such as joining a gang or cult. Some may have given
up hope of belonging and avoid people or become isolated or distrustful. They can
be helped by being encouraged and supported in positive social interactions and
ultimately relationships of trust and intimacy.

Those young people who believe that they are unworthy or are failures may seek
competence in distorted ways such as skill in delinquent activity. Others will give up
and withdraw from trying anything. They will benefit from an environment which is
rich in opportunities for achievement. Interests and activities should be encouraged
and supported and should not be linked to behaviour or ‘deserving’.

It is only through experiencing mastery that young people learn the vital skills for
future problem-solving. When they put themselves or others at risk through their
behaviour, it seems an almost instinctive adult response to control and protect.
However, if this is overdone it can result in the young person experiencing
powerlessness. Young people fighting against such feelings may assert themselves
in rebellious or aggressive ways. Others may react to their impotence by believing
they are too weak to manage their own lives and become the pawns of others.
Such young people need to be in environments where there are opportunities for
them to make decisions and they are given the power to exercise self control.

Research on resilience shows that simple communications which convey kindness,
such as a smile, a wave or a touch on the shoulder, have a powerful corrective
impact. When kindness and care are absent, young people remain self-centred and
fail to develop empathy. The most dangerous people are those deprived of kindness
and love. Everyday interactions with their carers are the most powerful way in which
young people experience kindness and generosity. If carers manage to convey
liking, empathy and regard to young people irrespective of their behaviour, these
young people will feel valued and be able to reciprocate these qualities.

Residential workers are in a unique position to help troubled young people build
resilience. This is because they work with young people in their lifespace and have
many spontaneous as well as planned opportunities to provide compensatory
experiences. Workers also have chances to help young people develop self-
efficacy. They can praise young people for small everyday achievements. Those
living with the young people will be in the best position to judge when it is time to
allow them some degree of autonomy and to ensure they are being given
opportunities to develop inner control and self discipline.

The essential challenge to residential workers is to strike an appropriate balance
between the firmness and exercise of appropriate authority required to provide
physical and emotional containment to young people, and the qualities of warmth,
nurture and affirmation required to help them grow (Mann, 2003).


Conclusion
A considerable body of psychological (and social work) thinking is moving away
from a focus on difficulties towards a focus on strengths. In many ways this calls for
a reappraisal of some of our earlier approaches. Rather than concentrating on what
is problematic in young people, it shifts our focus to working alongside them and
believing in their capacity for recovery and growth. Strength-based perspectives are
essentially optimistic and this can be important in sustaining staff morale.

Suggested reading
Brendtro, L., Brokenleg, M. & Van Brockern, S. (1990). Reclaiming youth at risk: our
hope for the future. Bloomington, Indiana: National Educational Service. This is an
inspirational book, which draws on native American child rearing practices to offer a
strengths based philosophy of practice.

Gilligan, R. (1997). Beyond permanence? The importance of resilience in child
placement practice and planning. Adoption and Fostering, 21(1), 12-20.

Mann, V. (2003). Relatedness and control. Relational Child and Youth Care
Practice, 16(3), 10-14. Provides a good discussion on getting the balance right
between care and control and in rooting this in the personal relationship.

Conclusion
It should be apparent from this chapter that theory only offers insights. It does not
offer easy answers to the complexities of everyday practice. Some of the theories
presented here have been developed in the context of therapeutic work with
individuals. In residential work we work with individuals, but also with their families.
We work with individuals who live in groups and therefore with groups themselves.
We have to take into account the dynamics of the larger group made up of residents
plus staff, and we need to bear in mind the influence of the wider organisations of
which we are a part. We need to be aware also of sociological and political factors
which affect the lives of residents and their families.

In this multi-dimensional setting it is unlikely that any one theoretical framework will
meet all of our needs for understanding the experiences and behaviours of those we
work with or for helping us decide how best to intervene with them. Practice will
benefit from clear theoretical orientation but concepts and techniques may be drawn
from a variety of models. For example, techniques from Cognitive Behavioural
Therapy might be applied sometimes at the level of working with the individual or
formal group (given appropriate staff training), while a view of child development
may be informed by attachment theory.

If there is an overarching concept that helps illuminate practice in residential child
care it is lifespace. Irrespective of whatever theoretical orientation might be brought
to practice, residential workers ought to be united in appreciating the importance of
using everyday events to enhance young peoples' growth and development.


Training Links
SVQ:
Most of the units within the revised SVQ level 3 award Health and Social Care
(Children and Young People) ask candidates to refer to theories of development.
This chapter would be applicable across the award.

HNC in Social Care:
HN unit Caring for young people in secure care settings: outcome two (optional
unit).


Introduction
4.01
Mark Smith

The three previous chapters provide background knowledge for those working in
secure accommodation. This chapter assumes a more applied focus and considers
some specific areas of practice. A number of considerations informed our thinking in
the way the chapter is structured.

The papers follow a timeline which reflects the stages of a young person’s stay in
secure accommodation. They start at the point of referral and end with a paper on
throughcare and aftercare. There is an obvious chronological logic to this. However,
it is also intended to emphasise that placement in secure accommodation should
represent only an interlude in a young person’s life. There is a past that goes before
admission and a future that extends beyond discharge. Secure placement should be
considered within that wider continuum.

Paper 4.04, Assessment, care planning, programming and monitoring is pivotal.
These are the areas where staff need to be clear about what needs to be done
during a young person’s stay in secure accommodation and how they are going to
go about this. Understanding these concepts and getting these processes right will
maintain a focus and a purpose to the work.

Subsequent papers taken together might be thought of as comprising a unit’s overall
‘programme.’ There are two strands to this. Young people should benefit from the
general experience of being in an appropriate care environment - the ‘therapeutic
milieu’ (see chapter 3 and paper 4.06). This provides a context that promotes
healthy growth and development. It is the primary instrument of change. Appropriate
attention to universal aspects of care, such as education, health, sexuality and
activities all contribute to a positive residential experience for young people.

However, those young people admitted to secure accommodation demonstrate very
specific difficulties that may require more targeted interventions. Examples of such
difficulties or behaviours might include self harm, problematic drug use, mental
health problems or offending. Care plans need to consider how young people might
derive maximum benefit from the everyday experience of a therapeutic milieu. They
also need to address specific areas of difficulty.

Having outlined our general thinking around these two strands of residential
practice, there is an inevitable crossover between the two. Issues of trauma, for

Secure in the Knowledge - Chapter 4.01 - May 2005 1

instance, may have roots in past experience and may induce particular mental
health difficulties.

Young people who experience these will, however, require a safe, predictable and
relationally based response from staff who work with them on a daily basis. We
have tried to ‘flag’ some of the links between papers. It is for readers to decide
whether our thinking in the grouping of papers reflects what is useful to them in their
work and to use them accordingly.


Referral, screening and
4.02 decision-making
Bob Forrest

Secure placements once made, should only be for so long as it is in the best interests of the
child.
(The Children (Scotland) Act 1995 Guidance, Vol 2, ch. 6:4)

Introduction
This chapter examines how young people are referred to secure accommodation,
the legislative framework governing this, the decision making process and gate-
keeping arrangements.

Legislation
The legislation in relation to the admission of young people into secure
accommodation is covered in detail in chapter 1.

Referral
Many young people at some point in their lives may be argued to meet the legal
criteria for placement in secure accommodation. In the vast majority of these cases
the crisis will pass or be resolved through appropriate intervention. Professionals
involved in making referrals to secure accommodation and those who make
decisions about placement need to ensure that they make considered judgements
about which of those young people referred for placement are actually offered a
place. They cannot afford merely to react to the understandable emotion and
anxiety which can surround young people when they hover on the edge of crisis.

One thing that needs to be taken into account in considering any request for
placement in secure accommodation is that almost all behaviour is contextual.
Young people displaying behaviour that brings them into the frame for secure
accommodation may be reacting to an environment, whether the family home or an
alternative care setting, that is out of control. The literature on secure
accommodation (e.g. Harris & Timms, 1993) points out quite clearly that badly run
residential units will throw up more candidates for secure accommodation than well
run units. Secure accommodation should not be used as a prop for deficiencies
elsewhere in the care system. In situations where young people may be thought to


be responding to a dysfunctional environment those making decisions about
placement may consider an alternative open setting before offering a place in

It is often claimed by social workers that it is very difficult to get young people placed
in secure accommodation. This is the way it should be, for the decision to deprive
any person of their liberty is not one that should be taken lightly. And while it may be
said that it is difficult to get a young person placed in secure accommodation, it
might be argued that it is equally difficult to get them out. There is a danger that
once in secure accommodation young people can be labelled in a way that makes it
hard to reintegrate them into other areas of the care system.

‘In most cases young people who go into secure care have a long history of
problems, disturbed behaviour and criminal offences’ (Social Work Services
Inspectorate for Scotland, 1996). In the majority of cases it will have been known
for weeks or months that a young person might require placement in a secure
setting. This should allow a period of preparation and for application to be made to
secure units. Some element of planning should go into most placements. Social
Work Departments concerned that a young person might require placement in
secure accommodation should seek advice at the earliest opportunity from the
appropriate secure unit. Some units issue application forms to be completed and
guidelines to be followed for the consideration of secure placement of young people.
In most cases units should have some information on a young person prior to
admission. The Code of Practice 1985 supports planned placements and makes it
clear that ‘Although emergency admissions may be necessary in the child’s
interests……such emergency admissions should be the exception, not the rule´
(p. 9).

Admissions on an emergency basis can have adverse implications for young people
leading to uncertainty about how long they are likely to stay. There may also be
adverse implications for the related processes of assessment, care planning and
programmes. Secure units should expect referral agencies to supply background
information in advance, or at the very least, with young people at admission. This
should include appropriate Looked After Children (LAC) material, notably the care
plan (see paper 4.04). Missing information, particularly in relation to events
preceding admission, has a knock-on effect on the next steps of placement. Heads
of units in conjunction with care authorities should ensure that arrangements are in
place for the timeous transfer of up to date and complete background information
about young people.


• What are the referral and admission procedures for your unit?

Decision making
The HASSASSAA (1983) legislation requires that three independent parties are
involved in the decision to admit a young person to security – the Children’s Hearing


(or Court), the Chief Social Work Officer and the Head of Establishment. Whereas
the Children’s Hearing or Court will be primarily concerned as to whether the legal
criteria are satisfied it is the responsibility of the Chief Social Work Officer and Head
of Establishment to satisfy themselves that it is ‘in the child’s best interests’. This
principle remains in the Children (Scotland) Act 1995.

The legal criteria for placement in secure accommodation under the Children
(Scotland) Act 1995 are set out in section 70 (10):

(a) having previously absconded, is likely to abscond unless kept in secure
accommodation, and, if he absconds, it is likely that his physical mental or
moral welfare will be at risk; or

(b) is likely to injure himself or some other person unless he is kept in secure
accommodation.

Given the intention of the overall arrangements for the use of secure
accommodation i.e. that it is an exceptional measure, only those children who
genuinely need it should be placed there, and that the length of time should be
restricted to the minimum necessary, it is important that the decision is made at an
appropriate level and by staff who have an understanding of issues related to
secure accommodation. Chief Social Work Officers and Heads of Establishment
both have a statutory role in admitting a young person to secure accommodation
and need to agree before a young person can be locked up. This joint decision
making ensures young people of the legal protection enshrined in the HASSASSAA
legislation.

Young people sentenced under Solemn Procedure (see Chapter 1) are placed in
secure care at the behest of Scottish Ministers. In such cases decisions as to the
need for secure care are taken by the Scottish Executive Justice Department
(SEJD) officials on behalf of Scottish Ministers.


• What information about young people do you think should be provided for an
appropriate decision to be taken about admission to secure care?
• Who in your unit and referring local authorities have the authority to decide on
a young person’s admission to secure care? Who else is involved in the
process?

Screening

Given the difficult task of deciding on the admission of a young person to secure
accommodation, and indeed in prioritising admissions, the Director of Social Work
and Head of Establishment may wish to seek advice from a range of expertise to
help inform his/her decision. In the years following the introduction of secure


accommodation legislation in 1983 formal Referral or Screening Groups
incorporating specialist advice e.g. Psychological and Psychiatric were constituted.

The remit of such a group was threefold:

• to consider referrals from social workers who believe that a
particular young person may benefit from a secure care
placement;
• to consider young people who have been made the subject of
Children’s Hearings Orders with a condition of Secure
Accommodation;
• to consider retrospectively the case of young people admitted by
emergency/administration process, i.e. from courts or on the
authority of the Director of Social Work and Head of
Establishment, and the appropriateness of these decisions.

The Screening Group aimed to fulfill two roles:
• to ensure that those young people with the greatest need and
difficulty are given priority for a secure bed;
• to provide the referring social worker with an opportunity to
examine what other help the young person might require.

In providing a multidisciplinary overview of young people being considered for
secure accommodation or alternative placements, the Screening Group was able to
contribute to initial assessment and planning thereby increasing the likelihood that
subsequent placement would provide the young person with a positive experience.

Over the years the use of screening groups has changed. Units now operate a
variety of different processes in dealing with referrals and admissions. Regardless of
the particular arrangements in place, these need to be suitably rigorous, ensuring
that the decision to deprive young people of their liberty is subject to appropriate
checks and balances.

It is important that criteria are kept in mind once a young person is admitted. The
need for security requires ongoing review. This is particularly so in cases where a
young person is admitted on a warrant from a children’s hearing. In such
circumstances, admission may have been in response to a particular crisis and
panel members will have had insufficient information to make an informed decision
as to any longer term need for security. A central task in this initial three week
period is to assess whether this is in fact required.


• What is your unit’s gatekeeping process? Who is involved?
• Think of a young person in your unit. List all the people who were involved in
the referral and screening process.


Conclusion
The legislation surrounding a young person’s admission to secure care is complex.
The decision to admit a young person to secure care is not one taken lightly as
fundamental issues such as deprivation of liberty are involved.

It is essential that the referral, decision making and screening processes are
rigorous so as to ensure that only those who appropriately require security are
placed. To maintain the highest standards these processes should be transparent
and draw upon the expertise of different professionals.

Training links

SVQ: Unit HSC 413 Manage requests for health and care services (Generic optional
unit in the revised SVQ qualification Health and social care: children and young
people level four).

Further reading

McNorrie, K. McK. (2004). The Children (Scotland) Act 1995: 2nd edn. Edinburgh:
Green & Son Ltd.

Scottish Office. (1997). Scotland’s children: the Children (Scotland) Act 1995
Regulations and Guidance: volume 2: Children looked after by local authorities.
Edinburgh: Stationery Office.

Social Work Services Inspectorate for Scotland. (1996). A secure remedy: a review
of the role, availability and quality of secure accommodation for children in Scotland.
Edinburgh: Social Work Services Inspectorate.


Admission
4.03
Mark Smith

A range of tasks face staff in the early stages, but attending to these with an appropriate
sense of purpose will set the tone for a placement.

Introduction
This paper outlines the circumstances under which young people are admitted to
secure accommodation. It identifies initial tasks facing staff and those which need to
be addressed in the early stages of placement.

Admission routes
Young people can be admitted to secure accommodation through different legal
routes. They may come through the Children’s Hearing system on either a warrant
or a supervision requirement. They may come through the courts on either remand
or sentence. They may in the first instance be admitted through administrative
process with the agreement of the chief social work officer and head of the secure
unit. For a full discussion of the legal routes into secure accommodation see chapter
1.

The legal route into secure accommodation will have a bearing on the way in which
individual admissions are handled. It is important that staff are aware of the legal
basis of placement.

Admission circumstances
‘Planned’ admissions
By the very nature of the provision, there are few ‘planned’
admissions to secure accommodation as such. ‘Anticipated’
admissions might better describe this category. Few young people
arrive in secure accommodation entirely unknown to the social
work system. Many will have been ‘bubbling under’ the need for
secure accommodation before they are actually admitted. They
may have been discussed at a referrals group or with secure unit
staff and reports should be available. Staff should therefore have
some idea of presenting issues and should be able to do some
initial planning prior to admission. The nature of their admission


may be reasonably ordered in that they may be brought by social
workers or staff from other residential units. In such cases units
should expect a full set of paperwork on young people as per the
Looked After Children (LAC) material.

Emergency admissions
Some young people will enter secure accommodation unknown or
virtually unknown. These are sometimes called ‘late erupters’ in
the sense that they have had little or no contact with social work
services until they become involved in a serious incident. They
may be placed initially on remand through the courts.
Other young people may be known to the wider social work
system but have to be admitted to secure accommodation on an
emergency basis, possibly in extreme circumstances, late at night
and/or under the influence of drink or drugs.
Again, the circumstances of an admission will determine staff
responses.


• Can you identify different circumstances surrounding the admission of young
people to your unit?
• What were the implications of this for the way the admission was handled?

Staff anxiety
The extreme nature of the difficulties presented by young people admitted to secure
accommodation can cause anxiety in staff. Some will have reputations for violence
in their local communities. They may have connections with existing residents.
Others will come with a history of making allegations, others with serious drugs
habits or issues of self-harm. Depending on how settled or otherwise a unit is at any
particular period, a new admission can provoke considerable anxiety.

Staff should ideally have some opportunity to talk through any anxieties and how
these might be allayed prior to a young person’s admission, otherwise their
anxieties may be projected on to the young people, thus failing to convey essential
messages of security and of staff being in control. If possible some thought should
be given to what staff member/s will be involved in an admission. Questions of
experience, confidence and gender might be taken into account.



• Think about the admission of a particular young person to secure
accommodation.
• What feelings were around for you and/or for colleagues?
• How were these dealt with?

Receiving a young person into secure accommodation
In the past, receiving a child into care involved severing their connections with the
outside world and giving them an identity as a child in care. Nowadays, their
connections with the world they are coming from and will be returning to should be
central to the admissions process, especially for young people admitted through the
Hearing system or on a short-term sentence.

Irrespective of their reputations or their previous experiences, admission to secure
accommodation is likely to be a traumatic event for young people. Some may hide
this behind a show of bravado, but, nevertheless, they will have all sorts of anxieties
about what to expect.

First impressions
The point of admission to secure accommodation will be one that young people are
likely to remember for the rest of their lives. Staff need to be sensitive to the
impression they give. Too many keys and locking doors will convey a powerful
impression to a young person of being jailed and this is likely to influence their
subsequent response to placement.

Staff need to strike an important balance between presenting a sense of personal
authority and confidence with a genuine concern and respect for the young person.
In their conversation they should help young people make connections, finding out
where they have come from, a bit about their families and whom they know.


• What are your unit’s arrangements for admitting a young person to secure
accommodation?
• What messages do they give to young people?

Paperwork
Some necessary paperwork attaches to any admission to secure accommodation.
First of all, staff need to be sure that there is appropriate legal authority to lock a
young person up. In most cases this should be sent to the unit in advance of
admission.


There are also basic details about next of kin, social work contacts, doctor, etc., that
need to be collected. Details of the type of information to be collected are set out in
the Children (Scotland) Act 1995, Regulations and Guidance: volume 2. Units will
have their own forms for doing this. Again, in planned admissions this information
should be readily available and social workers may be able to provide most of it in
advance. The way that staff interact with young people to access the required
information is important in conveying a message of care rather than just seeming to
process details of a child’s life.


• What paperwork do you need to obtain when a young person is being admitted
to secure accommodation?

Immediate needs
In some emergency admissions consideration may need to be given to an early
body search, or to practicalities such as the need for a shower or change of clothes.
If a young person is under the influence of drink or drugs, arrangements will need to
be made to monitor them until staff are satisfied that these are sufficiently out of
their systems.

Settling
Once the preliminary information gathering is complete, young people can be
introduced to their living space and then to the group. Care should be taken to
ensure that bedrooms are properly prepared to admit a new resident. Beds should
be made and towels and toiletries on hand. At some point, young people should be
asked to comply with a search of their belongings and of their person. They will
need to be advised as to what items, such as glass, aerosols, money, etc., are not
allowed in the unit. Again, searching and the prohibition of certain items should be
explained and couched in terms of the need to ensure a safe environment. The
intrusiveness of any search should be linked to individual circumstances and
consideration of risk.

Young people should be given some basic information at this point on what to
expect. Those coming on remand or on a warrant may have little idea of what
happens next for them, so staff should be in a position to talk them through the
process. Too much information is unlikely to be taken in or retained at this point.
Information sheets or booklets will allow young people to go back to what they need
to know.

One thing to bear in mind is to try to allow young people to keep some belongings or
items that connect them to their past.


Entering the group
Every unit will have its own arrangements for young people entering the resident
group and these may vary from case to case. Connecting them with an existing
resident may ease their entry into the group.


• What are the arrangements in your unit for bringing a young person into the
unit?

The first few days
The first few days are important in setting the tone and purpose for a placement. A
number of things need to be considered in this period. These include:

Identifying key staff
Most units will operate a keyworker system of some sort. In ‘planned’ admissions
keyworkers may be identified in advance and may be rostered to be on shift. In
other cases they should be identified within the first day or so. Some consideration
should be given to matching keyworkers to particular young people, although this is
not always possible for practical reasons. It can also be difficult to predict how
relationships might develop.

Given the range of tasks involved in a secure placement it is essential that an
identified individual (or individuals) have responsibility for co-ordinating a case.
Other staff may be identified as having particular roles with young people but
keyworkers need to pull these together and ensure things are kept up to date.

Units may also identify key teachers to maintain an overview of a young person’s
educational progress.

Contact with social workers
One of the early tasks in a secure placement is to establish a working relationship
with allocated social work staff. There are a number of purposes to this. One is to
ensure an early sharing of information on a young person and to make sure units
have all the information they need to work with them.

Another task is to establish expectations about respective roles. Given the sense of
focus of most placements and the need to make early decisions around such areas
as the continuing need for secure accommodation, and the identification of future
placements, it is essential that social workers are actively involved in placement
planning. Expectations of the level of this involvement are now laid out in the Youth
Justice Standards (see chapter 1). These lines of responsibility and respective
expectations may be the focus of an initial review meeting.


Health
Young people may arrive in secure accommodation with a number of unaddressed
health needs, some immediate, others which are less acute but nevertheless need
to be identified and dealt with. Admissions medicals should involve filling in gaps in
young people’s medical histories and ensuring that arrangements are made to carry
out outstanding immunisations, dental treatment etc. However, this should be done
in the context of a proactive engagement with young people around their health
needs (see paper 4.10).

Education
Units will make their own arrangements for integrating young people into education.
Education will comprise a considerable block of a young person’s day and is a
crucial element of the routine in secure accommodation. An assessment of a young
person’s attainment and level of functioning and an early admission to the education
service is important in providing an early sense of purpose for the placement.

Family
We have identified the importance of their families to young people in care (see
chapter 3 and paper 4.21), yet working with families is an underdeveloped area of
practice in secure accommodation. Where possible, staff should invite a young
person’s family to an early meeting. In some cases it might be preferable to visit
them in the family home as this may give access to more family members and may
offer a more rounded picture of family functioning. This type of built-in contact with
families is vital in gaining their understanding of the issues that face a young person
and of what different family members might be able to offer to support a placement.

Families visiting young people in secure accommodation should be encouraged and
made welcome. Obviously some security and safety considerations might attach to
family visits if there is a perceived risk involved. In most cases however, with
appropriate briefing and supervision, visits can be carried off successfully. It is
important that staff begin to think about families as an asset to young people rather
than as a risk, as can be the case in secure accommodation settings.

The initial assessment
Assessment is a key task for workers in secure accommodation (see paper 4.04).
There are now expectations that units will produce an action plan in the early stages
of a placement. Keyworkers need to draw together the information and produce this.
This can only be tentative at such an early stage but may include pointers as to how
a placement will be managed.

Preparing for and attending meetings
There should be an early child in care review for young people admitted through a
Children’s Hearing route. There may also be a Children’s Hearing to consider
placements made under administrative process.


Reflective Task

Make a list of all the tasks a keyworker has to undertake in the early stages of a
placement.

Conclusion
The way in which a young person is admitted to secure accommodation and their
experiences in the first few days are important. A range of tasks face staff in the
early stages, but attending to these with an appropriate sense of purpose will set the
tone for a placement.

Training links
SVQ:
Unit W3 Support individuals experiencing a change to their care requirements and
provision (optional unit in the SVQ level 3 qualification Caring for children and young
people).
Unit HSC 413 Manage requests for health and care services (Generic optional unit
in the revised SVQ qualification Health and social care: children and young people
level four).

HNC in Social Care:
HN unit Caring for young people in secure care settings: outcome three (optional
unit).

Further reading
Gabbidon, P. & Goldson, B. (1997). Securing best practice: an induction manual for
staff working in secure accommodation. London: National Children’s Bureau.

Rose, J. (2002). Working with young people in secure accommodation: from chaos
to culture. Hove: Brunner-Routledge.



Assessment, care planning,
4.04 programmes and monitoring
Phil Garland

If you don't know where you are going, every road will get you nowhere.
(Henry Kissinger)

Introduction
This paper covers assessment, care (or placement) planning, programmes and
monitoring. These are crucial concepts which, together, encompass the overall task
of secure accommodation. Everything that workers do can be located within this
framework. It presents an overview with some definitions of these terms set in the
particular context of secure accommodation. Finally there is an outline of a
framework that pulls it all together. This paper should be read alongside the
appropriate youth justice standard referred to in chapter 1.

What is assessment?
Assessment is something we do most days of our lives. When we get in a car to go
somewhere new we look at a map to tell us where we are before setting out on the
journey. This is assessment – the art of identifying where you are as a basis for
planning where you want to go. In our daily child care practice we make continual
informed judgements about young people; where they're at and where we want to
get them to.

The process of assessment is fundamental to our work in child care. In order to help
a young person move forward the practitioner needs to develop a picture of him or
her in their wider environment. It is from this picture that the child’s needs are
identified. Thereafter we can begin to frame interventions that seek to respond to
those needs.

A useful definition of assessment is:
the ongoing process, in which a client participates, the purpose of
which is to understand people in relation to their environment; it is
the basis of planning what needs to be done to maintain, improve
or bring about change in the person, the environment or both.
(Coulshed & Orme, 1998, p. 21)


The initial assessment, then, identifies where a young person currently is and starts
to plan the route ahead. However, young people change and develop, and the staff
team’s interaction with the young person will also result in movement. Therefore,
assessment is not a once and for all event. The initial picture of a young person may
alter as we find out more about them. Additionally, as they grow and develop, their
interactions, their needs and their ways of functioning will change. We need to build
in mechanisms that will take any changes into account and allow us to fine tune our
responses.

Assessment frameworks

When a young person is referred to secure accommodation, the social work
department should have carried out an assessment (often a whole number of
assessments!). The role of assessment in secure accommodation must be seen
within the context of, and as adding to, the comprehensive assessment that should
already have been carried out, rather than replacing it.

Most local authorities use assessment models based on The Department of Health
(DOH) framework, Assessing Children in Need and their Families. This is essentially
an ecological model of assessment (see chapter 3), which seeks to understand
children within their wider environment. The central task in the DOH framework is to
safeguard and promote the welfare of a child. To do so requires an assessment
along three broad dimensions, the child's own developmental needs, the parenting
capacity of his or her carers and family and environmental factors. Given the range
of needs to be assessed such assessments should draw on the knowledge and
skills of other groups such as teachers, and health professionals. Coordinating this
comprehensive assessment is the responsibility of the social work department
responsible for the child. The social work department also has a statutory
responsibility to develop a care plan, ensuring that provision is made for the needs
identified in the assessment to be adequately met. There is an expectation that local
authorities will use the Looked After Children (LAC) material as a framework for their
assessment and care planning.

Assessment in secure accommodation

The assessment task for staff in secure accommodation is more specific.

In many cases, the first task is to make some judgement as to the continuing need
for security. This is especially important if young people are admitted on a warrant
and will be returning to a children’s hearing within a three week period. Panel
members will expect a well-argued case around the need or otherwise for continuing
a placement.

Some larger units operate a specific assessment unit with the task of reaching a
decision about the ongoing need for security. In units that operate a differentiated
service model, whereby different residential units specialise in specific areas of
practice, the assessment unit will decide on the most appropriate unit for a young
person to move on to.


The Scottish Executive now expects that referring agencies will use ASSET or YLS
frameworks (see chapter 1 and paper 4.18) prior to admission. The Youth Justice
Standards also specify that an action plan setting out the aims of a placement
should be completed ten days after admission. Inevitably, any plan made at this
stage can only be tentative and must be open to review. However, it is right that
staff should focus from the point of admission on the purposes of any placement in
order to avoid ‘drift’.

Therefore, assessment needs to focus on the overall circumstances which led to
admission to secure accommodation and should identify specific needs related to
the criteria (see. chapter 1). It should take as a starting point the reasons given for
placement at the points of referral and admission.

Buist & Whyte (2004) makes the case for assessment and planning to be specific.
They identify that most young people in secure accommodation have a history of
problems, disturbed behaviour and offending. They go on:
The most commonly identified problem was running away, allied to
difficulties with family relationships, followed by offending for boys,
while for girls it was substance abuse.
Assessment reports stated the young people’s general needs
together with details of their offending and the action taken, but
although care plans were clear about how to meet general needs,
they were less clear about how to deal with the behaviour and
difficulties which led to the young people being placed in secure
care.
The review concluded that the outcome of assessment should be a
programme that aimed to change the behaviour that led to the
placement in secure care, and recommended improvements in the
process with attention to aftercare arrangements which were poor
or non existent.
(Buist & Whyte, 2004)

Of course these principles apply to young people who have non-offending
behavioural difficulties as well as those who commit offences.

In essence, assessment in secure accommodation needs to address both general
care needs and the specific behaviours that led to the young person being placed in
security. As noted, this assessment should sit within the social work department's
comprehensive assessment. Some aspects of what happens in secure
accommodation will affect and will be affected by events that happened before
admission; much of what happens in secure will need to be continued once a young
person moves on. However, there is merit in narrowing the scope of the
assessment task specific to secure accommodation to what is mandated and
manageable within that context. Facilitating the continuation of work done in secure
accommodation, through suitable throughcare programmes and the development of
appropriate community links is vital.

Units should aim to produce an initial action plan (an account of where a child is at,
including some of the specific difficulties facing them and a plan of what needs to be
done to allow them to move on from secure accommodation) within the first 10 days


of placement. As the issues facing a child are likely to be multi-dimensional,
assessments should include the input of different professionals, such as education
and medical staff, and psychological and/or psychiatric support. They should also
draw on the insights of family members, who are likely to know a young person
best. Important insights are also provided in the everyday living situation and staff
who share in the lifespace (see paper 4.06) of young people should contribute to
the assessment. Most importantly, the views of the young person themselves need
to be incorporated into the assessment. Staff and young people need to be 'on the
same page' in their understanding of a situation and how to go about addressing it.

Unit three, as the assessment unit, had exemplary record keeping. Here records
were seen as working tools, which had to be “accessible, clear and purposeful, as
opposed to files from which information cannot be accessed, which are in turn
confused and from which mistakes may emanate, which may harm young
people.”

Inspection report of St Mary’s Kenmure, March 2004, p. 23


• Think of a young person placed in your unit. How would you conduct an
assessment of them?
• Identify the different people and agencies that were involved in the assessment
of one of the young people that you work with.

What is care planning?
Assessment provides a platform for what is done in secure accommodation. The next
stage is the care plan or placement plan. Following the road map analogy, you are in
Edinburgh and you want to go to Glasgow. You need to plan the route. Will you go by
train or car? If you choose the car, who will drive, etc. This is the development of a
‘plan’ which specifically addresses how you will get there and answering all the who,
what, where, when and how questions.

So, when the assessment is completed (the art of identifying where you are and
where you want to go), a Care Plan may be defined as working out how to get there.
It is a plan for the provision of services to an individual or family, identifying what
services or interventions will be provided, when, where and by whom. Ideally the plan
should involve users, carers and their families as well as other professionals who
may be contributing to the plan. As noted, it is the responsibility of local authorities to
develop care plans for young people.


Care planning/placement planning in secure accommodation

Care planning in secure accommodation should follow on from the initial assessment.
The social worker is responsible for developing the overall care plan within which
certain components are addressed by the specific secure unit care plan. To avoid
confusion, this specific care plan might better be called the placement plan. The
placement plan is the ‘road map’ that outlines the journey that the child will take
towards tackling the issues that led to him/her being admitted to secure
accommodation.

The placement plan might be thought of as identifying specific pieces of work that
can realistically be undertaken in secure accommodation. At a simple level, the very
fact of placement in a secure environment should allow particular health needs to be
addressed. There may therefore be some generic aspects of care plans that
determine that all children should be fully inoculated and have any outstanding
medical, dental and optical treatment brought up to date.

More specific elements of the placement plan might seek to address particular
aspects of offending or self-harming behaviour, for instance (see the appropriate
papers in this section of this manual).

It is also helpful to consider in a placement plan how aspects of the overall milieu
might be actively utilised to promote particular objectives or goals. For instance, how
might staff intervene in everyday life events (see paper 4.06) to try to work on a
young person's problems with anger management? Or how might an understanding
of some of the particular needs of boys or girls (paper 4.12) or of adolescent
sexuality help explain and give pointers as to how to intervene with particular
behaviours?

The placement plan needs to be continually revisited to make sure that the best route
is being taken, and that everyone, child, staff, family and professionals are all on the
same road. In addition the placement plan should regularly review the continuing
necessity for a young person to be held in secure accommodation, in line with the
imperative that they stay there for the shortest possible time.


• Think of a young person placed in your unit. How would you construct a
placement plan for this young person?

The programme
There is little point in developing a placement plan unless you are then able to
access sufficient resources or expertise to be able to carry it through. The means
through which a placement plan is implemented might be described as the


programme. The programme is essentially what units will do to address areas of
difficulty and to get young people to where we (and they) want them to be.

The term programme can have a variety of different meanings in residential child
care (Fulcher, 2004). In recent years it has been used to describe specific
proprietary interventions targeted at particular difficulties, such as anger
management, cognitive skills or challenging offending. For the purposes of this paper
it is helpful to think of the idea of programme in a far wider sense. A unit's
programme incorporates everything that informs the way it works with young people,
from its philosophy and ethos through to the particular interventions it has developed.
Thus, activities might be thought of as being part of the overall programme, as might
specialisms for instance in dealing with young people who self-harm. The programme
can be thought of as a menu of possible interventions that staff can draw upon to
service care or placement plans. The programme can include everyday lifespace
experiences or in-house interventions carried out by keyworkers or others. It may
also pull in professionals with particular areas of expertise.


• What are the range of interventions available within your own unit to service a
young person's placement plan?

Reassessment and monitoring

The final component covered in this paper is monitoring. Monitoring is basically the
art of ‘knowing that you have got to where you wanted to go’ and changing tack if you
are not where you intended to be (reassessment).

There are a number of external mechanisms through which work done in secure
accommodation is monitored. The most obvious of these is the Looked After Child
Review process, through which each case of a child in the care of a local authority is
subject to a statutory review. Children's Hearings review the progress of children
placed in secure accommodation through that route. Young people placed by
Scottish Ministers on Court sentences are subject to review through the Scottish
Executive. Care Commission inspections involve monitoring a range of a unit's
functions. All of these mechanisms will reflect the effectiveness of assessment, care
planning and programming.

Reassessment and monitoring in secure accommodation
Whilst assessment, care planning and programmes may be subject to external
monitoring mechanisms, good practice would suggest that units should also develop
internal systems through which staff know that they continue to be on the right road.
This is important because secure accommodation is a dynamic and fast moving
environment, where things can change half a dozen times between formal reviews.


Inevitably there will be times in a placement when staff or young people feel as
though they are lost or they come across roadblocks and need to change direction to
get to where they want to go. That's why they need to have systems that allow them
to keep track of where they are going and to readjust and change direction if
necessary.

One way of doing this might be to build in weekly placement planning meetings
where a key worker and a child and, if possible, the social worker, parents or other
appropriate parties, sit down and review the placement plan objectives in light of
events of the past week. These meetings might also be the forum where decisions
about mobility levels can be taken.

These weekly meetings might then be collated within monthly evaluative reports,
which would provide a mechanism for the review and re-assesment of a case. Thus,
if particular interventions are not working the placement plan can be changed
accordingly. Such systems would ensure that staff stay abreast of issues and that a
momentum is maintained in placement planning. It also means that when staff are
faced with writing reports for external agencies such as Children's Hearings much of
the work they have done is already documented. Units would need to ensure the
cooperation of social work departments to ensure there was a common
understanding of the remit and purpose of such a system.


• Think of a young person placed in your unit. Identify the monitoring framework
to ensure that the assessment and care plan are, and continue to be,
appropriate for them.

Principles and professional issues
In undertaking an assessment within the context of secure accommodation, the
following principles should underpin our work.

Conducting an assessment in an inappropriate way can be harmful. Middleton (1996)
issues a warning:
Those charged with assessment need an intelligent understanding
of its purpose; its context; and its potential to harm as well as to
help; in addition to having the skills that enable an assessment to
be carried out.

Assessment is a skilled task. It involves trying to understand what is going on for
another person within a complex social arena. It isn't something that can be reduced
to a set of tick-boxes. Any assessment will include some of the insights and values
of the person doing the assessing. The incorporation of our own values and insights
into the social world of a child brings a human dimension to the process of
assessment. A caveat would be that we are aware of the intrusion of our own values


and we do not try to pass them off as fact or to pretend that we really know what is
going on for the person we are assessing. Any judgements we make can only be
provisional and tentative and subject to change as circumstances and our own
understanding evolve.

The purpose of assessment is to understand rather than judge. It involves ‘doing
with’ rather than ‘doing to’ - those most likely to understand a child are that child and
his/her family members. Therefore we must seek out and include their views in
authentic rather than tokenistic ways.

Putting it all together – A framework for assessment, care planning and
monitoring
Throughout this paper the following points have been referred to. They are outlined
here to provide an overview of the entire process.

1 ‘Identify where you are’ (assessment)

This is the key to the assessment – identify the problem/s at hand. This will
involve clearly identifying the risk factors/behaviour patterns that meet the
criteria for a child’s admission to secure accommodation. For example, a
young person may be a persistent absconder and place him/herself at risk
whilst absconding. In this situation, the assessment would seek to identify the
issues that underpin the absconding behaviour and possibly the type of risk at
which they put themselves.

1a ‘Identify where you want to go’

When the problems are identified, the assessment will identify objectives that
the child might attain.
Assessment of a young person should take place in the early stages of a
placement. This will draw together previous information held on a resident as
well as the child’s own perceptions and our observations of them. This
document should provide the baseline assessment that informs the care plan
and consequently how we engage with this young person. It starts to point
interventions in particular directions.

2 ‘Identify how you will get there’ (the Care Plan)
In the section on assessment the initial parts of an assessment were identified
as ‘identifying where you are’, and ‘where you are going’. When the problems
are identified, the care plan will identify a means to tackle the presenting
issues. It is a statement as to ‘how to get there’, identifying the pieces of work
that need to be done.
This will include how the child will benefit from living within a therapeutic milieu
in conjunction with specific, tailored interventionist programmes. The people
who should undertake these pieces of work should also be identified.
It is important that any objectives set are realistic. These need to be governed


by the length of time a young person will stay in secure accommodation
(bearing in mind the need to ensure that this is kept to a minimum) and the
complexity and longevity of some of the problems that face young people in
secure. To return to the car analogy, there's no point in thinking you can travel
from Glasgow to London by car in two hours. Yet sometimes we set placement
objectives that are as unrealistic as this.

3 What do you need to support you on the journey (the programme)
This is the tool-kit of resources you can call on to service the care plan. It might
involve everyday events and activities, planned interventions and the use of
external agencies.

4 ‘Are you on the right road?’ (Review/Reassessment)
Assessment and care planning are not single events. They need to be
continuously reviewed in the light of the progress of the young person. Units
should develop mechanisms to ensure ongoing assessment that record any
alterations to our initial assessment and any consequent changes to our
placement planning.
The placement plan will need to be reviewed frequently so as to measure the
success or otherwise of the interventions. This will feed in to the reassessment
of the child’s specific needs in relation to the criteria that led to admission to

5 ‘How do you know that you have got there?’ (Monitoring)
This includes a range of internal and external audit, monitoring and supervisory
functions.

Conclusion
This paper has set out to outline the concepts; assessment, care planning,
programming and monitoring. The young person is on a journey and the role of the
staff group is to assist him/her to reach that destination – safely.

Training links
SVQ: Unit SC8 Contribute to the development, provision and review of care
programmes (mandatory unit in the SVQ level 3 qualification Caring for children and
young people).
Unit HSC 36 Contribute to the assessment of children and young people’s needs
and the development of care plans (specific optional unit for the revised SVQ level 3
qualification Health and social care: children and young people).

HNC in Social Care: HN unit Caring for young people in secure care settings:
outcome three (optional unit).


Further reading
The assessment framework is available on the Department of Health’s website:
www.dh.gov.uk/Home/fs/en.

Calder, M. (2003). Assessment in child care: using and developing frameworks for
practice. Lyme Regis: Russell House Publishing. This is a comprehensive edited
volume around assessment generally and in relation to specific areas of practice.

