A new approach to improving youth mental public health - the TRIUMPH network

In this blog, Professor Lisa McDaid, Programme Leader of the Social Relationships and Health Improvement programme, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, announces the launch of The Transdisciplinary Research for the Improvement of Youth MentalPublic Health (TRIUMPH) Network.

One in eight children and young people experience mental health problems and the majority of these have onset before their mid-twenties. Yet, 70% of young people have not had the appropriate intervention that they need. Young people face considerable pressures as they grow up; pressures that are driven by the ever-changing environment in which we live. Changes in technology, communications and the media that we are exposed to have coincided with an increasing prevalence of mental health problems, especially among girls – just last week, a new study reported that nearly one in four young women aged 17-19 have experienced mental illness. Yet we have few effective solutions for the improvement of youth mental public health.

Treatment and care, when accessible, treats the problems, not the causes.

The traditional mental health sciences most often focus on understanding and solving mental health problems at the individual level, but many of the drivers of poor mental health sit at the broader social, environmental and cultural level and are affected by the relationships we have, and the settings and communities that we live within.

The TRIUMPH Network

In setting up the TRIUMPH (Transdisciplinary Research for the Improvement of Youth Mental Public Health) Network we believe that there is a different, solution-focused approach. One that seeks to understand young people’s strengths, assets and resiliences, which we can draw on to improve health. Moving from problems to solutions is not easy, but if we do not act, we are in danger of failing a generation of young people. 

To improve youth mental public health, the TRIUMPH Network will bring together young people with academics from across the clinical, social, arts and design sciences in sustained collaboration with practitioners, policy-makers and third sector partners.  To make a difference, and deliver a transformative agenda of engagement and research, we will incorporate two core approaches: co-production and co-design with young people.

Co-production

Young people will be at the centre of the TRIUMPH Network. We as researchers will work with young people to facilitate their ideas, using our knowledge, training, methods and techniques to turn these into reality, into new solutions to improve youth mental public health. We will work together to find new ways to improve mental health and wellbeing, especially among marginalised groups, such as lesbian, gay, bisexual and transgender (LGBT) and care experienced young people, where need is greatest. We will target our efforts at the peer groups, social networks and education settings with strongest influence on young people’s health and behaviours.

Co-design

To understand and identify innovative solutions, while recognising the complexity of youth mental public health, we will take a participatory design approach. This means using different visual methods and creative outputs to support engagement with young people, bringing innovation to our planned activities, making the decision-making process more accessible, and supporting productive dialogue across the Network and beyond. This will include workshops to understand the mental health problems facing young people, identify possible solutions and take forward project ideas, and information exchange and community engagement events to share learning and increase the involvement of those most affected by youth mental ill-health.

Youth mental public health is a big problem and identifying solutions at the population-level needs a bold approach. TRIUMPH’s long-term vision is to improve youth mental public health in the UK; to reduce the proportion of young people that do not receive appropriate intervention. By finding the solutions to prevent and reduce mental health problems, we can benefit young people, as well as their families, friends and the communities they live in.

TRIUMPH will achieve this by focusing where need is greatest, co-producing solutions, and building transdisciplinary research capacity to take forward interventions that are effective, acceptable, and sustainable in the real world.

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The TRIUMPH network is open to anyone with an interest in young people's mental health and wellbeing, including young people, service uses, those with lived experiences, and others directly affected by mental health issues. If you would like to join, please visit: http://triumph.sphsu.gla.ac.uk/contact 

Disclaimer: The views expressed in this blog are those of the author.

The TRIUMPH Network is funded by UKRI. The MRC/CSO Social and Public Health Sciences Unit is funded by the Medical Research Council and the Scottish Government Chief Scientist Office. The views expressed are not necessarily those of the Medical Research Council or the Scottish Government.

This blog was originally published on 1st December 2018 (https://www.gla.ac.uk/researchinstitutes/healthwellbeing/research/mrccsosocialandpublichealthsciencesunit/sharingourevidence/blog/headline_624666_en.html)

Making Scotland an ACE informed nation: continuing the conversation - an event summary

CRFR co-director Dr Emma Davidson summarises the key themes emerging from our recent seminar reflecting on the emergent ACE (Adverse Childhood Experiences) and resilience agenda in Scotland.