Fahlberg, V. (1994). A child’s journey through placement. London: BAAF.

Fulcher, L. (2004). Programmes and praxis: a review of taken-for-granted
knowledge. Scottish Journal of Residential Child Care, 3(2), pp. 33-45.
Provides a discussion of the nature of programme in residential child care.


Working in secure
4.05 accommodation
Mark Smith & Margaret Sloan

The ultimate objective of secure accommodation is to effect a shift from physical security to
security based around relationships….

Introduction

This paper identifies some of the features that make working in secure
accommodation distinct from other areas of residential child care. These differences
are linked to the legal mandate of secure accommodation and the need to maintain
physical security and safety. Areas covered include: the differences and similarities
between secure accommodation and other areas of practice, environmental
considerations, the pace of work, and specific aspects of practice in secure
accommodation.

Differences and similarities between secure accommodation and other
settings
Many young people growing up may, from time to time, meet the legal criteria for
secure accommodation. Only a small proportion of these will be locked up, either
because a resource is not available on a particular day or because an alternative
intervention is preferred. Although there is a need for rigorous decision making in
the referral process, there is also an arbitrary aspect to who gets locked up and who
does not. The behaviours of those who get locked up may, or may not, be more
extreme than those of other young people in care or in the community. Their needs
are rarely qualitatively different. Being placed in secure accommodation should not
unduly stigmatise or set young people apart.

While there are underlying similarities between young people in and out of secure
accommodation, those who are placed there, by the very nature of that placement,
demonstrate a need for physical security and for controls to be placed on them for a
while. Moreover, placing agencies, politicians and the public have particular
expectations as to the role and purpose of secure accommodation. Taking the
decision to lock a young person up brings with it certain expectations and
responsibilities which call for a distinct way of working.

The above point is particularly pronounced in units that work with young people
sentenced through the courts. This places additional demands on staff to ensure


that placements meet the requirements of the criminal justice system, whilst also
addressing their welfare needs. The fact that young people on sentence are, for the
most part, confined to the secure unit introduces particular dynamics to ways of
working with them.

The purpose of secure accommodation
The primary purpose of secure accommodation is to ensure safety and security for
the period of time a young person spends there and hopefully beyond. This requires
that staff impose temporary controls to help a young person develop sufficient
internal controls so as to minimise the need for external control. This, of course, is
not a once and for all transition. Young people may make progress, but may then
regress and need greater external control placed upon them for a while. The
process might be likened to an elastic band. At times it may be stretched tight; at
other times it may be pulled in. Staff have to try to locate the level of control needed
at appropriate points along this ever shifting continuum. The ultimate objective of
secure accommodation is to effect a shift from physical security to security based
around relationships, where the quality of the attachments young people establish
with adults is what keeps them safe.


• Before you started your present work, what did you think the purpose of secure
accommodation was?
• Has this changed and if so in what ways?

Environmental considerations
A properly designed building ought to be the first expression of the security a young
person requires. Buildings should be robust. If young people identify a weakness in
physical design they will seek to exploit this. However, security should be as
unobtrusive and understated as possible. Units should appear attractive. Small
features such as paintings and photographs or the presence of flowers and plants
can have a 'softening' effect on the environment.

The regime that operates in a secure setting should not set itself up as a challenge
to young people placed there. Placement should not be seen as a notch in the belt
of a delinquent career. Staff should not see themselves as performing just
containment and control functions, and some thought should be given to the
possible messages conveyed by aspects such as the way staff dress and
arrangements for carrying keys. Over-emphasising a control function in secure
accommodation can lead to a ‘them and us’ culture.

A sensitive balance needs to be struck between proximity and privacy. Staff need to
demonstrate a background awareness and presence whilst respecting a young
person's need for personal space. Again, good building design and layout can


facilitate this for instance, through the shape of rooms and the positioning of
windows.

Staff considerations
Working in secure accommodation does not suit everyone. Staff who have worked
in other areas of residential child care can have difficulty adjusting to secure
settings. Whilst some of the skills in building relationships may be similar, there are
also significant differences. Whilst there may be an emphasis in open settings on
offering choice and seeking to empower young people, the role of secure
accommodation, at least in the early stages of a placement, is to limit choice and to
assume temporary control over a young person’s life. Some staff may feel
uncomfortable with the requirement to lock doors on young people. Others may
struggle with the need for some of the security provisions that follow on from the
nature of the setting.

On the other hand, secure accommodation can also attract individuals who like the
structure and routine of the setting. Some may fail to appreciate the inevitable
complexities and tensions involved in locking young people up. Such staff may over-
emphasise considerations of security and order and pay insufficient attention to the
therapeutic aspects of a placement.

An appropriate balance needs to be struck between the need for control and the
need for nurture. The two are of course mutually compatible. Staff need an
appropriate confidence and sense of their own authority and an ability to convey this
to young people in non-threatening ways. The necessary sense of order in a unit
comes through the establishment of authoritative yet nurturing relationships (see
chapter 3).

There is a need for recruitment and ongoing training and supervision to establish a
common understanding of the nature of work in secure accommodation and the
everyday implications of this. Staff who are not comfortable in the setting perhaps
need to be given the opportunity to come to this conclusion and if possible to find
work where their skills are better suited.

The intensity of the work
The experience of being locked up can be a frustrating one for young people. In
open residential settings there is a release valve in situations where feelings run
high inasmuch as young people can take off and cool their heels. In secure settings,
frustrations, distress and anger can lead to feelings boiling over. This can be
manifest in confrontation, violence, non-cooperation or attempts to escape. Dealing
with such intensity of pent-up emotion is part and parcel of working in secure
accommodation. In such an environment the need for physical restraint is almost
inevitable at times. Its use however, requires constant review to ensure it does not
become part of the culture of a unit.

Most staff would like to work on the basis of trusting relationships with young
people. In secure settings it is best for this to be a wary trust. You will rarely know
entirely what pressures are around for particular residents at any given time. They


may break any trust you felt you had with them. It is better to acknowledge this
possibility from the outset and to seek to minimise the opportunities for you to feel
let down, but more importantly for young people to feel they have failed or let you
down.

It is not only young people who are locked up in secure accommodation. For the
duration of their shift staff may also be. There are few lulls in the day to draw breath
or relax. The work is full-on and requires a constant attentiveness to issues of
supervision, safety and security. Staff need to be ‘active scanners’, alert to what is
going on around them.

The nature of the work can confront staff with the sometimes frightening and
reprehensible behaviours of some young people and this might lead to particular
judgemental responses. The work also brings staff into regular and intimate contact
with the pain of young people. Coping with this pain, expressed through self-harm or
violence, takes an emotional toll on adults confronted with it. An understandable
response may be to try to distance oneself from the emotional impact of the work.
Adults should however be affected by the emotional distress of young people. It is
not a weakness to acknowledge this. They need opportunities, in supervision or in
everyday interaction with managers and colleagues, to discuss how young people
make them feel (see chapter 3).


• Identify all the emotions young people you work with can arouse in you.
• How do you deal with them?

The pace of work

Not only are staff in secure settings subject to a particular emotional intensity in their
work, they are also confronted with a higher volume of paperwork than in other
settings. The legislative requirement to keep young people in secure
accommodation for the shortest possible time requires purposeful care planning.

Young people in open settings may be placed on a supervision order that only
requires annual review. By contrast, a young person in secure accommodation may
be admitted on a warrant. In this initial three week period staff will need to undertake
an assessment (see paper 4.04) and prepare a report for a Children’s Hearing.
Subsequent Hearing reviews are at three-monthly intervals. Running parallel to
Hearing reviews there will also be Looked After Child Reviews and any internal care
planning meetings. Ensuring that young people attend hearings may also require
staff to be involved in escort duties on a regular basis, although units may have
negotiated arrangements with local authorities for this.


Such demands, taken together, mean that the pace of work in secure
accommodation is significantly faster than in other residential settings. This needs to
be reflected in staffing levels and rostering.


• Think about a particular young person. Identify all the reports that need to be
written on them.
• What are the arrangements in your unit to support these tasks?

Specific areas of practice

Technology
Secure units nowadays are sophisticated places. Many of the systems outlined
below will be subject to computerised control mechanisms. Staff need to have a
working knowledge of the various technological systems they will have to use on a
day-to-day basis.

Keys
Locking young people up is the central task of secure accommodation. Locking
systems therefore need to be effective. Each unit will need to have specific
arrangements for the allocation and return of keys, tabs or cards, as staff come on
to and leave shift. While staff have keys in their possession they may benefit from
some arrangement for these to be attached to their persons, without this appearing
too custodial. They also need to be made aware that they cannot lay down keys in
the way that they might in other settings. There are a range of sophisticated lock
systems that can allow, restrict or track the use of keys, although none of these
should take away from the need for staff vigilance.
Alarms
All secure units now operate some sort of personal alarm system that staff can use
to summon support. The over-use of personal alarms and disproportionate
responses to these can heighten tension in a unit. Again, most systems allow for a
graduated response. Protocols need to be in place to ensure that staff know how to
use and respond to alarms appropriately.

Units are also likely to have a variety of intruder alarms or devices that staff should
be aware of.

Fire safety
The locked physical environment poses particular challenges in the event of a fire.
Building design should take this into account with egress to secure courtyards in the
event of a fire. Units will also need to have worked out specific drills and escape
routes with their local fire brigade. Staff need to have regular drills so they are clear
on fire safety arrangements.


Prohibited items
Units will need to determine procedures around those items which they consider to
pose a danger to the safety of the setting. These may include glass bottles, matches
and lighters, aerosols, specific items of jewellery and possibly particular items of
clothing.

Accounting for sharp implements
Young people in secure accommodation may seek out everyday objects they think
might be useful to help them escape, to use for self-defence or attack or for self-
harming. Accordingly, staff need to be able to account for implements that might be
used for such purposes. The most obvious of these is cutlery. After every meal,
there should be some protocol to ensure that all cutlery issued is returned. This can
usually be done fairly unobtrusively out of the direct sight of young people. In
situations where cutlery is missing staff will need to take steps to account for it. This
might include searches of rooms or in some cases of individuals. However, this
should only be considered when initial searches of the immediate location have
proved fruitless. In some cases it may be best just to maintain an awareness that
something is missing and to be on the lookout for it as the day progresses. In other
situations, where it is felt that there may be a particular risk involved, a more
immediate response will be required.

There will be other occasions in educational settings, such as art, craft, design and
technology (CDT) or home economics where young people will also have access to
potentially dangerous implements. Similar security considerations need to be given
to their storage and return after use.


• Where can you find your own unit's procedures on these areas of practice?
• What other areas of practice have procedures which relate to the secure nature
of the setting?

Searching
Searching is a contentious area of practice in secure accommodation. Many staff
feel uncomfortable with it. However, there are times when it is required. Again, this
necessity links back to the purpose of secure accommodation in ensuring a safe
and secure environment.

It is up to individual units to develop their own protocols for searching. This paper
identifies some of the issues to be aware of. Searching might be considered at
different levels:
• maintaining an awareness
• room searches
• body searches.


Maintaining an awareness: The most effective way to maintain a safe environment
is for staff to be vigilant in the course of their everyday duties. They should be aware
of any items that are prohibited and which may be dangerous and should remove
these. Young people should be advised if anything has been found and told what
has been done with it and why.

Room searches: In some cases, more specific searches may be required if staff
have reason to believe that a prohibited item is being secreted. In the first instance a
young person should be asked to show that there is nothing hidden. If they refuse to
do so, staff should conduct a search, ideally in the young person’s presence.

Body searches: Body searches are one of the most contentious areas of practice in
secure accommodation. They can be uncomfortable and demeaning for young
people and staff. However, there are times when they are necessary. When young
people are first admitted or return from periods of leave or absence or when staff
believe they may be secreting a dangerous object or substance, a search of their
person may be required. Specific circumstances in which this should take place, the
protocols for carrying out a search, and if and when police assistance might be
sought in the process, should be worked out at local level.

Searches should not become routine. There should be a presumption that respects
the privacy of a young person’s physical space and belongings. Staff should have
reasonable suspicion that not to conduct a search would result in a specific risk.


• What are your unit's procedures on searching?
• How do they make you feel?

Removing young people from the group
There are times when a young person will need to be kept apart from the rest of the
resident group if they are persistently disruptive or aggressive. The physical layout
of a unit will determine where a young person might be removed to. The use of a
bedroom for this purpose is not ideal inasmuch as this confuses the purpose and
‘feel’ of a space. Bedrooms should be a safe haven for young people and to
associate them with ideas of removal and seclusion may compromise this feeling of
safety.

The availability of locked rooms in secure units should not become an easy way out
for staff to avoid having to work situations through with young people. Taking them
aside and having a word in their ear can be more effective than putting them in their
room.


Working with others
One of the features of secure accommodation is the requirement for cohesive
teamwork. The safety of young people and of staff depends on staff maintaining an
awareness of their surroundings. At any point of time staff need to be aware of the
whereabouts of each other and of all the young people. Individual units will have
protocols for coordinating this.

Another feature of secure accommodation is that different professional groups work
together under the same roof. The two main groupings are of course the care and
education staff teams although, increasingly, there may also be psychologists,
programme teams and nurse practitioners on site. Working together brings its own
tensions as different professional groups are trained differently and may have
divergent expectations of their roles. The question of care staff providing support for
teachers and what this should consist of can be a thorny one in many settings
where both groups have to work together. The interfaces between the different staff
teams need to be continually worked on, but ultimately, the best way to ensure good
joint working is through establishing trusting personal relationships.

Recording
In settings where intervention in the lives of others is as obtrusive as it is in secure
accommodation, some checks need to be kept to ensure that these incidents do not
become breaches of rights. The use of single isolation, for instance, will be
legitimate in some circumstances. It should not however, become routine. A record
should be kept of every occasion a young person is isolated. This enables internal
and external checks to be kept on its use and may prompt some discussion about
patterns of usage and whether these might merit further exploration and change.
Other sanctions and practices such as searching should also be recorded.

The profile of secure accommodation also demands that recording is thorough. This
may apply to procedures for the distribution and supervision of medicine. It may be
around the decision making attached to mobility programmes. If anything goes
wrong in such areas, staff have to be able to account for their practice. Again this
need to account for practice relates back to the purpose of secure accommodation.
There is no point in locking young people up if you cannot then demonstrate that
you are taking appropriate measures to keep them safe.

Conclusion
Secure accommodation is a very specific area of practice that calls for staff to
appreciate the purpose of the work and the practice implications of this.


Training links
SVQ:
Unit C7 Provide a framework for the management of behaviour (optional unit in the
SVQ level 3 qualification Caring for children and young people).
Unit HSC 324 Process information relating to children and young people’s offending
behaviour (specific optional unit for the revised SVQ level 3 qualification Health and
social care: children and young people).

HNC in Social Care:
unit).

Further reading
Gabbidon, P. & Goldson, B. (1997). Securing best practice: an instruction manual
for staff working in secure accommodation. London: National Children’s Bureau.



Daily rhythms, rituals and
4.06 routines
Mark Smith

…healthy and purposeful milieux don’t just happen. They need to be worked at.

Introduction
This paper outlines the importance of developing daily rhythms, routines and rituals
in our practice with children in secure accommodation. The key points include
developmental group care, the therapeutic milieu, changing the tempo and the life
space intervention.

Overview
We all need some structure and routine in our lives. Children and young people
admitted to secure accommodation are no exception. Many are admitted at a point
where their lives have lost any structure or meaning. They need to experience a
regime which restores some coherence to chaotic and disintegrated circumstances.
This is a prerequisite before they can begin to address some of the specific
difficulties which may have contributed to their admission to secure care and before
they can be in a position to consider moving on.

Experience tells us that children may initially resist our attempts to impose some
order on their lives. It tells us too, that most will come to accept and appreciate this.
This sense of their lives gradually coming under more control happens less as a
result of specific interventions such as counselling or groupwork but more though
the experience of nurturing everyday care. This is known as the ‘lifespace’ in group
care literature. Lifespace work can be described as the use of everyday events to
promote learning and growth. A classic text on ‘lifespace’ is The Other 23 Hours
(Trieshman, Whittaker & Biendtro, 1969). The title conveys the relative importance
of the hours of the day when children and young people are not involved in formal
treatment.

A centre’s regime should not be rigid or impersonal but needs to become part of the
lived experience of the young people and staff who work in secure settings. Some
pointers as to how this might be brought about are provided in the group care
literature.



• Think about a child or young person you are working with. In what way(s) was
their life out of control when they were admitted?
• How did they respond to being placed in secure accommodation?

Rhythms, rituals and routines
The above terms are introduced in Henry Maier’s paper The Core of Care (1979),
one of the most influential texts on child and youth care. Routine refers to the
structures of a place, that sense of what follows what in the course of a day. Care
must be taken to ensure that routine doesn’t become ‘routinised.’ Maier (1979)
cautions that a healthy sense of order doesn’t come from a book of house rules but
needs to grow out of the lived experience of those who live and work in a centre.

This state where order develops organically can be described more as rhythm than
routine. Rhythm is that state where things happen because they become ingrained
in the everyday life of a centre. To get to this stage, there needs to be a general
acceptance from young people and staff that the expectations that frame routines
are reasonable and sensible. Appropriate rituals of care can help bring about this
level of acceptance. Essentially, rituals are those encounters between young people
and staff that develop and have a particular meaning for those engaging in them.
Thus, the particular ways we get young people up in the morning, the individualised
ways we greet them through gestures or actions such as ‘high fives,’ all contribute
towards an experience of care that is personal rather than functional. Rituals speak
of a personal connection. They ‘oil’ the smooth running of a centre.


• What are the rhythms of the day in your centre?
• Can you think of any rituals that have developed between you or a colleague(s)
and a particular young person?
• How do these influence the daily rhythms of the centre?

Developmental group care
Henry Maier (1979) provides a context within which we might consider the
development of rhythms and rituals of care. He outlines seven components of care
which he regards as being essential to the everyday care of children and young
people (see also chapter 3):
The provision of bodily comfort (good basic care personalised to
the individual young person);
Recognition of and responding to the differentiations or different
temperaments of individual young people – this calls into question
the whole notion of consistency as it is often applied to residential


child care, as Maier advises that we need to respond differently to
different young people;
The development of rhythmic interactions between young
people and caregivers (the kind of rituals described above);
Predictability – a sense of knowing what will happen next;
Dependability – which follows on from predictability and from
which stems attachment and mutual caring.
If these foregoing components of care are achieved then,
according to Maier:
Personalised behaviour training should achieve its fullest
impact. Within this model, acceptable behaviour follows from the
quality of the developing relationships established between young
people and staff rather than through a set of house rules.
Maier’s final component of care is:
Care for the caregiver – which works on the assumption that staff
can provide nurturing care only if they experience it themselves.


• Think about the way your relationship with a particular child has developed.
Consider this within Maier’s framework. Discuss this with your supervisor.

The therapeutic milieu
The overall sense of what a unit ‘feels’ like is called the milieu. The milieu is the
environment of a home. The term is not particularly tangible. It has been described
as the 'particles in the air' (EUROARC, 2002). However anyone who has set foot in
a group care centre picks up very quickly on its atmosphere; whether there is a
tension or a 'buzz' or a sense of calm. The 'feel' of a centre is fundamental to how
good it is and will impact profoundly on the experiences of the children and young
people placed there.

Practitioners need to try to identify the elements that go towards shaping the milieu,
in order that they can influence it for the benefit of children and young people. A
range of variables will impact on the milieu; organisational design and culture,
including that of the wider organisation, physical environment and the composition
of resident and staff groups.

Healthy milieux are likely to promote positive growth for those who live and work in
them. A sense of wanting to be there will be apparent in the fabric and furnishings,
through the construction of the rhythms, rituals and routines and through the
attitudes of staff and young people and the relationships existing between them.
Conversely, if these aspects of a centre are not given adequate attention and are
not functioning effectively, the quality of care will be inadequate.



• What are the different components that go towards defining the milieu of your
centre? How might you begin to change some of these to influence the milieu?

Rhythms of secure care

Staff are in a position to help make the milieu work for the benefit of young people,
and indeed for themselves, through some reflection on the rhythms and rituals of
care. The way they get young people up in the morning, for instance, may set the
tone for the day. Sufficient time needs to be given to accommodate the different
temperaments of young people. Some will take longer than others to undertake the
same tasks. Trying to rush them is likely to be counter-productive. Staff need to
ensure sufficient time to facilitate a reasonably relaxed start to the day, allowing time
for breakfast, chores, etc. whilst not building in too much ‘dead’ time.

Mealtimes should be a community experience in which staff and young people both
participate. There should be recognisable start and end points to meals, reinforced,
for instance, by expectations that young people and staff ask permission to leave
the table once they are finished. Once such expectations are established, mealtimes
are likely to extend long after the food has gone and will become a focal point of
community life.

In any secure setting there are transition periods in every day such as the move
between unit and school. These transitions need to be effectively managed to
ensure that they become ingrained in a centre’s way of doing things and to avoid
them becoming flash points. Again, some preparation needs to go into these
transitions so that staff and young people are aware of expectations and are ready
to go when the time arrives.

Bedtime too is a critical time in child and youth care. The period before bedtime
should be one where things start to wind down. Young people may be encouraged
to shower, have some supper and watch some television or chat amongst
themselves or with staff before going off to their rooms. It is better not to move
directly from periods of heightened activity, such as the gym, straight to bed.


• How do you manage critical points in the life of your centre?
• Could they be improved in any way?
• How would you go about this?


Changing the pace of a programme

Secure accommodation is by its nature confining. In open settings there is a release
valve when feelings are running high in as much as young people can take off and
cool their heels. This isn’t available in secure units. Pent up emotions can lead to
strong feelings. This is more likely to happen if boredom sets in. Staff need to be
able to vary the tempo of a shift.

There should be times when there is a clear sense of purpose. The education
programme is the most obvious example of this. There needs, too, to be an
opportunity for confined young people to burn off some energy, either in the gym,
swimming pool or courtyard. Access to fresh air at some point of the day should be
built in. However, young people in secure care also need opportunities to slow down
– to relax and reflect. Obvious times to do so might be in the period after meals or in
the hour or so prior to bedtime.

Staff can influence the tempo or the atmosphere of a unit through simple
interventions in the rhythms of daily living. Actions such as drawing curtains,
dimming lights or playing particular types of music can give the message, ‘It’s time
to slow down now.’


• How would you describe the pace of your unit?
• How might you build in changes of pace to ensure that different needs for
action and reflection are taken into account?

What staff need to do
Although good residential workers can make it seem as though things come
naturally, healthy and purposeful milieux don’t just happen. They need to be worked
at.

To start with, staff need to be prepared. They need to give themselves sufficient
time to plan even for the most routine events such as rising or mealtimes. The
enemy of a smooth shift can be that rushed extra cup of coffee or chat about the
weekend past. If staff do not plan properly, if they are hurried, or if they think they
can leave things to the last minute, some unforeseen situation such as school
clothes not being ironed has the potential to turn a shift upside down. If they are
adequately prepared, they will give the impression of being relaxed and purposeful,
and this demeanour will rub off on the residents and set the tone for the shift.

Although they may have a clear idea about the task in hand, staff also need to be
able to change tack in response to altered circumstances – there is no room for a
textbook residential worker. However, when staff do deviate from established
routine, they need to do so consciously and to remain in control of the change rather
than being perceived as bowing to pressure. This might be done by being clear with


children and young people: ‘I’ve taken the decision to do this differently on this
occasion but don’t let it become an expectation.’


• How do you and colleagues prepare for a shift?
• How might this be improved?

The life space intervention

As noted earlier, working in the lifespace involves the use of everyday life events to
help promote the learning and development of young people. The notion of the
lifespace intervention is a useful one. It involves reflecting more consciously on how
everyday events link to the overall in the life of a resident. Such an orientation might
determine that issues of anger management, for instance, should not be left to
particular focussed programmes, but might be powerfully addressed in a dispute
over who does the dishes or in the aftermath of a flare-up in class.

This concept of lifespace intervention is consistent with Adrian Ward’s (1994) idea of
opportunity-led work whereby staff identify opportunities for therapeutic intervention
within the everyday life events of a centre.


• Think about a recent situation you have been involved in.
• How might you have used it more consciously to address a particular issue with
the young people involved?

Conclusion

This paper has sought to outline the importance of daily events in contributing to the
developmental experience of children and young people.


Training links

SVQ: Unit M8 Plan, implement and evaluate routines for children (optional unit in
the SVQ level 3 qualification Caring for children and young people).

Unit NC 10 Contribute to the developing and maintaining cultures and structures in
which people are respected and valued as individuals (optional unit in the SVQ level
3 qualification Caring for children and young people).

Unit HSC 323 Contribute to child care practice in group living (specific optional unit
for the revised SVQ level 3 qualification Health and social care: children and young
people).

HNC in Social Care: HN unit Supporting and managing provision in secure care
settings: outcome one (optional unit).

Further reading

A central paper in the development of a child and youth care approach to practice is

Some of the ideas outlined in this paper are developed in Smith, M. (forthcoming).
Rethinking residential child care: a child and youth care approach. In D. Crimmens
and I. Milligan, Facing forward: residential child care in the 21st century. Lyme
Regis: Russell House Publishing.


Prosocial modelling
4.07
Chris Johnson

Prosocial behaviours are types of interaction which favour and foster social relationships. A
consensual definition would include those behaviours which show respect, interest and
concern for others, and which may be exemplified in helping, caring and sharing.
(Warden & Christie, 1997, p. 9)

Introduction
Very often in secure accommodation we can become fixed on anti-social
behaviours. This can get in the way of our recognising the more positive aspects of
young people's behaviours and considering how we might best promote these. A
prosocial modelling approach provides a framework to do so.

The key points in this paper include: antisocial values, prosocial values, prosocial
modelling and some pointers as to how such an approach might be applied in
practice.

Antisocial values
Many of the children with whom we work may operate to a different set of values
from society at large. They may see theft as an acceptable practice and not accept
that it has negative consequences for others, their victims. A child who steals a car
and damages it may rationalise his action by saying ‘the car was insured’. This is a
how some young people in secure accommodation might think.

The roots of such thinking are likely to go back a long way in the upbringing of the
child. The child may have values that present themselves in many different ways.
They may bully others and demand their own way all the time. They may be
unusually aggressive or sexually aggressive or may have what seems a total
disregard for others’ property and sometimes their own. They may well display a
number of these attitudes and many other antisocial behaviours.

By 1970 a number of different interventions were being used with antisocial and
aggressive children. These ranged from, at one end of the scale, a psychodynamic
approach through humanist, and nondirective approaches to behaviour modification.
Some of these approaches, especially those described as behaviour modification
(see chapter 3) fell out of favour, as the focus on behaviour alone was felt to be too
crude. There was a realisation that the presenting antisocial behaviours were


actually learned. Some people felt therefore that appropriate behaviours could be
learned to replace unacceptable behaviours. This is the basis of social learning
theory.


• Can you identify behaviours in others that are antisocial?
• Can you remember incidents in your life where others have presented
antisocial behaviours but have now changed? Why did they change?

Prosocial values

There were of course many children who behaved in a socially acceptable way and
it was realised that again they had learned this behaviour. Clearly there was interest
in finding out whether the children who displayed antisocial behaviour could be
taught prosocial values and behaviour.

There are many definitions of prosocial values. At one level one might think of
“values and actions that are not criminal”. However, at a more positive level pro-
social behaviours might be defined as they are in the introduction to this paper:

... types of interaction which favour and foster social relationships.
A consensual definition would include those behaviours which
show respect, interest and concern for others, and which may be
exemplified in helping, caring and sharing.
(Warden & Christie, 1997, p. 9)

Actions and values that support others are extensive and may include many things
such as:
• Helping others with difficulties;
• Sharing things with others;
• Non-sexism;
• Non- racism;
• Anti-violence;
• Equally shared responsibilities in a relationship;
• Protecting others from harm.


• What other Prosocial Behaviours can you add to this list?


What is Prosocial modelling?
Prosocial modelling is a structured and thoughtful way of working with people in
which the objective is to teach the person how to behave in a prosocial way by
example and reward. Prosocial modelling aims to accentuate an individual’s
strengths and tries to eliminate inappropriate or antisocial values and behaviours,
replacing them with prosocial ones. The use of appropriate role models and positive
reinforcement is key to the way in which any prosocial modelling programme or
regime works.

Prosocial modelling comes from social learning theory and was widely pioneered in
the United States via the 'skillstreaming' programmes introduced for those young
people who had a propensity to aggression. The model was introduced to the United
Kingdom in the early seventies and was championed by Leicester University and a
few specialist residential units such as Glenthorne Youth Treatment Centre and
Aycliffe School.

There are a number of good training programmes that are well documented
explaining how prosocial modelling can be accomplished via specific programmes
and working practices.


• Can you think of any situations where you have tried to change the behaviour
of others by positive role modelling?

Why Prosocial modelling?
Previously mentioned interventions such as behaviour modification have been used
as a screen for schemes that were sometimes seen as harsh and not particularly
child centred. Some establishments used token economy systems where children
were rewarded for positive behaviours with tokens so that they could ‘purchase’
luxuries. There were systems that were so regimented that even the necessities of
life had to be earned. This led to professional and political reservations and the use
of such schemes fell out of fashion.

Prosocial modelling avoids the pitfalls of previous behaviourally based programmes
by building positively on the child’s appropriate behaviours and rewarding them.
Antisocial behaviours are challenged rather than punitive action being taken against
the child.

The literature on prosocial modelling emphasises the attributes of honesty, concern
and commitment on the part of the supervisors. Together with a collaborative
approach to problem solving and client-defined problems and goals, these personal
qualities are as important to effective work with offenders as the need to
demonstrate and reinforce alternatives to pro-criminal thoughts (Trotter, 1999).


Applying a prosocial approach
Any prosocial modelling regime requires that all members of staff become ‘trainers’
(in their everyday interactions with young people) and are positive role models for
the children. Language should be used in a positive way, reinforcing appropriate
behaviour with praise. The whole lifestyle of the worker should be one that sets a
good example to the ‘trainee’, from manners at the dining table to knocking on doors
and saying please and thank you. Appearance (e.g. style of dress) of ‘trainers’
should be appropriate to the job that is being done so as to show the ‘trainee’ what
is appropriate.

The ‘trainers’ achieve best success when they work together and are seen by the
‘trainees’ as a unified team who are there to teach appropriate skills and offer help.

Trotter (1999) outlines a four-part approach in promoting prosocial outcomes:

Identify prosocial comments or actions

This includes clear-cut prosocial comments or behaviours as well as
acknowledgement of harm done or remorseful feelings for antisocial words or
deeds.

Reward those comments and actions wherever possible

Praise is identified as being the most frequent and powerful of reinforcers
available to workers, but is only effective if it is genuine and directed at the
prosocial comments and behaviours of the clients. The use of other rewards
must be explicitly linked to desired behaviour, and the promise of a reward is
less effective than simply providing it as a result of the prosocial act.

Model prosocial comments and actions

This not only includes modelling the behaviours the worker wants to foster in
the client, but also coping modelling (the demonstration of coping strategies),
or acknowledging vulnerability and difficulty in consistently conducting oneself
in a pro-social manner.

Challenge antisocial comments and actions

This includes clear-cut antisocial comments or behaviours, as well as
rationalisations for such comments or behaviours. Negative reinforcers include
expressions of disapproval, ignoring of behaviour or simply pointing out that a
comment is a rationalisation for an unacceptable behaviour. This aspect of the
approach, however, must be used with caution, as studies indicate that greater
emphasis on positives (with sparing use of negatives) is more effective.
Inappropriate behaviours whether physical or expressive should be challenged
in a way that suggests an alternative rather than as an unexplained directive.


This approach seems well suited to residential work for a number of reasons. The
effectiveness of praise, modelling or disapproval can be directly related to the
strength of relationship between worker and young person. The time residential
care workers spend with their ‘clients’ is intense and sometimes prolongued, thus
providing fertile ground for deep, strong relationships. It must also be said that this
can be a double-edged sword, in that uninformed, unskilled or unscrupulous use of
positive or negative reinforcers can hurt or confuse young people and will be
counterproductive.

In a residential child care setting, the purposeful use of activities (see paper 4.08)
can provide a context within which staff can identify, reward and model prosocial
comments and actions while challenging antisocial ones. Praise or disapproval
often carries greater weight when it is related to something of value to the recipient,
and a well planned and implemented programme of activities can be an excellent
avenue for prosocial work.


• Can you identify pieces of work where a team collaborated?
• Can you identify an antisocial behaviour you have challenged in a positive
way?
• Can you identify a prosocial behaviour that was rewarded?
• Can you think of how you might use particular activities to promote prosocial
behaviours?

Prosocial skills
The following table lists a number of key skills that children require. Situations are
identified where children need to be able to use prosocial skills. Programmes should
reflect these skills and supervisors should be able competently to demonstrate them
as part of their prosocial role modelling.

Beginning Social Skills Advanced Social Skills

1. Listening 1. Asking for help
2. Starting a conversation 2. Joining in
3. Having a conversation 3. Giving instructions
4. Asking a question 4. Following instructions
5. Saying thank you 5. Apologising
6. Introducing yourself 6. Convincing others
7. Introducing other people
8. Giving a compliment


Skills for Dealing with Feelings Skill Alternatives to Aggression

1. Knowing your feelings 1. Asking permission
2. Expressing your feelings 2. Sharing something
3. Understanding the feelings of 3. Helping others
others 4. Negotiating
4. Dealing with someone else’s anger 5. Using self-control
5. Expressing affection 6. Standing up for your rights
6. Dealing with fear 7. Responding to teasing
7. Rewarding yourself 8. Avoiding trouble with others
9. Keeping out of fights

Skills for Dealing with Stress Planning Skills
1. Making a complaint 1. Deciding on something to do
2. Answering a complaint 2. Deciding what caused a problem
3. Being a good sport 3. Setting a goal
4. Dealing with embarrassment 4. Deciding on your abilities
5. Dealing with being left out 5. Gathering information
6. Standing up for a friend 6. Arranging problems by importance
7. Responding to persuasion 7. Making a decision
8. Responding to failure 8. Concentrating on a task
9. Dealing with contradictory
messages
10. Dealing with an accusation
11. Getting ready for a difficult
conversation
12. Dealing with group pressure
(Goldstein & McGinnis, 1997)


• Think of a child in your unit. Consider the above lists. Which prosocial skills do
they demonstrate?
• What areas might you want to work on and can you think of ways that you
might do this?


Conclusion
This paper offers a brief explanation of prosocial modelling. For any prosocial model
of practice to be used to best effect all staff in a unit need to buy into it and be
trained in this way of working. A number of recognised programmes can be drawn
on for this purpose.

Training links
SVQ:
Unit C7 Provide a framework for the management of behaviour (optional unit in the
Unit NC 11 Contribute to the planning, implementation and evaluation of therapeutic
programmes to enable individuals to manage their behaviour (optional unit in the
Unit HSC 327 Model behaviour and relationships with children and young people
which recognises the impact of crime on victims and communities (specific optional
unit for the revised SVQ level 3 qualification Health and social care: children and
young people).
Unit HSC 397 Reinforce positive behavioural goals during relationships with
individuals (generic optional unit for the revised SVQ level 3 qualification Health and

HNC in Social Care:
HN unit Supporting and managing provision in secure care settings: outcome one
(optional unit)
unit).

Further reading
Goldstein, A. P. & McGinnis, E. (1997). Skillstreaming the adolescent: new
strategies and perspectives for teaching prosocial skills. Chamaign Illinois:
Research Press.

Trotter, C. (1999). Working with involuntary clients. London: Sage. This provides a
good introduction to Prosocial modelling and is a standard text for those interested
in criminal justice work.

Warden, D & Christie, D. (1997). Teaching social behaviour: classroom activities to
foster children’s interpersonal behaviour. London: David Fulton. An emphasis, as
the title suggests, on work in the classroom but sets out the general principles of a
prosocial approach and provides some practical examples.


Activities
4.08
Laura Steckley

Within these new experiences, young people can experience themselves in a new way, one
that begins to weave together a personal story that includes competence, trustworthiness,
happiness and, probably most importantly, hope.

Introduction

This paper considers the potential therapeutic benefits of appropriate activity
programmes in secure accommodation. It goes on to offer some guidelines for the
implementation of activity programmes and then provides some resources that
might be used to develop a repertoire of activities.

Overview

Activities have long been an integral component of the therapeutic milieu. They
have been regarded on the one hand as time fillers, separate from therapeutic
processes and goals, and on the other as vehicles through which young people
interact with each other, with staff and with their environment in a manner that
promotes change and development. Activities have no rival in terms of encouraging
a sense of mastery and self-esteem, and can prevent the all-too-often adversarial
climate that can develop between staff and young people. Activities (particularly
sports) in residential settings can be important in helping young people develop self-
discipline.

I also think that staff should try and encourage residents to pick up activities, try
and spend more time with them to stop them getting into bother and it will keep
them preoccupied and make them a lot happier in their placement. It would be a
chance to meet other people.

(female 15, Who Cares? Scotland, 2003, p. 68)

The challenges of sharing and co-operating, contributing to the team, persevering
when tired, and controlling (and appropriately channelling) aggressive impulses are
more demanding than some youth can manage, especially early in their placement.


Over time, the skilled use of activity planning and implementation within a safe and
supportive environment can help young people meet these challenges.

There can also be more subtle benefit from activities. As an adult attempts to guide
and advise a young person through an activity, the experience can reveal to the
young person, sometimes for the first time, the value of constraints that someone
else wants him to accept. While this might be a lengthy process, when it does occur
(and is reinforced by success), the value of self-discipline can be experienced by the
young person in a powerful manner. Over time, this realisation can transfer to other
areas of that young person’s attitude and behaviour.


• How are activities viewed in your unit?
• What purposes do you think they serve?

Care workers as ‘experience arrangers’

Phelan (2001) describes a model of activity planning that is based on the notion that
many of the people with whom we work are so stuck in a negative personal story
that they have little or no hope of being able to change. Their associated beliefs,
based upon past experiences, are reinforced time and again by what has often been
referred to as ‘self-fulfilling prophecy.’ This continually colours their view of the
future. With requisite safety and trust, care workers can provide activities that serve
to create a free place, where young people encounter an experience gap, a place
where they can be in the present moment with ‘minimal interference from these self-
defeating messages, so that new experiences can happen and be acknowledged’
(p. 2).

Within these new experiences, young people can experience themselves in a new
way, one that begins to weave together a personal story that includes competence,
trustworthiness, happiness and, probably most importantly, hope. Communication
occurs through the senses and through the experience, rather than just through
words. Care workers must utilize skills of presence, relationship, doing with,
understand each young person and his or her personal story, and be aware of
activities as a strategy for change in order to be effective ‘experience arrangers.’

For activities successfully to create a free place in which young people can
encounter an experience gap, a degree of safety and trust must be present, the
level of challenge presented must be a manageable fit with how the young person
views himself, and there must be an ongoing process of supporting his fledgling
beliefs springing from the experience. Win/lose dynamics are unhelpful and
particularly hopeless or self-defeating young people are unlikely to benefit from
competition, especially if it is emotionally charged.



• Think of a young person who has recently participated well in an activity.
• How might he have experienced himself differently from his normal day to day
experience?

Resilience

A sense of competence or experience of mastery have long been considered
important in promoting positive development and, more recently, resilience. The
concept of enhancing and promoting resilience in young people who have
encountered adversity seems likely to be one of the most salient and enduring
themes in helping further our understanding and effectiveness in working in
residential child care (see chapter 3). Resilience has been defined by Gilligan
(1997) as:

..qualities which cushion a vulnerable child from the worst effects
of adversity…and which may help a child or young person to cope,
survive and even thrive in the face of great hurt and disadvantage.
(p. 12)

Gilligan points out that activities provide an avenue through which young people can
access supportive relationships. The divergence from more clinical approaches
(which involve talk), as well as the importance of relationship as a context within
which a young person can gain the most benefit from involvement in
hobbies/activities, resonates well with Phelan’s emphasis on communication
occurring through the senses and the experience, rather than through words.


• Think of a young person who is doing well in your unit.
• Does she respond favourably to intervention approaches that rely on talking?
• Has her involvement in any of the activities contributed to her development of
relationships with any of the staff?
• Think of a young person who is struggling to do well in your unit.
• Does he respond favourably to intervention approaches that rely on talking?
• How might your unit provide different opportunities for him to experience
mastery or improve his relationships with staff through an activity?

Promotion of prosocial values

Activities may also have a role in re-awakening or nurturing natural prosocial
tendencies in children (see paper 4.07). Trotter (1999) points to particular
behaviour exhibited by parents or carers associated with prosocial behaviour.


These include clear communication about rules, principles, and expected behaviour,
as well as messages about the inherent goodness of the child.

Trotter asserts that skilled use of prosocial modelling and reinforcement (a
component of his model) is shown in research to be effective, and in his own study,
was the most influential skill of the worker.

Activities can provide a context within which staff can identify, reward and model
prosocial comments and actions while challenging antisocial ones. Praise or
disapproval often carries greater weight when it is related to something of value to
the recipient, and a well planned and implemented programme of activities can be
an excellent avenue for prosocial work.


• Think of a recent activity that you facilitated.
• Which behaviours that the young people exhibited could be identified as
prosocial?
• Can you remember the praise that you gave, and how much of it was for
prosocial comments or actions?
• What behaviours did you model, and what do you think you communicated to
the young people through them?

Guidelines for therapeutic implementation of activities:
Be prepared
A lack of preparation, even something as simple as not having the
footballs pumped up, can contribute to an activity falling on its face
(sometimes even before it starts). Preparation not only involves
ensuring the necessary props, equipment or location is available
and in working order, but an assessment of the group and the
individuals involved in terms of their needs and capabilities
(emotional and physical). Part of being prepared will involve
ensuring that staff organising an activity have the expertise to do
so and that the activity falls within any policies an agency may
have on activities.

Be flexible
Be prepared to alter the plan if you assess the change will better
meet the needs of the participants. Also, be on the lookout for
opportunities for spontaneous games that satisfy an immediate
mood and do not require planning (but do not rely solely on this
approach to activity planning).

Be brave
Breaking out of the familiar to try new things can be difficult for
staff and young people. Creative activities, co-operative games
and other initiatives can provide opportunities of mastery for those


young people not generally used to being good at something. Just
as important, these alternative activities can give young people a
chance to relate to each other and to staff in a different way. Non-
competitive activities can often be more enjoyable and rewarding,
and are worth the effort of overcoming any initial fear or
resistance.

Be enthusiastic
Your own enthusiasm and sense of fun can be exceedingly
contagious. Young people almost invariably respond favourably to
someone who wants to be with them and conveys it.
Young people should experience a beginning, middle and end
Begin not only by reviewing the rules, but by negotiating fair
expectations for behaviour. Be clear and explicit. A discussion
about the purpose of the activity and some perspective work (e.g.,
this is not the Olympics, it’s okay to make mistakes, we’re here to
have some fun and learn how to work together) can set young
people up with a frame of mind more likely to yield a positive
experience.
The activity itself represents the middle, and many of the other
points give guidance to support successful delivery.
The end should be a review of what happened, how it went, and
should provide closure on the event. A discussion of what went
well, what they enjoyed, what they wish had been different, and
what they hope to do differently next time is an excellent way to
end an activity. The ending should also include role modelling on
your part and involvement on their part of good upkeep and
storage of any props or equipment.

Remember your role
Providing opportunities for young people to experience themselves
differently, enhancing their resilience and promoting prosocial
values through the use of activities’ requires a focus on the
process (rather than the outcome). Point out teamwork,
sportsmanship, creativity and perseverance (i.e. prosocial
comments and actions) more than the score or a final product.
Praise for a pass might carry more weight than praise for a goal.

Change the rules
Take a familiar activity and change it in order to serve an aim (e.g.,
co-operation, experiences of mastery). Three passes before a
goal can be scored might involve more players, or using a beach
ball instead of a volleyball can help more young people to
experience themselves as capable.

Do with
Participating with young people in activities will often encourage
their involvement, and can strengthen and deepen relationships. It
also provides you with an opportunity to model prosocial
behaviour.


Manage your own competitiveness
Your own competitiveness can easily replace your focus on the
process and the aims of the activity. It is also more difficult to
model the behaviour we hope young people will adopt if we are in
the midst of our own competitive desires.
Stop while it’s still going well
This may be one of the most difficult guidelines to follow, because
when everyone is still having a good time (and showing signs of
positive development), it is hard to call things to an end. However,
letting things go too long will frequently lead to fatigue, conflicts
and behavioural breakdowns. In these instances, young people’s
memory of the activity can often be tainted by anger, shame or
guilt and the positive gains are overshadowed.

Have fun
On the one hand, use of activities for therapeutic intervention
should be taken seriously in terms of planning and attention to
process. Conversely, a light and humorous approach will more
likely yield positive results. Be playful, laugh, laugh at yourself and
delight in the fun.

Play together as staff
The opportunity to experience self and others differently should not
solely be extended to young people. Co-operative initiatives and
team building activities that have a component of play in them can
often be more powerful in helping teams to function effectively
than just meetings alone can. Individual members of staff may
become more effective at facilitating therapeutic activities after
experiencing organised, purposeful play.


• Think about an activity you might organise.
• What would you hope to accomplish through the use of this particular activity?
• What do I need to do and consider in preparing for it?
• How might a given activity benefit a particular young person(s) and what would
I need to do in order to get maximum mileage toward that aim?

Conclusion

This paper provides a brief outline of the many important facets of using activities in
our work with young people. It stresses the need for staff to use do this purposefully.
A binder containing a write-up/copy of those activities that have been used, along
with notes on necessary preparation, what went well and what might be done


differently is exceedingly useful to have on hand in the unit. A section about
activities to try might also be included.

Training links

SVQ: Unit Z13 Enable clients to participate in recreation and leisure activities
(optional unit in the SVQ level 3 qualification Caring for children and young people).
Unit HSC 323 Contribute to child care practice in group living (specific optional unit
for the revised SVQ qualification Health and social care: children and young people
level 3).
Unit HSC 420 Promote leisure opportunities and activities for individuals (generic
optional unit in the revised SVQ level 4 qualification Health and social care: children
and young people level 4).

HNC in Social Care: HN unit Supporting and managing provision in secure care
settings: outcome one (optional unit).

Resources
Teamwork and Teamplay: A Guide to Cooperative, Challenge, and Adventure
Activities That Build Confidence, Cooperation, Teamwork, Creativity, Trust,
Decision Making, Conflict Resolution, Resource Management,
Communication, Effective Feedback, and Problem Solving Skills.
James Hallie Cain, Jim Cain, Barry Jolliff
1998
This book is filled with ideas, activities and information as well as an extensive
bibliography of other books on group games. There is also a well illustrated chapter
on making your own equipment. The writing style is easy to follow with graphics
and photographs that enhance understanding. It has been referred to as one of the
most comprehensive manuals of its kind.

Silver Bullets: A Guide to Initiative Problems, Adventure Games, Stunts and
Trust Activities
Karl Rohnke
1984
This book is an excellent source of creative and fun games that involve trust,
reasoning, initiative thinking and problem solving skills. The author, Karl Rohnke,
has written several games books, and while they are somewhat dated, they are still
relevant and worth pursuing.

The Cooperative Sports and Games Book: Challenge Without Competition
Terry Orlick
1989
This book is a follow up to The Cooperative Sports and Games Book, and provides
directions for more than one hundred new games based on cooperation rather than
competition. These include indoor and outdoor games, games for special-education
classes, and games for children and adults.


104 Activities That Build: Self-Esteem, Teamwork, Communication, Anger
Management, Self-Discovery, and Coping Skills
Alanna Jones
1998

This book contains 104 games and activities for therapists, counsellors, teachers
and group leaders that teach anger management, coping skills, self-discovery,
teamwork, self-esteem and communication skills. Every game works as a unique
tool to modify behaviour, build relationships, start discussions and address issues.
Each activity is simple to follow, requires minimal resources, includes helpful
discussion questions and is designed to be interactive and fun.

Further reading

Some of the material covered in this paper is adapted from a forthcoming book
chapter Steckley, L. (forthcoming). Just a game? The therapeutic potential of
football. In D. Crimmens & I. Milligan, Facing the future: residential child care in the

Brendtro, L. K., Brokenleg, M., & Van Bockern, S. (1990). Reclaiming youth at risk:
our hope for the future. Bloomington, Indiana: National Educational Service.

Daniel, B., Wassell, S., & Gilligan, R. (1999b). 'It's just common sense isn't it?'
Exploring ways of putting the theory of resilience into action. Adoption & Fostering,
23(3), 6-15.

Gilligan, R. (1999). Enhancing the resilience of children and young people in public
care by mentoring their talents and interests. Child and Family Social Work, 4, 187-
196.

Lennhoff, F. G., & Lampen, J. (2000). The inherent discipline of crafts and activities.
Retrieved Dec., 2002, from: http://www.cyc-net.org/today/today000628.html.

Phelan, J. (2001). Another look at activities. Journal of Child and Youth Care, 14(2),
1-7.

Trotter, C. (1999). Working with involuntary clients: a guide to practice. London:
Sage.

VanderVen, K. D. (1985). Activity programming: its developmental and therapeutic
role in group care. In L. C. Fulcher & F. Ainsworth (Eds.), Group care practice with
children. London: Tavistock.


Educational issues in secure
4.09 accommodation
Graham McPheat

...They encourage you, believe in you
(views of a boy in a residential school about his teachers, Smith, McKay & Chakrabarti,
2004, p. 92)

Legislative framework
The regulations and guidance provided with the Children (Scotland) Act 1995 make
clear the requirements for the educational development of children who are looked
after.
• They should have the same opportunities as all other children for
education, including further and higher education.
• They should, where necessary, receive additional help,
encouragement and support to address special needs or
compensate for previous deprivation or disadvantage.
• Educational needs should be addressed in the care plan.
• Planning should have regard to continuity of education, take a long
term view of education, provide educational and developmental
opportunities and support, and promote potential and
achievement.

Further statements are made specifically in relation to secure care.
• There is recognition of the disruption that many children and young
people may have experienced in their schooling prior to being
admitted to secure care and the resistance to education that this
may foster.
• Effective planning of individual curriculum packages by
educational staff is recognised as a means to challenge this
resistance and convince children of the value and possibilities of
education.
• The necessity for co-operation between education and care staff is
also highlighted if positive educational attainment is to be
achieved.
Scotland’s Children: The Children (Scotland) Act 1995
Regulations and Guidance.



• Consider your workplace. Evaluate it against the seven requirements listed
above. Are they consistently being achieved? If not, what changes or
developments need to take place to allow this to happen?

Education and looked after children

Despite these legislative and policy requirements, evidence from a variety of
sources reveals that children and young people looked after away from home are
educationally disadvantaged. Research highlights a marked difference in
educational outcomes for this population compared to their peers in the community.
• Amongst children living in the community the average number of
standard grades achieved is seven. For the looked after population
the average number of standard grades achieved is two.
• Amongst children living in the community 30% achieve at least one
higher. In the looked after population only 3% achieve at least one
higher.

Whilst not minimising the worrying implications of these statistics, they do require to
be interpreted in a correct context. Prior to being accommodated children and young
people have often experienced interrupted educational provision. This can be
characterised by inconsistent attendance, poor attainment and low aspirations from
both the children and young people themselves as well as the teachers and
educational staff involved with them. The poor educational achievements for these
children and young people can reflect existing progression and the outcomes might
not have been markedly different had they remained in the community.

Other evidence also indicates that looked after children and young people are more
likely to be responded to in a manner that is detrimental to their education.
• Looked after children account for 13% of all exclusions although
they represent only 1% of the school population.
• Over 70% of care leavers have been temporarily or permanently
excluded from school at some point in their education.

The nature of the types of behaviour that lead children and young people to be
placed in secure accommodation means that many or all of these factors will often
be present. It then becomes the task of secure accommodation either to reintroduce
them to education and its positive possibilities or to build on and develop existing
educational attainment and progression.

Aspects of education that require to be considered in order that this may be
achieved include:
• Assessing and Planning
• The Curriculum


• Learning and Teaching
• Educationally Rich Environment.

Assessing and planning
Despite legislation dictating that care plans have been a legal requirement since
1997, research associated with Learning with Care in 2001 revealed that these were
not always in place. The educational component of a care plan is vital. Pupils in
secure accommodation often have a wide range of educational needs. Care plan
reviews, which are required to occur at least every six months, provide a good forum
for making plans to support looked after children’s education.

Evidence from Learning with Care revealed that discussion regarding education at
reviews was more likely to focus on behaviour and attendance than educational
attainment and that discussions, and consequently decisions, made at reviews
tended to be more detailed and accurate when a teacher was present.

The findings of the Social Work Services Inspectorate in 1996 when undertaking A
Secure Remedy highlighted that the existence of prior educational assessments
were not always identified when children and young people were first admitted to
secure accommodation, including cases when a formal record of needs had been
opened. The need to use all available assessments and information in order that
accurate plans can be developed is vital.

Non-attendance at school is regularly a problem before children and young people
enter secure accommodation. Although they will attend school when they are in
secure accommodation, this may become an issue again when they leave if
appropriate plans are not in place. This may involve the identification of a new
school, as many will be without a school placement at the point that they enter

A recommendation of the Learning with Care report was that local authorities carry
out a full assessment involving education and social work personnel at the time
when a child becomes looked after. Good practice in a secure setting would involve
a similar process, planning for education in both the short term, in the secure unit,
and in the long term, when placements end.


• Consider LAC reviews within your setting. Is education discussed in adequate
detail?
• What receives more focus – educational attainment or management issues
such as behaviour and attendance?
• Is evidence from prior educational assessments drawn on?
• Are educational needs, both short and long term, adequately reflected in care
plans?


The curriculum

The educational curriculum provided in secure accommodation requires to be
carefully considered. It should be broad and help children and young people to
progress. Where possible it should reflect the 5-14 curriculum and allow pupils to
work towards SQA units, standard grades and highers. The nature and breadth of
curriculum available in units will depend on their size and on the flexibility of the
arrangements they can make to bring in staff in particular subject areas. However,
as identified in A Secure Remedy (1996), curriculum structures should not become
a restricting factor. Individual needs have to be recognised and planned for.

Flexible learning and teaching approaches are a means to achieving this. Older
pupils who are particularly resistant to school education following prior negative
experiences may benefit from an introduction to further education or vocational
training. The findings of the Quality Assurance in Education in Secure Provision
group also emphasised that flexible approaches are required to meet individual
needs and identified that personal and social education should be at the heart of the
curriculum (Scottish Office Education and Industry Department, 1997). This will
ensure a good balance between an academic and a supportive/therapeutic
curriculum.

Specific attention has to be paid to the assessment and identification of any learning
difficulties that children and young people have. Appropriate levels of learning
support have to be available where required – especially in relation to reading,
writing and mathematics. Many of the problems experienced in these areas by
children and young people entering secure accommodation can be tackled with
targeted support and encouragement.

Positive practice should also involve children and young people in using curriculum
frameworks to set educational targets. Involvement of care staff in this process, both
in planning and implementation, can help to achieve a good balance between the
formal curriculum and personal and social education.


• Consider the educational curriculum followed by residents in your workplace.
How involved are care staff in helping residents set and achieve educational
targets?
• Is there a suitable balance between the formal curriculum and personal and
social education?
• Evaluate the co-operation between education and care staff in designing and
implementing the educational aspect of the care plan.


Learning and Teaching

Teaching residents in secure accommodation is a demanding task. The children and
young people have different educational needs, different educational experiences
(the most common characteristic being an interrupted and/or problematic
educational history), they can present challenging behaviour and will spend varying
amounts of time in the secure unit.

This variety of circumstances places high demands on the teachers working with
children and young people in secure accommodation. A key skill of teaching staff is
the ability to be responsive to the needs of individual residents and deliver
personalised educational packages within the group setting. Good classroom
management and confidence in dealing with challenging behaviour and critical
incidents is necessary. Clearly negotiated procedures and roles for both teaching
and care staff have to exist in this regard.

Alongside these skills teachers require to claim residents and convince them they
are committed to them, their education and the future possibilities it can provide for
them. This commitment can be central to challenging some of the resistance to
education that they may encounter.

The issue of teaching and care staff co-operating to provide effective learning
opportunities is again relevant here. Effective practice by teaching staff can help to
deliver the formal curriculum. Many issues related to personal and social education,
the informal curriculum, can be introduced in the classroom but require further
emphasis and consolidation outside the classroom within the day-to-day activities of
the secure unit. This requires a commitment from care staff also. They need to be
aware of this informal curriculum and be able to practise and interact with children
and young people in a manner that promotes and supports it. Issues covered here
may involve values and attitudes, lifestyle choices or health. This is closely linked to
the concept of care staff providing positive role models for the children and young
people they look after – in this case modelling positive attitudes and expectations of
education.


• Consider the curriculum delivered to residents in your workplace. How
personalised are individual educational packages?
• Do clearly negotiated roles and procedures exist for teaching and care staff
dealing with critical incidents?
• Do care staff play an active role in delivering informal educational opportunities
to children and young people?


Educationally rich environment

The Learning with Care report recommended that local authorities should undertake
an audit of their residential units to assess how far they were educationally rich
environments. Characteristics of an educationally rich environment include:
• Staff knowledge and training opportunities in the context of
education;
• Practical procedures and arrangements to allow educational
progress, including communication with schools;

Practice involved in supporting children and young people with their education, such
as homework and private study.

Each area is interlinked and all are important. An abundance of resources is unlikely
to contribute if it is not backed up by the values and attitudes of staff. Any number of
computers or text books will have no impact unless care staff model and encourage
positive attitudes towards participation in education. Positive intentions of staff can
be easily undermined however if not supported by policies and procedures that help
to deliver effective educational provision.


• Consider your workplace. Using the characteristics listed above, identify the
ways in which it can be described as an educationally rich environment.
• Are there aspects of practice that require to develop and improve?

Conclusion

Educational outcomes for accommodated children and young people are worryingly
poor. Education has to be assessed and planned for all accommodated children,
particularly those in secure accommodation. For much of this population prior school
attendance has been poor and educational attainment low. Consequently, many of
them will have negative attitudes to education and school. Education should be
addressed in their care plan, covering both their short term needs when within
secure care and long term needs when they move on. The curriculum delivered has
to be flexible, covering both the formal qualification route and the informal
curriculum concerning personal and social development. Teaching and care staff
require to work together at all stages of this process, particularly in modelling
positive attitudes towards education and delivering personal and social
development. Teaching and care staff in secure accommodation should strive to
create and maintain an educationally rich environment.


Further tasks

Following the Learning with Care report a pack of training materials for carers, social
workers and teachers involved in the education of looked after children and young
people was produced. The activities and tasks contained within this provide an
excellent framework for reviewing and developing positive practice in the area of
education with looked after children and young people.

Further reading

Hudson, B., Furnivall, J., Paterson, S., Livingston, K. & MacLean, K. (2003).
Learning with care: training materials for carers, social workers and teachers
concerning the education of looked after children and young people. Glasgow:
University of Strathclyde Faculty of Education.

HM Inspectors of Schools and the Social Work Services Inspectorate. (2001).
Learning with care: the education of children looked after away from home by local
authorities. Edinburgh: Scottish Executive.

Scottish Office. (1997). Scotland’s children: The Children (Scotland) Act 1995
Regulations and Guidance: Volume 2 Children Looked After by Local Authorities.
Edinburgh: Stationary Office.

Scottish Office Education and Industry Department. (1997). Quality assurance in
education in secure provision. Edinburgh: Scottish Office Education and Industry
Department.

Social Work Services Inspectorate. (1996). A secure remedy: a review of the role,
availability and quality of secure accommodation for children in Scotland. Edinburgh:
HMSO.


Health issues in secure
4.10 accommodation
Graham McPheat

... we are concerned not only with prevention of ill health but with actively promoting positive
mental, physical and social health.
(Residential Care Health Project, 2004, p. 43)

Introduction
This section outlines the key health issues that present with young people in secure
accommodation and gives an overview of appropriate responses. It takes as its
starting point the idea of the health promoting unit. Issues pertaining to mental
health are addressed in paper 4.11.

Overview
All people have a range of health needs. In recent years research evidence, such as
The Big Step Project (2002a) in Glasgow and the Residential Care Health Project
(2004) in Edinburgh, has highlighted the particularly poor health outcomes for
children and young people who are accommodated. These poor outcomes can be
attributed to a variety of factors. Many children and young people suffer from
neglected health whilst living at home and this does not improve when they become
accommodated. Some of the issues associated with this include the frequency of
placement moves and lack of continuity of carers. Others can be directly related to
practice within residential child care, particularly the way in which health issues are
viewed and the lack of effective joint working with other agencies.

A common characteristic amongst many children and young people at the time they
are placed in secure accommodation is that they are at a point of crisis. Their
lifestyles can often be chaotic and include a lot of risk-taking behaviour. Within this
scenario their health needs are regularly neglected. This can include failure to
attend to routine health maintenance, missed immunisations due to irregular school
attendance, smoking, poor diet and sleep patterns, abuse of alcohol and drugs, and
problems with sexual health.

At the time of admission to secure accommodation these circumstances can often
be at their most extreme. A prime aim at this time is to introduce routine and order to
chaotic and out of control lives. Targets in relation to health needs should be in
keeping with this philosophy. Children and young people in secure accommodation


require stability in order that they may be encouraged to recognise and prioritise
their health needs.

This is not merely an issue of health education. Research undertaken by the Health
Education Board for Scotland indicated that much of the behaviour and the poor
associated health outcomes are not the result of a lack of knowledge (Shucksmith &
Spratt, 2002). Instead many of the young people have accurate knowledge of how
to maintain their health but their actions are often shaped and influenced by the
social circumstances in which their behaviour occurs.

Accordingly, the focus of work requires to be associated with encouraging the
recognition of health needs and how these are to be met. The Big Step Research
Report (2002a) identified that many accommodated young people find health a
difficult or uninteresting concept and do not view it as a major life concern in the way
that many adults do. The challenge for workers caring for accommodated children
and young people is to help them to recognise the importance of their health and the
direct links between their lifestyle choices and health outcomes, both in the short
and long term.


• Consider a child you are working with. At the point they were admitted to
secure care were their health needs being met?
• What impact was their lifestyle and behaviour having on their health?
How able or willing where they to make connections between their lifestyle
choices and their health?
• What importance or value did they place on their health?

Legal considerations

Staff need to be aware of some of the legal considerations that surround the health
of young people. The Age of Legal Capacity (Scotland) Act, 1991 enables those
under the age of 16 to consent to medical or dental treatment if a medical
practitioner is satisfied they are mature enough to do so and are capable of
understanding the nature and possible consequences of treatment. A young person
in these circumstances has the same right to confidentiality as an adult has with
their doctor, unless the doctor suspects abuse. This legal situation can cause some
tensions in residential units (and indeed for anyone in a parental or substitute care
role), as young people may be subject to medical diagnosis, treatment or
prescription without their carer's knowledge. In most cases this is unlikely to be a
major problem and young people will generally be open enough with staff about
medical issues. However, staff do need to have an awareness of the legal situation
and of the rights young people have in this area.


Health promotion: lifestyle and well-being

To begin to address the challenges involved in encouraging children and young
people to recognise the importance of their health and the direct links between their
lifestyle choices and their health outcomes, residential care practitioners are
required to consider the health of accommodated children and young people in a
rounded or holistic manner. This will involve concentrating on areas of lifestyle and
well-being and disregarding past models of practice where units would merely
provide a functional initial health assessment when a child was admitted and
thereafter deal only with emergencies and health problems.

Therefore we are concerned not only with prevention of ill health
but with actively promoting positive mental, physical and social
health.
(Residential Care Health Project, 2004, p. 43)

Likewise, concentrating only on problematic areas of behaviour and associated
health risks without placing them within the framework of lifestyle choices and
associated well-being is not effective. Placed within a chaotic lifestyle in which more
holistic and general health needs are not adequately addressed, the likelihood of
achieving longer term lifestyle changes and positive health outcomes is hugely
diminished.

This is an important distinction to make as the findings of the Residential Care
Health Project indicated that staff in some residential units were still prone to react
to what were viewed as ‘immediate’ health needs and less emphasis was placed on
proactive planning in relation to longer-term health needs.

Making the links between lifestyle and wellbeing is an intricate task. Health
promotion will be a component of it, as will encouraging the ability of children and
young people to recognise and influence their health outcomes through their
behaviour and lifestyle choices. To achieve this, a unit’s milieu and the routines that
accompany this have to reflect these issues. When factors associated with positive
lifestyles and well-being are encouraged to become part of the individual child’s
routines and thinking, they are more likely to be sustained when they leave the
secure unit for different living environments.

Diet is of particular importance in any residential unit. There is increasing
recognition of the importance of a balanced and healthy diet and of the implication
of poor diets in a range of health and indeed behavioural problems. Many residential
units will be faced with changing the eating habits of young people who, until that
point, may have eaten very poorly and irregularly. Mealtimes are crucial periods in
any residential unit and these should be used to introduce new and balanced dietary
experiences for young people. The importance of regular meals and of eating as a
social experience should also be built into the routines of a centre.



• Consider the unit you work in. Does work concerning health involve proactive
planning or responding to health emergencies?
• How are children and young people encouraged to make links between their
lifestyle choices and their health?
• What is the diet like in your unit? What considerations are taken into account in
menu planning?

Secure units
Secure units provide a unique opportunity to address health issues of
accommodated children and young people. An increase in risk taking behaviour will
often precede a move to secure accommodation. The following period of stability
and removal from the environment where this risk taking behaviour was occurring
provides the perfect opportunity for a full and comprehensive inter-agency
assessment of the needs of the young people and the opportunity to engage in
therapeutic work

The Residential Care Health Project (2004) developed a model of integrated health
care for secure units involved in the project. This not only involved residential and
social work staff but those from primary care, community child health, mental health
and education. This reflected a holistic approach to health and also placed due
emphasis on the need for effective inter-agency working to achieve positive health
practice.

Health promoting units
Having established that residential child care should consider the health of
accommodated children and young people in a rounded or holistic manner,
concentrating on areas of lifestyle and wellbeing, practitioners require a framework
to plan and assess this. This framework should help to promote a milieu and
routines where the importance of health is recognised and promoted.

The model of health-promoting schools is one that can be readily applied to
residential child care. This model has already been successfully implemented in
various settings and all Scottish schools are required to be working towards health-
promoting school status by 2007. This approach considers health in a broad sense
and when applied to residential child care can provide a planning and evaluation
framework within the care setting.


health &
welfare of
staff
curriculum
& activities
environment

THE HEALTH
PROMOTING
UNIT

ethos & links with
climate family &
community
role of
specialist
services

This diagram illustrates the many aspects to consider when establishing a holistic
health promotion approach within a residential unit. These aspects are described
below.

Ethos and climate
The ethos and climate achieved within a unit guides much of the learning and
development of the young people resident within the unit. A culture where the
importance of health is recognised is imperative, where staff act as positive role
models for young people and where the young people are encouraged to recognise
the holistic nature of their health needs (how behaviour in one regard impacts on
other areas of their health), and where the young people are encouraged and
allowed to make decisions that develop self-caring skills that can lead on to an
ability to meet their own health needs after leaving secure care. Appropriate
messages and modelling around issues of smoking, drinking and drug use are
particularly important.



• Think about the unit you work in. What attitudes towards health care are
communicated to children and young people by the culture of the unit?
• What emphasis do staff place on this issue through their language and
behaviour?
• Are young people encouraged to recognise and take ownership of their health
needs, either formally in a care plan or informally in day-to-day activities?
• To what extent do policies (and attitudes) on smoking, drinking and drug taking
support a health promoting culture?

Environment
The environment of a unit, particularly a secure unit where residents will be
spending much time, can be health promoting. Particular attention can be paid to
the use of space and availability of facilities. Issues in secure units may often centre
on the availability of space and facilities for exercise as well as adequate social
space for large groups and individuals.

The living environment of a secure unit will have a large impact on the attitude and
demeanour of residents. This is particularly relevant when considering research
findings in relation to the mental health needs of accommodated children and young
people. There is much evidence to suggest that accommodated children and young
people suffer from poor mental health (see paper 4.11). A residential environment
that places value on children and young people can do much to contribute to
positive self-esteem and positive mental health.


• Think about the unit you work in. What value is placed on creating a pleasant
living environment for the children and young people?
• How do staff participate in this process?
• How effectively are space and resources utilised to create a pleasant living
environment?
• Are children and young people able to or encouraged to personalise their living
environment?

Curriculum and activities
The issue of curriculum can be interpreted in the traditional meaning if thinking
about education facilities within secure units, but can also refer to activities residents
experience as part of the living environment. The activities and events that young
people are offered and encouraged to attend can be used to promote different
aspects of health (see paper 4.08). Health requires to be promoted in a holistic and


balanced way. A skills-based approach where young people are offered the
opportunity to learn about and maintain their health needs can help to achieve
sustainable change.


• Think about the unit you work in. To what extent do daily life and routines
within the unit promote or otherwise those issues associated with health?
• Think particularly of activities, diet and exercise. Do these contribute to a health
promoting unit?
• Are children and young people encouraged to develop skills to meet their
health needs?

Health and welfare of staff
To achieve positive health outcomes for the children and young people in a
residential unit, the staff require healthy and positive attitudes. Without this the
required positive role modelling of behaviour and attitudes is unlikely to be achieved.
Issues such as good working conditions and a meaningful process of supervision
and appraisal that takes account of staff health needs – physical, emotional and
mental – require to be addressed.

Positive developments in the other areas of the health promoting unit will also prove
beneficial in this regard. A positive and pleasant living environment for children and
young people is a positive and pleasant working environment for staff. A culture
where health needs are prioritised for children and young people is then able also to
take account of the health needs of staff.


• Think about the unit you work in. What impact does the health and welfare of
staff have on the children and young people?
• How much emphasis is placed on the health and welfare of staff?
• Do processes such as supervision and appraisal act as a supportive tool,
aiding development and enabling workers to practice in a positive manner?

Role of specialist services
Effective inter-agency working is a vital component of health-promoting practice in a
secure environment. Specialist services, such as Looked After Nurses and Children
and Adolescent Mental Health Services (CAMHS) teams, have a vital role to play in
the health of accommodated young people. To be utilised effectively, appropriate
communication and working relationships have to be achieved between the relevant


health professionals and care staff. Some secure units employ or contract their own
nurse practitioner and this role can facilitate this link. It can also be instrumental in
ensuring effective protocols regarding referrals to more specialist services. The role
of these services has to be recognised and promoted by the unit. Again the
behaviour and attitudes of staff will be vital in transmitting this to the young people.


• What specialist services have links with your unit?
• How well does the practice of residential staff and of these services
complement each other?
• What protocols and working agreements are in place in order that effective
collaborative work can take place?

Links with family and community
Links with family and community have to be promoted and achieved if sustainable
health-promoting behaviour, and consequently positive health outcomes, are to be
achieved. Continuous parental participation is to be encouraged, particularly in
supporting and attending health appointments and a process of regular updates,
both formal and informal, has to be set up. Again the attitudes of staff towards
family, and their commitment to involving them in the process will play a large part in
determining how successfully this is achieved.

Throughcare and aftercare planning should consider the current and future health
needs of the young person. Plans are currently in place to develop a new Scottish
Health Network to take forward the work of the Scottish Throughcare and Aftercare
Forum Health Working Group (see McCluskey, Greaves and Kean, 2004).


• Think about a child you are working with. How involved are the family in the
care-planning process?
• Is their role and involvement actively promoted by staff? What advantages or
disadvantages to the health of the child does this have?

Conclusion
The health needs of accommodated children and young people have to be
considered in a holistic manner. Proactive health care planning is required. The
model of a health-promoting unit provides a useful framework for planning and
assessing health-promoting practice. All areas within this framework are interlinked.


Training links
SVQ: Unit CYP2 Contribute to promoting health and social well-being for children
and young people (optional unit in the SVQ level 3 qualification Caring for children
and young people).

Unit HSC 313 Work with children and young people to promote their own physical
and mental health needs (specific optional unit for the revised SVQ qualification
Health and social care: children and young people level 3).

Further reading
Chambers, H. (2002). Healthy care: building an evidence base for promoting the
health and well-being of looked after children and young people. London: National
Children’s Bureau.

Department of Health. (2003). Promoting the health of looked after children. London:
Department of Health.

McCluskey, S., Greaves, E & Kean, C. (2004). Scottish Health Network: promoting
the health and well-being of children and young people in and leaving care. Scottish
Journal of Residential Child Care, 3(2), 55-58.

Residential Care Health Project. (2004). Forgotten children: addressing the health
needs of looked after children and young people. Edinburgh: Astron.

The big step. (2002a). The health of young people in care and leaving care in
Glasgow: the big step. Glasgow: The big step.


Mental health
4.11
Ian Milligan

The recent Office of National Statistics survey for Scotland found that overall 45% of looked
after children suffer from a mental health disorder.

Introduction
Young people in secure care are some of the most troubled and troublesome young
people in the country. This chapter provides a mental health perspective on care
practice in secure settings. The key points include: a discussion of the nature of
mental health, prevalence of mental health disorders, available services, stigma,
and care practice.

Overview
Despite their problematic backgrounds it has often been the case that young people
in secure care, in common with young people looked after and accommodated
elsewhere, have not been easily able to access specialist mental health services.
Similarly, workers in secure accommodation, although working very closely with
extremes of behaviour and emotion, have themselves often not had ready access to
psychiatrists or psychologists for advice on dealing with specific emotional and
behavioural issues.

This is not to say that health issues have not been recognised in residential work
with children. The Skinner Report (SWSI, 1992) put ‘Health’ as one of the eight
principles and also emphasised the importance of ‘Collaboration among
professionals’ as key components of good quality care. However, mental health as
such was not mentioned in the Skinner Report. Following a period of years in which
it has been difficult for young people in care or their carers to access NHS mental
health services, the needs of ‘looked after children’ have begun to receive more
attention from NHS policy makers and psychiatric professionals. In recent years the
Scottish Executive has also been encouraging greater integration of services for
children. Children’s mental health is one area in particular in which we could expect
to see mutual benefit from closer working relationships between residential staff
teams and mental health specialists. The health needs of children in care have
become clearer through the publication of a number of recent studies (Residential
Care Health Project, 2004).


Prevalence of mental disorder
Studies have shown high rates of mental disorder among looked after and
accommodated children and young people. What happens in the care system is a
reflection of what is happening in society and there has been concern about the
mental health of children and young people more widely. Figures from a
comprehensive UK study indicate that about 9% of all children and young people
experience a mental health disorder (Meltzer, 2000). Among the emotional and
psychological problems reported in recent years are increasing rates of eating
disorders, an increase in suicide rates among young men, and considerable
increases in hyperactivity among younger children.

Terminology
The terms used in this paper, mental illness, mental disorders and mental health
problems, are drawn from the language of psychiatry. From an educational
perspective (including residential schools), the same children and young people will
be described as having ‘emotional and behavioural problems’, while within social
work the idea of ‘children in need’ has usually been considered sufficient most of the
time. We are often describing the same children, although we may be focusing on
the way they come to our attention in different settings. All of these terms can be
useful and appropriate and it will be helpful to young people if residential staff can
understand the basic meaning of various terms that mental health professionals use.

The term mental health problem refers to a broad range of emotional and
behavioural difficulties. These difficulties vary in the extent to which they interfere
with everyday living. Studies of representative samples of the population suggest
that at any one time between 15 and 20% of children and young people in the UK
have mental health problems. Children and young people whose problems are
more severe, extreme or distressing, so as to cause serious disturbance with their
everyday life, and which persist over weeks and months, can be described as
having a mental disorder. Mental disorders have been classified using internationally
recognised classification systems, and include conditions or groups of disorders
such as ‘conduct disorder’, ‘emotional disorders’, including depression, ‘obsessive
compulsive disorder’, and ‘attention deficit hyperactivity disorder (ADHD)’. It is this
category of mental health that has become more recognised as affecting a large
number of children and young people in the care system and which is the focus of
much of this paper. In the general population of children under 18 between 9 and
10% may have a mental disorder but in residential care the most recent statistics
suggest it may be as high as 66%. (Meltzer, Lader, Corbin, Goodman & Ford, 2004)
There is a much smaller group, about 1-2% of the whole population, which has a
diagnosed mental illness, such as schizophrenia, anorexia nervosa, or very serious
depressive illnesses.

The information in the section above is taken from the training package ‘Young
Minds: Looking after the mental health of looked after children’ (Talbot, 2002)

The recent Office of National Statistics survey for Scotland (Meltzer et al, 2004)
found that overall 45% of looked after children suffer from a mental health disorder.
This confirms earlier more localised studies such as the one in Glasgow (Dimigen et
al., 1999) which found that many of the children aged 12 and under had mental


health disorders at the time of entering care. This study also found that many of
them had not received any treatment for these disorders.

The majority of disturbed children seen in secure care will primarily have either
emotional or conduct disorders. Emotional disorders include high levels of anxiety
and distress resulting from difficult life experiences. Children with conduct disorders
are often rather superficial in their relationships with others and anti-social behaviour
such as violence and lack of consideration for others is common. Although these
two types of presentation can be seen separately, they are often combined.


Think of young people in your unit who have diagnosed mental health
difficulties.
• What are those diagnoses?
• Might there be others who are not diagnosed?

Developments in mental health services
This level of unmet need has led to the recent development of a number of
specialist mental health services for looked after children in various places in
Scotland, such as East Dunbartonshire (The Open Door project), Glasgow (The
LACES service), the LEAP Project in Ayrshire, and Edinburgh (Connect) and a
number of pilot projects in other health board areas. Some residential schools,
including secure units, have also been directly employing or gaining access to more
psychologists and psychiatrists. A good example of this is the Promoting Mental
Health and Welfare Project, a joint venture between Dundee City Council and
Rossie School. The profession of psychology has been undergoing something of an
expansion in recent times which has seen the emergence of a number of different
specialisms, including forensic psychology.

Within the NHS generally most mental health professionals working with children
are grouped into teams called Child and Adolescent Mental Health Services
(CAMHS). These multi-disciplinary teams include a psychiatrist and psychologist
and one or more mental health nurses. They may well include professionals from
other backgrounds such as teaching or social work who have gained qualifications
in mental health or specific therapies such as ‘psychotherapy’ or ‘family therapy’.
Social workers are also often found in CAMHS teams. Some of these teams are
based in hospitals and others are based in community clinics or centres of various
kinds. Generally speaking Health Boards in Scotland have not developed their
CAMHS teams to the same extent as has happened for example in England. At the
present time Boards are being asked by the Executive to increase this provision.
This is a welcome development but there is currently a shortage of people to fill the
vacancies which exist in many places across Scotland.


CAMHS teams have often tried to develop a non-hierarchical way of working. The
whole team will sit down together to look at referrals and then decide which team
member’s skills are best suited to the particular referral. Teams usually prefer to
work with the whole family if they can as it is evident that many children’s troubles
are very much related to family functioning. This has posed a problem when young
people in care have been referred, as CAMHS teams have sometimes not been
sure about the value of working with a young person in isolation from others they
live with, especially if the placement is short-term or appears likely to break down. It
is also true that some teams have felt that they would find it difficult to engage with
children in crisis and have wanted to delay treatment until the child is in a ‘stable
placement’. The recent emergence of dedicated Looked After Children (LAC) mental
health services has sought to overcome this problem of access to services for
looked after children. The mental health professionals in these teams are keen to
show that they can in fact make a contribution to helping stabilise placements which
are at risk of breaking down.

It should be noted here that in recent years CAMHS teams in many parts of the
country have been understaffed and have worked under pressure of a large number
of referrals. This has meant that there have often been very long waiting lists.


• What are the arrangements in your area to access the local CAMHS team?

Thinking about mental health - Professional biases and stigma
Until more recently it has seemed that residential workers did not think much about
how a mental health perspective might inform their own practice. At times they may
have wanted to refer young people to a psychiatric service although, as we have
noted, access to services has been difficult. Furthermore, located as they are within
social work departments or agencies, residential workers have probably been
influenced by the views of social workers who have been very concerned about
‘labelling’ young people. And in any case, such is the stigma around anything to do
with ‘mental’ health that young people themselves may be reluctant to be referred to
such a service. All these things together have meant that young people’s needs and
behaviours have usually been interpreted in terms of their personal and family
problems and residential workers and foster carers have been expected to manage
a lot of difficult and disturbed behaviour. They have been expected to rely on basic
residential practice, which usually focuses on the need for consistent boundaries
and establishing caring relationships to help young people.

This ‘policy’ of coping and containing has usually persisted until a young person’s
behaviour has become particularly extreme or sometimes bizarre. This has often
been when young people display consistently violent and destructive behaviour – in
terms of attacking staff or other young people or smashing up their own property
(often in the case of boys) or self-destructive behaviour such as self-injury or
extreme risk-taking (often in the case of girls).



• Can you think of behaviours that you find difficult to understand?
• How can we gain a better understanding of why a young person behaves the
way they do and how their previous experience of adults may be influencing
their thinking, feeling and acting?

Care practice
In this context it is vital that residential staff do not simply react to behaviours but
seek to develop their knowledge and understanding so that they can get a deeper
and more informed perspective on the emotions and trauma that may underlie the
behaviour. Young people in secure accommodation need the relationships of care,
the provision of a nurturing and stimulating environment and the careful targeting of
problem behaviours, which social care teams at their best can provide. But young
people will also need workers who are able to access mental health professionals
for advice and who are self-confident enough to work in partnership with mental
health specialists on treating emotional and psychological problems. As has been
said, we do not need a psychiatrist at the foot of every child’s bed and in fact in
many places residential workers are best placed to offer truly therapeutic care; but
they will need the advice and consultancy of others to confirm their work or to offer
other suggestions on how best to understand and respond to the behaviour of each
individual young person.