We began a conversation on ACEs and resilience in December 2017 at the seminar, ‘The Troubling Concept of Resilience’, where Dr Eric Carlin and myself voiced our concerns that the dominant narrative on resilience could obscure inequalities; penalising individuals by making them responsible for their own wellbeing. Since then, we have witnessed the mounting influence of ACE and resilience-focused policy in Scotland. It is now even more important to provide a space in which popular rhetoric on ACEs and resilience can be constructively and respectfully critiqued.

Our event on 6^th November 2018 aimed to reignite that process. We welcomed three speakers: Dr Amy Chandler, Dr Cara Blaisdell and Laura Wright, each of whom talked from their perspective of their own field of research.

Amy’s presentation (which you can watch here) examined the potentially counter-productive ways ACEs are used in research on suicide and self-harm. Early experiences, Amy noted, are undeniably important in shaping later risks of, or experiences with, suicide and self-harm. However, there is a tendency to rely on a mechanical or ‘addictive’ analysis, with a correlation drawn between early adversity and later problems. The work of explaining what these correlations actually mean, or understanding the mechanisms behind them, are less well developed. Drawing on her own research, Amy highlighted that this focus can mean that interpretation and meaning is omitted – what do adverse experiences mean and feel like to different people, at different times? And how are social and political conditions implicated in this? Also absent, Amy suggested, is the role of agency. The popular narrative of resilience plays into the long standing stigmatisation of mental health problems as being associated with weakness. This way of thinking about resilience implies that those experiencing self-harm and suicide are not resilient.  The reverse can in fact be true, with the practice of self-harm being evidence of extreme resilience in extreme circumstances.

Dr Cara Blaisdell’s work picked up on this critique within an early years setting (read Cara’s new blog here). She highlighted the potential for the ACE agenda in Scotland to reinforce what Tuck (2009) refers to as a ‘damage narrative’. Rather than holding those in power to account, these narratives can reinforce particular ideas about children and society: where the ‘poor’ child is a site of damage to self and society; where professional labels children and seek to ‘fix’ them; and where structures of oppression remain unchallenged and unchanged. Cara’s made the acute observation ‘what you focus on is what grows’. This is not a denial that bad things happen, but rather an acknowledgement that deficit based models can label, provoke normative ideas (of family, of parenting, of childhood). Ultimately deficit models stigmatise, and they leave little room for the complex meaning making emphasised by Amy as being so crucial.

Our final speaker was Laura Wright who raised what is an under-acknowledged issue within ACEs – and that is the role and status of children’s rights. Scotland is, noted Laura, a country recognised as a global leader in children’s meaningful participation. This work is supported by multiple organisations, initiatives (we are now coming to the end of the Year of Youth People) and legislation (i.e. Children and Young People (Scotland_ Act 2014). A tension, nonetheless, remains between participation and protectionism – with the latter superseding the former. The implications of this, argues Laura, requires exploration. At present, children and young people have not been given the opportunity to meaningfully participate in discussions about what is included or excluded from the list of ‘adverse childhood experiences’. Indeed, at an individual level, adults are completing checklists for children and young people, and using this to make decisions about possible interventions. What, asked Laura, does such an approach look like, and how it is given meaning by children and young people? Critically, how can a plan designed to be child-centred, like Getting it Right for Every Child, better engage children and young people in active conversations about their own well-being?

There is – as Laura concluded – no magic bullet. However, the speakers agreed that the way forward is not simply to shift from asking ‘what’s wrong with you’, to ‘what happened to you’. Rather, what is required is a move towards a strengths approach which asks what is right with you, your family, your community and your society. On a practical and pragmatic note, more reflection and time needs to be spent on how complex ideas – such as meaning, context and interpretation – be meaningfully incorporated in institutional structures and practices already under incredible pressure.

We intend to continue these conversations and look forward to seeing you at our forthcoming events. There are four more seminars planned for 2019. Each will consider ACEs and resilience through a different conceptual lens. These are: 

·        ACEs and foetal & infant development

·        ACEs, resilience and gender

·        Resilience in the Majority World

·        ACEs and resilience in Scottish schools

We will be announcing dates for these seminars in the New Year. Please subscribe to the CRFR website for updates on this, and CRFR’s other events and research activities.

Further links

Drs Emma Davidson and Eric Carlin reflect on their CRFR Informal Seminar ‘The Troubling Concept of Resilience’.
Resilience – continuing the conversation

CRFR Associate PhD student Ariane Critchley provides her thoughts on resilience in response to the recent CRFR Seminar ‘The Troubling Concept of Resilience’ given by Eric Carlin and Emma Davidson.
How resilient do we want our children and young people to be?

Dr Caralyn Blaisdell from the University of Strathclyde continues our discussion on the theme of resilience and how this term is being used, with specific reference to early years.  
Resilience in early years – continuing the conversation

ACE Awareness,damage narratives and social justice in early years practice: personal andprofessional reflections

Laura Wright, University of Edinburgh talks about engaging children in the ACE agenda.

ACE Aware Nation: Engaging Children in the Conversation

ACE Awareness, damage narratives and social justice in early years practice: personal and professional reflections

Dr Caralyn Blaisdell from the University of Strathclyde continues our discussion on the theme of resilience and how this term is being used, with specific reference to early years. 

As an experienced practitioner, researcher and lecturer specializing in early childhood education, I have had a mixed reaction to the recent push for being ACE Aware. Discussions about love, kindness and empathy are very welcome and needed. At Strathclyde, our students discuss how their settings are moving away from punitive practices, toward a deeper culture of listening to children and young people and reflecting on relationships of power. There seems to be a real interest in recognising and remedying injustice and changing practices within systems. There has been increasing discussion of children’s rights within ACE Awareness, which is also very welcome and needed in early years.

At the same time, there is a danger that ACE Awareness is reinforcing damage narratives (Tuck 2009) and deficit thinking about young children and families:

•        The (poor) child and family as a site of damage to self and society

•        Labelling—professionals telling people what they are

•        Hero worship--the valiant professional who swoops in to fix the individual

•        Oppressive structures and behaviours remain unchanged 

(Quarrell and Davis 2018)

This vision of the heroic professional is not new or revolutionary in early years—it is just more of the same. Early years education is plagued by deterministic and simplistic views of human development—for example, the belief that the pattern for our lives is set by three years old. This belief easily leads to aggressive diagnosing of difference and labelling of young children. Alternative visions for early childhood education include celebration of difference as a source of strength, anti-bias work, political action, and walking alongside children and families to dream equitable worlds into reality (RECE, 2014).

In the CRFR seminar, we heard from audience members who felt curiosity, hesitance, inspiration and anger about ACE Awareness. Calls to dismiss or even condemn those who aren’t sure about ACE Awareness, or to accuse people of not caring about children or even doing more harm to children by questioning ACEs, are profoundly unhelpful and disheartening. In early years, ACE Awareness could potentially help challenge oppressive practices, recognise children and families’ own voices about their lives, disrupt power dynamics in institutional settings, and inform political education and action. However, ACE Awareness also has the potential to reinforce damage-based thinking, paternalistic practices and professional ego. If we choose to accept ACE Awareness, we must see it as only one facet of the intellectual and moral challenges of early childhood work. We must insist on continuing to ask uncomfortable questions about who benefits from this awareness.

To view her presentation from seminar on 6 November 2018, click the link below
http://www.crfr.ac.uk/assets/Ace-Aware_Cara-Blaisdell-1.pdf

Children’s Participation in Decision-Making: Questioning Competence and Competencies

Carine Le Borgne asks if we need to be more challenging in recognising children’s competence to contribute to decision-making.

Children’s participation rights remain highly dependent on adults, who in one way or another, hold powerful positions such as legal guardians, administrative or political decision-makers, or front-line professionals. The attitudes of such adults towards children and childhood strongly influence whether or not the adults recognise, facilitate and support children’s participation. One of the most persistent adult concerns is whether children are competent enough to participate in decision-making. Thus, power - and particularly the power of adults - is key to children’s practical achievement of competency.

My research on children’s participation[1] at the community level highlights the challenge of adults’ perceptions of children’s competence and competencies. The research focused on why children are often seen as ‘incompetent’ and how that translates into a lack of participation. Based on the findings, in collaboration with Professor Kay Tisdall, I wrote an article on Children’s Participation: Questioning Competence and Competencies.[2]

Our article recalls the memorable phrase coined by Hinton[3] - ‘the competence bias’. This phrase captures how the use (and misuse) of a child development paradigm leads to perceiving children as starting from a position of limited competence and emphasising their evolving capacities. The ‘competence bias’ then is applied to exclude children from participation. Children’s exclusion is furthered when competence is presumed to be individualised and intrinsic, rather than recognising competency as contextual and relational.