You know some people in their lives go through a bad time and [now is] maybe
my time. You don’t really know what’s wrong with you. I feel like I’m in this dark
dimension and I can’t find the light, I can’t get out and I’m trying my hardest to find
the light. It’s like I’ve got problems with school, problems with my friends,
problems with this and that, and I’m trying to be good at school, and it’s working,
but then just at the wrong time, the wrong place, I do something and I get into
trouble for it. It feels like this dimension is holding me back, every time I’m trying
to get out of it, it’s pulling me back in again.

(female 16, Who Cares? Scotland, 2003, p. 37)

Both the research literature and the experience of SIRCC staff is that residential
workers want more training in mental health issues and that working more closely
with mental health specialists can improve practice and build the confidence of
residential teams when working with very difficult behaviour (van Beinum, Martin, &
Bonnett, 2002). Residential workers have always had to wrestle with the emotional
difficulties of young people in their care. In recent years, as units become smaller
and care planning more individualised and detailed, they have increasingly relied on
their relationships with the young people as the primary tool for helping them
overcome their problems. There is no doubt however that young people who have


had traumatic experiences of family life often find it difficult to respond positively to
the personal care offered in residential units. Many of the young people in secure
settings will have experienced many changes of placement within the care system
further undermining their trust in adults to provide them with any stability and also
undermining their own sense of self-worth or even self-control. Working with
children and young people who have suffered trauma can make the staff feel bad,
and having a mental health perspective can sometimes help staff understand their
own, and their colleagues’, reactions to the young people. In describing what they
learned in East Dunbartonshire the Open Door project supervisors write:

Such children, some of whom had suffered terrible abuse, at times
could only communicate inner distress by a primitive process of
trying to make a staff member feel, inside them, some of the pain
and confusion that the child her or himself suffered but was unable
to put into words, and therefore could not work through by thinking
and talking about it.
(van Beinum et al, 2002).

It is important that care staff are able to understand and interpret behaviour and to
realise the effects that it may have on them and on their staff team. Secure units
can all call on psychological support for consultation and advice on how staff might
understand and work with young people. Access to psychiatric support in those
cases requiring this type and level of interventions can still be more difficult to
access.

Conclusion
While staff in secure accommodation will want to draw on any expertise that mental
health specialists may have we should not think that mental health professionals will
always be able to achieve a great deal in a short period of time – they have no
magic wands either!

In relation to the emotional well-being of young people it is the job of the carer to
show that they can contain or ‘hold on to’ the emotions which the young person
themselves find unbearable or ‘un-containable’ (see chapter 3 and paper 5.03). In a
secure setting the young person is physically contained and made safe in a physical
sense but the aspiration of care workers must be to transfer that sense of security or
containment from the buildings to the people who surround the young person in their
daily life.

Our goal is to provide young people with the experience of being understood and
cared for so that they can begin to recover from the traumas that have led them into
the secure placement in the first place. This is necessary if the young people are to
establish a more stable emotional foundation on which to build their own capacity to
cope and to re-make relationships with their family and the community to which they
will soon return.


Training links
SVQ: Unit CYP2 Contribute to promoting health and social well-being for children
and young people (optional unit in the SVQ level 3 qualification Caring for children
and young people).

Unit HSC 313 Work with children and young people to promote their own physical
and mental health needs (specific optional unit for the revised SVQ level 3

Further reading
Dimigen, G., Del Priore, C., Butler, S., Evans, S., Ferguson, L., & Swan, M.
(1999). Psychiatric disorder among children at time of entering local authority
care. British Medical Journal, 319, 675.

Meltzer, H. (2000). The mental health of children and adolescents in Great
Britain. London: Office of National Statistics.

Meltzer, H., Lader, D., Corbin, T., Goodman, R., & Ford, T. (2004). The mental
health of young people looked after by local authorities in Scotland. London:
Stationery Office.

Residential Care Health Project. (2004). Forgotten children: addressing the
health needs of looked after children and young people. Edinburgh: Astron.

Talbot, R. (2002). Young minds: looking after the mental health of looked after
Children. Brighton: Pavilion.

van Beinum, M., Martin, A., & Bonnett, C. (2002). Catching children as they fall:
mental health promotion in residential child care in East Dunbartonshire. Scottish
Journal of Residential Child care, 1(1), 14-22.


Working with boys and girls
4.12
Mark Smith & Laura Steckley

What are young men made of?
What are young men made of?
Sighs and cheers, and crocodile tears
And that are young men made of.

What are young women made of?
What are young women made of?
Ribbons and laces, and sweet pretty faces,
And that are young women made of.

Introduction
This old nursery rhyme suggests that boys and girls are somehow made differently.
One of the great debates in psychology is the nature/nurture one. Are people born
with particular personality or behavioural traits or do they acquire these through their
processes of socialisation? In relation to the focus of this paper, do girls and boys
behave in the ways they do as essential attributes of their biological state? Or do
repeated parental peer and media images determine for them what it means to be a
girl or a boy and accordingly, how they should act? Some discussion of the
terminology is provided in paper 4.13

Overview
Whilst most people who come into contact with boys and girls in any capacity would
attest to some differences in the ways they behave and in how they are responded
to, the whole area of gender difference is not one that has been developed much in
social work thinking. Part of the reason for this is understandable from an ideological
standpoint. For much of history girls were seen as less valuable or able than boys.
Families would invest in boys’ education and development in ways they would rarely
consider for girls. Expectations of girls often consigned them to a future of
domesticity. Traditionally, education systems and institutions were set up to service
the needs of boys and men.

Professions such as social work and education have rightly sought to promote
issues of gender equality. Schools, for instance, are much more geared to the
needs of girls that they were even 20 or 30 years ago. Girls in fact, over the past
decade or so, have outperformed boys academically throughout the English-
speaking world. However, in promoting the rights and needs of girls, we have


arguably neglected the particular and different needs of boys. As Steve Biddulph
(1997) says:
For 30 years it has been trendy to deny masculinity and say that
boys and girls are really just the same. But as parents and
teachers know, this approach isn’t working.

Effective child care requires that practitioners work with the equal but different
needs of boys and girls. In this, a balance must be struck between understanding
difference (in order to help) and perpetuating stereotypes. Staff need to consider the
individual needs and preferences of young people rather than responding to them
solely as boys or girls.


• From your experience as a parent, relative or carer, what would you say are
the behavioural and personality differences between boys and girls?
• Do you think boys and girls are born different or do these changes emerge?
Give some examples why you think this.
• To what extent does your unit acknowledge differences between boys and girls
and how does it respond to these?

Nature or nurture?
To return to the previous question around nature or nurture, the reality is that
differences between boys and girls are attributable to the interplay of both. They
start in biology and end in culture.

Gender differences are apparent in the ways girls and boys respond and are
responded to, from a very early age. Girls generally appear more securely attached.
Boys respond less well to being separated from their mothers in particular.

Some psychoanalytic writers (see chapter 3) suggest that girls’ identities are more
secure because they seek to replicate that of their primary care givers – initially their
mother, and then carers outside the home. For boys to be able to attain a secure
sense of being a male, they need to separate from their mothers and construct
identities around what they perceive to be male ways of being. They begin to do this
from the age of about six when they start to identify more with father figures. This
process of separation continues into adolescence when the focus is on finding male
role models outwith the home that they can identify with.

Other biological influences on development are hormonal, particularly associated
with puberty. In boys, testosterone levels increase 800 fold around age 14. This has
obvious effects on physical appearance but also on mood and energy levels. Girls
are also experiencing changes in their hormones and in the shape of their bodies.
This can also have effects on mood and energy levels, as well as increase anxieties


about weight and desired thinness. Just when their bodies are becoming rounder,
many girls are becoming more acutely aware of the barrage of messages from
family, friends and media surrounding the overriding importance of being slim.

The problem with boys
Boys both experience and present a number of particular difficulties growing up.
Their relative educational underachievement has already been noted. In addition to
academic difficulties, boys also account for more than 80% of school exclusions. In
Scotland, over three quarters of those referred to the Reporter to the Children’s
Panel on offence grounds are boys. Involvement in crime can be seen by some
boys as a way of ‘doing masculinity’ (see paper 4.16).

Mental health problems are far more prevalent for boys than girls. At the extreme
end, suicide among 15 - 24 year olds is three times greater for boys than for girls
(see paper 4.11). The number of suicides increased by 18% over the course of the
1990s. Diagnoses such as attention deficit hyperactivity disorder (ADHD) have also
risen substantially in recent years, and again, those affected are almost all boys.
Some commentators question whether conditions such as ADHD may in fact reflect
social situations such as the lack of a father figure, or educational systems that are
not geared for the ways boys learn.

So what’s the problem with boys?
There are different schools of thought as to why boys experience some of these
difficulties. William Pollack in Real Boys (1999) suggests that boys are pushed by
societal pressures to subscribe to what he calls ‘The Boy Code’ − a set of
expectations which lay down how boys are expected to behave. Features of the boy
code require that boy are:
Sturdy Oaks - they must be stoic and unemotional in the face of suffering; the big
boys don’t cry syndrome;
give ’em hell - they need to make their presence felt through shows of physical
prowess and a ‘come ahead’ attitude;
big wheels - they are interested in power and dominance and in being in
control;
no sissy stuff - an essential aspect of being a boy is not being a girl and not being
seen to engage in ‘girly’ things. This fits in with other research
(Frosh, Pheonix and Pattman, 2002) which found that boys’
identities are described and constructed around not being a girl
rather than around concrete examples of being a boy.

Pollack argues that having to subscribe to the boy code inhibits boys from
expressing their more caring and emotional sides.

Christina Hoff Sommers (2000), however, gives another view. The title of her book,
How Misguided Feminism is Harming our Young Men says it all. She argues that
boys are suffering because Western culture devalues manhood and seeks to
feminise boys. Both these writers share a belief, from different ideological positions,


that the problem with boys is that they are not allowed to get in touch with their inner
selves.

One camp wants to reform masculinity, the other to restore it; one
seeks to rescue boys from patriarchy, the other from feminism.
(Young, 2001, p. 1)


• Think of any specific difficulties faced by boys you work with. To what extent
might these be related to gender?
• Why do you think boys face problems growing up?

The problem with girls
As is the case with boys, the problem with girls often has little to do with girls
themselves and more to do with the culture within which they are trying to grow up.
The literature on the difficulties faced by girls growing up predates that for boys. A
central book is Mary Pipher’s Reviving Ophelia: Saving the Selves of Adolescent
Girls (1994). Pipher identifies some of the characteristics and issues presented by
adolescent girls. They can be obsessed with complicated and intense relationships,
have confused and contradictory feelings towards the same people at the same
time, and get sexuality, romance and intimacy all mixed up.

Girls can be concerned to the point of obsession with their physical appearance,
especially their weight. According to Pipher, these concerns, as well as all sorts of
mixed messages such as ‘be sexy but don’t be sexual’ are rooted in cultural and
media driven expectations about what girls and women should be like. Such
expectations split adolescent girls into true and false selves. There are some
general ways they can respond to these cultural pressures; they can conform,
withdraw, be depressed or get angry.

A more recent UK study (Reay, 2001) picks up on similar themes and places girls
into four categories according to their responses to cultural pressures. Girls can
present as spice girls, nice girls, girlies or tomboys. What was interesting about this
study is that while the children (both boys and girls) saw girls as harder working,
more mature and more socially skilled, all of the boys and most of the girls believed
it was better being a boy.

It is clear that girls also absorb many of our culture’s messages to boys about the
importance of not being like a girl. The nice girls and girlies conformed to societal
expectations of feminism and were viewed by their peers as ‘boring’ and ‘no fun’
(nice girls) or ‘stupid’ and ‘dumb’ (girlies). The spice girls and tomboys resisted
traditional definitions of how good girls are supposed to behave, but were seen as ‘a
bad influence’ and ‘little cows’ by their teachers (spice girls), or rejected and scorned
their own gender completely (tomboys). It seems that these girls and girls in


general, have little if any accepted and valued space for genuine expression of what
it is to be a girl.

Girls generally physically develop earlier than boys, and as a result staff may have
unrealistic expectations for their behaviour. Their emotional and cognitive
development, however, can often be still be at an immature stage despite the fact
that they look (and often want to be perceived as) mature. Extreme and changeable
emotions, egocentricity, concrete thinking, overreacting and emotional reasoning
are often seen as deliberate manipulations or character defects, when in many
instances they are a normal and necessary part of the developmental process.


• What are some media images of girls?
• What kind of conflicting pressures might these place upon girls growing up?
• How would you categorise the girls in your care? Why might they behave in the
ways they do?
• How might you support girls’ healthy expressions of femininity and challenge
damaging ones?

Girls and boys in secure accommodation
Around three-quarters of young people admitted to secure accommodation are
boys. The numerical imbalance in the gender composition in secure accommodation
is compounded by generally different reasons for admission. Boys are generally
admitted for behaviour that involves offending, girls on account of their vulnerability
or moral danger. There are ongoing concerns around the placement of sexually
vulnerable girls in the same unit as boys, some of whom may be placed there for
offences involving sexual aggression. On the other hand, the social backgrounds,
experiences of adversity and overall welfare needs are common to both sexes.

Nevertheless, girls and boys in secure accommodation do have some distinct
patterns of need. Girls are generally more academically able and require counselling
or psychiatric help for sexual abuse or self-harming. Boys are more likely to be
persistent offenders and absconders and to abuse alcohol and/or drugs. In contrast
to the backgrounds of boys, over half of whom had come to the attention of
specialist services before the age of eight, most girls had a relatively short history of
social work involvement.

Some research (O’Neil, 2001) suggests that young women placed in secure
accommodation on welfare grounds do not fare particularly well from the
experience, as the regime is geared towards the needs and demands of boys. The
planned new all girls unit at The Good Shepherd Centre has been commissioned to
take some of these concerns into account (see chapter 1). Indeed, the planned
reconfiguration of the secure estate is set to introduce more single sex units than
has been the case in recent years.



• What might be some of the arguments for and against single sex provision in
secure accommodation?

Working with boys and girls
Many secure units might already run or have run groups to seek to address the
specific needs of girls. It is less likely that they will have considered the specific
needs of boys, perhaps assuming that the overall programme is geared around the
needs of boys in any case. However, there are some particular differences in the
ways boys and girls respond that might be usefully taken into account in the way
any programme operates.

Care has to be taken in any generalisations around gender but, generally speaking,
boys tend to respond better to a clear articulation of the rules, whereas girls can be
appealed to on a more emotional level. That is not to say that just laying down the
law will work for boys. They need to respect whoever is setting the rules otherwise
they will drive a coach and horses through them.

The following table suggests some recommendations for staff from youth in
custodial settings. (The study is Canadian but the ideas are transferable).

Girls like staff who Boys like staff who

Are friendly and nice Talk and joke with them

Provide information that helps them with Play sports with them
their problems including counselling and
medication

Listen to them and take time to talk Try to understand their feelings and
be fair

Are consistent and fair Don’t hand out excessive
consequences

Cut them some slack and joke around with Provide them with positive feedback at
them the end of a shift

Make it safe for them to show how they feel

Are sensitive to them when they are
experiencing hard times

From Nicholson and Artz (2003)


While boys and girls need many of the same things, how these things are delivered
might be different. Some helpful advice for staff in working across gender issues
might be:
• Ask questions that encourage young people to think clearly;
• Congratulate young people on their maturity, insight, or good
judgment;
• Validate their autonomous, adult behaviour and support their
barely emerging maturity;
• Avoid panicking;
• Watch for trouble and convey the message that we are strong
enough to deal with it;
• Avoid taking behaviour personally;
• Reassure;
• Model respect and equality (use inclusive language);
• Give a message that appearance isn’t everything.


• Can you add to these lists as to how best to respond to boys and girls?

Ensuring an appropriate mix of staff
Around two thirds of residents in residential child care generally are boys, yet only
around one third of the staff are male. The gender balance on staff teams is likely to
be more even in secure settings. As noted however, the resident population there is
also more heavily skewed towards boys.

It is important to look beyond some of the superficial assumptions that can be made
about the gender composition of staff teams. Men can be portrayed in some
quarters as being employed, especially in secure units, primarily for their physical
prowess in restraint situations. Men do have a role in managing behaviour but to be
cast only in this role can be very uncomfortable for most men. It also undervalues
their potential to model healthy images of masculinity which are not oriented around
power and control to both girls and boys in their care.

Adolescent boys in particular need adult mentors outwith the home from whom they
can learn how to be a man. As Biddulph (1997) says,
They (boys) need to download the software from an available
male.

One of the difficulties agencies can face in appointing staff is that equal
opportunities legislation may prevent them from developing a gender balance in the
workplace that takes into account the particular gender needs of boys and girls in
care for suitable role models. The lack of men in residential child care across the
board is an area of increasing professional attention and concern. Kibble Education


and Care Centre has recently secured a grant from the European Social Fund which
acknowledges men as being under-represented in the social care workforce. The
resultant men can care project seeks to address this by providing academic and on
the job training to a group of trainees. Interest in this project suggests that with
relevant recruitment strategies men can be attracted to this area of work.

The whole area of gender is one that should be discussed in staff groups. It is
potentially contentious and in the absence of open discussion, myths can grow up
around it. It is perhaps especially necessary to address gender in secure
accommodation, where issues of control and the gendered assumptions that can go
along with this are to the fore. Issues of how staff model particular images of
masculinity or femininity are crucial.


• What is the gender balance in your unit?
• Are male and female staff expected to fulfill different roles?
• What are the implications of this?
• How can you challenge gender stereotyping of staff and/or young people while
still tuning into the unique needs of boys and girls?

Conclusion
It is increasingly recognised that residential child care needs to respond to the
needs of boys and girls differently. This is consistent with wider themes around
valuing the individuality of each person. Staff who work in secure accommodation
need to be aware of the different (and of course the similar) needs of girls and boys
and to respond to these accordingly. The kind of gender relations that exist in staff
groups will be important in modelling healthy gender roles.

Training links
SVQ:
Unit O2 Promote people’s equality, diversity and rights (mandatory unit in the SVQ
level 3 qualification Caring for children and young people).
Unit HSC 34 Promote the well being and protection of children and young people
(mandatory unit for the revised SVQ level 3 qualification Health and social care:
children and young people).

HNC in Social Care:
unit).


Further reading

Biddulph, S. (1997). Raising boys. London: Thorsons. This is a particularly
readable, sensitive and reassuring book about, as the title suggests, raising boys.

Frosh, S., Pheonix, A. & Pattman, R. (2002). Young masculinities: understanding
boys in contemporary society. Basingstoke: Palgrave.

O’Neill, T. (2001). Children in secure accommodation: a gendered exploration of
locked institutional care for children in trouble. London: Jessica Kingsley.

Pipher, M. (1994). Reviving Ophelia: saving the selves of adolescent girls. New
York: Ballantine Books.

Reay, D. (2001). ‘Spice Girls’, ‘Nice Girls’, ‘Girlies’ and ‘Tomboys’: gender
discourses, girls’ cultures and femininities in the primary classroom. Gender and
Education, 13(2), pp. 153-166.

Smith, M. (2003). Boys to men: exploring masculinity in child and youth care.
Relational Child and Youth Care Practice, 16(4), pp. 12-21.

Young, C. (2001). Where the Boys Are. CYC-Online. Posted 21 February 2001.
Retrieved 18 July 2002:
http://www.cyc-net.org/today2001/today010221.html.
This article summarises the debate around the problem with boys outlined in this
paper

Kibble Education and Care Centre have developed a website to support their men
can care project. This gives details on the project itself but also contains some
useful links


Sexuality
4.13
Mark Smith

Despite its fundamental importance in our work, we rarely address sexuality, other than
superficially.

Introduction
This paper outlines some themes around sexuality with the intention of giving
practitioners a base from which they might develop their understanding and practice
in this area. The key points include: gender and sexuality, adolescent sexuality,
working with sexuality and staff support.

Overview
Sexuality is one of the most important but least explored areas of work with children
and young people. Its importance can be gauged by a cursory glance at the things
which concern us in relation to secure care; we lock up girls very often on account of
their sexual vulnerability; we lock up boys primarily on account of violence or
increasingly what is termed sexually aggressive behaviour.

At a wider social level, youth sexuality has become big business. It is used,
blatantly, for marketing purposes. Children and young people are increasingly
constructed as sexual beings. In the specific context of residential child care,
sexuality gone wrong is responsible for a series of abuse scandals. Major reports
such as the Edinburgh Inquiry stress the need to consider attitudes towards
sexuality in the recruitment process (Marshall, Jamieson & Finlayson, 1999).

More than any of this, though, sexuality is integral to ‘self.’ It is part of who each of
us, staff or young person, is as a human being. It encompasses our gender identity,
our sexual orientation and much of our social behaviour. When we connect with
others in our everyday encounters, our sexualities inevitably enter into that
engagement. We need to become aware of this to ensure that the reality of our
sexual selves becomes a healthy rather than a damaging force in our work with
young people.


Sex, gender and sexuality
Language around these terms can be confusing and can become confused in
practice. There is indeed an inevitable crossover between them, reflecting the whole
nature/nurture debate. For the purposes of this paper it may help to think about sex
as the biological fact of being either male or female, and gender as referring to a
more complex notion of how an individual should dress, behave, express oneself,
relate to others, etc., based upon his or her sex (i.e. man and woman; feminine and
masculine). Sexuality is intimately connected with notions of gender, but represents
more of a focus on a person’s sexual and romantic attractions. How a person
defines their own gender and sexuality is influenced, to a large extent, by social
norms and assumptions. So whilst sex is biological, gender and sexuality are
largely socially constructed and defined differently in different cultures and periods
in history.


• How is the sexuality of children and youth represented in the media?
• How is the sexuality of carers represented in the media?
• To what extent is the sexuality of the young people you work with implicated in
their admission to secure accommodation?

Gender roles over time

Gender roles are not static. They differ over cultures and history. From Victorian
times, gender roles were, on the surface, relatively well-defined and straightforward.
Men were cast in the role of breadwinners and women as carers and home-makers.
Such gender roles were reflected, too, in residential child care, in family group
homes or in the housemother/housemaster system in residential schools.

From the 1960s, the position of man in the breadwinner role became less clear with
the decline in traditional industries. In addition, feminists began to question the
patriarchal assumptions behind such delineation of gender roles across society.
They also began to explore what it meant to be a woman and held out possibilities
for them beyond those traditionally defined. Feminism presented a challenge to men
around their privileged positions in the workplace and in society more generally. It
also forced some men into a deeper exploration of what it meant to be a man. From
the early 1990s there has been an increasing body of writing around masculinity and
men’s issues.

Despite the complex and dynamic nature of sexuality, there are powerful and
sincerely held social forces which promote what might be considered to be
‘normative’ views, which continue to ascribe particular gender roles and assume a
moral position on issues such as same sex partnerships. The moral and political
dimensions to debates around sexuality make it an area where practitioners need to
tread carefully.


Hegemonic masculinity
Robert Connell, an Australian writer on masculinity coined the term ‘hegemonic
masculinity’ in the 1990s (Connell, 1995). Hegemonic masculinity is the ‘taken for
granted’ state of what we think a man should be: strong, heterosexual, into sport,
stoic and undemonstrative. Social power and status are vested in those who
demonstrate such qualities. Women and men who do not fit the bill are judged and
positioned as being inferior to this ideal. Men who would wish to express their
masculinity in different ways can find it hard to assert a place for themselves as ‘real
men.’

In recent years, understanding and experience of sexuality have become more
diffuse. Ideas of the ‘new man’ may soften images of hegemonic masculinity. Same
sex partnerships are accepted to a degree that would have been difficult to imagine
20 years ago. Our understandings of sexuality cannot then be static. As individuals
we are all positioned at different points along continua of sexual orientation and
expression. It is increasingly difficult to hold on to erstwhile assumptions of what
might be thought to be ‘normal.’


• How have your understandings of sexuality changed over the years?
• How are gender roles played out in your workplace?
• Are there any areas of practice where men or women take a lead role? Why
might this be?
• What are/might be the implications of a member of staff expressing their
sexuality in ways that would not be thought of as ‘traditional’?

Adolescent sexual identity
The fundamental developmental task of adolescence is to deal with the ‘Who am I?’
question. Addressing issues of sexual identity is integral to this (see chapter 3).

With ever increasing pressures related to appearance and sexual attractiveness,
girls frequently have difficulty defining their sexual selves (or really any sense of
self) as anything other than being adequate objects of males’ desires. If they do not
conform to societal standards of how they should look and relate to members of the
opposite sex, they can be attacked by their female peers who are also desperately
trying to measure up to unrealistic expectations. Girls’ bodies are often
developmentally ahead of their ability to manage the subsequent pressures (from
outwith and from within) and as a result are ill-equipped to cope with them. Their
inability to make self-affirming decisions and recover from poor ones has often been
viewed as a failing of strength or character, but has more to do with the exploitative
and devaluing climates they are struggling to navigate.


Boys too can find it difficult to assert an appropriate self-identity in adolescence.
Much of a boy’s identity is constructed around not being a girl. When boys describe
themselves it is often in terms of not being ‘sissy’ or ‘girly’ in any way, rather than
around any more positive picture of emerging masculinity. Their assertions of
boyhood are often expressed in sexist or homophobic language and behaviours.
Such behaviours might be construed as masking some confusion over their sexual
identity. It can be very difficult for any boy who thinks he may be gay or bisexual to
express any of these feelings in such a hostile climate, although there is growing
evidence that a large proportion of young people question their sexual identity at
some point and on some level. Experience tells us that a number of the young
people we work with in residential care will go on to experience different types of
sexual relationships. Indeed, given the confusion and lack of stability in so many
areas of their lives, it is likely that their sexual identities may also lack stability.

Adolescence is also a time of heightened sexual interest and activity as a result of
the hormonal impact of puberty. In the confines of a secure unit this means that
some powerful sexual energies will be directed in all sorts of directions. Again, the
kind of children and young people who are placed in secure accommodation can
confuse sexual drive with wider aspects of sexuality such as the desire for intimacy
and validation.

Working with issues of sexuality
Working around issues of sexuality involves a number of possible pitfalls for staff.
They need to be sensitive to the value conflicts that surround the whole area. In
supporting young people in their developing sexuality, they potentially leave
themselves open to accusations of promoting one form of sexual expression over
another.

Staff need to be clear too about where they stand and where their employing
agency and indeed wider society stand on some of the moral tensions that exist
around sexuality. They will, for instance, be regularly confronted with questions
around what to do on issues pertaining to the age of consent:

Is sexual behaviour necessarily harmful, just because it is deemed to be illegal?
Might the response of the system be more harmful to the young people involved?
What scope do I have to make this kind of judgment?

Staff have to work too on the border between what may be considered normal and
healthy sexual behaviour and what crosses that line to become possibly more
abusive or exploitative. Depending on their own value positions, individual staff
members will reach different conclusions about where the line is to be drawn on
such matters.

The law and received practice wisdom can be equally contradictory as to where
some of the lines lie. There are potentially confusing ages of consent for different
actions. For instance, the Age of Legal Capacity Act (1991) (see paper 4.10) allows
a GP to prescribe the contraceptive pill to girls under 16 while the law sets the age
of consent for sexual activity at 16. Differential laws apply too to boys and girls in the
area of sexual activity. Practitioners need to be aware of the legal frameworks and
to apply appropriate professional judgment within these.


The challenge for staff working with young people and their sexuality is to assist the
young person to develop their own integrated sexuality irrespective of whether that
sexuality is heterosexual, homosexual or bisexual.

The challenge of the organisation is to facilitate this process taking place.


• Can you think of a young person you work with or have worked with who may
be gay, lesbian or bisexual?
• What messages do/did they get from their experience in the unit that might
have supported or suppressed their expression of their sexuality?
• How do you deal with issues of sexual attraction in your workplace?
• Identify some of the contradictions you are faced with in practice around issues
of sexuality.
• Think of particular situations that have presented you with dilemmas around
sexual matters. How did you resolve them?

Why we don’t do sexuality
Despite its fundamental importance in our work, we rarely address sexuality, other
than superficially. It may be reduced to a mechanistic consideration of sexual health
and even at this level there can be a tendency to farm it out to ‘experts’ such as
health professionals or specialist agencies. Many workers lack confidence or feel
uncomfortable about addressing issues of sexuality in the workplace. There can be
good reasons for this. In a climate of heightened anxiety over sexual abuse, workers
may be understandably reluctant to enter into areas where their motives could be
questioned.

At a deeper level, because sexuality and self are so intertwined, to address issues
of sexuality involves examining that aspect of our ‘selves.’ That can be uncharted
territory for many workers. It can also be made particularly difficult when discussions
touch on areas from a worker’s own or family experience which is personal and raw.

Talking about sexuality
Talking to young people about sexuality is not neutral. It is not like talking to them
about the weather or about football. Because we are all sexual beings, when we talk
to young people about sexuality, it touches on aspects of our own sexual selves and
can trigger a range of emotions. To deal with these safely and comfortably, workers
need to reflect on their own sexuality and maybe identify why particular situations
may throw up particular responses. This can be a tricky area to get into. As a result,
many workers find it easier either to deny these feelings or else not to get involved


in such areas. Yet, because sexuality is such a fundamental part of our developing
beings, it might be argued that we fail properly to promote the holistic development
of young people if we do not acknowledge them as sexual beings.


• Consider your own views about what you think is normal or acceptable sexual
behaviour. Where do these come from?
• How might your views differ from those of colleagues?
• Think about a time you tried to engage with a young person over a sexual
matter.
• How did you feel? Why might you have felt that way?

Supporting healthy sexuality
With practise and support, workers can engage in positive ways around issues of
sexuality. Perhaps the first step is to open up the area for discussion within staff
teams. Once staff have had a chance to talk through their own values and feelings it
should become easier to settle on strategies on how to work with young people.
Trying to be as open and matter of fact as possible is likely to be the best way to
proceed. Using appropriate humour may make it easier for staff and young people
to deal with the issue without becoming too embarrassed. However, jokes should
not trivialise the subject or be used to hide discomfort altogether. Some reflection is
required too as to what assumptions lie behind any humour or behind our use of
language more generally and how young people might interpret this.

The most powerful way to encourage healthy attitudes towards sexuality is to
ensure that we model appropriate attitudes and behaviours in the lifespace. We
should ideally provide different images of both femininity and masculinity that young
people might draw upon. Staff should take care not to use sexist or homophobic
language. They should treat colleagues and young people respectfully.


• How is sexuality modelled in your unit?
• What opportunities are available to discuss issues of sexuality?

Supervision
Because sexuality is such a sensitive yet essential area, staff need to be properly
supported to feel confident about working in this area. A suitably open environment
where sex can be addressed openly is essential. To protect both young people and


staff from inappropriate practice in this sensitive area, specific work around issues of
sexuality should be included in young people’s care plans.

Supervision should offer an opportunity for staff to explore some of the feelings and
possible value conflicts that working with sexuality can raise for them. This requires
supervisors who are themselves confident in working with these issues.

Conclusion
Questions of sexuality are fundamentally linked to who young people (and staff) are
and how they behave. It can be an uncomfortable area of practice for staff to
become involved in but it is important that they do. To do so safely and positively,
issues of sexuality need to be addressed openly in staff meetings and in
supervision. Most importantly though, staff should seek in their everyday practice to
model and promote non-oppressive sexual attitudes and behaviours.

Training links
SVQ: Unit CYP 4 Encourage young people to develop and maintain a positive
sense of self and identity (optional unit in the SVQ level 3 qualification Caring for

Unit O2 Promote people’s equality, diversity and rights (mandatory unit in the SVQ 3
qualification Caring for children and young people).

Unit HSC 312 Support the social, emotional and identity development of children
and young people (specific optional unit for the revised SVQ level 3 qualification
Health and social care: children and young people).

Further reading
A good website which addresses issues of masculinity from a pro-feminist
perspective is www.xyonline.net.

Christie, A. (2001). Men and social work: theories and practices. Basingstoke:
Palgrave.

Orme, J. (2002). Feminist social work. In R. Adams, L. Dominelli & M. Payne, Social
work: themes, issues and critical debates (pp. 218-226). Basingstoke: Palgrave.

The Journal of Child and Youth Care 14(4) is on the theme of sexuality.


Self-harm
4.14
Shannon A. Moore

….young people in secure accommodation have an even greater risk of deliberate self-
harming ….. because of the stress and emotional strain related to admission into secure
care….

Introduction
This paper considers issues surrounding deliberate self-harm and injury in secure
care settings. The key points include: the prevalence and reasons for self-harm,
effective staff responses and interventions, providing safe alternatives, and the
establishment of clear policies.

Overview
Across all sectors of society individuals engage in self-harm or self-injury through a
variety of behaviours such as smoking, excessive drinking and dangerous driving.
Behaviours like these become particularly concerning when they impair daily
functioning. This paper is focused on deliberate self-harming and self-injuring
behaviours that occur in secure care settings among young people, placing them at
risk of mental health disturbance (see paper 4.11), scarring, permanent injury and
even death. Deliberate self-harm is a complex behaviour that can be effectively
addressed through reflection on interventions and theories focused on responding to
it.


• Identify some self-harming behaviours that you or someone close to you
engages in. Are any of these behaviours intentionally self-harming?
• What distinguishes intentional and unintentional self-harm?


Prevalence, explanations and definitions of intentional self-harm and
self-injury
Intentional self-harming is often a response to severe emotional pain associated
with past or current experiences of abuse, grief and loss, neglect, lack of support,
stress, abandonment or a sense of meaninglessness. In the general population of
young people in Great Britain aged 11-15, a recent survey found that one in 17 had
tried intentional self-harm or self-injury (National Statistics, 2001). A recent study by
Bywaters & Rolfe (2002) found that these behaviours most commonly begin
between ages 12 and 14. With these figures in mind it becomes even more
worrying that emotional and psychological challenges to well-being are more
common for young people in care systems as opposed to the general population.
Moreover, young people in secure accommodation have an even greater risk of
deliberate self-harming behaviours than those in other care settings because of the
stress and emotional strain related to admission into secure care, harsh custodial
regimes (in the case of young people placed in penal settings), and isolation from
family and community (O’Neill, 2001; Rose, 2002).

In secure accommodation young people are at greater risk for internalising problems
such as depression and other mental health challenges, as well as externalising
problems such as aggression and risk behaviours (O’Neill, 2001). In secure care
settings intentional self-harm or self-injury behaviours range broadly. A few
examples are: biting, burning or cutting themselves; seeking physical restraint;
hitting themselves; hitting walls or other hard objects; misuse of alcohol, drugs and
other substances; overdosing with drugs; suicide attempts.

These extreme responses to life pressures present complex challenges for staff
providing care in secure settings. By understanding underlying factors that lead to
self-harming behaviours, and by reflecting on strategies for responding to these
challenging behaviours, staff will have the tools more effectively to fulfill the duty to
provide a safe and secure care environment (Rose, 2002).


• How might self-harming help young people cope with emotional and
psychological pain?
• How does it make you feel when someone deliberately self-harms?
• What are your instinctive reactions in response to witnessing another person
self-harm?

Reasons for intentional self-harm
As we respond to self-harming behaviours by young people living in secure
accommodation, the difficult emotions we feel can give us insight into the intensity of
feelings young people are grappling with when engaging in these behaviours. The
reasons for self-harming are invariably individual. At the same time common
patterns in the meaning of these behaviours can be identified as an underlying


attempt to communicate and as a way of coping. Some of the underlying reasons
are as follows:

Coping with current life stresses such as admission to secure
accommodation.
The stress of being placed in secure accommodation could result
in being isolated from community and family and loss of freedom.
This breakdown in intimate relationships and regular channels of
communication may increase the likelihood of self-injury. Secure
accommodation and other care settings may also put young
people at greater risk of stigmatisation, bullying, abuse and other
stress. Young people may self-harm as a response to admission to
secure accommodation and may be at greatest risk in the first 24-
48 hours of admission.

Coping with past trauma.
Intentional self-harming may be a way to deal with the
psychological discomfort and stress associated with the trauma of
past emotional, physical or sexual abuse or grief and loss.

A way to feel alive and to stay alive.
Although self-harming behaviours have been found to increase the
chance of a completed suicide, it is common for individuals to state
that deliberate self-harm helps them stay alive and may help them
feel alive.

Release and relief.
The sensation of physical pain may be a way of relieving
emotional pain and feelings of self-hatred. This pain in turn may
help the young person dissociate from reality and escape into a
dreamlike world. The sight of scars and flowing blood may also be
interpreted as healing.

Self-punishment.
As a result of guilt and shame felt for requiring secure
accommodation, young people might feel they need a further level
of punishment for being bad or wrong by hurting and scarring as
an act of self-retribution.

Expression of feelings and form of communication.
When young people lack the capacity to express their emotions
and pain through language or other positive action, intentional self-
harming may be a way to illustrate the depth of their emotional
anguish. It is important to note that it is not attention seeking
behaviour - other easier and less extreme ways to seek attention
exist.

Feeling in control.
When young people are admitted to secure accommodation they
lose personal freedom as external controls are enforced to ensure
their safety and the safety of others. Intentional self-harming may
help the young person regain a sense of control, as they can


choose when to start and end self-harming behaviours, and these
behaviours are often carried out in a secret and private context.
Intentional self-harming also forces a response from staff, which
could also lead to a sense of greater control. In addition, when
individuals feel a lack of emotional control or are experiencing
flashbacks to previous traumas, the choice to self-harm may give
the young person a sense of control and power over the present
moment.

To receive caring, touch or affection.
When young people are in secure care they are isolated from
familiar sources of affection, support and physical touch such as
caregivers, family, and peers. By seeking physical restraint young
people may consciously or unconsciously be accessing human
contact that is otherwise missing from their daily experience. Also,
scars and wounds from self-harm that are bandaged and treated
may give young people a sense that others are willing to care for
them. Self-harm may also give young people a chance to care for
themselves through self-nurturing behaviours that relieve pain and
discomfort.

Bravado, environment and cultural norms.
Intentional self-harm may be a mechanism to gain acceptance
from peers or initiation into a peer group through ritualistic self-
injuring behaviours. Young people may also demonstrate bravado
and personal power to peers and use self-injury to prove
themselves. If self-harming behaviours become part of the culture
of the secure environment these challenging behaviours may help
the young person gain acceptance in their peer groups through
mimicking behaviours. Secure contexts that develop a culture of
self-harming are often indicative of a breakdown in communication
and relationships between young people and staff.

By reflecting on some of the reasons for intentional self-harming it is possible to see
that young people also may experience positive reinforcement to continue these
challenging behaviours: self-harming can become a habit, an obsession, a
compulsion or an addiction.


• Think back to the self-harming behaviours that you identified with the first
reflective question. What purpose do these behaviours serve?
• Do any of these behaviours serve a positive purpose?


[I] tried [self harming] and got scared of it. If they asked why [I harmed myself], I’d
say ‘anger, release’, that would put them off. They’d leave it to settle down a bit
but they don’t come back to speak to you and that’s when you feel unwanted and
low again.

(Male 14, Who Cares? Scotland, 2003, p. 39)

The needs of intentionally self-harming young people
In order to provide safe and secure accommodation for young people it is essential
to consider the motivation and needs of intentionally self-harming young people.
The following provides some guidelines for understanding some of these complex
needs (see Arnold & Magill, 2000):
• Safe skills for expressing, responding to and coping with emotional
pain and distress through an increase in knowledge of the range of
emotions and how these are linked to thinking, feeling and being;
• A safe context for the expression of difficult emotions and
memories that includes acceptance and respect for the whole
young person including their self-harming behaviours;
• Open channels of communication between staff and young people;
• Control, choice and dignity to the greatest extent possible following
admission to secure accommodation and in line with the UN
Convention of the Rights of the Child 1989;
• Hope that change is possible and that new ways of coping can be
developed;
• Practical information and support to understand intentional self-
harm, the reality of secure accommodation, external support and
access to advocating agencies such as Who Cares? Scotland.

Young people who self-harm need to understand the factors that provoke and
sustain these behaviours if they are to stop self-injuring. Communication and
understanding are the keys to alleviating these behaviours (Rose, 2002; O’Neill,
2001).


• What system factors in secure accommodation might increase the likelihood
that young people will engage in self-harming behaviours?
• What could you do in your own working environment and in your own style of
working to alleviate some of these factors?


Effective responses and interventions
Communication always works two ways and it is important that staff are open and
sensitive when responding to young people. At the same time staff will need to
manage the difficult emotions and instinctive reactions that witnessing such
behaviours will inevitably provoke (see Arnold & Magill, 2000):

Show caring & clear boundaries:
It is important to show caring for the well-being of the self-harming
individual. At the same time the emotional charge for both the
young person and staff can be overwhelming. It is important not to
become overwhelmed or lost in the experience of caring - this
would lead to ineffective interventions, a lack of a secure base for
the young person and escalating personal stress for you as a staff
member. Even if you experience a strong reaction it is best to
contain this response and present a concerned and curious front
that is at the same time in control with a calm straightforward
response (e.g., ‘I see that you have hurt yourself. I will get some
bandages so that you can care for you injury. I am sure it is hurting
and I don’t want it to get infected’). Moving the young person
toward ever increasing safety and security must be the aim of any
intervention.