Through my research, we trace evidence from local participation projects, of the continuing power of the competence bias. We consider how staff members can validate and enhance children’s competence and competencies, and thus recognise children’s participation rights. The analysis identifies that perceptions of children’s competence were both facilitators and inhibitors of children’s participation. The research was undertaken in Tamil Nadu (South India) and Scotland (UK), with two non-governmental organisations (NGO) supporting children’s participation.

The research highlights the key role of NGO staff members in contributing to children’s social competence. The NGO activities in this research increased children’s knowledge, which they not only used in their communities but were able to transfer to school and family contexts. The NGO staff members were key to providing the link between children and adult decision-makers in their communities, though this was done less successfully in Scotland than in Tamil Nadu.

The findings also indicate that, without NGO support, children were limited in expressing their social competence. This leads to two conclusions. First, strengthening the role of the staff members in children’s participation is worthwhile because they can play key roles in developing and validating children’s competence and enhancing children’s competencies. Staff members’ own perceptions of children’s competences and competencies influence how well they support children and children’s influence on decision-making.

Second, the competence bias remains pernicious and often unhelpful to children’s participation. The bias can mean that participation workers, as key intermediaries, may be necessary to facilitate children’s participation rights. It may also mean that children’s competencies are under-recognised, as children only achieve participation through ‘borrowing’ NGO power and not power or influence in their own right.

All this leads us to conclude - do we need to be more challenging yet in recognising children’s competence to contribute to decision-making?

Carine Le Borgne was an affiliated PhD Student with the Centre for Research on Families and Relationships (CRFR) and is now Senior Policy Adviser at World Vision UK. Kay Tisdall is Programme of the MSc in Childhood Studies[4] at The University of Edinburgh and Co-Director of CRFR.


References

1 https://www.era.lib.ed.ac.uk/bitstream/handle/1842/21025/CRFR%20Briefing%2087.pdf?sequence=1&isAllowed=y

2 https://www.cogitatiopress.com/socialinclusion/article/view/986

3 http://booksandjournals.brillonline.com/content/journals/10.1163/157181808x311141

4 http://www.sps.ed.ac.uk/gradschool/prospective/taught_masters/a_g/msc_childhood_studies

 

Children's rights and wellbeing

Kay Tisdall, CRFR co-director

How do children’s rights and children’s wellbeing fit together? I became concerned about this in 2012. The Government proposed new legislation, in Scotland, promising ‘to make rights real’ for children. And the Government said it would legislate for ‘Getting it Right for Every Child’ (GIRFEC), so that the initiative was fully implemented across Scotland. GIRFEC seeks to improve how professionals and agencies work together, encouraging prevention and early intervention with children and their families. GIRFEC is outcomes-based, organised around 8 children’s wellbeing indicators. With both children’s rights and children’s wellbeing placed in the same legislation, an intellectual interest – how do the two concepts fit together? – became a practical policy concern.

Over the next 3 years, I have worked with colleagues, the Common Weal, and then colleagues in Europe and North America, to work out how the concepts are similar and different. If there are differences, do the differences matter? After all, children’s rights can fit into children’s wellbeing; children’s wellbeing can fit into children’s rights.

In the article just published in the Journal of Social Policy, I suggest that the time is past for casually pairing children’s rights and children’s wellbeing. Children’s rights and children’s wellbeing are distinct concepts, each with their own historical, philosophical and practical strengths and weaknesses. Children’s wellbeing benefits from being aspirational and maximising. It can easily incorporate children’s relationships and collective needs. Researchers have developed advanced quantitative methods of measurement, attractive for outcomes-based indicators. But children’s wellbeing risks being apolitical, utilitarian and professionally-led in both measurement and practice. Children’s rights, in contrast, emphasise minimum standards, do not easily include such important matters for children like love and friendship, and has had limited investment in quantitative measures to date. Children’s rights can be accused of over-emphasising individual autonomy and thus antithetical to more collective cultures around the world. Yet, children’s rights are powerful politically, backed by law and hold duty-bearers to account.

Melton claimed in 2014 that ‘the most fundament need in child policy is for due respect towards children as people’. Children’s rights require and underline such respect for children. It is possible for children’s wellbeing to include children’s rights. But this is not essential to how children’s wellbeing is conceptualised, measured or implemented. I thus favour children’s rights, at least for Scotland, where we still have so much to argue for: from children’s access to justice, to unacceptably high and increasing levels of child poverty, to urban estates replete with ‘no ball games’ signs on unused grass.

With children’s wellbeing on the national and international ascendance, a decision needs to be made about whether wellbeing or human rights best frame policy and practice. In Scotland – if only to rationalise dual planning tracks and other confusing policy requirements – we certainly need to do so.

Tisdall, E. K.M. (2015) 'Children’s Rights and Children’s Wellbeing: Equivalent Policy Concepts?' Journal of Social Policy, vol 44, no. 4, pp. 807-823., 10.1017/S0047279415000306

Melton, G. (2014) ‘ ‘Because it’s the right (or wrong) thing to do’: when children’s wellbeing is the wrong outcome’, in Ben-Arieh, A., Casas, F., Frones, I. and Korbin, J. (eds) Handbook of Child Well-Being, Dordrecht: Springer.

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Do you want to develop your skills in research and consultation with children and young people? Take a look at our Continuing Professional Development courses, delivered by Dr Susan Elsley and Professor Kay Tisdall:

10-11th March 2016: Involving children and young people in research and consultation
28-29th April 2016: Using creative methods in research with children and young people

All over now? Children's contact when there is domestic abuse

CRFR Research Fellow Fiona Morrison reflects on the findings of her recently published work examining children and mothers' perspectives of contact with fathers following parental separation in the context of domestic abuse.

People used to think domestic abuse was something that only affected adults. However a body of research[i] has shown that simply isn’t the case. Children overhear, witness, intervene and deal with the consequences of domestic abuse. A child may call the police following an assault. They may physically intervene to stop an attack. They may become homeless because of domestic abuse.  Through research, children have provided their own unique accounts of domestic abuse that have expanded our understanding of how domestic abuse affects children.

People often think that domestic abuse stops when couples separate. Unfortunately that’s not always the case either. Domestic abuse may continue following separation. Research[ii] has in fact found the presence of children to be a ‘risk factor’ for continued abuse following separation.

This raises difficult questions about post-separation contact between children and their fathers when there is domestic abuse. Post-separation relationships between children and parents are important. But what about the risks that contact may pose?

My PhD examined children and mothers’ perspectives of contact with fathers following parental separation in the context of domestic abuse. I interviewed children and their mothers about their experience of separation, making decisions about contact and children having or not having contact with their fathers. I have recently published some of the findings from my research. These confirm findings from other research – the ending of a relationship does not necessarily translate into the ending of abuse and contact often becomes a focus for the continued abuse of children and mothers.

My findings also elaborate on how parental relations continue to influence children’s contact with their fathers.  Far from being ‘all over now’, I found the relational consequences of domestic abuse to continue following separation through children’s contact. An absence of direct communication between parents created a vacuum that children often had to fill. This in turn rendered children exposed and vulnerable to continued abuse and parental conflict.  This was evident through fathers’ hostility towards mothers during contact, problems connected to parents’ re-partnering and conflict about legal proceedings and finances, all of which played out through children’s contact.

This raises further questions about how contact when there is domestic abuse should be considered. How can contact be safe? How can children be supported in this context? How do we ensure mothers are not undermined as a consequence of contact? How can fathers be supported in their relationships with their children while also accountable for their behaviour?

Contact is an important issue following separation and my research shows that in the context of domestic abuse we must be mindful of the risks that contact may pose as well as how parental relations affect the contact that children have.

You can read more about my research and other articles on Domestic Abuse and Safeguarding Children in a Special Issue of ChildAbuse Review.

If you have any concerns about domestic abuse or child contact you can get help from the following places:

ClanChildLaw provide free legal advice and representation to children across Scotland.

Childline provide confidential support to children.

ScottishWomen’s Aid provide information and support to women and children affected by domestic abuse across Scotland.