Open communication channels and increase insight:
Convey a tolerant attitude and openness to talk about self-harm,
and a willingness to get the young person specialist support.
Provide a context for the young person to understand difficult
emotions and learn how to express them safely. Help the young
person identify the triggers for self-harming and how they feel
before, after and during these behaviours.

Acknowledge feelings and show respect:
Acknowledge the young person’s capacity to cope with stress,
trauma or difficult feelings and to stay alive. Help the young person
understand that when the underlying factors leading to self-injury
are uncovered, strong and difficult memories and emotions are
often found. In this way a young person’s impulse to self-injure
could become a trigger for seeking help. Normalize strong
emotional reactions over the first 24-48 hours of being admitted
into secure accommodation and let the young person know that
staff are present to support them through this transition.

Understand that it takes time to stop:
Remember that progress will come in small and gradual steps.
The magnitude of the difficult emotions/context leading to self-
harming behaviours is indicative of the challenge young people
face when changing these behaviours. It will take a period of time
and personal power to stop self-harming once it begins. This
begins with gradually reduced intensity and duration of self-
harming over time. It may also begin with better self-care of
injuries and increased communication skills.


Provide safe alternatives to self-harming:
Providing a safe alternative to self-harming is a strategy that helps
distract from intentional self-harm so that young people can begin
to deal with their distress and emotions more safely. Encourage
the young person to identify the emotion associated with the urge
to self-injure. Here are some suggestions:
Anger: focus on physical activities that are safe, like hitting
something soft, tearing up paper, hitting a pillow or throwing it
against the wall, running, or walking.
Depression: encourage the person to self-care: focus on calm and
comforting activities like taking a bath or having a hot drink.
Dissociation from reality, numbness and floating feelings: focus on
here and now objects in the room and have the young person
describe what is around them; support them to focus on their
breathing and notice the weight on their body as they sit on the
chair or floor.

Establish clear policies and guidelines:
Ensure your establishment has clear policies and guidelines for
staff to respond to self-harming behaviours which include
reporting, recording and monitoring these behaviours. Staff should
have access to training and support in order to respond to these
behaviours effectively. Information about the risk of hepatitis and
AIDS should also be available so that young people understand
the additional risks of sharing or using dirty implements to harm
themselves.

Consider alternative care contexts:
Self-harming behaviours can increase in contexts that are
restrained and controlling such as secure accommodation. It is
important to consider alternative care settings for young people
who intentionally self-harm, whenever this is possible (see O’Neill,
2001).


• Think about an incident when a young person in your care engaged in self-
harming behaviours.
• What emotion was associated with this behaviour for the young person?
• What strategies might you use now to respond to this young person’s needs?
• Can you identify any local resources that might help in working with young
people who self-harm?


Conclusion
Intentional self-harm is one of the most complex behaviours that staff are called on
to respond to in secure accommodation. These challenging behaviours vary broadly
and the reasons for young people to self-injure are very individual. It is important to
remember that these behaviours are indicators of underlying stress and hurt that
need to be cared for. Finally, keeping our duty to provide care and security to young
people in the forefront of our work can guide sensitive and effective interventions
that reduce the risk for young people to hurt themselves.

Training links
SVQ:
Unit Z8 Support individuals when they are distressed (optional unit in the SVQ level
3 qualification Caring for children and young people).
Unit SC17 Evaluate risk of abuse, failure to protect and harm to self and others
(optional unit in the SVQ level 3 qualification Caring for children and young people
and mandatory unit in the SVQ level 4 qualification in Care).

Further reading
Arnold, L. & Magill, A. (2000). Self-harm: a resource pack. The Basement Project:
Abergavenny, UK.
http://freespace.virgin.net/basement.project/Publications%20list.htm
Bywaters, P. & Rolfe, A. (2002). Look beyond the scars: understanding and
responding to self-injury and self-harm. London: NCH.
Meltzer, H., Corbin, T., Gatward, R., Goodman, R. & Ford, T. (2003). The mental
health of young people looked after by local authorities in England: summary report.
London: Office of National Statistics.
Piggot, J., Williams, C., McLeod, S. & Barton, J. (2004). A qualitative study of
support for young people who self-harm in residential care in Glasgow. Scottish
Journal of Residential Child Care, 3(2), 45-55

Web Site Links:
The Basement Project: The Basement Project provides support groups for those
who have been abused as children and people who self-harm. They also provide
training, consultation and supervision for workers in community and mental health
services, as well as a range of publications offering practical guidance for workers.
Address: PO Box 5, Abergavenny NP7 5XW
Tel: 01873 856524
http://freespace.virgin.net/basement.project/default.htm
Who Cares? Scotland: Is a national children’s charity
http://whocaresscotland.net


NCH: Is a national children’s charity (Tel 0207226 2537)
www.nch.org.uk/selfharm
YoungMinds: is a national children’s charity (Tel 0800 018 2138)
http://www.youngminds.org.uk/publications/booklets/selfinjury.php
National Self-harm Network: information for people who self-harm
www.helen.ukpet.com
Mental Health and Growing Up, Second Edition
Deliberate self-harm in young people - a fact sheet from the Royal College of
Psychiatrists (for parents and teachers)
http://www.rcpsych.ac.uk/info/mhgu/newmhgu30.htm
The Young People & Self-Harm Information
Resource http://www.selfharm.org.uk
Email: selfharm@ncb.org.uk
United Nations Convention on the Rights of the Child (1989): Adopted and
opened for signature, ratification and accession by General Assembly resolution
44/25 on 20 November 1989, entry into force 2 September 1990. Available on-line
http://www.uncrc.info.


Drugs
4.15
Brian Wood

Young people and those responsible for them need to be prepared both to resist drugs and,
as necessary, to handle drug related problems. Information, skills and support need to be
provided in ways that are sensitive to age and circumstances, …..
(Tackling Drugs to Build a Better Britain, 1998, p. 4)

Introduction
This paper aims to support the practice of front line residential workers in working
with issues of drugs. Chapter 1 and paper 4.16 contain further discussion around
the prevalence and impact of drug use among young people. This paper will attempt
to further workers’ knowledge and understanding of drug use amongst young people
in secure accommodation. It considers how workers might use and develop their
skills and resources to reduce aspects of harm to young people in their care,
relating to drug use.

Background
Drug use among young people in Scotland has been on the increase for as long as
statistics around this issue have been gathered. In particular drug use among young
people in local authority care is on the increase. Staff working in a variety of settings
feel powerless to make any kind of meaningful impact on what can be a traumatic
experience for the young person and the staff member alike.

Practice experience in secure accommodation suggests that when the issue of drug
use comes it can elicit uncertainty in the staff group. They may seek to respond in
standardised and narrow ways, such as automatically involving the police. Such a
response is, in part, due to a concern to ‘cover’ themselves in relation to the agency
by whom they are employed. If staff are to make any kind of impact on this growing
problem, then they need a supportive agency culture to do so.

Residential workers have a responsibility if they are aware that young people in their
care have drugs on their person.

All residential workers should be actively involved in the communication of values,
skills and accurate knowledge to young people in order to aid them in making


informed choices in relation to drugs. This should take place alongside the provision
of a safe, secure and drug free environment wherever that may be.

What do we mean by drug?
There is a range of opinion around what constitutes a ‘drug.’ For the purposes of
this document the following definition is used:

A drug is any substance taken into the body which alters the way
the body functions either emotionally, physically or mentally. This
includes tobacco, alcohol, solvents, prescribed and over the
counter medicines as well as illicit substances.

Within individual units this could be used as a topic for opening a broader discussion
around workers’ opinions, as well as their knowledge of drugs and their effects. An
appendix to this document covers the main drugs used by young people in Scotland
today. This list is far from exhaustive and further information can be obtained from a
number of the websites listed.


• What is your individual perception of what constitutes a drug?
• Is your perception the same as the perceptions of your colleagues?

Why young people take drugs
The cultural context of young people and their drug use is difficult for many adults to
comprehend. Young people take drugs for a number of reasons. The first reason
can be hard for adults to understand; it is enjoyable, especially in the early stages of
usage. However, enjoyment can shift into dependency and this has implications in
terms of funding a drug habit. Young people may also take drugs as a release from
the pressures in their lives. It can be helpful in some cases to think of drug use as a
dis-ease – young people who are not at ease with themselves may turn to drugs.
There is also a peer group dimension to usage, both in terms of accessibility and
peer culture.

Approaches to working with drugs
In Scotland at the moment there are two main approaches to working with people
who have problems with drug use. They are harm reduction and abstinence.

The total abstinence model has been around for quite some time and has proved to
have had limited success in tackling what is a growing social and cultural problem.


There is evidence to back up the theory that this form of intervention is more
successful with people who are well into their drug taking careers.

Harm reduction attempts to lessen the impact that drug misuse undoubtedly has on
the individual and society in general. This is usually facilitated by linking the drug
user into specifically designed services around their drug use and lifestyle.

Both approaches have their merits and their downside; abstinence among curious
young people is unlikely to be a successful approach. However, being linked into
what is fundamentally a legalised cycle of drug use has its own issues and
limitations.

Practice implications
It is important that units acknowledge that there will always be the possibility of
drugs being brought in and that staff must make it clear to all people that have
access to the building that drugs in the unit are not acceptable. Clearly staff
members must regularly and in a consistent manner make young people aware that
it is not part of the unit culture to allow drug use and at the same time show the
young people that there are viable alternatives.

Providing information and education to young people around drug use should
happen in a number of different ways. It should be impartial and include information
about drugs that all young people need to know. This should include the
components of health and safety when things go wrong, along with more targeted
information in relation to a young person’s drug status.

There must also be scope for the development of educational inputs that transcend
young peoples’ fears around adult misunderstanding of drug use. This type of
approach will facilitate a more open dialogue and remove the feeling that the
process is fraught with danger. It is time to create a forum that allows young people
to engage in open discussion around their drug use with no fear of being
condemned for it.

Having regular and honest discussions in group form that focus on healthy attitudes
towards drug taking, smoking, drinking and lifestyle will open up the subject for
further discussion (see paper 4.10).


Good Practice
In order to prevent use or supply of drugs in your unit staff groups should engage
with the topic proactively. Here are some examples of how they might do so:

• Organise a regular discussion group for young people in relation to drug use;

• Make drug use a live issue in your unit;

• Ensure the resident group are aware of the units policy around drug use;

• Maintain vigilance, conduct searches when appropriate;

• Ensure staff are well supplied with information that can be passed on to the
residents;

• Ensure adequate supervision and lighting;

• Apply graduated sanctions e.g. withdrawal of privileges or non participation;

• Temporarily exclude young people from the group;

• Make connections with the local service provision who’s remit involves drug
use and young people.


• Within your unit, how are the issues of drug and alcohol use dealt with in the
staff team?
• How aware are unit staff of local or national agencies that work with young
people around drug issues?
• Does your unit have good links with services which work specifically in this
area? If not what are you doing about it?

Confidentiality in practice
Working with young people in a residential setting is built upon relationships.
Developing positive working relationships with young people can depend to a large
extent on trust and confidentiality. It is therefore important that workers make young
people aware of situations where confidentiality may not be maintained.

Trust based on confidentiality is of paramount importance in a residential worker’s
relationship with the young people in their care. When a young person discloses that


they are using drugs, there are a number of factors to consider relating to whom to
inform:
• The welfare of the young person. Where there is a significant or
immediate risk to the young person related to their substance
misuse, it is likely that their parents will need to be informed.
• Risk to other people
• The age and developmental maturity of the young person
concerned
• The wishes of the young person and the possible consequences of
the information being disclosed to other parties
• Likely legal implications
• Consequences for the client/worker relationship.

Police involvement
One of the most frequently asked questions in relation to the discovery of drug use
or supply in residential units is, ‘should we involve the police?’

There is no legal requirement to report a drugs related offence to the police,
although local codes of conduct or practice may impose a duty upon staff in
residential units to report an alleged offence to their employer. Consideration should
be given to the effect of any decision taken on the welfare of the child and of the
implications for the unit concerned.

It would be useful for units to develop a protocol with the local police to consider
how they might work together on drugs-related issues.

Working with others
Drug use has different causes, manifestations and implications for different young
people. Different professionals might be involved in helping young people with their
difficulties. This may include GPs’ mental health workers or drugs counsellors. Staff
in residential units may think that the issue is beyond their expertise. However, in
addition to any specialist services, young people will need supportive and trusting
relationships with those around them. It is important then that staff become
comfortable in working with drugs issues.


• How would you access information around drug or alcohol dependency?
• Can you recall a situation when your unit worked well with another service
around drug use?


Training links
SVQ:
Unit Z17 Support clients who are substance users (optional unit in the SVQ level 3
qualification Caring for children and young people).

Unit HSC 342 Assess and act upon immediate risk of danger to substance users
(generic optional unit for the revised SVQ level 3 qualification Health and social
care: children and young people)

HSC 341 Help individuals address their substance use through an action plan
care: children and young people)

Further reading
McIntosh, J., MacDonald, F. & McKeganey, N. (2003). Dealing with the offer of
drugs: the experiences of a sample of pre-teenage schoolchildren. Addiction, 98, 7,
977-986.

Kandel, D. & Yamaguchi, K. (1993). From beer to crack: developmental patterns of
drug involvement. American Journal of Public Health, 83(6), 851-855.

Scottish Executive. (2003b). Getting our priorities right: good practice guidance for
working with children and families affected by substance misuse. Edinburgh:
Scottish Executive.

Misuse of Drugs Act 1971.

HMSO. (1998). Tackling drugs to build a better Britain. London: The Stationery
Office.

Useful websites
www.drugworld.org

www.sdf.org.uk

www.emcdda.eu.int

www.lifeline.org.uk


Appendix 1 Dealing with an Incident


Dealing With An Emergency

Guidelines for Practice
An emergency exists when a young person:

• Is unconscious

• Displays difficulty in breathing

• Shows signs of overdose

• Is seriously disorientated

• Tells you it is an emergency.

If the above is happening

Call an ambulance
Stay calm – demonstrate you are in control
Use first aid procedures
Take steps to protect yourself and the young person

• Assess the situation, ensure you and the young person are not in
any danger.

• If first aid qualified, apply first aid.

• Save any substances involved and pass them to the ambulance
crew.

While waiting for the ambulance – DO NOT PANIC
Do collect any substance for medical analysis

Do not give anything by mouth

Do not induce vomiting

1. If the young person is conscious
Ask the young person what happened and try to identify any
substance used.
Keep the young person warm and if possible quiet.


Put them in the recovery position and attempt to engage them in
order to keep them conscious.

2. If the young person is not conscious

Do ensure that the young person is breathing and place in the
recovery position.

Make a note of the incident, what time the ambulance was called,
along with a brief description of the young person’s condition.

Do not move the young person unnecessarily; move the rest of
the group if need be.

Do not leave the young person unattended for any reason.

When the ambulance arrives make sure you ascertain what
hospital the young person is going to, and if possible send a staff
member along with the young person.


• What is your knowledge of the effect of different substances?
• Does your unit have a policy or the capacity for working with a young person
who is withdrawing from any substance?
• How have you and your unit dealt with drug-taking episodes in the past?
• Did it work? If yes, why? If no, why not?


Appendix 2 Drugs used by young people in Scotland

Cocaine

Description:
White or creamy in colour, grainy, powder or rock.

Aliases:
Coke, Charlie, Ching, Toot, Snow, Posh

Methods of consumption:
Cocaine is most usually chopped into a fine powder using a sharp
blade or credit type card and then snorted up the nose.
Other methods include smoking it either in a pipe or a joint,
swallowing it in a wrap of paper or injecting into the veins.

Effects:
Cocaine is a stimulant drug (upper).
The effect is almost instant and is usually short lived.
The user may feel more confident than is usual and may appear
talkative and alert.
Coming down from a cocaine high can cause disrupted sleep
patterns, loss of appetite and being more irritable than usual.
Cocaine can cause the user to experience quite dramatic episodes
of paranoia, panic attacks, arrogance and extreme anxiety.
Regular use of cocaine leads to a buildup of tolerance, so that
more of the drug is needed for the same effect. Cocaine is a highly
addictive substance, so regular usage could lead to dependency
problems.
As with many of the powder-based drugs, cocaine differs in
strength from batch to batch. One batch can be ten times stronger
than the next, exposing the user to possible overdose.


The Law
Cocaine is a class A drug, under schedule 1 of the Misuse of
Drugs Act.
Possession and supply are illegal.
Maximum penalty for possession is seven years imprisonment and
an unlimited fine.
Maximum penalty for supply is life imprisonment and an unlimited
fine.

Heroin

Description:
Heroin is a powdery substance that varies in colour from white to
brown, depending on its country of origin.

Aliases:
H, horse, smack, brown, gear, skag, Roberta flack.

Heroin can be smoked either in a joint or by burning it on tin foil
(aka chasing the dragon).
Heroin can also be snorted up the nose.
Heroin can also be injected into the body.
Smoking the drug is less risky that snorting or injecting. It enters
the bloodstream more slowly and as such the dosage can be
controlled.
Injecting the drug is the most risky method of consumption,
exposing the user to possible overdose and a range of
transmissible diseases.

Effects:
Consuming heroin can make users feel relaxed and at peace with
themselves. It sometimes gives the user a sense of security.
Depending on the strength of the drug the effect can last for four to
six hours.
Negative side effects are lethargy, nausea, vomiting, loss of sex
drive and irritability.
The pupils of the eye shrink to pin size when using heroin.
Regular usage can lead to dependency problems; also more drug
is needed for the same effect.


The Law:
Heroin is a class A drug, under schedule 1 of the Misuse of Drugs
Act.
an unlimited fine.
fine.

Cannabis

Description:
Cannabis is most usually sold as a compressed block of resin in a
variety of brown shades. It also comes as dried leaves or the
flowers of mature plants.

Aliases:
Draw, blow, grass, weed, skunk, ganja, pot, hash, tarry.

The drug is usually consumed along with tobacco in a joint, bong
or pipe.
It can also be eaten; this method of consumption takes longer for
the effect to come on and will be more intense and longer lasting.

Effects:
In small amounts and with infrequent use, the drug can make the
user feel relaxed, increase creativity, feel more sociable, hungry
(the munchies) and giggly.
When used more frequently and in larger doses, the drug can
cause feelings of paranoia, panic attacks, anxiety and make the
user feel physically sick.
Some of the stronger variations of the drug, e.g. skunk, can have a
hallucinogenic component to them.
It is often held that cannabis is not physically addictive; however
some people report a psychological dependency.

The Law:
Cannabis has recently been reclassified under the Misuse of
Drugs Act from a class B to a class C drug.


The maximum sentence for possession is two years and/or an
unlimited fine
The maximum sentence for supply is 14 years and/or an unlimited
fine
Usage of the drug remains an offence and the police still have
licence to arrest users at their discretion.

Ecstasy

Description:
Most commonly presented in pill form; can also be supplied in
capsules and in powder form.

Aliases:
Es, MDMAs, party smarties, eccies.

Ecstasy is most usually consumed orally both in powder and in pill
form.
When in powder form it can be snorted, although MDMA is a
caustic substance and burns the lining of the nose.

Effects:
Causes user to have euphoric feelings
Feelings of well being and increased sociability
Increases blood pressure and body temperature
Taken regularly the drug causes mood changes; in particular it can
cause anxiety and lead to panic attacks.

The Law:
Ecstasy is a class A drug, under schedule 1 of the Misuse of
Drugs Act.
an unlimited fine.
fine.


Tranquillizers

Description:
The majority of these drugs originate from the medical profession
and are legally held with a prescription.
Their primary function is to promote calmness; they are also used
to treat different forms of anxiety, depression, insomnia and
nervousness.
The word tranquillizer is a generic term for a large number of drugs
that have similar properties.
As such the following information is not specific to any one drug.
Further information can be found on the websites listed.

Aliases:
Valium, vallies, norries, jellies, nitrazepam, lorazepam, moggies,
eggs, benzos, mazzies.

Mainly taken orally in pill or capsule form.
Can be administered anally in suppository form.
Can also be injected; however this is an extremely dangerous
practice and can be fatal.

Effects:
Tranquillizers are designed to suppress the central nervous
system and therefore have a sedative effect.
Tranquillizers are highly addictive as tolerance increases very
quickly.
The symptoms of withdrawal can be witnessed after relatively
short periods of regular use. These symptoms range from mild
nausea, dizziness and confusion, through to panic attacks and
seizures (fits) when usage has been greater and for longer
periods.

The Law:
Tranquillizers are controlled under the Misuse of Medicines Act.
They are classified a class C drug.
They can only be prescribed legally by a doctor or a pharmacist.
The maximum sentence for possession is two years and/or an
unlimited fine.
The maximum sentence for supply is 14 years and/or an unlimited
fine.


Methadone

Description:
Methadone is a synthetic man-made derivative of the opioid drug
such as heroin or morphine.
Methadone is most commonly found in linctus form which is green
in colour and is known as methadone mixture. This can vary in
strength, 1mg to 1ml is the most common mix and represents, for
example, 30ml mixture = 30mg methadone.
It is also available in tablet and ampoule form.
This drug is used widely in the treatment of opiate addiction.

Aliases:
Meth, green, green madness, green juice, phy and turtle.

Usually consumed orally.
Can be injected however this method of consumption is risky and
will lead to permanent damage to the vascular system.

Effects:
The initial effect of the drug will take 45-90 minutes to come on.
The user will experience a general feeling of well being.
The drug regularly causes the user to ‘speed’ during the effect.
There is a real risk of overdose when using this drug as it has a
residual or half life that can last up to 24 hours. This causes a
gradual buildup of the drug in a regular user’s system.
Given that the drug is a member if the opiate family, pinprick pupils
are a side effect of usage.

The Law:
Methadone is a class A drug, under schedule 1 of the Misuse of
Drugs Act.
Non-prescribed possession and supply are illegal.
an unlimited fine.
fine.


Solvents and Gas

Description:
Various household and industrial chemicals.

Aliases:
Glue, petrol, thinners, aerosols.

Method of consumption:
Inhalation directly from the product into the lungs.
Usually involves the use of a plastic bag, with the substance
inside.

Effect:
Some products similar to alcohol.
Hallucinogenic effect and drowsiness.
Long term heavy usage will cause brain and liver damage.
Short term memory loss and inability to concentrate.

The Law:
It is illegal for shopkeepers to sell these product to anyone under
the age of 16 if they suspect it will be misused


Offending
4.16
Susan Batchelor & Fergus McNeill

…studies suggest that the vast majority of people have committed a crime at some time in
their lives…

Introduction
This paper provides a brief overview of what we know about young offenders in
Scotland. After presenting some basic trends and patterns of offending, we discuss
how criminal careers are established and developed, paying particular attention to
characteristics associated with young people involved in persistent offending.

Patterns of youth crime and persistent offending

The extent of youth offending
It is widely accepted that age is a major indicator of involvement in offending and
that young people, in general, are responsible for a disproportionate amount of
crime. They constitute a quarter of all known offenders and, depending upon the
age and crime types selected, are ‘credited’ with between 40 and 66 percent of all
indictable crime. According to a recent report (Audit Scotland, 2002), approximately
£230-240 million of public money is spent on dealing with youth offending in
Scotland each year. On top of this financial burden, crime has wider social impacts
including, for example, psychological distress to victims and the effects of fear of
youth crime and disorder.

Number of young offenders
There are currently about 915,000 young people aged between 8 and 21 years
living in Scotland. A review of offenders’ files carried out in 2001 revealed a total of
over 76,000 recorded offenders under the age of 21 (Audit Scotland, 2001). This
represents one in 12 young people.

In 2003/04 34,266 referrals were made to the Children's Reporter on offence
grounds, a 13% rise over the previous year. This rise is roughly in line with an
increase across all grounds of referral. 1201 young people were identified as
'persistent young offenders.' (SCRA, 2004b).


Since the mid-1980s referral rates for girls have risen (from 8 to 12 referrals per
1,000 population in 2000/01. That said, young women still constitute a very small
proportion of overall offence referrals – it is not surprising that gender is another of
the strongest predictors of offending. The peak age for offence referrals in
2000/2001 was 15 for boys and 14 for girls, although a study of the fast-track
hearing pilot scheme (SCRA, 2005) indicates that 15 is the peak age for both sexes.
According to this same study, girls who offend are more likely to have been in
residential child care than are boys.

In the adult system the peak age of conviction was 18. Seven per cent of 18-year-
old males were convicted on at least one occasion for a crime, simple assault or
breach of the peace, compared with 1% of females

‘Normal’ deviance or criminal careers?
The vast majority of young people are ‘temporary delinquents’ for whom offending is
‘a transitory phenomenon linked to their social development’. The prevalence of
youth offending is demonstrated by self-report research studies involving young
people (e.g. Graham & Bowling, 1995; see also the Edinburgh study of Youth
Transition and Crime, www.law.ed.ac.uk/cls/esytc). Such studies suggest that the
vast majority of people have committed a crime at some time in their lives, albeit of
a relatively minor nature such as stealing from school, vandalism, shoplifting and
fighting. Lesser offending may therefore be considered a typical rather than
abnormal form of behaviour, particularly for young men who offend not only more
often but also until an older age.

That said, there are undoubtedly some young people for whom offending is not
simply part of ‘normal’ youth activity, but is more problematic. It is now widely
accepted that a comparatively small proportion of ‘persistent’ offenders account for
a high proportion of all offences. In Scotland in 2001 over half of all convictions
were accounted for by the 26% of individuals who were convicted on more than one
occasion. Those aged under 21 were the most likely to have been convicted more
than once (Scottish Executive, 2002b).

The Scottish Executive’s 10 point Action Plan on Youth Crime (Scottish Executive,
2002a) defined persistent young offenders as ‘young people who have been
referred to a Children’s Hearing on offence grounds in respect of at least 5 offending
episodes in the last 6 months.’


• Why do you think offending is less prevalent among girls than boys?
• Thinking of your own adolescence, can you identify individuals who were
involved in criminal behaviour? What happened to them?


Characteristics of young people involved in persistent offending
Comparisons between persistent young offenders and less frequent offenders do
not reveal any striking differences in terms of characteristics and family
backgrounds. They do, however, show characteristic risk factors to a much greater
degree.

Age of onset
One of the best predictors of persistence is the early onset of offending. Young
people who become involved in crime before the age of 14 tend to become the most
persistent offenders with longer criminal careers. Evaluations of two projects in
Scotland which target persistent young offenders revealed that in one project almost
75% had been charged before their 14th birthday and in the other project 66% had
been charged by the age of 12 (Lobley & Smith, 1999; Lobley, Smith & Stern, 2001).

Patterns of offending
Most young offenders commit a range of offences rather than concentrate on one
type of crime. Various studies suggest:
• the greater the number of offences young people had committed,
the more likely they were to have been involved in a wide range of
offences (Lobley et al, 2001; Hagell & Newburn, 1994);
• juveniles who remain involved in crime commit more serious
offences as they age (Blumstein, Cohen, Roth & Vischer, 1986);
• violent offenders are essentially frequent offenders (Farrington,
1996).

Family influences
The family is central to an understanding of why some people offend and others do
not.
Family factors can be usefully grouped into four:
• Parental neglect;
• Parental conflict and discipline;
• Deviant parental behaviour and attitudes;
• Family disruption.

Those involved in persistent offending are more likely to come from families who fit
into several of the above groups.

History of social work involvement
In general, persistent young offenders tend to be well known by social work
departments and more often have been referred in the first instance on welfare
grounds and not on offence grounds. Many young offenders have experienced
neglect or physical, sexual or emotional abuse. Another feature that distinguishes
persistent offenders is experience of local authority care.


Educational experience
Youth delinquency is strongly associated with not liking school, poor school
performance, weak attachments to school and teachers and low educational
aspirations. Persistent young offenders tend to have more pronounced educational
problems with high rates of disruptive behaviour, truancy and school exclusion.

The influence of delinquent peers
Evidence suggests that relationships with criminal peers are associated with
criminal behaviour. However, it is not clear whether membership of a delinquent
peer group leads to offending or whether delinquents simply gravitate together.
Persistent young offenders are more likely to associate with other persistent young
offenders (as opposed to re-offenders) whom they usually meet in children’s homes,
custody or elsewhere in the local area, and with whom they tend to co-offend. They
are also more likely to ‘hang about’ in public places than other offenders/non-
offenders.

Substance misuse
A high proportion of young people involved in persistent offending have problems
related to misuse of alcohol and drugs. In many cases the use of drugs and alcohol
is associated with unstructured and often chaotic lifestyles. Far more young people
identified as delinquent have used what might be considered to be more socially
acceptable drugs, such as cannabis, alcohol or tobacco than have used hard drugs
such as heroin or crack cocaine. Moreover, the use of the former, substances is
more strongly related to offending than any other drugs. The drugs-crime connection
is complex. No single causal relationship between substance misuse and crime has
been established, though it is generally accepted that 'addictive type' drug use
(heroin, methadone, crack cocaine and valium) in particular requires a level of
involvement in crime to finance the addiction and is frequently related to shoplifting.
'Stimulant and polydrug’ use is often related to stealing cars and violence while
young people who are ‘heavy’ or ‘binge’ drinkers are more likely to be involved in
violent crime.

Psychological factors
Studies suggest that persistent offenders may be subject to psychological factors.
They are likely to be inclined to aggression, impulsive or risk taking behaviours and
tend to have poorer physical health than those who do not offend.

Social, economic and environmental factors
Finally, social and economic deprivation is an important predictor of antisocial
behaviour and crime. The risks of becoming involved in persistent offending are
higher for young people growing up in poor housing, particularly public housing in
deteriorated inner city areas and peripheral housing estates. Other environmental


risk factors include social disintegration, criminal opportunity, the availability of drugs
and a high percentage of children and young people living within the community.


• Can you think of examples of the behaviours or situations that would fit into
each of the four groups of factors identified in the paragraph on ‘Family
influences’?
• Think of a young offender in your unit. To what extent does s/he fit the pattern
of characteristics identified in this paper?

Conclusion
There is a widespread view that a small number of persistent offenders are
responsible for a high proportion of crime in Scotland. The difference between
offenders and persistent offenders seems to be one of degree.

It is clear that persistent young offenders have very high levels of need. For
delinquency in general, risk factors include: poor parenting; association with
delinquent peers; poor school performances and persistent truancy; high levels of
impulsiveness and aggressiveness; poverty and poor housing. We do know that
young people who experience one or more such factors are at greater risk of
offending. Within the individual life histories of persistent offenders, these risk
factors tend to accumulate and reinforce one another. Early onset of offending is an
indication that young people have a range of characteristics that may cause them to
behave antisocially throughout their lives.

Though talk about crime and punishment tends to treat victims and offenders as
discrete groups, recent evidence from the Edinburgh Study of Youth Transition and
Crime suggest that victimisation and delinquency are linked. Indeed, experience of
being a victim of crime at the age of 12 is one of the most powerful predictors of
offending at the age of 15.

Though persistent offending causes real and serious damage to communities, the
evidence in this chapter suggests that it is itself, in part at least, the product of other
forms of disadvantage and victimisation.

Training links
SVQ:
Unit C7 Provide a framework for the management of behaviour

Unit HSC 322 Prepare, implement and evaluate group activities to address the
offending behaviour of children and young people (specific optional unit for the


revised SVQ level 3 qualification Health and social care: children and young
people).


HNC in Social Care:
unit).

Further reading
Batchelor, S. & Burman, M. (2004). Working with girls and young women. In G.
McIvor (Ed.), Research highlights in social work: women who offend. London:
Jessica Kingsley.

Batchelor, S. & McNeill, F. (2005). The young person-worker relationship’. In T.
Bateman and J. Pitts (Eds.), The Russell House Companion to Youth Justice (pp.
166-171). London: Russell House Publishing.

practice issues in community and criminal justice, Monograph number 3, London:
National Association of Probation Officers.

Scottish Children's Reporter Administration. (2004b). Annual Report 2003/04.
Scottish Children’s Reporter Administration. Retrieved 12th December 2004:

www.scra.gov.uk/AR_03_04_Pack.html

Scottish Children's Reporter Administration. (2005). On the right track: a study of
children and young People in the fast track pilot. Scottish Children’s Reporter
Administration. Retrieved 17th April 2005:

www.scra.gov.uk/AR_03_04_Pack.html


Sexual offending and sexual
4.17 vulnerability
Mark Smith

…The key to all of the interventions is helping the young people to learn about respect. They
need to learn how to respect themselves, as well as other people.
(Charles & Collins, 2000b, pp. 2-3)

Introduction
The whole area of sexual offending is subject to intense political, media and public
concern. This places considerable pressures on staff who have to work with young
people deemed to be sexually aggressive. This paper considers:

• problems of definition;
• the policy context;
• the characteristics of young people identified as sexually
aggressive;
• approaches to working with them;
• implications for the regime in secure units.

Adolescent sex offending
It is generally accepted that between a quarter and a third of all sexual abuse is
carried out by children and young people. Many adult offenders begin their offending
careers in adolescence. That is not to say that this is an inevitable progression.
Recidivism rates for young people who sexually offend are in fact significantly lower
than that for adult sex offenders. Many, in appropriately supportive environments,
simply grow out of such behaviours and can move on to develop appropriate and
non-abusive adult relationships. Nevertheless, it is important to respond
appropriately to sexually aggressive behaviour in adolescence lest it continue into
adulthood, with all the resultant consequences for possible victims and abusers
alike.

The first difficulty in this area is one of definition. Some more serious acts are fairly
unambiguous. However, adolescence is a time when sexual identities are being
developed (see chapter 3) and can involve some crossing of sexual boundaries


which may be inappropriate but not necessarily indicative of ongoing problems with
sexual behaviour.

Moreover, because most sexual behaviour is conducted in relative privacy, those
cases that come to our attention are likely to be the tip of an iceberg as far as
adolescent sexual behaviour is concerned.

Another issue is that many young people identified as sexually aggressive have
themselves been subjected to sexual or other forms of abuse. This crossover
between the sexually abused and the sexually aggressive is highlighted in secure
accommodation, where young people can be placed on account of either or both
sexual offending and/or sexual vulnerability.

Despite such difficulties in defining and quantifying sexual aggression, the term itself
is heavily value laden and can evoke a range of strong emotional reactions.

Nevertheless, it is important that staff have some definition of sexual offending to
work with. As good a working definition as any might be:
the commission of any sexual act against an individual’s will,
in an aggressive, exploitative or threatening manner.


• What comes to mind when you hear the term sexual aggression?
• Can you think of any adolescent behaviour that might be construed as sexually
aggressive or offensive?

The policy context
A Commitment to Protect (Social Work Services Inspectorate, 1997) identified that
young people's offending must be more effectively addressed at an early stage if
their progression to more serious offending in adulthood is to be prevented. A
subsequent Expert Panel on Sex Offending, set up by the Executive recommended
that all children identified as being at risk of sex offending or who are displaying
sexually aggressive behaviour should have access to an appropriate personal
change programme.

Young people identified as sexually aggressive
Sexual offenders are rarely the monsters the media portray them to be. The majority
are boys. Many are assessed as having learning difficulties and have previously
been in special education or other care settings. Many will have traumatic personal
histories or traumatic episodes within these. Problems of poor personal and social
skills prevail. They are described by Grant Charles and Jennifer Collins (2000a) as:


extremely needy young people who have not yet learned how to
make appropriate connections with other people. They are often
victims of abuse who have learned through their own victimization
that it is okay to use others to meet their own needs. They are kids
who have taken a different path to deal with their own victimization.
(p. 2)

While most of those officially identified as sex offenders are boys, practice
experience tells us that girls too can be sexually aggressive and exploitative,
perhaps as a learned way of responding to males or as a result of confused
boundaries between sex and affection. This can lead them to initiate inappropriate
sexual contact with males or perhaps other girls. Yet because of received societal
norms around the male as sexual aggressor, we can fail to acknowledge or else
minimise this dynamic (see paper 4.13). The effects of being pushed towards
sexual contact that is unwelcome can have detrimental consequences irrespective
of the sex of the aggressor.

Whilst some sexually aggressive youngsters may demonstrate particular sexual
preferences, in other cases there may be a more indiscriminate aspect to their
behaviours. Commonly understood boundaries between gay and straight
expressions of sexuality may well be blurred.


• Can you think of any young person/people in your unit considered to be
sexually aggressive?
• What are their backgrounds?

Interventions
Vital components of working with sexual offenders include the effective provision of
assessment and therapeutic services. There are a number of generally accepted
goals in programmes developed for work with sexual offenders. These are identified
as:
..increasing offender accountability; assisting offenders to
understand and interrupt the thoughts, feelings and behaviours
that maintain sexual offending; reducing deviant sexual arousal, if
present; developing healthy attitudes towards sex and
relationships; and reducing the offenders' personal trauma, if
present.
(Worling & Curwen, 2000 cited in Kendrick, Mitchell & Smith,
2004, p. 40)

The general consensus of those working in this field to date has favoured personal
change programmes based around cognitive behavioural approaches (see chapter
3). Such interventions focus on changing patterns of deviant arousal, correcting


distorted thinking, development of victim empathy and increasing social
competence. Participants on such programmes are also encouraged to consider
diversionary strategies to prevent relapse into offending patterns.

Whilst cognitive behavioural methods seem to be the preferred clinical approach to
this work, other writers stress the need for a more holistic approach when working
with young people.

Holistic treatment means treating the whole person not just a
particular problem....When we see the whole person as a person
with many facets, many of which are damaged parts, then we are
better able to understand the nature of what we must treat and the
complexities of doing so.
(Longo, 2002, p. 229)

Currently, a number of secure units and residential schools run units with a
particular focus on working with sexually aggressive youngsters. Some locate these
within a wider context of the boys themselves (they are almost always boys) having
had past experiences which have resulted in them being traumatised. This trauma is
thought to contribute to their sexually inappropriate behaviour. Working with
personal trauma therefore becomes central to the task of tackling sexual
aggression.

An issue of concern in establishing separate units is the possibility of residents in
these specialist units becoming stigmatised. There is a risk too that the programme
in such units becomes overly focussed on addressing issues of sexual offending at
the expense of a more normalising environment. On the other hand, placement in
specialist units where there is an openess about the remit can allow boys to realise
that they are not alone in their thoughts and behaviours and they may feel freed up
to address their difficulties. A clear focus and well articulated programme can also
give staff a clear sense of purpose and direction in their work.

Another issue to bear in mind is the question of who does the specific work with
boys to address their sexual aggression. Some units use external consultants or
specialist agencies which are contracted in, others have developed specific
programme teams, and others expect care staff to undertake direct work with
youngsters with the support of line managers or external consultants.

Whichever model is preferred there is a need to ensure that staff on the ground are
aware of the treatment plans for young people and can reinforce these in everyday
practice. As in every area of residential child care, the adoption of a whole person
and lifespace based approaches would appear to be particularly appropriate (see
paper 4.06). Writers with specific experience in this field note:
we believe that the most powerful and influential work with these
young people occurs in the milieu. Therapy is an adjunct. It
provides important education and opportunities for self-awareness
but the day-to-day modelling, support and teaching moments that
happen within the daily lives of the young people is often where
the real change occurs.
(Charles & Collins, 2000b, p. 3)



• How does your unit work with sexually aggressive young people?
• What might be the possible advantages/disadvantages of this approach?

The milieu
Working with sexually aggressive youngsters highlights a number of practice issues
and dilemmas for staff. When sexual boundaries are absent or distorted, the need
for levels of supervision adequate to avoid inappropriate sexual activity becomes a
priority. However, this needs to be balanced with human rights principles such as
free association, confidentiality and privacy (see paper 4.20).

Another balance to be struck is that between normal adolescent sexuality and
sexual behaviour that is problematic. Not all sexual expression should be
pathologised. Masturbation among adolescent boys, for instance, is normal and for
the most part healthy. Again practice scholars in this field give their views:
We approached this premise from the stance of encouraging
young people to be responsible for their own sexual feelings.
Instead of trying to deny and blunt sexual feelings as part of
treatment, we wanted to teach the young people to learn how to
respond appropriately to their own sexual urges.
(Charles & Collins, 2000a, p. 2)

In working with sexually aggressive young people, as in any other area of residential
child care, an appropriate unit culture is vital. The impact of stress is a significant
factor in sex offending. Young people who feel under stress are more likely to
relapse into sexual offending. They are also less likely to respond to any
interventions. It is essential, then, that young people should feel safe and respected
if they are to be able to work on areas of sexual difficulty. Staff, by the nature of their
involvement with young people, make legal or moral judgments on their behaviours.
They must ensure that they themselves model appropriately respectful behaviours
in relationships. They need to avoid language which is sexually stereotyping or
demeaning.

A key component of supporting a young person who has sexually offended is to
supervise their interactions with others appropriately. In this way the unit can seek
to reduce the possibility of reoffending and maximise the modelling of appropriate
interactions to the young person.

An important part of developing a supervision/support model is the development of
an appropriate risk assessment (see paper 4.18).



• How does your unit deal with issues of adolescent sexuality?
• To what extent does the unit culture promote healthy attitudes towards
sexuality?

Supporting staff
If staff are expected to undertake direct work around areas of sexual aggression,
they need to feel confident and sufficiently equipped to do so. Working with specific
programmes demands an understanding of their theoretical basis (see chapter 3)
and of notions of programme integrity (the need to see programmes through to
completion and in a certain order). A pick and mix approach to programmes or a
lack of understanding as to how they fit together is likely to be counter-productive.

Working with sexually aggressive youngsters is not emotionally neutral (see paper
4.13). It can elicit a range of strong feelings among staff. Some may adopt a
particular moral position on certain sexual behaviours. For others, proximity to
youngsters who have committed sexual offences can touch some raw emotions,
perhaps relating to past personal abuse, or maybe, relating to feelings around their
own children's stage of development or vulnerability. This has the potential to lead to
some fairly primitive judgemental positions being taken. Consequently, it is
important that staff have a well developed awareness of self and the ways in which
work in this area might touch on those aspects of self. It is also essential that
appropriate supervision and support structures for staff working in this area are in
place.


• Have you experienced a situation where a young person has caused a
particular emotional response in you?
• What supports are available in your workplace to address such issues?

Moving on from secure
A lot of good work can be done in secure accommodation to address inappropriate
sexual behaviour. However, research consistently points to the need for any lessons
learnt and support offered in security to be continued once a young person moves
on. This is why it is important to include relapse prevention in any work done with
young people. Essentially, this is about rehearsing with them strategies they might


adopt to sublimate problematic thoughts and impulses once they have moved on
from security. Ensuring that there are appropriate family or other community
supports in place once a young person moves on is vital. Indeed, involving families
in the work done to support young people, where possible and appropriate, is linked
to improved outcomes in work with sexually aggressive young people.

The issue of exits and mobility for those who have sexually offended will be at the
forefront of plans in relation to leaving secure. The reader is directed to consider the
papers on risk assessment (paper 4.18) and exits and mobility (paper 4.26) in
conjunction with this paper.

Conclusion
Charles and Collins (2000) provide a good summation of this area:
Supporting and developing the strengths of a young person and
his family are likely to prove significant in reducing risk.
Interventions that focus solely on offence related behaviours do
not fully address the development of the range of skills and
abilities that are generally required to lead an abuse-free lifestyle.
Developing a model that incorporates the identification and
utilisation of strengths and assets as well as risks is therefore
essential.

Training links
SVQ:
Unit C15 Contribute to the protection of children from abuse
(mandatory unit in the SVQ level 3 qualification Caring for children and young
people).

Unit W5 Support clients with difficult or potentially difficult relationships (optional unit
in the SVQ level 3 qualification Caring for children and young people).


Unit HSC 356 Support individuals to deal with relationship problems (generic
optional unit for the revised SVQ level 3 qualification Health and social care:

Further reading
A Scottish perspective on some of the subject area of this paper is offered in both:

Kendrick, A. (2004). Managing children and young people who are sexually
aggressive. In H. Kemshall & G. McIvor (Eds.), Managing sex offender risk (pp.
165-186). London: Jessica Kingsley


Kendrick, A., Mitchell, R. & Smith, M. (2004). The development of a residential unit
working with sexually aggressive young men. In H. G. Eriksson & T. Tjelflaat
(Eds.), Residential care: horizons for the new century (pp. 38-55). Aldershot:
Ashgate.

A series of three brief practice based papers, by Grant Charles and Jennifer Collins,
which are referenced through this paper can be found at:

www.cyc-net.org/cyc-online/cycol-1299-offenders.html
www.cyc-net.org/cyc-online/cycol-0200-offenders3.html
www.cyc-net.org/cyc-online/cycol-0100-offenders2.html


Risk assessment
4.18
Mark Smith, Fergus McNeill & Susan Batchelor

To be alive at all involves some risk.
(Harold Macmillan)

Introduction
Risk has become a dominant, some might say an all-consuming, professional and
societal concern in recent years. Risk is now increasingly equated with danger. In
just about every area of social work practice, the language of risk assessment is
prominent. This paper considers the concept of a 'risk society', the development of
risk perspectives in the areas of child protection and criminal justice, and some of
the specific areas of risk that might concern staff in secure accommodation.
Limitations of risk assessment are discussed.

The 'risk society'
Some sociologists suggest that we live in a 'risk society’ (Beck, 1992). It is helpful to
locate this idea historically. The period in history from the Enlightenment of the
eighteenth century, throughout most of the twentieth century has been characterised
by belief in scientific explanations of the social world and in the prospect of continual
human progress. However, the world has become increasingly complex and recent
events such as pension and mortgage crises, concerns over the environment and,
most starkly perhaps, the spectre of international terrorism post 9/11, introduce
questions to this erstwhile belief in progress. Old belief systems are not as sure as
they once seemed. To try to cope with our resultant anxieties we have adopted the
notion of risk to help us regain some order in our world. Risk, according to Nigel
Parton, a social work writer on the subject, has become a collective state of mind
rather than an objective reality (Parton, 1999). Much of this is fuelled by the popular
press. However, it may have some basis in reality. Science, which might once have
been thought to offer some objective insight into our world, no longer provides the
answers. Consider for instance the recent publicity over diagnoses of shaken baby
syndrome or Munchausen's syndrome by proxy. Approaches to child protection
based upon scientific principles have been opened to question. We need to find new
ways of understanding and living in our world in all its complexity.



Think of some examples from your everyday experience where there is a
concern about risk.
• What are these risks and how real are they?
• Do you feel any safer as a result of attempts to minimise risk?

Risk in child protection
Until the mid-1980s, the social work approach to child protection was to consider it
within a wider welfare framework. Inquiries into high profile child abuse cases have
re-framed the social work task to trying to identify only 'high' and 'significant' risk
cases.

In England, Messages from Research (1995), a Department of Health compendium
of research studies, argued that approaches to child protection should be located
within a wider, family support context. Current assessment frameworks (DOH)
operate from an ecological approach which takes into account a range of systems,
as well as individual, considerations (see chapter 3 and paper 4.04). However,
because of political, public and media sensitivity, the assessment of risk rather than
wider (but invariably related) welfare concerns has become the predominant
concern for children and families social workers in recent years. Social workers are
often said to be ‘damned if they do and damned if they don't’ in responding to child
protection cases.

In secure accommodation workers may be faced with making decisions in cases
where there is a child protection component. Such cases may arise in relation to
decisions about home leave, for instance, or about a young person having contact
with particular individuals. These decisions are rarely clear-cut. It may be that there
are good arguments for promoting and maintaining family contact (see chapter 3
and paper 4.21) even in situations where there are concerns about the level of care
in a home or about the presence of a particular individual. The pros and cons of
particular courses of action need to be considered and balances have to be struck.


• Think of a case where you have had to balance risks.
• What considerations did you have to take into account and what informed your
final decision?

Risk in criminal justice
Current concerns in youth justice are with risk of re-offending (or recidivism) and risk
of serious harm (to potential victims). However, the above two risks differ in that risk
of re-offending is essentially about the probability that an offence will occur, whereas


risk of serious harm is about the impact or consequences of an offence, should it
occur.

During the 1990s, risk of re-offending increasingly came to be seen as pivotal in
determining what level or intensity of service should be provided in individual cases.
As ‘the risk principle’ became increasingly well known, researchers worked to
develop risk assessment tools that could supplement professional judgement and,
perhaps, provide for greater consistency in practice. Risk assessment approaches
increasingly emphasise priorities and issues around community safety and public
protection. Both issues, re-offending and serious harm, have driven the
development of new techniques of risk assessment.

Approaches to risk assessment in criminal justice service
Until recently there have been two main approaches to risk assessment. Clinical
approaches (or ‘first generation’ risk assessment) rely on the professional
knowledge, skills and experience of individual practitioners. Actuarial approaches
(or ‘second generation’ risk assessment) seek to apply statistical calculations of
probability correlating specific risk factors with reconviction data.

Both approaches have been subject to a number of criticisms. The reliance on
professional judgement in clinical approaches has been questioned on grounds of
accuracy, personal bias and subjectivity. Actuarial approaches may seem to be
more objective. However, conviction is not, in and of itself, a measure of criminal
behaviour (see paper 4.16) and therefore predicting reconviction is not the same as
predicting re-offending. Furthermore, though actuarial tools assess the likelihood of
reconviction, they say nothing about the type or seriousness of predicted conviction.
Thus, they fail to assess risk of serious harm.

‘Third generation’ approaches to risk assessment (like both ASSET and YLS/CMI,
described below) integrate ‘dynamic’ (or changeable) risk factors in the process.
Dynamic risk factors correspond with ‘criminogenic’ (or crime-generating) needs. By
highlighting specific criminogenic needs, third generation risk/needs assessment
tools aim to individualise risk assessment in order to guide practice, but without
compromising the predictive validity of such tools. Since such instruments can also
capture changes in levels of assessed risk across time, they have important
applications in terms of monitoring and evaluation of intervention effectiveness.

However, third generation instruments generate their own set of issues and
problems. These include the demands which their increased complexity creates in
making demands on workers’ time, sometimes leading to ‘completion fatigue’;
dilemmas in balancing comprehensiveness and predictive accuracy with usefulness
and brevity; the re-introduction of elements of professional judgement and related
issues of consistency and bias; and concerns about the ability of such tools (derived
largely from research involving white males) to accommodate and respect diversity
and difference vis-à-vis gender and ethnicity in assessing risk.


Risk/needs assessment instruments in youth justice
The two available instruments designed to inform, supplement and structure
‘clinical’ or professional assessment in work with young people are ASSET and
YLS. These are increasingly used in youth justice services including secure
accommodation.

ASSET
The Youth Justice Board in England and Wales has developed ASSET in
collaboration with Oxford University’s Centre for Criminological Research. The Core
ASSET form runs to 12 pages, including sections on personal details, care history,
criminal history, offending behaviour, living arrangements, statutory education,
employment, training and further education, neighbourhood, lifestyle, substance
use, physical health, emotional and mental health, perception of self and others,
thinking and behaviour, attitudes to offending, motivation to change, positive factors,
indicators of vulnerability and indicators of serious harm to others.

The assessment should be informed by at least one interview with the young
person, an interview with his or her caregiver, existing reports and records (including
details of previous convictions), and discussion with individuals or agencies
currently or recently involved with the young person. In each section of the form,
workers are required to enter responses to a range of questions, to arrive at a rating
of the association between the issues raised and the risk of further offending, and to
state the evidence for this rating. In the conclusion these ratings are aggregated to
produce an overall score. A three-page form entitled ‘What do YOU think?’ aims to
facilitate self-assessment by the young person. In cases where the core ASSET
indicates a risk of serious harm there is a further four-page form for a full
assessment of any such risk.

ASSET can be subject to the concerns about time and resources, especially for
lower level offence categories, and the potential for worker bias as noted above. Its
structure allows for, and indeed encourages, workers to make professional
assessments and professional judgements about needs and risks and to think
through the evidence for these judgements.

Youth level of service/case management inventory
The second available instrument is the Youth Level of Service/Case Management
Inventory (YLS/CMI). Though this tool was developed in Canada, it is currently in
use in a number of Scottish local authorities, through the Cognitive Centre
Foundation. It is essentially a junior version of the Level of Service Inventory
discussed above, which has become the most widely used risk assessment tool in
criminal justice social work in Scotland. YLS/CMI (at 5 pages) is shorter than
ASSET, containing 54 items within 8 major ‘risk domains’. Part 1 provides an
assessment of risk and needs by scoring a variety of factors related to prior and
current offences and disposals, family circumstances and parenting,
education/employment, peer relations, substance abuse, leisure/recreation,
personality/behaviour and attitudes and orientation. In Part 2, these scores are
aggregated to give an overall risk score. Part 3 provides space for assessment of
other needs and Part 4 allows the professional to record and explain his or her


assessment of risk and need. This assessment may depart from the score recorded
in Part 2. Part 5 sets contact levels and Part 6 details the case management plan.


• What, if any, formal risk assesment tools are used in your workplace?
• What would you say are the advantages and disadvantages of these?

Risk in secure accommodation
By definition, dealing with risk is central to work in secure accommodation. Young
people are admitted on account of risk to themselves or others. It is therefore an
essential task of secure accommodation to try to minimise the risks that led to
admission. Young people’s exit strategies will be linked to the success with which
these risks are addressed.

The initial assessment of a young person (see paper 4.04) should identify particular
risks, such as violent behaviour, self-harming, drug use, sexual vulnerability, sexual
aggression, propensity to need restraint and perhaps other factors such as a history
of making allegations against staff. The identification of such behaviours should
form the basis of informed strategies and responses to address them, thus matching
identified needs with the resources required to meet these. This might involve
specific practical measures such as restricting access to glass bottles or aerosols.

Some units may operate a phased introduction to particular areas of their
programme, such as education or the use of the gym. As a placement progresses,
considerations of risk attach to decisions over mobility programmes, family contact
and participation in particular activities.

Like any assessment, risk assessments need to be dynamic and able to be adjusted
in light of changing circumstances. Risk assessment and risk awareness ought to be
a habit of mind for staff working in secure accommodation. They need to try to
anticipate possible risks in situations without over-reacting to them.

Matching needs to resources is particularly important in secure accommodation. In
some cases, building design may determine (sometimes inhibit) what can be done
to avoid certain risks. In other cases, staff numbers and skill levels will determine
how realistic any planned response to risk might be. If, for instance, it is determined
that three members of staff are required to restrain a young person, what are the
implications for supervising the rest of the group?



• What areas of practice are subject to risk assessment procedures in your unit?
• What are the mechanisms for this?

Limitations of risk assessment
Critics of risk assessment and approaches claim that they lead to defensive and risk
averse cultures of practice. They induce a concern to do things right (i.e., to follow
procedures) rather than to do the right thing. As such they devalue professional
judgment. The inclination not to take risks, but to 'play it safe' is particularly apparent
in organisational and wider political and media climates where practitioners fear a
blaming reaction if anything goes wrong. On the other hand, risk assessments within
suitably supportive cultures can also be used to argue and support a case to take
particular informed risks in a case.

Robinson (2003) writing about work with offenders makes a point which has a wider
applicability:
‘In recognition of the inherent unpredictability of future behaviour, it
is generally accepted that ‘defensibility’ rather than ‘certainty’ is the
goal of risk assessment practice. A ‘defensible’ risk assessment is
one which is judged to be as accurate as possible and which
would stand up to scrutiny if the handling of the case were to be
investigated…’
(Robinson, 2003)

Risk should not be allowed to dominate other practice considerations in working with
young people. As discussed in the papers on safe care and children’s rights (4.19
and 4.20), there are competing rights and developmental requirements that need to
be taken into account. Nor should risk assessments (which focus primarily on child
protection or offending concerns) be allowed to be substituted for a more holistic
ecological assessment (see paper 4.04). Risk assessment needs to be considered
within a ‘whole child’ approach (see chapter 2).

Tuddenham (2000) argues for and outlines a model of ‘reflexive risk assessment’
within which practitioners recognise that their knowledge is emergent, tenuous and
open to revision; that definitions and discussions about risk are contestable and
culturally relative; and, that risk assessment functions within certain policy contexts
and within a society increasingly pre-occupied with risk and its prediction.

Worker skills
Risk assessment is not neutral in any area of practice. Decisions that follow on from
a risk assessment rely significantly on worker skill. In secure accommodation for
instance, young people on mobility programmes may be less likely to abscond from
workers they have a strong relationship with, who demonstrate appropriate personal
and professional qualities (Trotter, 1999, 2002) (See also chapter 2 and paper 4.07).


Conclusion
Risk assessment instruments can usefully supplement professional assessment,
enhancing its comprehensiveness, consistency and credibility. In terms of service
planning and delivery, they offer advantages in allowing for the development of
consistent policies and practices around gatekeeping and the prevention of net-
widening.

However, risk assessment instruments have some limitations and require judicious
and critically informed use by professional staff.

Training links
SVQ:
SC17 Evaluate Risk of Abuse, Failure to Protect and Harm to Self and Others

Unit HSC 395 Contribute to assessing, and act upon risk of danger, harm and abuse
care: children and young people).

HNC in Social Care:
unit)

Further reading
Stalker, K. (2003). Managing risk and uncertainty in social work: a literature review.
Journal of Social Work, 3(2), 211-233. Provides an overview of the development of
risk perspectives in social work.

Nigel Parton has written extensively on risk in child protection. Anything by him in
this area is worthwhile reading. The source cited here is Parton, N. (1999).
Reconfiguring child welfare practices: risk, advanced liberalism and the governance
of freedom. In A. S. Chambon & L. Epstein (Eds.), Reading Foucault for Social
Work. New York: Columbia University Press.

Department of Health. (1995). Child protection: messages from research. London:
HMSO. Outlines research on child protection and advocates a family support model
of practice.

The sections of this paper relating to criminal justice are abbreviated from a fuller
version of a monograph by Fergus McNeill & Susan Batchelor (2004), Persistent
offending by young people: developing practice issues in community and criminal
justice, Monograph number 3. London: National Association of Probation Officers.


Safe care
4.19
Mark Smith

....respecting children’s rights is the biggest safeguard against abuse, because children who
are listened to and respected will be assertive in their dealings with adults....who they can
trust to take their concerns seriously.
(Moss & Petrie, 2002, p. 2)

Introduction
A feeling of safety is identified in the Skinner Report (SWSI, 1992) as one of the
underpinning principles of effective residential child care. This paper considers:
• why children entering secure accommodation may not feel safe;
• how the culture and the nature of relationships in a unit might
contribute to safe care;
• the role of policies and procedures;
• how to work with children who have been abused.

Children in secure accommodation are likely to have had a range of experiences
that make them feel unsafe. They may have been abused, physically, sexually or
emotionally. They may have had abusive experiences at the hands of other young
people or adults in previous care placements. They may have been moved from
pillar to post in their previous care careers, leading to feelings of instability and
impermanence. Many will have encountered combinations of such experiences, all
of which will impact on their initial response to secure accommodation. Having been
out of control, some will resist adult attempts to put a structure around them. Others
may appear over-compliant. Almost all will have, at best, a wary trust of the adults
and other young people in the living situation.

Before any meaningful work can be done with young people, they need to feel safe.
This calls for an element of containment. By definition, in secure accommodation
there will be a physical or buildings dimension to this. However, children also need
to know they can be contained emotionally. They need to know that staff can soak
up some of their inner turmoil; to help them feel safe from themselves and their own
destructive thoughts and impulses. And they need to start to build or re-build trust in
adults.


They don’t realise how much they want to be listened to and how much that
makes us feel safe.

(male 16, Who Cares? Scotland, 2003, p. 42).

The first step in making children feel safe is through a unit’s rhythms and routines
(see paper 4.06). The aim of any secure unit is to establish feelings of predictability
and dependability. Young people who have been or who feel unsafe or out of control
will benefit from being surrounded by a relatively tight structure, where, as far as
possible, they know what will come next.


• Consider the backgrounds of the children in your unit.
• What experiences do you know of that might make them feel unsafe?
• To what extent do the rhythms and routines in your unit contribute to children
feeling safe?

The development of safe care perspectives
One of the unsavoury realisations over the past decade or so is that children have
been abused in residential child care. This has led agencies to introduce a range of
measures to minimise the chance of such situations happening again. All
organisations providing residential child care are obliged to operate a range of
policies to ensure children are safe. Inquiries and reports on residential child care
highlight the need for appropriate personnel policies around areas such as
recruitment, selection and responses to allegations.

There is also an expectation that agencies will have in place mechanisms through
which staff can raise concerns about the safety of children. Inquiries and reports
invariably stress the need for staff to be suitably trained, supervised and supported
to be able to perform what is a very complex job. The Kent Report (Kent, 1997) in
particular recognises this complexity and argues that the level of qualification
required ought to be at least the equivalent of those required for other areas of
professional social work. Other safe care initiatives include the development of
accessible and child friendly complaints procedures.

Complaints
One of the findings of the various inquiries into abuse in residential child care is that
children at times did complain about their treatment but these complaints were
either not believed or not acted on. All organisations now need to operate
complaints procedures to which young people have easy access. Formal complaints


should be dealt with by someone suitably removed from the source of the complaint,
in some cases someone independent of the establishment itself.

In any situation children will have gripes about aspects of their everyday care.
Agencies may wish to consider a different level of response to these. A climate that
provides for grievances to be resolved at the lowest appropriate level is likely to help
young people learn, negotiate and to feel valued and listened to by the adults
around them.

Children should have access to children’s rights or advocacy services to help them
express their views. Many local authorities now employ or commission children’s
rights officers. Young people also have access to Who Cares? Scotland, who have
recently established a specific presence in secure accommodation.

Given the locked physical environment, it is especially important that young people
in secure accommodation have access to trusted adults outside the secure
environment. There are always balances to be struck in such settings around issues
such as the use of the telephone, as identified in the paper on children’s rights
(4.20). However, there should be a presumption that young people do have
reasonably free access to a telephone or other means of making contact with
parents, social workers or other possible advocates outwith the unit. Exceptions to
this need to be argued on a case by case basis in terms of the safety of a young
person or others being compromised by them having such free access to means of
communication.

Bullying
The biggest concern of most children in residential settings is not that they will be
abused by staff, but that they will be bullied by other young people. This fear may be
particularly pronounced in secure accommodation where some of the residents will,
rightly or wrongly, have reputations that go before them.

Increasingly, units are expected to have anti-bullying policies or strategies.
However, there is no easy answer to bullying. Again, the culture of a unit will be
central to how safe residents in it feel. For them to feel safe, staff need to be
authoritative and in control. They need to be able to intervene to stop overt bullying.
They also need however to be able to differentiate between bullying which is an
inappropriate expression of power and normal adolescent jockeying for position in
the peer group. The line between the two can be a fine one and may vary from
individual to individual. However, to treat every adolescent fall-out as bullying may in
fact highlight it and contribute to the continuation of a situation.

Bullying policies need to take care that they do not match power with power or that
they do not lead to further victimisation of the bullied child (see Brown, 2004 for a
good discussion of this). In secure settings they must also proceed from an
understanding that a bully is unlikely to be able to be moved on. Strategies need to
attempt to work with both the bully and the bullied to address the problem. In this,
the ability of staff to understand and work with group dynamics and to model
relationships that are respectful will be vital.



• What are the policies and procedures in your organisation designed to keep
children safe?
• How appropriate are they?

Regulatory bodies
Government interest in seeking to ensure appropriately safe social care provision is
evident in the establishment of two new statutory bodies in recent years. The SSSC
has responsibility for regulating the workforce through establishing a qualifications
framework setting out minimum qualifications required for work in various areas of
social care. All staff will require to hold at least an academic qualification at HNC
level and a vocational award at SVQ level 3 or above by 2008/9. The SSSC has
also established codes of conduct for workers in social work and social care
settings.

The other body, the Scottish Commission for the Regulation of Care (SCRC) is
responsible for inspecting all care establishments against sets of national standards.

However, the Kent Report acknowledges that belt and braces do not make good
trousers (see chapter 2). Healthy units and cultures are essential to the provision of
safe developmental care. It is the feeling of safety that is important, not just the
procedural devices put in place to try to ensure this. A holistic understanding of the
care task and an awareness of the wider context in which care is provided are
essential if young people are to feel truly safe.

Safety and risk
We live in a society which is increasingly risk conscious and risk averse (see paper
4.18). Whilst it is appropriate that reasonable measures are taken to minimise the
risk children face in residential care or any other walk of life, there is a balance to be
struck between ensuring a safe environment and one that meets young people’s
developmental needs. For example:
The director of a residential establishment was describing his
centre’s grounds. He spoke of swings, ropes and tree houses. He
said that sometimes people asked him if children got hurt. His
reply was that yes they did but his view was ‘Better a broken arm
than a broken psyche’.

Indeed the need for residential establishments to address the broad range of
children’s developmental needs is enshrined in Article 6 of the United Nations
Convention on the Rights of the Child: the right to survival and development (see
paper 4.20). This Article includes the right to developmental approaches which
should be ensured ‘to the maximum extent possible’. The term ‘development’ in this
context is interpreted in the broadest sense and adds a qualitative dimension – not
only physical health, but also mental, emotional, cognitive, spiritual, social and
cultural development.


Cultural safety
Children and young people in secure accommodation are likely to come from a
range of different backgrounds. They may come from urban or rural areas, east or
west, Catholic or Protestant traditions. Even within cities, particular housing estates
may have their own cultural nuances. In the coming years secure units, as with
other areas of residential child care, may find themselves admitting increasing
numbers of children from different racial backgrounds. In these latter cases, cultural
differences may be apparent and may call for particular care arrangements to be
made.

However, even in areas where differences are less obvious, there will still be cultural
nuances which will affect the ways young people experience care. Children will feel
safest when they feel that staff are in tune with their cultural experience. The
importance of staff having an awareness of issues of cultural safety is increasingly
acknowledged in the child and youth care literature. Cultural safety is defined as:
the state of being in which the child or young person experiences
that her or his personal well-being, as well as social and cultural
frames of reference, is acknowledged – even if not fully
understood by the worker(s) claiming to help him or her.
Furthermore, cultural safety means that each child or young
person will be given an active reason to feel hopeful that her or his
needs and those of her or his family members and kin will be
accorded dignity and respect.
(Ramsden, 1997).

It follows from this that workers in any residential care setting should attempt to find
out a bit about the cultural backgrounds of children and their families and to
recognise cultural dimensions to particular behaviours and responses. Practice
issues such as how workers greet children or family members, for instance, or
around matters of privacy, will assume a particular significance.


• Think of a time that you have felt truly cared for and at ease.
• What have been the components of this sense of comfort?
• Consider the cultural backgrounds of the children and young people in your
unit.
• To what extent does practice in the unit take account of these?

Staff care
Maier in The Core of Care (1979) identifies care for the caregiver as an essential
component in the provision of care. Put simply, if staff do not feel safe and valued,
they will not be in a position to make young people feel safe. If staff feel under
physical or emotional threat in their work environment, or if they feel bullied and


under threat of disciplinary action, they will be unsure and defensive in their
interactions with young people.

For any unit to be a healthy and safe environment everyone in it needs to feel safe.
There needs to be an appropriate ‘fit’ between unit culture and that of the wider
organisation. If organisational cultures are bullying and unsupportive, this is likely to
be reflected in unit cultures which are either similarly bullying or lacking in
confidence and unduly passive.


• Are there aspects of the culture in your workplace which make staff feel
unsafe?
• How might these impact on the experience of care for the young people?

Resilience
As we have seen in Chapter 3, the notion of resilience is increasingly influential in
work with young people. In relation to a young person’s feeling of safety, it is
worthwhile not just confronting the bully, but working on the protective factors that
are likely to boost a bullied young person’s resilience. Practice experience suggests
that young people can be encouraged to feel stronger and better able to stand up
for themselves. Staff should actively encourage them to do so through their
everyday interactions and lifespace interventions.

Notions of resilience also have relevance to other areas of the safe care agenda.
Resilience theory points to the importance of staff and young people sharing
activities across a range of sporting, cultural and leisure pursuits (see paper 4.08). It
also highlights the importance of strong, appropriate adult-child relationships as a
powerful bulwark against abuse. Overly defensive organisational policies and
cultures risk preventing the development of the very relationships that are likely to
keep children safe.

Resilience theory also tells us that different children will react differently to the same
experience. We cannot afford to make assumptions, for instance, that young people
who have been abused should not experience physical contact from staff. In certain
cases this may be something to bear in mind. In most cases, however, children will
need to experience safe physical contact from non-abusive adults if they are to
develop realistic and healthy attitudes towards future relationships. This makes it
vital that decisions about what is appropriately safe care are located within individual
placement plans rather than within a defensive procedural frame.


Working with children who have been abused
The whole area of child protection can bring about anxiety and uncertainty in
residential workers. They may feel that only those with particular training should
become involved in work with children and young people who have been abused.
The reality is that almost all young people in secure accommodation will have
encountered some previous abuse. Their primary needs are for a safe and
predictable environment where they can experience trusting adult relationships.

If a young person discloses specific abuse to a member of staff, there are some
fairly basic things to bear in mind:
• do not over-react;
• respond to the immediate needs of the young person for comfort and
reassurance;
• don’t probe too much for information, but conversely, don’t run away from the
discussion - let the young person set the pace;
• at an appropriate point, advise the young person you may have to pass on
what they tell you, in accordance with child protection procedures;
• be aware that some disclosures of abuse may touch on elements of your own
past experience. In such cases, you should try to seek support in this from a
supervisor or colleague (see paper 4.13);
• discuss the case with a supervisor or designated child protection person.

Child abuse is not a neutral term or concept. Ideas of what constitutes abuse will
vary from individual to individual and indeed from professional to professional. In
considering what is a child protection matter, some care needs to be taken that the
net is not widened too much and that situations which may be inappropriate or
which do not sit comfortably within our own particular frame of reference are
automatically dealt with through child protection procedures. In low level cases a
child protection response may not be in the best interests of a child and may in fact
cause them more harm than their original concern. Always consider what is in the
best interests of the child in determining what is a child protection matter rather than
adopting a defensive procedural response.


• What are your own views of what constitutes child abuse?
• How might these impact on how you respond to young people talking to you
about abuse?
• What are your organisation’s child protection policies?


Conclusion
For young people to experience a feeling of safety demands that agencies providing
care put in place a range of appropriate procedural safeguards. However, these
alone are not enough and if they become the sole or predominant organisational
focus they risk detracting from the relational nature of care itself. A holistic
consideration of safe care has to be located within an understanding of children’s
wider developmental needs. It also requires organisational cultures where staff feel
sufficiently safe and supported to carry out the care task and are able to discuss and
question practice.

Training links
SVQ:
Unit C15 Contribute to the protection of children from abuse (mandatory unit in the
Unit SC17 Evaluate risk of abuse, failure to protect and harm to self and others.

Further reading
Brown, D. (2004). Beat on the Brat? Care and Health Magazine. pp 27-28.
Kendrick, A. & Smith, M. (2002). Close enough? Professional closeness and safe
caring. Scottish Journal of Residential Child Care, August/September, pp. 46-54.
Kent, R. (1997). Children’s safeguards review. Edinburgh: Stationery Office.


Children’s rights
4.20
Richard Mitchell

Every child deprived of liberty shall be treated with humanity and respect for the inherent
dignity of the human person.
(United Nations Convention on the Rights of the Child, Article 37 (c))

Introduction
This chapter outlines the background to, and importance of, applying a human rights
perspective in our practice with children in secure accommodation. The key points
include:
• Scotland and the United Kingdom have signed up to the United
Nations Convention on the Rights of the Child (CRC).
• Practice in secure accommodation needs to take this into account.
• Rights-based perspectives can be incorporated into practice.

Children’s rights should not be confused with children’s wants. For example, a child
has a right to privacy, but does not necessarily have a right to watch the television
or stay up late. This paper looks at the international legal framework for a rights-
based approach.

Background
There is a growing awareness and respect for human rights in Scotland and this is
increasingly evident in the development of policies and procedures in relation to
children and young people. The rights agenda is perhaps nowhere more important,
or more challenging, than with young people placed in secure accommodation. The
recognition of a rights dimension to practice is apparent in the provision made for
legal representation of children and young people being considered for placement in
secure accommodation. The recent appointment of Professor Kathleen Marshall as
the first Scottish Commissioner for Children and Young People to safeguard and
promote children’s rights is an example of this acknowledgment of the importance of
children's rights in the Scottish tradition.

The CRC is a legally binding treaty in international law. Scotland signed up to it in
1991. There can however be a lack of even basic information about children’s
rights, contributing to confusion and suspicion of these in institutional and practice


settings. In one study of Scottish residential care, Heron and Chakrabarti (2002)
argue that ‘the superficiality of the rights agenda has added to the complexities and
tensions permeating residential provision’ and has undermined practitioner morale
in the process (p. 356). The Convention on the Rights of the Child provides a
framework within which children’s rights can be upheld and has a number of
passages that speak specifically and clearly to care providers in order to ensure that
the best interests of young people remain paramount. The following pages provide
some direction for interpreting the CRC in the context of Scotland’s secure
accommodation.


• What kind of information do you provide for staff, residents, parents and care
providers regarding the CRC?
• How do you balance the need for young people to participate actively and their
need for protection?

Core CRC articles and secure accommodation
Article 42 suggests that awareness of the CRC’s main principles and provisions will
be made ‘widely known’ through ‘appropriate and active means to adults and
children alike’. Most importantly, there are many examples of children’s rights
statutorily embedded throughout The Children (Scotland) Act 1995 and in the scope
of The Commissioner for Children and Young People (Scotland) Act 2003.

As with all CRC principles and provisions, the fullest definition of ‘the child’ is meant
to include all young people under 18 years of age, knowing that in different
jurisdictions the age of majority may come sooner or it may come later. Generally
speaking, care providers should also understand that there are four basic human
rights principles meant to help with interpreting the Convention as a whole: Articles
2, 3, 6 and 12.

Non-discrimination (Art. 2): States parties must ensure that all children within their
jurisdiction enjoy their rights. No child should suffer discrimination.
This applies to every child, ‘irrespective of the child's or his or her
parent’s or legal guardian's race, colour, sex, language, religion,
political or other opinion, national, ethnic or social origin, property,
disability, birth or other status’. The essential message is equality
of opportunity. Girls should be given the same opportunities as
boys. Refugee children, children of foreign origin, children of
indigenous or minority groups should have the same rights as all
others. Children with disabilities should be given the same
opportunity to enjoy an adequate standard of living.

Best interests of the child (Art. 3): When the authorities of a state take decisions
which affect children, the best interests of children must be a
primary consideration (see chapter 1). This principle relates to


decisions by courts of law, administrative authorities, legislative
bodies and both public and private social-welfare institutions. This
is, of course, a fundamental message of the Convention, the
implementation of which is a major challenge.

The right to life, survival and development (Art. 6): This Article includes the right
to survival and to development which should be ensured ‘to the
maximum extent possible’. The term ‘development’ in this context
is interpreted in the broadest sense, and adds a qualitative
dimension: not only physical health is intended but also mental,
emotional, cognitive, social and cultural development. In this
context, this Article also has important implications when looking
at the repeated evidence regarding poor educational outcomes
and levels of homelessness for Scotland’s young people after
leaving out-of-home accommodation.

The views of the child (Art. 12): Children and young people should be free to have
opinions in all matters affecting them, and those views should be
given due weight ‘in accordance with the age and maturity of the
child’. The underlying idea is that children have the right to be
heard and to have their views taken seriously, including in any
judicial or administrative proceedings affecting them.

The way in which these four principles work together offers a straightforward, rights-
based approach for practitioners to apply the central idea of best interests in
combination with anti-discriminatory practice, respect for physical and cognitive
development, and the right of young people freely to express their views. Secure
care providers know and understand that children and young people are themselves
primary sources for information regarding adult interpretations of their ‘best
interests’, and, in fact, are active partners in the process of case management while
being accommodated. While participation is also a central concern in all discussions
about young people’s rights, this principle cannot be practised in isolation or without
an holistic appreciation of these other fundamental children’s rights principles.


• How do you facilitate active and informed participation of children and young
people in all decisions that affect them?
• How do you ensure the fullest development of each resident – intellectually,
emotionally, socially, culturally, spiritually?

Other CRC provisions and secure accommodation
While the above core principles provide a minimum rights-based approach, in terms
of secure care and case management, CRC Articles 37 and 40 also provide clear
direction for Scotland’s secure facilities. For example, adults in authority are asked
to recognise the right of every young person ‘having infringed the penal law to be
treated in a manner consistent with the promotion of…dignity and worth, which


reinforces the child’s respect for human rights and fundamental freedoms of others
and which takes into account the child’s age and the desirability of promoting
reintegration and assuming a constructive role in society’ (Article 40.1). ‘Every child
deprived of liberty shall be treated with humanity and respect for the inherent dignity
of the human person, and in a manner which takes into account the particular needs
of persons of his or her age. In particular, every child deprived of liberty shall be
separated from adults…and shall have the right to maintain contact with his or her
family through correspondence and visits, save in exceptional circumstances…’
(Article 37c).

As is the case in all residential care facilities, authorities are required to take such
protective measures ‘to provide necessary support for the child and for those who
have the care of the child…for identification, reporting, referral, investigation,
treatment and follow-up of instances of child maltreatment…and, as appropriate, for
judicial involvement’ (Article 19.2). Of additional significance, Article 20 provides
that any young person ‘temporarily deprived of his or her family environment, or in
whose best interests cannot be allowed to remain in that environment, shall be
entitled to special protection’, and particular regard for the ‘ethnic, religious, cultural
and linguistic background’ shall play a role in decision-making and case
management. Furthermore, Article 25 suggests that authorities ‘recognise the right
of a child who has been placed by competent authorities for the purposes of care,
protection or treatment…to a periodic review of the treatment provided and all other
circumstances relevant to his or her placement’. These reviews provide
collaborative, democratic opportunities actively to engage a young person as well as
parents, family members or care providers, and educational and other concerned
professionals.

A frequently thorny issue for providers of secure accommodation is the Article 16
consideration that no young person ‘shall be subjected to arbitrary or unlawful
interference with his or her privacy, family…or correspondence’ since young people
have ‘the right to protection of the law against such interference’. This passage is of
particular concern with regard to the monitoring of telephone calls, contact with
family members and other forms of correspondence. Generally speaking, unless a
clear threat to safety can be established because of these contacts, the
interpretation of this Article is unambiguous - all young people have a human right to
respect for privacy while in secure accommodation.

In some instances a child’s right to privacy may have to be subordinated to the right
to be safe. This would need to be considered where the issue of potential suicide is
present.


• Do you screen letters and telephone conversations of residents, and what are
the protocols/rationales for this?
• Is the impact of isolation from family, culture and community taken into account
during planning and programming for residents?


Establishing a culture of respect for children’s rights in secure
accommodation
One way in which secure units already draw on a children's rights approach is
through their involvement with Who Cares? Scotland. Who Cares? has a number of
staff who work specifically with young people in secure accommodation. They are
able to provide an advocacy service to individual young people and to ensure that a
rights perspective informs practice in units.

The following suggestions are made for those who wish to take forward rights-based
principles in their care facility. Adopting this approach to practice is not likely to be
any easier than any other institutional approach, and indeed, these guidelines are
certainly not meant to suggest this will be the case. Often, the complexities may well
increase but by having accurate and clear information, along with an understanding
of how to apply the CRC in practice, care staff may proceed ethically with the daily
challenges that will doubtless continue to multiply in this field. Establishing a culture
of respect for human rights also allows for an interdisciplinary, ‘joined-up’ approach
to engagement, support and treatment with and for young people to run parallel with
other placement goals.
• Initial and ongoing staff training in basic knowledge of what the
Convention on the Rights of the Child says generally - and
specifically to providers of secure accommodation.
• Basic written and video resources provided for all new staff, new
residents and their family members and care providers based
upon the four core CRC principles. Institutional policy guidelines
for practice founded upon CRC principles and provisions.
• Effective internal and external complaint procedures for all
residents, and for all staff.
• Regular in-service visits and ongoing communication with the
Commissioner for Children and Young People.

The establishment of an appropriate culture of children’s rights requires that these
be considered within a wider context of human rights and personal responsibilities.

Conclusion
While these pages have offered a brief overview of human rights considerations for
providers of secure accommodation. Adopting a rights-based approach to
institutional culture goes far beyond ticking off an auditor’s checklist. The above
framework also offers the opportunity for all practitioners and young people
professionally to engage on common ground - clearly a morale booster for any
secure facility.


Training links
SVQ:
Unit O2 Promote people’s equality, diversity and rights
people).

HNC in Social Care:
unit).

Further reading
Barry, M. (2002). Minor rights and major concerns: the views of young people in
care. In B. Franklin (Ed.), New handbook of children’s rights (pp. 239-253). London:
Routledge.

Kearney, B. (2000). Children’s rights and children’s welfare in Scotland. In N.
Baldwin (Ed.), Protecting children promoting their rights (pp. 37-50). London:
Whiting & Birch Ltd.

Scottish Parliament. (2001). A Children’s Rights Commissioner - Research Notes.
From The Information Centre:

http://www.scottish.parliament.uk/S1/whats_happening/research/pdf_res_not
es/rn00-62.pdf.


Partnership with families
4.21
Maura Daly

On the day he went into secure care, I cried all day, asking myself over and over again
“where did I go wrong?”
(grandparent of a child admitted to secure accommodation)

Introduction
This chapter is based on two important premises. Firstly, regardless of the child’s
earlier experiences, the family remains important to the child in care and most
children will at some point return to their family of origin. Secondly, family networks
are important to children’s development, even if the child is unable to live within that
network (see chapter 3).

Families and secure accommodation
Historically links with family were severed for many children coming into care.
Admission to secure accommodation might be seen as confirmation of family
relationships having broken down or in some cases being implicated in the need for
placement in secure accommodation. This way of thinking can lead staff in secure
accommodation to view families as problems. They can be identified as dangerous
and staff can get caught up in trying to restrict or manage access. This way of
working sets workers in opposition to families.