[i] Stanley N. 2011. Children Experiencing Domestic Violence: A Research Review. Research in Practice: Dartington.

[ii] Brownridge DA. 2006. Violence against women post-separation. Aggression and Violent Behavior 11(5): 514–530.

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Do you want to develop your skills in research and consultation with children and young people? Take a look at our Continuing Professional Development courses, delivered by Dr Susan Elsley and Professor Kay Tisdall:

10-11th March 2016: Involving children and young people in research and consultation
28-29th April 2016: Using creative methods in research with children and young people

What does transformative participation mean for children and young people?

CRFR Co-Director, Kay Tisdall has recently co-edited a book on the theme of children's participation in public action. As Scottish 16 and 17 year olds prepare to vote in tomorrow's referendum vote, this blog sets outs the key questions the book seeks to address:

Children and young people’s participation in decision-making is increasingly promoted in countries across the world and internationally. Yet such participation continues to face remarkably similar challenges across contexts and countries: challenges such as tokenistic involvement, lack of impact, short-term and unsustainable activities, and concerns about who is included and excluded in such activities. How can we move beyond these?

Through the Leverhulme Trust’s International Academic Network, we had the chance to learn from children and young people, practitioners and academics in Brazil, India, South Africa and the UK. We became intrigued by the phrase ‘transformative participation’ and whether such participation could transcend the common list of challenges. But what was ‘transformative participation’ and for whom was it transformative? What is it transformative of and transformative to? How would one know participation was transformative?

We have just published an edited book that seeks to address such questions. Titled Children and Young People’s Participation and Its Transformative Potential, the book wrestles with conceptual debates and has overview analytical chapters for each of the 4 countries with an accompanying case study. We found the writing together challenging and inspiring – and not always consensual – as we sought to bring together different academic, theoretical and disciplinary backgrounds.

World-wide attention is now focused on Scotland, as we go towards the referendum on Thursday. With 16 and 17 year olds voting for the first time at this national level here, the publication date of the book is timely. How do we ensure that children and young people’s participation is meaningful, effective – and sustainable?

Can babies be homeless?

Wendy Bunston from La Troube University in Australia kindly presented a seminar based on her PhD research during a recent visit to CRFR. Using infant observation and interviews with mothers and staff, Wendy is exploring what happens to the baby when they first enter refuge after fleeing family violence.

If it’s hard for us to think of how violent it must be for a woman to flee her home, how much harder is it to think about what a baby goes through? Perhaps that’s why we don’t. Most would prefer not to know that babies feel terror, fear, sadness and despair. Very few people would stop to consider what happens to, or for, babies who go into refuge (Bunston, 2011). My work in this area has led me to explore what happens to the infant made homeless by family violence and accompanying their mothers into refuge (Domestic Violence Resource Centre Victoria, 2012; Glennen, 2011). The reason women typically go into crisis accommodation services is to escape family violence. A large proportion of these women are mothers, most often with children under five. Infants are rapidly developing, and what happens in these early years can have an impact for life. Early, repeated trauma caused by family violence, can lead to future mental health, language, learning, behavioural and relationship difficulties. Getting in early, can absolutely make a difference to infants who, either in utero, or after birth, have been exposed to violence (Bunston, 2006; Bunston, 2013). My PhD research is interested in what happens to the baby who with their mother comes in refuge. Are babies thought about as their own person, who have their own feeling states and reactions? What do infants make of these new sights, smells, noises and people? Do they miss their fathers, do they miss what they knew of as home? Do they feel that something is different for their mother and does that difference feel good, sad, or maybe confusing? So far, I’ve met babies in refuges across three countries, and I hope to find out.

Bunston W (2006) The Peek a Boo Club: group work for infants and mothers affected by family violence. The Signal: newsletter of the World Association for Infant Mental Health 14(1):1-7.

Bunston, W (2011) Let's Start at the Very Beginning: The Sound of Infants, Mental Health, Homelessness and You [online]. Parity 24(2):37-39.

Bunston W (2013) What about the fathers? Bringing ‘Dads on Board™’ with their infants and toddlers following violence. Journal of Family Studies 19(1):70-79. doi: 10.5172/jfs.2013.19.1.70.