This is not to deny that some families operate in ways that are not in the best
interests of children and young people, and staff in secure accommodation do need
to be aware of their potential for harm. When it comes down to it however, most
families actually want the best for their children. They often just do not know how to
provide this or are not in a position, materially or emotionally, to do so. For some,
their way of trying to show their care for a child is to pit themselves against those in
authority. In attempting to work in partnership with families we need to try and break
down some of these barriers. Research has concluded that children perform better
socially, emotionally and educationally where family connections are preserved.

Placement in secure accommodation can in many cases take some of the sting out
of fractious family relationships. Knowing that their child is safe and no longer the
cause of constant angst can allow a breathing space where family members can
begin to think more positively about them again. Likewise for young people, just


feeling under control again provides an opportunity to reappraise their feelings for
their family.

Before I moved to (the centre) I never saw my Da'...never saw him since I was four
(my mum kicked him out) - last year I saw him again. I stay with my dad at the
weekend.
Young person in residential school, cited in Smith, McKay &
Chakrabarti, 2004, p. 92

Many staff in secure accommodation engage well with families on an individual
level. The purpose of this chapter is to explore ways in which we can engage with
families at a more systematic level. Units should consider how they might involve
families at every stage of the care experience, from admission through assessment,
ongoing care planning to throughcare and aftercare.

As with all aspects of our care-giving, a degree of self-awareness is needed to
identify any issues arising from our own family experiences and their impact on our
practice.


• Think about your own views and experience of family life. How might this affect
your approach to work with the families of children in your care?
• What is/are your unit’s approach/policies in relation to work with families?

What is family?
There are a number of political, legal and organisational definitions of ‘family’ but
none which manages to encompass the widely diverse family backgrounds from
which the children in our care are likely to have come. These may include traditional
two-parent nuclear families, single-parent families, re-constituted families with step-
parents, same sex partnerships, and extended kinship. Rather than strive for a
definition of family, it will be best to view it as whatever the individual child considers
it to be regardless of biological relatedness. (That is not to ignore the latter as it is
necessary to have an understanding of the biological family composition and its
impact on the child as well). Our work therefore has to be in the context of the
‘constructed family’.

Irrespective of their actual composition, the families of the children in our care will
be characterised, invariably, by a number of the following:
• structural disadvantage including low income, unemployment, poor
education, physical or mental ill-health
• drug or alcohol dependency
• unresolved pain from parents’ own histories of attachment
problems


• breakdown in family communication
• conflict in the marital relationship
• ineffectual parenting throughout parenthood
• disagreement about how to manage behaviour.
And as a member of that family the child might have experienced:
• abuse or neglect
• early attachment problems
• scapegoating
• middle-child syndrome (may not actually be the middle child but
position in family may be relevant)
• non-acceptance of/ambivalence in relations with a step-parent.


• Think about some of the families of the young people you work with. What is
the composition of their families?
• What are some of the difficulties they face?

Why family work?

There are legislative, organisational and, most importantly, ethical reasons for
engaging in work with the families of children in our care.

The European Convention on Human Rights (ECHR), the United Nations
Convention on the Rights of the Child (UNCRC), and the Children (Scotland) Act
1995 all make clear our legal responsibilities to work in partnership with families.

There are also good organisational reasons. Actively involving the family gives a
message to the child that staff and family are openly working together, reducing
opportunities for situations to be manipulated. Furthermore, it signals to all that
problems do not lie exclusively with either the child or the family, but are symptoms
of wider dysfunction. It can reduce any uncertainty or conflict about the roles of
parents and of substitute carers.

Finally, and most importantly, there are clear ethical reasons for close working with
families. For children, their family is the key connection to understanding their
identity, their attachments and their heritage.

As with other interventions, care staff in secure units may question who has
responsibility for family work. Traditionally, it has been the locus of the statutory field
social worker. Several factors, however, challenge this view. Firstly, field social
workers are increasingly locked into child protection investigation, assessment and
care management, with little time for either preventative or therapeutic work.
Secondly, in the minutiae of everyday work with children in their life-space, you will


have developed close and trusting relationships, the foundation for therapeutic work.
Finally, you can bring a fresh perspective, possibly after years of social work
intervention. Care planning meetings provide a forum for discussion and agreement
as to who has the principal role in this and how it is to be achieved.

Family work may be beneficial for a number of reasons:
• to re-establish regular contact between the child and family
• to reaffirm the child’s position in the family
• to mend broken relationships with parents and siblings
• to pave the way for the child’s eventual return to the family unit
• alternatively to ‘free’ the child to move on to another situation (see
paper 4.22 )
• either way, to assess the longer term options.


• Identify possible purposes of family work with the families of young people in
your unit.

What is family work?

‘Family work’ can be a difficult concept to define. It incorporates a broad spectrum of
interventions. At one end of a continuum, it can be task-centred to address
immediate problems and identify simple, achievable yet highly important solutions
for the child. At the other end, it can involve complex and intensive family therapy,
with a heavy focus on psychotherapy, designed to alter the family’s functioning
significantly. And along the continuum will be specific interventions such as family
group conferencing.

Some knowledge around attachment theory, family functioning, and human
development (see Chapter 3) is needed in order to be able to understand and
respond appropriately. Skills in active listening, where the emphasis is on the
emotional undercurrent rather than the words, observation and non-verbal
communication are important. As in all human intervention, relationship is key.
Research increasingly points to the importance of the helping relationship as the
conduit for change (see Chapter 2). A worker’s skill level and confidence will dictate
where on the continuum of work with families they can intervene most effectively.
Any intervention needs to be thought through and agreed. Ill-conceived or badly
executed interventions can be intrusive and unhelpful for everyone concerned.

Residential workers have an important role to play with families. By the time a child
reaches secure care, their family is likely to have been ‘social-worked’ for years.
Initially you may be perceived as the next in a line of professionals trying to impose


an order in their lives. By taking a different approach, and indeed without the
‘shackles’ of the statutory social worker, you can offer something new.

A change in outlook is central to successful work with families. We need to shift our
thinking from treatment of a dysfunctional unit to involvement and participation,
respecting and trusting families more and judging them less. We need to view
families as partners in the care of their children – part of the solution rather than the
problem. A child will have arrived accompanied by extensive background reports,
detailing the minutiae of his family life, wherein will be contained all sorts of
assumptions. This may be a good time for the family to review some of these, to
gain family members’ own stories of their situations and to become partners towards
a common goal.

Whatever the approach taken, in our interventions with families we are modelling
parenting, either consciously or unconsciously. We should therefore treat families in
the way we wish parents to treat their children, confronting negative behaviours
without threatening, moralising or ordering. Fahlberg (2001) explores some
messages for positive parenting that we can convey in our interactions with parents:
• emotional nurturing
• a basic sense of acceptance
• times of unconditional giving
• appropriate limit setting
• positive role modelling
• encouragement for growth and change
• teaching responsibility
• teaching appropriate expression of emotions
• encouragement for reciprocal interactions
• a balance between dependency and independence
• discipline rather than punishment
• teaching life-skills
• teaching relationships.


• Can you think of workers who relate well to families? What qualities do they
bring to this work?

Approaches to family work
As stated earlier, family is whoever the child constructs it to be. Therefore wherever
possible, everyone identified by the child as having a role within what they consider
to be family should be included in any work we undertake. Traditional social work


interventions in families have often focussed on mothers as the primary carers to
the exclusion of fathers. This has served to undermine fathers’ rights with regard to
their children’s care, and indeed their responsibility to be involved in child care. This
can have the effect of placing disproportionate responsibility and often blame on to
mothers. There is now an increasing body of knowledge and recognition of the role
fathers can play in their children’s care. This is perhaps especially relevant for
children in secure care as they strive to work out their identity (see papers 4.12 and
4.13).

Here are some approaches to family work that could be considered within the group
care context, dependent on the knowledge and skill level of individual workers and
teams and the needs of the families. Just as there is no single definition of family,
there is no standard approach to working with families.

A child and youth care approach
Recent literature on child and youth care (Garfat, 2003) talks about developing the
concept of lifespace (see paper 4.06) for family work. It is based on the premise that
in the same way as we can engage therapeutically with children in the daily care-
giving experience, we can also work positively with families as they live their lives.
By getting involved in the rhythms and routines of the family’s lifespace we can
promote improved relationships. This may involve being with families in their homes,
within their community, and in any other place where they live their lives. The
advantages of this approach are that you help families to learn new ways of
interaction as situations present, rather than hypothetically. The family will
experience you as reaching out to them, thereby shifting the inherently unequal
power imbalance. Moreover, you are more likely to engage with all family members
and to come to a better understanding of how they operate together.

Clearly this approach needs to be balanced with a need for confidentiality and
privacy, and our own comfort with regard to this degree of intrusion.

Solution-focused approach
Qualified and experienced care staff may feel confident in undertaking a more
focussed, therapeutic approach to work with families. This approach requires
regular commitment of time and space by all involved and all members should have
an opportunity to contribute.

The first stage in this therapy is for the worker and family to agree goals. These may
be for more contact with the child, for the child to return home, or for the child to be
freed up to move on elsewhere. The aim of the intervention is to achieve change
through opening up lines of communication; challenging scape-goating; decreasing
guilt and blame; increasing empathy with, and acceptance of, difference;
challenging myths; and making new agreements for being together. 'Problems' will
emerge, and while they will need to be aired and addressed, the focus should stay
on resolution.

This approach is strengths-based, exploring the knowledge and resources within the
family. In some situations parents feel so overwhelmed by their child’s problem


behaviour that they find it difficult to be positive about any aspect of their
relationship or functioning. Re-framing the meaning attaching to events can help to
redefine ‘problem’ behaviour. For example, a young person's negative behaviour is
often an acting out of anger or another emotional state.

Check out with families their dreams and wishes for the child in secure care. Usually
they are not much different from those of other families. Ultimately they want their
child to settle down, get an education, get a good job, meet someone nice and have
kids. The focus is on how these wishes can be achieved.

As in all interventions, language is important. Speak the language of the family;
identify with the feelings of each member. ‘Attach’ to the family. The focus is on the
family as a unit, not the individual child.

The goals should be regularly revisited, progress reviewed and outcomes evaluated.
Care planning meetings can be used to do this.

Family group conferencing
Family group conferences are a relatively new but popular model of working in
partnership with families. Most local authorities now have either their own team or
have arrangements to buy in the services of voluntary agencies who have specialist
family group conferencing teams. The model comes from New Zealand where there
was increasing concern about the over-representation of Maori children in care,
most of whom were with white carers. A key feature of the model is that it is
participatory, with facilities being provided to allow the young person to play an
active role. It is kinship-led, involving all players in his life. Any family member
should only be excluded in exceptional circumstances such as risk of violence or
intimidation. Family group conferences are particularly relevant for planning where a
young person is going to live long-term.

The ‘conference’ is facilitated by an independent co-ordinator. This role requires
particular skills in negotiation and mediation to ensure that the meeting reflects the
language, abilities, diversity and culture of the young person’s family. At the
meeting, professionals explain their roles and responsibilities, their concerns and
available resources. The family then meets in private to agree collectively the best
way forward, the resources required, and a system for monitoring. They also agree
a contingency plan. Professionals should accept the family’s plan unless it is likely
to place the young person at significant harm.

Some research has been done on this model. Generally it is perceived as
participative by families but is also stressful. A key concern from families has been
the failure by professionals to sustain their commitment to the plan. From a secure
accommodation perspective, this may require a shift in the way we work. If one
outcome from a conference was that a young person should return home with
intensive outreach support from care staff, this might present organisational
challenges. If this outcome is best for the young person and his family, then this is a
worthwhile investment.



• What approach(es) to family work might be useful in your agency?
• What kind of supports would you need to carry them out?

Tools
In order to work effectively with families it is important to organise the information
already held and that gleaned in the course of your involvement. Visual
representation of this can be helpful. A family map or genogram provides the
historical context to the young person’s life. It allows for fuller exploration of the
significant players and its creation provides a forum for discussing relationships,
roles, rules and myths in wider family functioning. An eco-map provides information
on the family’s whole environment. The family is a system, with all parts playing a
role in its survival. Finally a family 'life-snake' can help a family see the
connectedness of events and behaviours. These are illustrated in paper 4.22.

Training links
SVQ: Unit P2 Establish and maintain relationships with parents (optional unit in the

Further reading
Daniel, B. & Taylor, V. (2001). Engaging with fathers: practice issues for health and
social care. London: Jessica Kingsley Publishers. As the title suggests, this book
addresses the need to work with fathers. Well grounded in practice experience.

Fahlberg, V. (2001). A child’s journey through placement. London: British
Association for Adoption and Fostering. This is a classic text for anyone working
with children and families. It is particularly good on issues of transition and identity.
Although grounded in theory it is very accessible.

Garfat, T. (2003). A child and youth care approach to working with families. New
York: Haworth. This edited volume outlines a conceptual framework for working with
families from a child and youth care perspective. It identifies a number of the issues
to be taken into account in such work and offers some practical examples.

Garfat, T. & McElwee, N. (2005). Developing effective interventions with families.
Athenry, Co. Galway: EirCan Consulting. This is the first in a new series of child and
youth care texts (see cyc-net.org for details).

Helpful articles on family group conferences can be found on-line at
www.iirp.org/library/fgcseries01.html


Life story work
4.22
Maura Daly

…someone, cut off from their past and denied their future can only live for the present.

Introduction
Every young person has a unique history. For many, that will be a straightforward
account of a safe, predictable and protected childhood, and an easy passage into
adolescence. Young people in secure accommodation, however, are likely to have
suffered several changes in their lives, often involving multiple separations, losses,
traumas, and possibly physical, emotional or sexual abuse. Life story work can be a
useful tool to help young people make sense of past experience. This paper will:
• describe life story work;
• consider some of the purposes of life story work;
• identify some of the knowledge and skills required to undertake it;
• offer some suggestions as to how to use this approach.

What is life story work?
Life story or biographical work is a method of direct work with young people that can
facilitate and encourage personal growth. It is concerned with how a young person
sees, interprets and understands his/her world. Its roots are in ‘symbolic
interactionism’, the belief that we all have an interpretive self which helps us make
sense of our worlds and through this to discover our identity (see chapter 3).
Importantly, life story work is not just about recording the facts of a child’s life, but
about the language, meaning and thoughts a young person attaches to them.

As with many therapeutic interventions, life story work with young people is not just
for ‘the experts’. A long-held misconception is that this is the domain of the qualified
field social worker or other therapist. Increasingly however field social workers are
involved in assessment, investigation and case management, and are left with little
time for direct therapeutic intervention. Therefore the onus is on those providing
direct care to engage in this work. Given the central importance of the ‘relationship’
in all therapeutic work with young people (see chapter 2), workers involved in daily
care-giving are in a better position to engage in life story work than those less well
known to the child. Conveying a message of care, trust, responsiveness and


genuine interest in their world will elicit facts, thoughts and feelings which give the
intervention a therapeutic quality.

Purpose of life story work
There are many reasons why lifestory work with a young person might be
appropriate.

It provides a history for the young person.
Children who remain within their own birth families throughout their
childhoods will have evidence of their history all round them,
contained not only in photo albums and memory boxes, but in the
anecdotes and stories that trundle out on family occasions and are
regularly relived. Even as adults, we all enjoy hearing accounts
about our early years.
Young people in our care may have experienced several moves
during their lives. With each move, some of their history is lost,
both the hard, tangible evidence and that which relies on memory.
Creating a life story gives the young person a chance to retrieve
some of this and record it before it becomes lost forever.

It connects the young person’s past, present and future.
The experience of the survivors of the concentration camps
suggests that someone who is cut off from their past and denied
their future can only live for the present. Practice experience tells
us that the past for many of the young people in secure
accommodation is confused, the future uncertain. As a result they
only live for the present, and that this can lead them into risky
behaviours.

It helps the young person separate fantasy from reality.
In order to protect them at a young age, children may have been
given a less than honest reason for why difficult events occurred.
(This should happen less now than in the past as it is generally
accepted that children should know the truth from a young age).
Alternatively they may have invented their own explanation of
events in order to protect themselves emotionally. Life story work
provides an opportunity to challenge misconceptions in a
supported way. By adolescence, most young people have the
cognitive capacity to develop a firmer understanding of the realities
of their lives.

It contributes to identity formation.
Our identity is shaped by a range of experiences and influences
which make us distinct from others. If young people are unsure
about these experiences, then it is easy to assume an identity
ascribed by others e.g. ‘ned’, and live out the expectations that go
with that label. Young people need to develop an understanding of
what their gender, culture, class, ability, age, race and sexual
identity means for them.


It builds self-esteem.
Self-esteem is the collection of beliefs or feelings we have about
ourselves. The two main sources of self-esteem are competence
and self-worth. The first involves achievement or success, while
the latter is our self-belief in those achievements. Engaging in life
story work promotes both, through the sharing of responsibilities
and the accomplishment of tasks, with lots of opportunity for praise
and positive reinforcement.

It deals with anger and other strong emotions connected to early life events.
Anger is the most common emotional response we come across in
working with young people in secure accommodation. Our task is
to help them learn how to express it appropriately. Years of
suppressing strong emotions may have resulted in the behaviour
that brought them into secure care. Life story work will inevitably
involve discussion about the source of a young person’s anger. It
allows the worker to affirm that anger is a common emotion and
there are ways of expressing it appropriately.

It helps in preparation for another placement.
Young people in secure accommodation may be moving on either
to another placement or to a semi-independent setting. Life story
work can help to prepare them for these changes. This may be the
first time in many years that the young person truly feels secure
and protected emotionally and this positive experience should be
translated into longer term advantage.
It addresses specific problem behaviours.
Life story work provides an opportunity to examine how the young
person became involved in specific behaviours, e.g. drug use,
sexual exploitation, self-harm or offending. By adolescence, young
people should have developed some logic and insight, enabling
them to consider how their behaviour affects other people and how
other people’s behaviour affects them.

Knowledge and skills required
A range of knowledge and skill is required to undertake life story work. An
understanding of child and adolescent development will assist in gauging the young
person’s cognitive, social, and emotional development, while an overview of
attachment theory will help in understanding the impact of losses, separations and
traumas in their lives (see Chapter 3).

The essential skill required is delicate and sensitive communication. Flexibility and a
willingness to try a variety of communication techniques will aid the process. No
young person communicates solely through words, and effective communication
involves discovering the best way to communicate. If a young person is initially
resistant, the use of art, reading, storytelling, photography or other activities, which
may feel less threatening, can be used. These are not for interpretation but simply a
part of the process.


Some sharing of one’s own experience, an element in what is known in social work
as ‘use of self’, will encourage a flow of information. As in all communication, there
needs to be a degree of reciprocity. This is not to suggest that workers necessarily
disclose personal information about their own experiences, but rather that they
convey their humanity, warts and all. Since much of this occurs naturally in our daily
experience with young people in care, residential workers are already at that point.

One note of caution is about the need to ensure that events taking place on a daily
basis within the lifespace don’t get in the way of the work. Between sessions with a
young person, workers will be engaged with them in other contexts, and some
awareness and possible separating out of roles may be required.


• Before undertaking life story work for the first time, a good exercise is to think
about your own biography.
• How easy would it be to share this with someone else?
• With whom would I like to share it?
• Where might I hold back?
• Is it all real or is some of it fantasy?
• What do I not know about myself?
• Where would I find this out?

Preparing to do life story work
When preparing to do life story work the following factors should be considered:

Where?
There is no ideal physical location in which to do life story work. It
does not have to be limited to an office setting and, importantly, it
has to be comfortable for the young person. Some degree of
privacy is required if personal and confidential discussion is taking
place.

When?
Life story work is an intense intervention that requires time and
persistence. The young person needs to know that you will be
available for them and this will be the first test of whether you are
trustworthy. Given the competing demands on your time, it would
be useful to schedule a mutually agreed allocated time. In your
daily interactions with a young person outwith these planned
sessions other opportunities may present themselves and these
can also be used.


Who can do this?
In addition to having the knowledge and skills discussed above,
those engaging in this work must be able to accept a variety of
strong emotions without either minimising them or feeling
overwhelmed by them. Good self-awareness is also a prerequisite
as disclosure of certain events by a young person may evoke
strong emotions in the worker. Good supervision to support this
work is vital.

With whom can we do this work?
There is a tendency to believe that some of the young people in
our care are too damaged and chaotic to ‘engage’ in this work.
This is often used as an excuse when we are perhaps feeling
daunted by the task. What will become apparent however is that
being there consistently over time for a young person, being
flexible, and often doing it on their terms, will create the climate in
which they will want to engage.

What do we do?
There are any number of techniques and ‘tools’ (see Further
reading). The important thing is to be comfortable with what, if any,
you are using. Many can be adapted to fit the needs of young
people at different ages and stages of development, with different
experiences and from different cultural backgrounds.

Other considerations
Life story work should only be undertaken within the context of the
care plan. The reasons for doing so should be clearly articulated
and whoever does such work needs to be sufficiently confident
and skillful. In addition the following points should be considered:
does the young person give clear permission for access to social
work, medical and other records? Who can have access to the life
story work – parents, social workers, courts? Under what
circumstances will information be shared with a third party? Is the
young person fully aware of all these considerations?


• Are there other considerations that should be taken into account?

Content of a life story book
Before beginning life story work, ascertain what is to the forefront of the young
person’s mind. The here and now is what matters most to young people. Any
current difficulties should be addressed, e.g., home leave/family contact
arrangements, before embarking on discussion about the past or future. Equally,


there is a balance to be sought so as not to avoid the work by finding other things to
talk about.

There is no obvious place to start. Just as every young person’s collection of
experiences is unique, so will be his/her life story book. Sometimes his/her own
account of his/her history provides the foundation on which to base the work. The
use of a questionnaire can prompt the young person if s/he has difficulty knowing
where to start or has worries s/he usually chooses not to talk about. (This can also
be used later to evaluate progress.) The immediate past might be more relevant
than early life for the young person. It may also take the young person time to trust
and have confidence in the worker prior to unfolding their history.

Drawing an eco-map (see diagram 1) may help young people who are unable to
give a fluid, coherent account. Based on a systems approach (see chapter 3), it
helps the young person to see him/herself as part of a bigger system with all parts
playing a role. This book is not just about him/her in isolation but about the many
facets that have contributed to his/her make-up.

Because information may come at different times, a loose-leaf folder is probably the
best way of gathering the book together. There are prepared books available, but
while they are useful as a focus, they can restrict the breadth of information the
young person may want to include.

The language used in the book is very important and should reflect the young
person’s own vocabulary and sentence structure. Again, how the information is
recorded is open. If the young person has good writing skills and is confident in
them, s/he may choose to write much of it him/herself. If s/he has keyboard skills,
s/he may choose to type it. Some, however, will rely on the worker recording it.
Importantly, it needs to be legible to the young person later on.

Be careful in how you reflect the information back to the young person. It is
important to remember that while s/he might criticise parents/carers and others, s/he
will seldom tolerate you doing so!

Most life story work will include the following areas:

Birth details
Every life story book should contain details of the young person’s
parentage and place of birth. Even if these details are unknown,
this should be acknowledged in order that the young person can
then feel able to talk about it. A genogram (see diagram 2) may
help in this. The case files held within the social work department
will provide a lot of the information required and access to this can
be negotiated with the social worker. Parents and family members
and previous carers are an obvious source of information. The
young person may know of other sources. In most cases, school
medical records and GP files will have details of birth weight,
developmental milestones and early childhood illnesses.

In gathering and discussing this information, it is important to help
the young person to understand that being successful, moving on,


and achieving is not a rejection of their parents or early life
experiences.
Attachment history
Early experiences in relationships shape the quality of later
relationships (see chapter 3). If young children have not had their
physical and emotional needs met, leading to a secure
attachment, adolescence and the transition to adulthood is more
difficult as they test out the availability of the adults around them.
Young people’s earlier attachments will help them understand their
current situation. These attachments may have been to significant
relatives or other carers rather than to birth parents and this should
be recorded. Any letters received over the years may be included,
with the young person’s permission. In the course of the life story
work, it may become important to the young person to reconnect
with someone from their past. This would require thoughtful
consideration and careful planning.

The very act of engaging in this work with a young person, thus
enabling him/her to experience an unconditional relationship with a
reliable and available adult, could in itself begin the construction of
a secure attachment base.
Houses / neighbourhoods
Life story work requires to be done in the context of the young
person's social and physical environment. If s/he has had a
number of moves, it would be useful to draw a map with him/her,
showing all the addresses where s/he has lived. Photos or pictures
might be included here.
Schools attended / teachers’ names
Report cards, school photos (class and individual), drawings and
project materials should be included. If the child has no access to
these, schools will have copies of some.
Activities / sports / hobbies
Since good self-esteem is dependent on achievement, it is
important to reflect back on a young person's earlier attainments to
re-inforce the positive benefits they brought. This could also have
the dual effect of re-igniting their interest in healthy activity (see
paper 4.08).
Religion/ culture / race
An understanding of one's history in terms of religious, cultural and
racial experiences is necessary for identity formation. The issue of
cultural safety is addressed in paper 4.19.
Why the young person came into care
An honest account which does not attach blame to any individual
but rather seeks to put the events into a wider context will be
beneficial in helping a young person move on. By adolescence,
most young people have the cognitive ability to understand all the
factors which led to their coming into care. An exploration of these
can lead to eventual forgiveness of abusive or neglectful parents


through understanding the parents' own unmet needs. This
understanding and forgiveness can be a cornerstone on which the
young person develops future secure attachments.
Placement history
The young person may have had several care placements and
s/he may be unclear as to why some ended, especially where they
seemed to be going well. S/he may feel, at best confused and, at
worst responsible for this and clarification will help. It may be
appropriate to contact previous carers to get photos, cards,
documents and verbal accounts of the young person's time with
them.
Why the young person came into secure accommodation
Deprivation of liberty, in addition to separation from family and
peers, is a serious intervention which young people may need help
to make sense of. Many young people may not fully understand
what has led to them being there. Life story work can help set a
context to this.
Plans for the future
Although we cannot entirely undo the psychological damage of
early life experiences, life story work can help to equip young
people with the compensatory skills they will need to manage the
future. Most adolescents have the capacity for hypothetical
thinking. They can look ahead to the times when some of their
earlier difficulties might resurface. Certain events - becoming
intimate in a relationship, having children, suffering further loss, or
developing an illness - will trigger memories of their own past. How
they have addressed this will influence how they deal with future
situations. And in this way we can help to break the cycle of abuse
and neglect between generations.
Life story work may also assist a young person in developing a
'cover-story' for the future. This is not a lie but rather a method for
withholding sensitive and personal information from others.
Guidance can be provided about the degree to which information
needs to be shared and with whom.
A life snake (see diagram 3), summarising major events in a young
person’s life, with options for the future branching out, is a useful
visual aid to focus this discussion.

One of the staff who was in a home a few years ago with us is in the same home
now with us. It’s like old times again. Yes, she was our keyworker for us back
then and now she’s my keyworker. She knows what [my sister and I] have been
doing, she knows our history. Probably because she was there when we were
growing up and she still is really. She’s a part of my history because I was close
to her back then and I’m still close to her now.

(female 15, Who Cares? Scotland, 2003, p. 17).


Ending life story work
As with all therapeutic interventions, the ending is important and it is essential that it
does not constitute another loss in the young person's life. The ending should be
formally marked, perhaps with a special treat, and agreement reached as to where
the work should be kept. It should be acknowledged that, while the formal recording
has ended, the life story may be the basis for ongoing direct work on particular
themes.

Training links
SVQ:
Unit CYP4 Encourage young people to develop and maintain a positive sense of
self and identity (optional unit in the SVQ level 3 qualification Caring for children and
young people).

HNC in Social Care:
HN unit Supporting and managing provision in secure care settings: outcome one
(optional unit).

Further reading
Fahlberg, V. I. (1991). A child’s journey through placement. London: BAAF.

King, P. (1989). Talking pictures: trigger pictures to help children talk about
themselves. London: BAAF.

Ryan, T. & Walker, R. (1999). Life story work. London: BAAF.


Diagram 1

Eco Map


Diagram 2

Genogram


Diagram 3
Life Snake


Managing behaviour
4.23
Laura Steckley

The Scottish Institute for Residential Child Care (SIRCC) has been commissioned
by the Scottish Executive to develop guidance on best practice for staff and
managers about physically restraining children and young people. SIRCC is writing
this guidance in conjunction with managers, practitioners and experts in the field,
and the handbook will be informed by young people and staff who have spoken
candidly about their experiences of being restrained and restraining. The handbook
will be entitled ‘Holding Safely’ and this guidance will be published in summer 2005.
A practice paper will be written for ‘Secure in the Knowledge’ based on the ‘Holding
Safely’ guidance and applied specifically to secure care.


Learning disabilities
4.24
Irene Stevens

..it is society’s attitude which disables the child, and not the impairment itself.

Introduction
This chapter provides an introduction to issues surrounding working with young
people with learning disabilities in a secure setting. The key points include:
establishing a value base, the prevalence of learning disabilities, challenging
behaviour, a cognitive model and autistic spectrum disorders.

Establishing a value base: understanding and using the social model of
disability
Work with children and young people with learning disabilities requires staff to
operate from a perspective which allows them to challenge the discrimination that is
so obvious in this group. It also requires workers to be self-aware and to have
examined their own attitudes closely. Middleton (1996) discussed how children with
learning disabilities are impaired by the way in which society views them.

Some children are born with a disability, or may develop one in the course of their
younger life. This makes them different from other children. They are then subject to
discrimination within society and are therefore doubly impaired because they are
disabled by their condition and also by society’s attitude toward them.

Middleton argues that disability is a social construct and that it is never value-free.
The term often provokes negative reactions in people. As a society, we do not really
want children with disabilities. Attitudes and structures in society tend to exclude
children with learning disabilities and can deny their gender, sexuality, race and
even their rights as human beings.

Within our society, we see the disability as the problem. It is individualised and
viewed within the context of a ‘medical model’ which sees it in terms of therapy and
treatment. This saves people within society from examining themselves and their
attitudes closely. Children with learning disabilities are expected to ask for charity
and pity, and to demonstrate their need for help, not to invoke their right to equality
of opportunity. This unhelpful attitude extends to children and young people with
learning disabilities in secure care by fostering a paternalistic approach, not one


which accepts that the young person may have the ability to learn and take
responsibility. The myth of the Eternal Child can take over (see Sinason, 1993).

A social model of disability holds that it is society’s attitude which disables the child,
and not the impairment itself. Professionals often talk about a child with special
needs. Middleton would argue that a child or young person with learning disabilities
does not have special needs. They have the same needs as every other child, but
their needs might have to be met in different ways. What is needed is a conceptual
shift from seeing children with learning disabilities as problems for others, to a child-
centred perspective.


• Think about a situation when you have met or worked with a child or a young
person with a learning disability. Reflect on your own feelings toward them.
Also, think about other adults’ attitudes toward them. Now think how you would
feel if these same attitudes were applied to you. How might that make you
feel?

Prevalence
Children and young people with learning disabilities feature in all sectors of society.
Hence it is likely that they will also feature in the secure care system. The Scottish
Executive report The Same as You (2001b) indicated that 20 out of 1000 people
have a mild or moderate learning disability. Using these figures, the report estimated
that there were around 120,000 people in Scotland with a learning disability.
However, only around 30,000 are in regular contact with local authorities, and these
tend to be people with more severe and complex needs.

There are therefore, around 90,000 people who are not coming to the attention of
local authorities and health services which are charged with their care. A closer
examination of the research however, indicates that some of these young people
may be coming to the attention of the authorities in different ways – as young
offenders who have an undiagnosed or poorly understood learning disability (see
paper 4.16). Research by McGrother & Thorp (1999) suggests that the incidence of
people with learning disabilities will rise over the next ten years. Given that a
proportion of this number is children and young people, it is reasonable to assume
that some of them will find their way into secure care settings.

Myers (2004) carried out an extensive study for the Scottish Executive on people
with learning disabilities and/or autistic spectrum disorders (ASD) in secure, forensic
or other specialist settings. She found that although there was only a small number
of children and adults with learning disabilities or ASD in secure care, it was the
clear perception of prison staff that those identified represented only a proportion of
a larger number of prisoners with learning disabilities or ASD who had not been
identified, assessed or diagnosed. This is supported by the findings of Kewley
(2002) in his discussion on attention deficit hyperactivity disorder (ADHD). He said
that if ADHD is not diagnosed by the age of ten, a pattern follows of poor social
skills, learning delay and challenging behaviour (see paper 4.11). This often leads,
in adolescence, to school exclusion, lack of motivation and more complex learning


difficulties, all of which increase the risk of offending and a poor outcome for the
young person by increasing the likelihood of placement in a secure setting, or a
prison sentence.
In recent years, secure units have become better resourced and can now access
psychological services, often on-site, for help in diagnosis and advice on
intervention.


• Think about the secure setting/s you have worked in.
• Have you ever suspected that a child or young person may have a learning
difficulty?
• What resources are available in your organisation to support you in work with
young people with learning disabilities

Challenging behaviour and learning disabilities
One of the main areas of concern for staff when working with children and young
people with learning disabilities is when they display challenging behaviour. This
behaviour can range from self-harm to physical aggression. However, behaviour
cannot be labelled independently of the values of the person making the judgement.
The use of the word ‘challenging’ behaviour instead of words such as ‘aggressive’
behaviour or ‘violent’ behaviour is meant to reflect this. The behaviour is perhaps
best understood as a challenge to the organisation or system within which the
young person is living. For the child or young person who has a difficulty with
communication, this may be their only means of getting their message across.
The language of challenging behaviour requires residential child care workers to be
self-aware and to understand to what degree any particular behaviour is
challenging, and why.
A useful way to look at this is to try to define challenging behaviour in a personal
sense and in a professional sense, and to look at the similarities and differences
between these definitions.
Leadbetter and Trewartha (1996) illustrated this in the following description:

I am The Service User is

Angry Behaviourally disturbed
Upset Emotionally disturbed
Frightened Paranoid
Sociable Attention seeking
Assertive Obstructive
Non-conformist Disruptive
Unhappy Depressed


The examples given above show how the ways in which you think of your own
behaviour can be radically different from similar types of behaviour exhibited by the
young people you work with. If a young person has difficulty in communicating for
whatever reason, then you should work to try to increase their communicative
repertoire (e.g. using art, signs or symbols, physical play/activity, etc.).


• Think of a time when you dealt with challenging behaviour in a child or young
person with learning disabilities which ended up in the child or young person
being held safely. Having looked at the above, try to redefine the behaviour as
a communicative act. How might you have dealt with it differently?

A cognitive model of working with learning disabilities
Piaget was one of the most influential developmental theorists. As a child
psychologist, he was mostly interested in cognitive development. He said that the
child had to develop mental structures to be able to develop cognitively. There are
two sets of mental structures which the child develops. One of these mental
structures was called operations. He posited the existence of four distinct stages of
cognitive development, based on the development of operations:

Sensorimotor: (birth to two years)
At this stage the baby is unable to separate itself from its main
carer. It is characterised by egocentrism. Gradually, the baby
adopts a picture of itself as a separate being and this is one of the
main tasks of this stage.

Preoperational: (two to six years)
At this stage the toddler is beginning to explore their world in a
more independent way but is still quite egocentric in their thinking.
Their thoughts are characterised by animism and magical thinking.
They have not yet developed the mental structures to allow them
to indulge in what we would think of as reasoned thought.

Concrete operational: (six to twelve years)
At this stage, the child is developing the basis for logical thinking.
They understand rule-bound games and can apply rules to
relationships. They understand the world insofar as they can link
what is happening to concrete reality.

Formal operational: (twelve to nineteen years)
At this stage, the child is moving into adolescence and is starting
to develop the ability to think abstractly and to consider actions
and consequences. They are now developing the ability to
consider “the bigger picture” and move into holding reasoned
ideas and beliefs.


Schemas are frameworks within which the child comes to understand his world.
Piaget said that the child needs the correct type of stimulation to allow the schemas
to reach their potential. If a child does not have the correct type of experiences, then
their development will be hampered.

His model emphasises the importance of early experience. It is also quite appealing
from the point of view that it clearly points out adolescence as an important stage in
development. Piaget said that in adolescence, the developing person acquires the
ability to think systematically about all logical relations within a problem.
Adolescents display keen interest in abstract ideas and begin to question long-held
assumptions.

If however, the young person has not had access to the right kind of experiences,
then they may be operating at a level of thought which is much younger than their
years. The same applies to the young person with a learning disability. For example,
although they may be 14 years old, they may still be operating at the concrete level,
or even at the pre-operational level. They may, quite literally, not understand what is
being asked of them. This has implications for workers in secure accommodation in
their dealings with young people where there has possibly been a disruption of
attachment and a poverty of early learning experiences. This does not mean treating
them like a young child, but places a responsibility on you to adjust your
communication to take account of their level of understanding.


• Think of a way in which you might communicate to a young person in a
concrete way, that they cause disruption to their classroom by being late. Then
look at the results of the following piece of research by Duan and O’Brien.

The need for rehearsal in skills and the role of motivation was identified. Duan and
O’Brien (1998) looked at peer-mediated social skills training in a group home for
people with learning disabilities. They found that although skills were learned, these
were not generalised until the first participant was trained as a peer-tutor for other
participants. This increased motivation and provided opportunities for skill rehearsal.
This study also noted the importance of pre-training assessment to target
appropriate behaviours.

A Rights-based approach to working with learning disability
The Children (Scotland) Act 1995 lays a responsibility on all Councils that the voices
of children and young people should be heard and this is also stated in the United
Nations Convention on the Rights of the Child under Article 23, which states:

1. States Parties recognize that a mentally or physically disabled
child should enjoy a full and decent life, in conditions which ensure
dignity, promote self-reliance and facilitate the child's active
participation in the community.


2. States Parties recognize the right of the disabled child to special
care and shall encourage and ensure the extension, subject to
available resources, to the eligible child and those responsible for
his or her care, of assistance for which application is made and
which is appropriate to the child's condition and to the
circumstances of the parents or others caring for the child.

Other pieces of legislation such as the Disability Discrimination Act and the Human
Rights Act which place a responsibility on everyone to ensure that people are not
discriminated against unfairly. Young people in your care may be subject to secure
accommodation orders or may have committed serious crimes; however, they may
also be young people with disabilities.
For a fuller discussion of Children’s Rights see paper 4.20.

Reflective Question

• Think about the young people you work with. Do you think your service helps to
uphold the rights of children and young people with learning disabilities?

Autistic spectrum disorders
Recently, professionals in fields that work with autism have tended to speak not of
autism as such but of “autistic spectrum disorder.” The notion of a continuum of
autistic characteristics has been discussed by Wing (1988). Indeed, the work of
Wing and her associates has been very influential in recent times within the
professional field. This led to the development of a diagnostic aid in autism called
the “Triad of Impairments.” Wing indicated that a diagnosis of autism could be made
if the person met three criteria:
• Impairment in communication;
• Impairment in social relationships;
• Impairment in imagination.

Young people with ASD find it difficult to either understand or to make themselves
understood in terms of communication. They find it difficult to make friends. They
are inflexible in their thinking and behaviour and react badly to change, which
creates huge anxiety for them. The world is a very frightening place for the young
person with ASD. However, given Myers’s report (2004) it appears that there may
be a number of young people in secure accommodation who have undiagnosed
ASD. As staff, it is your responsibility to find out as much as you can about ASD, as
you may be the first person to notice that the young person meets the criteria for
these conditions.


Reflective Question

• Look at the “Triad of Impairments” above. Now think if you can identify any
child or young person within your experience who may have met these three
criteria. If you suspected that a child or young person had ASD, what would you
do?

Conclusion
Working with children and young people with learning disabilities presents real
challenges to secure care staff. However, by treating these young people as human
beings with potential, by affording them the same rights, and by expecting them to
be able to understand and accept responsibility, you will be carrying out tasks which
will be of lasting benefit for them.

Training links
SVQ: Unit
C17 Promote the care and education of children with special needs
Unit HSC 316 Support the needs of children and young people with additional
requirements (specific optional unit for the revised SVQ level 3 qualification Health
and social care: children and young people).

Further reading
It is helpful for staff working in this area to be acquainted with the arguments around
the social and medical models of disability. With reference to this area Middleton`s
book (1996) Making a Difference is very readable and engaging. In terms of the
Scottish context, the Scottish executive reports The Same as You? (2001b) and On
the Borderline (Myers, 2004) are particularly helpful, as these review the evidence in
the area and set out principles and approaches.
Middleton, L. (1996). Making a Difference. Birmingham: Venture Press.
Myers, F. (2004). On the Borderline? People with learning difficulties and/or autistic
spectrum disorders in secure, forensic and other specialist settings. Edinburgh:
Scottish Executive Social Research.
Jackson, R. (2004). Residential special schooling: the inclusive option. Scottish
Journal of Residential Child Care, 3(2), 17-33. Provides an interesting perspective
on concepts of inclusion, normalisation and argumants for special residential
schooling.
Scottish Executive. (2001b). The same as you? A review of services for people with
learning disabilities. Edinburgh: Scottish Executive.


Secure accommodation in the
4.25 continuum of care
Graham Bell & Mark Smith

The Scottish research confirms other findings that the demand for security reflects the
requirements of inadequate, open institutions and community services rather than the needs
of difficult children.
(Kendrick & Fraser, 1992, p. 105)

Introduction
One of the biggest challenges facing staff in secure accommodation is to remember
that there is life beyond its four walls – not just for them, but for the young people
they work with. This paper considers the place of secure accommodation in the
wider continuum of services. It addresses the need to work across boundaries and
some of the difficulties in this. It identifies a core and cluster model for the delivery of
secure accommodation within the newly developing secure estate.

Background
Research on secure accommodation (Petrie, 1980; Harris & Timms, 1993; Bullock,
Little & Millham, 1998) all points to the fact that secure accommodation can be
understood only in terms of its relationship with the wider child care system.
Deficiencies in preventative services or in other care settings generate demand for
secure accommodation. Children’s homes that are badly run, badly resourced or
badly supported are likely to fuel demand to lock up young people. Recent research
on the fast-track hearings pilot (Scottish Executive, 2003a) indicates that many of
those labelled ‘persistent young offenders’ achieve that status while in care. At the
other end of the spectrum, failure to put adequate supports in place for young
people leaving secure accommodation can undo any progress they might make
there.


• Chart previous social work interventions and care placements of a young
person in your unit.
• Are there any points at which more appropriate interventions might have
averted placement in secure accommodation?


The care plan
Paper 4.04 identifies secure accommodation as a specific component in the wider
care plan for young people. The Looked After Child care planning process should
provide the bridge between previous placements and interventions and admission to
secure accommodation. The placement plan should identify appropriate links and
resources that can be utilised in the course of a placement. The care plan should
also incorporate the throughcare and aftercare arrangements necessary to move a
young person on. Appropriate care planning should locate secure accommodation
within the wider continuum of care.

The needs of young people
When I looked into the backgrounds of young offenders, I could
hardly believe the facts about their lives. Eighty per cent were
below the educational standard expected on entry to secondary
school; 80 per cent had been unemployed; nine out of 10 were
misusing substances; three out of 10 were already parents; and 34
percent were living rough or alone at the time of their arrest, often
having been evicted from the home before they were 15.

The social neglect and gratuitous violence they experienced at
home was breathtaking. Feeling disconnected from society, their
attitude towards the general public was: ‘You don’t take any
interest in me, so why should I take any interest in you?’ Any
civilised country would surely challenge this situation?

(Sir David Ramsbottom, HM Chief Inspector Of Prisons, 1995-
2001)

Inevitably in a secure unit great attention needs to be given to the ‘here and now’ –
looking after young people, ensuring a good education and maintaining a high level
of security. But it is not enough that these are done to a high standard. The above
quotation highlights the extent of the difficulties faced by the kind of young person
we work with. Research in this field has consistently shown that the majority of
young people in both residential and secure care have long-established, multiple
and complex problems and have ‘dropped through’ a wide range of other services.
Most will have first been referred for specialist help between the ages of 5-7 and will
have lived in numerous settings. Most will have disrupted backgrounds. Their
placement in a secure setting usually means all alternative placements have been
exhausted. If these young people are to be successfully reintegrated into
mainstream society many bridges need built or rebuilt. Individual staff in secure
accommodation cannot hope to address all of these. The challenge is to establish
and maintain good links with family and other social networks and with other
services.



• Think about a young person in your unit.
• What are their range of difficulties and what types of support may be required
to address these?

Traditionally one of the biggest criticisms of secure settings is the lack of preparation
for, and contact with, these other services. This paper focuses on what services can
be linked to the secure centre and how these can be ‘joined-up’ to ensure an
integrated service to young people and the wider community.

As well as considering some of the services that child and youth care workers can
access to support their clients this paper will constantly emphasise the crucial role of
the keyworker. The secure centre may have links to a wide range of other services
but if the worker is not accessing these then they are useless. And remember, a
young person is even more dependent on the worker for information, support and
practical assistance than they would be if placed in an open setting.

Some terms and ideas
Holistic is a phrase in common use. Here is the definition:
Looking at the whole system rather than just concentrating on
individual components. The overall sum can be greater than a
simple totalling of the individual parts, because the "system" adds
something in addition. Another term is "systems thinking".

Another important concept to consider is the idea of ‘joined-up work’. Although this
is a common phrase it is worth remembering why it was developed.

‘Joined-Up Working’ is the term used to describe collaborative working across
organisational boundaries to tackle shared issues. Workers need to establish links
both within and between organisations. In public sector, ‘joined-up working’ is
becoming increasingly common where:

organisations need to work closely together and exchange
information in order to address problems which cannot be resolved
by any single organisation;

organisations need to join together in order to deliver services to
the public which are customer-focused and organised for the
convenience of the consumer, not the provider.

Increasingly young people in secure accommodation are involved with a variety of
agencies. They may be involved with specialist medical or counseling services; an
increasing range of projects work with young people who offend; those leaving care
should have support from through and aftercare workers. This is over and above
the ongoing role of social workers and the need to work with families (see paper
4.21).


Difficulties of ‘joined up’ working
While most people subscribe to the principle of ‘joined up’ working it is not always
easy. There may be:

Practical difficulties - geographical difficulties may be particularly apparent when
working across local authorities. Shift requirements and patterns
can also get in the way.

Cultural differences - there can be a mutual suspicion between staff in secure units
and those in other residential settings or in other agencies. These
may come down to divergent views on how best to work with
young people or with particular areas of behaviour.

Labelling - often the reputation of young people in secure accommodation precedes
them and that stigma can make placement in another setting
difficult to negotiate. In such circumstances staff need to take on
an advocacy role.


• Identify resources in a young person’s home community that might be used to
support their return there.
• How might you work with another care setting to support the transition of a
young person to there from secure accommodation?

Supporting ‘joined up working’ – the keyworker role
‘Joined up working’ makes particular demands of keyworkers. It is all about
coordination, collaboration and communication. No room here for empire building,
isolation or ‘professional’ feuding.

What is clear from the definitions above is that working beyond the ‘boundaries’ of
the secure centre will not just happen – the keyworker will need carefully to plan and
deliver an ongoing series of actions linking to other agencies and individuals. A
North American phrase is ‘intentionality’ – a way of acting and behaving in a
deliberate, purposeful, planned, intended, premeditated and calculated manner.

One of the key advocates of this way of working is William Purkey who has
developed ‘Invitational theory’. Purkey emphasises the importance of consciously
making our people, programmes, places, policies and processes ‘inviting’.

Invitational theory also emphasises the importance of consciously choosing to do
certain things – crucial for the keyworker negotiating external links for young people
in their care. Purkey describes this ‘intentionality’ as one of the four pillars of
successful work. The three other pillars are closely linked – they are optimism,
respect and trust. So the successful secure centre worker will embed these


features into their work as they begin to negotiate links with external individuals and
agencies on behalf of the young people they are working with.

There cannot be a ‘one size fits all’ approach – a spread of easily accessed services
will be essential. A criticism of secure units has been the ‘mix’ of young people they
have to work with – those with mental health problems, serious offenders, those
involved in prostitution, and so on. The new secure services coming on stream in
the coming years will allow a greater degree of specialisation and differentiation.
Everyone working in secure services knows that often these labels are arbitrary –
young people usually have a complex mix of serious problems requiring a variety of
specialist support. The competent keyworker will have knowledge of these various
services and know how to access them.

A core and cluster model
Core and cluster models involve groups of linked services with a common purpose.
Each individual element can draw on a range of central services. Thus, a residential
school or secure unit might have a range of residential units, possibly with
differentiated roles. There will also be a common education service and possibly
programme teams, psychological support and health professionals.

The current round of secure developments being supported by the Scottish
Executive aims to ensure that ‘throughcare’ work is paramount. The new secure
units are located within larger residential schools, thus facilitating the crossover of
young people and of services between open and secure settings in core and cluster
type arrangements.

‘On campus’ services are able to respond rapidly and effectively when a young
person is leaving the secure unit. This statement makes a few important
assumptions however. Firstly, it assumes planning for a young person leaving
secure care needs to take place not just early on in a placement but indeed before
the young person is even placed in the facility. An exit plan must be in place.
Secondly it assumes that the non-secure services are fully geared up to accepting
young people from the secure service. And thirdly, it assumes staff across the entire
organisation are consistently looking for the least restrictive and most effective
placement for the young people in their care.

So what are the possibilities offered by a ‘core and cluster’ approach work with
young people in secure care? In May 2004 staff from a number of secure settings in
Scotland and Ireland met to consider this. Some of the key findings are listed
below.

Advantages of a core and cluster approach
• Works because it is built on stability, consistency, continuity and a
common culture
• Systems theory helps us understand why it works
• Is dependent on accurate assessment
• Can be ‘preventative’ by stopping further disruption/displacement


• Allows and enables the flow and exchange of skills, experience
and practice
• Challenges outmoded ideas of isolated institutions and the
negative features of institutionalization
• Its focus is the individual, not the organization
• Enables a ‘menu’ of services to be developed and improves the
decision making
• Makes planning for alternatives to secure placements easier
• Encourages the development of social networks and resilience
• Some success in thinking outside traditional boxes of social work
and education, for example, health and leisure and recreation
• Works best when there are many more open than secure places.

Developing the model
Here are some features of a core and cluster approach that are already available in
some units or could usefully be developed:
• Parental/family support
• Wraparound home-based support
• Emergency admissions
• Specialised fostering
• Intensive Support and Supervision – residential and non-
residential
• Improved research and evaluation
• Post-custody supervision
• Mental health services
• Diversionary services
• Wider educational services
• Youth training and employment
• Comprehensive aftercare
• Specialist day services
• Respite services
• Young parent services
• Improved wider community access
• Outreach
• Closer working with local authorities
• Outdoor pursuits
• Increased use of specialists
• Specialist residential services.



• What range of services are available on your campus?
• What others can you access?
• How well does the exchange of services and/or expertise happen in your
workplace? What can get in the way of this?

Staff as transition workers
As secure accommodation ought to be an interlude in a young person’s life, it is
important that staff are skilled in supporting young people in their transitions
between different settings and services. Essentially they might be thought of as
‘transition’ or ‘boundary’ workers. This calls for skills in building relationships
between different contexts in a young person’s life.


• How do you support young people in maintaining important relationships and
connections when they move into or on from secure accommodation?

Conclusion
Working in secure accommodation requires that staff understand its place in the
wider child care system and can work effectively across boundaries to support the
range of young people’s needs and to help them move.

Training links
SVQ:
people).

Unit HSC 382 Support individuals to prepare for, adapt to and manage change

HNC in Social Care:
unit).


Further reading
Bullock, R., Little, M. & Millham, S. (1998). Secure treatment outcomes: the care
careers of very difficult adolescents. Aldershot: Ashgate. Charts the care careers of
very difficult adolescents from their point of entry to secure accommodation until two
years after they left and compares their experiences with those of other adolescents
dealt with outwith secure accommodation

Goldson, B. (2002). Vulnerable inside: children in secure and penal settings.
London: The Children's Society. Identifies the lack of structured work in many
secure units.

Harris, R. & Timms, N. (1993). Secure accommodation in child care: between
hospital and prison or thereabouts. London: Routledge. Interesting discussion of the
complexities of work in secure accommodation.

Purkey, W. W. (n.d.). Corollaries of invitational theory. International Alliance for
Invitational Education. Retrieved 12 April 2005:

http://www.invitationaleducation.net/ie/PDFs/Corollaries%20of%20Invitational%20T
heory.pdf

A succinct account of Purkey’s ideas on invitational theory.


Exits and mobility
4.26
Chris Johnson

The programme formulated should be designed for the gradual reintegration of the child into
the community, and should include the range of experiences normally available in an open
setting…
(Code of practice, 4.10)

Introduction
This chapter outlines rationales behind exits and mobility and factors that need to be
considered when operating such programmes. The key points include: legislative
framework, referral behaviour, supervision, and police liaison.

The purpose of exits and mobility
The aim of exits and mobility from secure care should be to reintegrate the young
person into society, ensuring that the young person eventually uses appropriate
internal controls, rather than controls having to be externally applied by those who
are in the supervisory position. Mobility programmes should be rooted within a
young person’s care plan and decisions about mobility should include all relevant
authorities (see paper 4.04).

I have been in here too long. I have not been in the world enough. I don’t know
what it will be like. I need to be in the world more.

(male 16, Goldson, 2002, p. 124)

Mobility is important in order to maintain appropriate family and community links; to
access appropriate constructive leisure and recreational pursuits; to attend relevant
medical and legal services e.g. court appearances, and to access specific
community resources which will assist the young person’s reintegration into the
community. In addition, the supervision of mobility will identify the degree to which
the young person is able to cope with open settings.


Risk assessment
Although risk assessment is dealt with separately (see paper 4.18) it should be
noted that any decision to start a programme of exits and mobility should only
commence after a risk assessment has been completed. Some units may undertake
risk assessments before access to education or particular areas of the building.

Referral behaviour considerations
Some of the factors that will affect the mobility programme and which must be taken
into consideration will be identified from the young person’s referral behaviour. The
young person may have special needs or a learning disability, may be a danger to
themselves or to others, may be at risk from others in the community, or there may
be mental health issues (see paper 4.11). When the young person has committed a
serious offence the issue of public opinion may have to be taken into account. This
is not an exhaustive list and other factors may be identified in individual cases.


• Can you think of other examples of factors that could be added to this list?

Legislative framework
The young person will be placed in secure accommodation via the courts or the
Children’s Hearing system. There are different constraints placed on the mobility of
the young person depending on the legislation used to place the young person. A
young person remanded by the court under Part V section 51 (1) (a) (i) of the
Criminal Procedure (Scotland) Act 1995 cannot start on a mobility programme.
Mobility may only occur for emergency medical or dental treatment, appearances at
a court or Panel, or, if agreed by the court, compassionate leave may be granted,
for instance to attend a parent’s funeral.

Where the young person has been sentenced under Part XI sections 205 or 208 of
the Criminal Procedures (Scotland) Act 1995 the young person may only commence
a mobility programme when agreed by the Parole Division of the Scottish Executive.
Emergency medical treatment can be attended outwith security, but the Parole
Division must be notified immediately.

Young people placed by the Hearing system and those sentenced by the Court
under Part V section 44 of the Criminal Procedures (Scotland) Act 1995 can be
dealt with differently.

The decision to start a mobility programme lies with the secure establishment and
the local authority, having regard for all the circumstances. Should the young
person be placed on a Warrant under Part II section 66 of the Children (Scotland)
Act 1995 then the young person may not commence a mobility programme that


allows them to be unaccompanied at any time. This therefore precludes the secure
establishment and the local authority from granting periods of leave or unescorted
home visits. Guidelines from the Scottish Executive also preclude young people
from travelling abroad whilst subject to any of the above orders.


• Can you identify which young people in your unit cannot leave the unit, which
young people can only do so with the agreement of the parole division, and
which young people can leave with the agreement of the head of establishment
in accordance with the care plan?

Supervision
Careful thought should be given to the arrangement of any mobility programme.
Again risk assessment is important. Factors that need to be taken into consideration
include destination and purpose of the trip, the form of transport to be used, the
number of staff required and their ‘suitability’, for example, in terms of gender,
experience or seniority.

It is not just unit staff who are involved in mobility programmes. Young people may
also leave the unit with parents and other relatives, previous carers, social workers
or workers from other agencies. Those who do not have experience of working in a
secure setting may have less appreciation of the need to maintain an awareness of
issues of proximity and supervision levels. Similar considerations to those above
should also be taken into account in these circumstances.

Any mobility programme should have a sequential build up which leads to the
fulfilment of the programme’s aims. Programmes should usually start with a well
supervised walk around the grounds to allow the young person to orient himself
having usually spent some time with restricted liberty. The young person should not
necessarily immediately visit the parent or carer’s home. Any early recreational trips
should avoid the environs of the young person’s home in order to lessen the
temptation for the young person to abscond. The mobility programme should go
hand in hand with any other programmes of intervention and should work toward
equipping the young person with sufficient internal controls to cope without
supervision.

Mobility should build from being escorted by two or sometimes three people through
to one person and then eventually to escorting the young person to the community
and leaving them alone to be picked up at a pre-arranged time. This can then be
built upon further so that the young person makes their own way and workers collect
them to bring them back relieving the young person of the need to make the
decision to return. When successfully established in this pattern, the young person
may be able to travel to their destination and back independently.



• Draw up a plan of mobility for a young person in your unit and detail the time
scale that it covers.

Rehabilitation vs education
There is a need to balance any mobility programme with the educational needs of
the young person. This can lead to some conflicts for workers whose aim is to
rehabilitate the young person yet recognise that the young person may have missed
much schooling and needs the tuition provided by their education centre. Thought
should be given as to how the mobility programme can be educationally orientated.
Her Majesty’s Inspectors of Schools will expect young people of school age to
spend some 27 or so hours a week in formal education. However, Care Commission
Inspectors may see different priorities for young people whose liberty has been
restricted.

Parent/carer issues
Parents and Carers must be involved with any programme of mobility. There will be
times when rejection has taken place and it is important to recognise that a young
person in this position will be disadvantaged compared with those that have
progressed to having time at home. Thought should be given as to how this
imbalance can be addressed. Parents and carers should be involved in all decisions
made at reviews regarding mobility, and regular contact with them should be
maintained in order to get feedback at the stage where the young person is
spending time in the community alone.

Police liaison
The importance of good links between any establishment providing secure care and
the local police authority cannot be overemphasised. Thought should be given to
having periodic meetings at a local level to ensure that any procedures for dealing
with absconding or dangerous situations are agreed and reviewed.

Missing person notifications
Establishments providing secure care have procedures for notifying the police about
young people who have absconded or failed to return from leave. These procedures
should afford maximum protection to the young person and to the general populace.
The procedures should enable you to pass on ‘soft information’ to the Police who
are responsible for finding missing young people.

The procedures should also include how the escape of a serious offender who may
be a danger should be dealt with. There should also be agreed procedures for
dealing with a mass escape from the unit.



• What are your unit’s procedures for reporting missing persons?

Conclusion
Whilst this paper has offered a fairly brief summary of issues that need to be
addressed when pursuing exit and mobility programmes, it is evident that a well
planned and executed programme is essential to the successful reintegration of a
young person into the community.


• What are your unit’s procedures for reporting missing persons?

Training links
SVQ:
Unit SC8 Contribute to the development, provision and review of care programmes
people).
Unit HSC 36 Contribute to the assessment of children and young people`s needs
and the development of care plans (specific optional unit for the revised SVQ level 3
HNC in Social Care:
unit).

Further reading


Throughcare and aftercare
4.27
Alison Caulfield-Dow

Planning ahead is vital to support successful transitions from secure care.

Introduction
Preparation for the time when a young person will no longer be looked after in
secure accommodation is a significant responsibility for service providers. This
takes time and involves a range of areas that need to be considered and addressed
with the young person before they move on. Key points considered in this paper
include legislation and policy, research findings, assessment and planning, and
support for moving on.

Legislation and policy context
The Children (Scotland) Act 1995 outlines the duties and powers to provide
throughcare and aftercare support for young people who are looked after by local
authorities. Legal duties as the name suggests place an obligation on authorities to
undertake particular actions, powers give them discretion to do so. Section 17 of
the Act states that a local authority must ensure that any child or young person is
adequately prepared for the time when they will no longer be looked after. Section
29 of the Act sets out the duty for providing on-going aftercare, until at least a young
person’s 19th birthday, and the power to continue to provide support until 21 if their
welfare requires it. Section 30 also states that assistance may also be given to
support a young person in education and training until such a course is completed.
In April 2004, new Regulations and Guidance were published by the Scottish
Executive to extend responsibilities for supporting young people leaving care. This
included a new duty to assess a young person’s aftercare needs and to establish
clear plans for aftercare support. Certain 16 and 17-years-olds will also receive
financial assistance from the local authority instead of claiming benefits.

The youth justice national standards (see chapter 1) introduce specific requirements
for throughcare and aftercare in respect of young people in secure accommodation.
Standard 5 states that;
• Every young person will have an aftercare plan covering a period
of at least 3 months following the day of departure from secure
accommodation.
• The young person’s caseworker must discuss the aftercare plan
with the young person at least 21 days before their planned


departure and agree this with the young person at least 5 days
before their date of departure.
• The young person’s caseworker will meet the young person within
1 working day of their release from secure and meet at least
weekly following this.
• The aftercare plan will be reviewed by the young persons
caseworker and the young person after 3 months and regularly
after that whilst the young person is under a supervision
requirement.
• The young person's aftercare plan should include reintroduction
into education or training, as appropriate.

Given the level of throughcare and aftercare policy and practice developments, it is
vital that workers have knowledge of what support a young person is likely to be
entitled to as they are leaving secure care.


• Do you know which young people are eligible for support under sections 17, 29
and 30 of the Children (Scotland) Act 1995?
• Are you aware of all the responsibilities under the Regulations and Guidance
for supporting young people leaving care in Scotland?
• Do you know where to find more information on this?

What does research tell us?
Until recently, most of the research on the outcomes for young people leaving care
was published in England. In 2002, the University of York and the Scottish
Executive published the findings of the first piece of major research on throughcare
and aftercare services in Scotland (Dixon & Stein, 2002a).

Some of the key findings from this research included:
• Most authorities (77%) offered a planned throughcare programme
but less than half (39%) of young people in the survey had
received one. Also, 40% had not had a formal leaving care review;
• The survey provided evidence of significant variation in
throughcare and aftercare arrangements across Scotland. Many
authorities were carrying out developments to extend and improve
services;
• The need to develop stronger links with corporate and external
agencies was evident;
• Almost two thirds of young people in the survey had no standard
grade qualifications and most had experiences of truancy (83%)
and exclusion (71%);


• Almost three quarters of young people left care at 15 (21%) or 16
(51.9%) years of age.
• A third of young people who had been looked after away from
home had experienced four or more placement moves during their
last care episode. Only 7% had remained in the same placement;
• Reliable support, whether formal or informal, was paramount to
positive outcomes in most life areas and the ability to access and
return to services when in need was crucial for young people
finding their way through the challenges of post-care living.


• How does your knowledge of the situation for young people leaving secure
accommodation compare with some of the above research findings?
• Can you give any examples of other leaving care studies that help to illustrate
what young people leaving care can face?

If I hadn’t come in here I could be dead now. I have future ahead of me now. I had
no future when I got in here. I have to think ahead now but before I just worked
from day-to-day. That’s the big difference – I’ve got a future now.

(girl 15, Goldson, 2002, p. 123)

Throughcare preparation and life skills development
Throughcare preparation is a shared responsibility, which works best when key
people involved in a young person’s life can work together to support a young
person, well in advance of any subsequent move from care.

What does it mean in practice?

Ideally, throughcare preparation should cover a range of areas including: life skills
development, planning for the future, seeking suitable information on resources, and
establishing young people’s and carers’ views in order to plan for and support the
young person’s move from secure care.

Throughcare preparation can be challenging when a young person is in secure
accommodation as workers may not be able to facilitate the range of opportunities
that are available to young people living in other forms of residential or foster care.
Imagination and ideas may therefore be needed in order to create an environment
which promotes the development of skills and maturity that is required for more
independent, adult living. Even when certain young people may actually be moving
on to penal institutions, it is still vitally important for them to develop adult living
skills.


If a young person is in secure accommodation, then it may be necessary to ensure
that key information is brought into the secure unit and discussions and focussed
work can still take place.


• When should throughcare preparation begin? Who should be involved and
how?
• Can you identify the wide range of areas that young people need to develop or
know about as they approach more independent, adult living?
• Do you know any practical resources that promote the development of life
skills, particularly using interactive and young-person friendly approaches?

Planning and supporting the transition
Young people can face many transitions and changes as they approach adulthood,
such as leaving school, starting work, leaving home. For young people leaving
care, we know that the transitions that they face are often accelerated and
compressed in comparison to their peers who are not in care. Most young people in
secure accommodation have probably faced more moves and instability in a
relatively short time as compared to many other young people in care.

Planning ahead is vital to support successful transitions from secure
accommodation. Providing ‘stepping stones’ to more independent living can also
mean that young people gain suitable support and develop skills at a pace that they
can manage. Unfortunately, not all young people have access to a range of options
as it can depend on where they are moving to, funding being made available or
suitable referrals being made.

Emotional support for young people in advance of and during the period of transition
is as important as focussing on practical issues and accessing suitable resources. If
a planned move is taking place, young people may regress to immature behaviour
or refuse to co-operate. This may be due to fears of the unknown and having to live
independently after long periods of group care. Throughout the throughcare
process it is important actively to seek young people’s views in order to gauge
where they see themselves.



• Think about some of the young people you have worked with in secure
accommodation. Consider how many moves in and out of care they have
experienced. How do you think this has affected the young person?
• What do you think the impact will be when they move from secure care?
• What has been your experience of ensuring that the local authority fulfils its
duties and provides resources to support a young person’s move from secure
accommodation?
• How does this vary between different parts of Scotland?

Assessment and planning: working in partnership
Local authorities have a duty to assess a young person’s aftercare needs, ensure
throughcare preparation and planning takes place, and regularly review the plans
and the outcomes of a young person’s aftercare support. When this is done
effectively in practice, it requires a significant degree of partnership working as
young people may be accessing support from a range of people.

A Scottish framework for throughcare and aftercare assessment and planning was
produced in 2004. This approach is called ‘Pathways’ and local authorities are
developing practice to ensure that they fulfil their assessment and planning duties.
Increasingly, local authorities are working in partnership with other agencies in order
to carry out a full assessment of a young person’s throughcare and aftercare needs,
which includes seeking the views of the young person and possibly any relevant
carers.

Providers of secure accommodation may therefore be asked to participate in this
process, as the staff working with the young person may be better placed to help
paint a clearer picture of the young person’s needs.


• What kind of assessment and planning processes do you currently participate
in?
• Are young people willing to share their views and thoughts? How can you help
to ensure that they are part of planning for their future?

Leaving secure care: steps to more independent, adult living
Under the Regulations and Guidance for young people leaving care, local
authorities have a duty to ensure that a young person is provided with or supported
in suitable accommodation. The Guidance states that local authorities will want to
make sure that the levels of support they provide meet the needs of each individual.


Some young people will need more support than others and authorities should have
a range of services which address these differences.

Again the availability of suitable accommodation can vary greatly between areas.
Some examples of steps that can promote more of a gradual move to more
independent living can include:
• The young person moves initially from secure accommodation to
an open unit or residential school setting;
• A specialist foster care service or supported lodgings may be
appropriate to re-introduce a young person to a closely supported
family environment;
• Semi-independent group living may then also result in accessing a
‘scatter flat’ where significant outreach support is received, before
a young person moves to their own tenancy.


• Think about some of the different kinds of accommodation that young people
have moved on to. Which types of accommodation seem to work best for
young people?
• Which areas or organisations have developed a range of resources for young
people?

Aftercare: on-going support for young people
For most secure care providers, the provision of aftercare support usually means
linking in with the relevant local authority team or workers. Increasingly, secure care
providers are also developing and providing their own outreach or aftercare workers
for young people who have been in their care. Experience has shown that many
young people prefer to maintain supportive relationships with the people who
supported them whilst in care. The first three to six months after a young person’s
move from care can often be the most vulnerable period, where intensive aftercare
support is often required. When on-going aftercare support is provided at a suitable
level, young people can often experience more stable outcomes in the future.


• Have you had any experience of providing support to young people after they
have left care? What challenges did this present?
• How long do you think aftercare support should continue for? What kind of
aftercare support do young people say they would like?


Reviewing progress and keeping in touch
An important element in providing on-going aftercare is keeping in touch with the
young person and knowing how they are doing. The Pathways framework includes
a requirement to review a young person’s progress after they have left care. This
should be done in a positive way and should recognise a young person’s
achievements, however big or small.

Increasingly, local authorities have to record details of the outcomes for young
people when they are leaving their care. This includes details of where a young
person moves on to, if they have been homeless, and if they are in education,
training or employment.

Some young people may prefer to maintain contact with individuals or organisations
outwith the local authority. Often young people keep informal contact with their
previous carers, which can be supportive or help to encourage a young person to
access support when needed.


• Is it possible or suitable to welcome young people back to where they have
previously stayed? Do young people keep in touch with any staff in your place
of work?
• How could keeping in touch be facilitated appropriately? How could this be
helpful for the young person and the care provider?

Conclusion
It is clear from this paper and the research that a key element in the success of a
young person’s transition from secure care is a well planned and executed transition
programme.

Suggested reading
The summary of the University of York’s Scottish research (Research Findings
No.3, 2002) highlights key areas that should be addressed by service providers. It
also indicates the importance of placement stability, throughcare preparation,
informal support networks and access to education, training & employment
opportunities for young people leaving care

It is clear from this paper and the research described in it that a key element in the
success of a young person’s transition from secure care is a well planned and
executed programme.

The Pathways Handbook (see below) explains the various steps to the assessment
and planning process for young people leaving care. It illustrates how the Pathways
materials can be used and also highlights key areas and step-by-step questions to
consider.


Training links
SVQ:
people).
Unit HSC 382 Support individuals to prepare for, adapt to and manage change

HNC in Social Care:
unit).

Further reading
Dixon, J. & Stein, M. (2002a). Still a bairn? Throughcare and aftercare services in
Scotland: final report to the Scottish Executive. York: University of York Social Work
research and development unit.

Dixon, J & Stein, M. (2002b). A study of throughcare and aftercare services in
Scotland. Edinburgh: Scottish Executive.

Scottish Executive. (2004a). Supporting young people leaving care in Scotland:
regulations and guidance on services for young people ceasing to be looked after by
local authorities: regulations and guidance. Edinburgh: Scottish Executive.

Pathways Materials and Handbook: A framework for throughcare & aftercare
assessment and planning. [Scottish Executive. (2004b). Pathways handbook.
Edinburgh: Scottish Executive.]

Umbrella programme. (2000). Looking to the future with skills for life: a throughcare
preparation pack. Umbrella programme.

www.scottishthroughcare.org.uk
Scottish Throughcare & Aftercare Forum:
A wide range of relevant throughcare & aftercare information, including policy and
practice developments, training opportunities and interactive web-based features
and discussion.

www.nwacf.com
North West After Care Forum:
Information on leaving care services, publications and developments in England.


Glossary

Approved school The term used following the 1937 Children and Young Person’s
Act, which brought together reform and industrial schools.

Child and Adolescent Mental Health Services (CAMHS) Service providing a
specialist and multi-disciplinary diagnostic assessment, treatment,
advisory and consultant service for children and adolescents
suffering psychiatric disorders, or where behaviour, emotional
state or development is causing serious concern to themselves or
those caring from them. (www.careline.org.uk)

Children’s Hearing A lay tribunal of three members, with both male and female
representation, drawn from the local children’s panel. Hearings
consider the full circumstances of a case and make decisions
based on the needs of the child or young person referred to them.

Children’s Hearing System Scotland’s system of juvenile justice, established in
1971 following passage of Social Work Scotland Act (1968), to
address the needs and behaviour of children and young people
who offend and/or are considered to be in need of care and
protection.

Children’s Panel A group of trained lay volunteers from which children’s hearings
are convened.

Children’s Reporter, The The administrative officer who decides on the basis of
reports whether a child may be in need of compulsory measures of
care. If so they call a children’s hearing. The Reporter also
ensures that the hearings system operates within its legal remit.

Children’s Safeguards Review (Kent 1997) Report pertaining to residential child
care which made a number of recommendations for improvements
to children’s safety, and for staff recruitment and training, and
carried out a major literature review.

Clyde Committee, the (1946) A government report into children’s services which
recommended a move towards smaller units based around the
model of the family.

Code of Practice on Secure Accommodation (1984) Guidance on the use of
secure accommodation, drawn up by a group including heads of
establishment and Scottish Office civil servants following the
introduction of the HASSASSAA legislation 1983, which introduced
legal criteria to the use of secure accommodation.

Department of Health (DOH) Government department responsible for health and
social care policy in England.

Secure in the Knowledge - Glossary - May 2005 1

Director of Social Work Local authority official in charge of social work services.
Has statutory responsibility in relation to secure accommodation to
agree with head of establishment that legal criteria are met. Since
reorganisation of local government in 1996, local authorities have
not been required by law to have a director of social work, but
must have a nominated chief social work officer, who has the
same statutory duty in relation to secure accommodation.

European Convention on Human Rights (1950) An assertion of a range of civil
and political rights based on the United Nations Universal
Declaration of Human Rights (1948).

For Scotland’s Children (2001) A policy initiative, which sets an agenda for
education and social work services to work more closely together
to meet children’s needs.

Head of Establishment The head of a secure unit. Has statutory responsibility,
along with the chief social work officer, to agree that legal criteria
for placement in secure accommodation are met.

Her Majesty’s Inspectors of Education (HMIE) Branch of the civil service with
responsibility for inspecting a range of education provision. HMIE
work with the Care Commission jointly to inspect secure
accommodation.

Joint Future A policy initiative, bringing together health and social services.

Kilbrandon Report (1964) Royal commission into youth justice in Scotland.
Proposed a welfare approach with emphasis on needs rather than
deeds. Many of Kilbrandon’s recommendations were incorporated
in the Social Work (Scotland) Act 1968.

List D Schools The name given to approved schools following the passage of the
Social Work (Scotland) Act, for no other reason that that they were
listed D in the Scottish Office’s range of special education
provision.

Office of National Statistics UK department dealing, as the name suggests, with a
whole range of statistical information, some of which is of
relevance to residential child care. The Scottish Executive also
compiles statistics of more specific relevance to secure
accommodation.

Regulations and Guidance When an act of parliament is passed it is
accompanied by legal regulations. These are further developed in
volume(s) of guidance. Guidance pertaining to the Children
(Scotland) Act, for example, is important in guiding practice.

Residential Care Health Project A project which has been encouraging and
developing a multi-agency approach to improving the situation for
one group of children and young people. The RCHP works
collaboratively with social work, health and other support agencies


to address these issues as they affect local authority residential
units for young people in Edinburgh, East Lothian and Midlothian.

Scottish Cabinet Group of Scottish Parliament ministers with particular policy
responsibilities.

Scottish Children’s Reporters Administration (SCRA) The national body
responsible for the administration of the Children’s Hearing
System.

Scottish Commission for the Regulation of Care (the Care Commission) Body
responsible for registering and inspecting all residential child care
units against sets of national standards. Remit covers local
authorities or other agencies.

Scottish Executive’s Intensive Support and Management Service (ISMS)
Scottish Executive initiative to provide intensive interventions to
young people who offend. Funds particular residential and
community projects, including electronic monitoring (tagging).

Scottish Institute for Residential Child Care (SIRCC) A partnership of
educational institutions, a young people’s advocacy organisation
and an international children’s rights organisation. Primarily
funded by the Scottish Executive, it offers specialised, professional
development training, certificate and degree courses, consultancy
services and undertakes a wide range of research projects.

Scottish Office Administrative branch of government in Scotland, prior to
Devolution in 1999.

Scottish Social Services Council (SSSC) Body responsible for the registration of
individual child care workers and the development of professional
codes of practice.

Secure Remedy, A A review of the role, availability and quality of secure
Accommodation for children in Scotland conducted by the Chief
Social Work Inspector in 1996.

Secure Unit A form of residential accommodation for young people who are a
danger to themselves or others in buildings they cannot freely
leave.

Skinner Report, The (Another Kind of Home) (1992) A wide ranging review of
residential child care discussing the purpose and role of residential
child care in Scotland. Proposed eight fundamental principles to
provide a framework within which relevant standards for evaluating
the quality of care could be developed.

Social Work Services Group (SWSG) Government department under the Scottish
Office with responsibility for inspecting and registering secure
accommodation. Became Social Work Services Inspectorate
(SWSI) in 2005.


Social Work Services Inspectorate (SWSI) Scottish Executive department whose
main task is to evaluate the quality of social work services in
Scotland.

United Nations Convention on the Rights of the Child An international treaty
ratified by 192 countries, including the UK. Reflects a global
consensus and has become the most widely accepted human
rights treaty. Broad ranging statement of rights including social,
cultural and economic as well as political and civil.

Youth Justice Strategy Groups A policy initiative, set up in every local Authority,
bringing together social work, housing, the police and the Reporter
to the Children’s Panel amongst others to address issues of youth
crime and disorder.


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Resources on secure
accommodation

The following is a list of relevant books, training packs and other materials on
secure accommodation which are available from SIRCC Library and Information
Service, 76 Southbrae Drive, Glasgow.

Asquith, Stewart (ed). (1996). Children and young people in conflict with the law.
London: Jessica Kingsley.

Blumenthal, G. J. (1985). Developments of secure units in child care. Aldershot:
Gower.

Boswell, Gwyneth. (1996). Young and dangerous: the backgrounds and careers of
Section 53 offenders. Aldershot: Avebury.

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outcomes: the care careers of very difficult adolescents. Aldershot: Ashgate.

Bye, Peter. (n.d. [c. 1981-2]). Securicare: a guide for staff working with children in
secure units. Derby: Derbyshire Social Services & East Midlands Regional Social
Services Departments.

Cavadino, Paul. (1996). Children who kill: an examination of the treatment of
juveniles who kill in different European countries. Winchester: Waterside press.

Central Regional Council Social Work Department. (1993). Children and young
persons' units operational procedures and guidelines. [Stirling]: Central Regional
Council.

Chapman, Tim. (2000). Time to grow: a comprehensive programme for people
working with young offenders and young people at risk. Lyme Regis: Russell House.

Children's Society Advisory Committee on juvenile custody and its alternatives.
(1993). A false sense of security: the case against locking up more children.
London: Children's Society.

Crowley, Anne. (1998). A criminal waste: a study of child offenders eligible for
secure training centres. London: Children's Society.

Dennington, John, & Pitts, John. (1991). Developing services for young people in
crisis. Harlow: Longman.

Eltringham, Tim. (1996). Sixteen and seventeen year old offenders in Scotland: are
their rights adequately protected? Glasgow: Glasgow Caledonian University.

Fry, Ena. (1994). On remand: foster care and the youth justice service. London:
NFCA.

Secure in the Knowledge - Resources - May 2005 1

Gabbidon, Predencia. (1998). Taking liberty: a guide to secure accommodation for
children and young people. London: NCB Enterprises.

Gabbidon, Predencia, & Goldson, Barry. (1997) Securing best practice: an induction
manual for residential staff in secure accommodation. London: NCB.

Goldson, Barry. (1997). A sense of security: curricula for the induction and training
of staff in secure accommodation. London: NCB.

Goldson, Barry. (2002). Vulnerable inside: children in secure and penal settings.
London: The Children's Society.

Goldson, Barry, & Peters, Eleanor. (2000). Tough justice: responding to children in
trouble. London: The Children’s Society.

Harris, Robert, & Timms, Noel. (1993). Secure accommodation in child care:
between hospital and prison or thereabouts? London: Routledge.

Hollin, Clive R. & Howells, Kevin. (1996). Clinical approaches to working with young
offenders. Chichester: John Wiley & Sons.

Howard League for Penal Reform. (2001). Missing the grade: education for children
in prison. London: Howard League for Penal Reform.

Howard League Troubleshooter Project. (1995). Troubleshooter: a project to rescue
15 year olds from prison: report of the first year. London: Howard League for Penal
Reform.

Howard League Troubleshooter project, Wade, Sue, & Hawker, Maurice. (1997).
Lessons for policy and practice on 15 year olds in prison. London: Howard League
for penal reform.

Hoynckh, Theresia, Soisson, Robert, Trede, Wolfgang, & Will, Hans-Dieter. (2002).
Youth care - youth punishment: approaches to juvenile delinquency: a European
perspective. Frankfurt/Main: Internationale Gesellschaft fur erzieherische Hilfen, &
FICE Europe.

Hurley, Norma. (1989). A need to be counted: employment and training
opportunities for 16-18 year old offenders, ex-offenders, and young people at risk.
Edinburgh: Apex Scotland.

Kelly, B. (1992). Children inside: rhetoric and practice in a locked institution.
London: Routledge.

Lipsey, Mark W., Wilson, David B., & Cothern, Lynn. (2000). Effective intervention
for serious juvenile offenders. Washington: US Department of Justice Office of
Juvenile Justice and Delinquency Prevention.

Littlechild, Brian. (2001). Appropriate adults and appropriate adult schemes: service
user, provider and police perspectives. Birmingham: Venture press.


Littlewood, Paul. (1987). Care appropriate to their needs? Summary of a
sociological study of a secure unit for children in Scotland (1982-1986). Edinburgh:
Scottish Office Central Research Unit Papers.

Loeber, Rolf, & Farrington, David P. (1998). Serious and violent juvenile offenders:
risk factors and successful interventions. Thousand Oaks: Sage.

Masham of Ilton, Baroness, & Howard League for Penal Reform. (1997). Lost
inside: the use of prison custody for girls aged under 18. London: Howard League
for Penal Reform.

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