Domestic Violence Resource Centre Victoria (2012) Resources for workers supporting children. Website. http://dvrcv.org.au/help-advice/service-providers/practitioners-working-children.

Glennen K (2011) The Homeless Infant [online]. Parity 24(2): 35-36.

Keeping Mothers in Mind: Trauma informed approaches to supporting mothers who have experienced violence and their young children

Angelique Jenney, Director of Family Violence Services at the Child Development Institute in Toronto, Canada is visiting CRFR in August as part of our ongoing collaborative work on gender-based violence. Angelique has kindly agreed to give an informal seminar while she is here. In this blog Angelique introduces us to her work on the impact of domestic violence on mothers and young children and provides an insight to what she will be covering in her seminar.

Identifying and responding to the mental health needs of young children who are exposed to domestic violence/maternal trauma is one of the most pressing issues confronting child welfare, child mental health, and social service sectors today. It is a common misconception that infants and young children are not affected by these experiences and their environment because they lack the ability to communicate distress or understanding with language. Yet, young children are disproportionately exposed to violence against their mothers simply because of their dependence and proximity to their mothers in these early years.

The evidence tells us that children living with domestic violence are at increased risk of experiencing emotional, physical and sexual abuse, of developing emotional and behavioural problems, and of increased exposure to other adversities. In particular concerns about emotional regulation, exposure to developmentally damaging toxic stress and the experience of witnessing harm to their caregiver are particularly high for such young children. A more detailed examination of these risks can be read here in The impact of domestic violence on infants and young people (IMHP 2012).

The evidence also tells us that, the most protective factor is the availability of a safe and responsive caregiver. Women’s experiences of domestic violence, often combined with a personal trauma history such as childhood physical or sexual abuse, impact all facets of women’s lives including their ability to parent. Being able to respond to mothers who are parenting children in the midst of violence is a particularly important area, given how violence affects children’s emotional health and well-being, the mother-child relationship, and future attachment relationships for children. But how are professionals to assess this impact and to find ways to work empathically and cooperatively with both mother and child to intervene in the best way possible?

Based on these concerns, Child Development Institute (www.childdevelop.ca), a multi-service organization in Toronto providing early intervention services for children under the age of 12 and their families, has developed The Mothers in Mind (MIM) program: a 12-week intervention program designed to meet the service needs of women with a domestic violence/trauma history who are parenting children under the age of 4. Group work has been shown to decrease isolation and reduce secrecy and shame that often accompanies experiences of abuse; however, in order to make positive shifts in the mother-child relationship impacted by trauma, specific support and attention must be given to the relationship.

Mothers in Mind™ is an innovative, relationship-based therapeutic mother-child program designed specifically to meet the parenting needs of mothers who have experienced violence and trauma and have very young children. The focus of the program is to intervene early in the lives of young children and their mothers in order to strengthen parent-child relationships, enhance parenting skills and reduce parenting stress. More information and tips for parents and practitioners can be found on the Mothers in Mind™ website.

This seminar will illustrate the importance of understanding the effects of domestic violence exposure on young children (under 4 years), consider risk factors and outline signs and symptoms for assessment of impact and implications for interventions in practice. The unique parenting issues facing mothers who have experienced violence and trauma will also be addressed, highlighting the need for specific trauma-informed parenting support.

Angelique Jenney, PhD
Director of Family Violence Services, Child Development Institute
Assistant Professor (Status Only), Factor-Inwentash Faculty of Social Work, University of Toronto

Book now:
Angelique's seminar, Keeping Mothers in Mind will be held on Thursday 28 August 2014, 12.30pm-1.30pm at CRFR in Edinburgh. The seminar is free but places are limited so please email Brenda.saetta@ed.ac.uk or call 0131 651 1832 to book your place.

Children, young people and the everyday

This month, Emma Davidson, Fiona Morrison (both CRFR) and Lisa Whittaker (Glasgow University) were lucky enough to present their research findings at the Centre for the Study of Childhood and Youth International Conference. The conference explored the concept of the ‘everyday’, and its role in helping researchers gain insight into children and young people’s social worlds. In this blog, we share our perspectives on everyday life and agency.

How an individual behaves, feels and relates to the people and spaces around them often consists of social practices considered mundane, routine and even unimportant – like walking to school, washing the dishes, watching TV or playing outdoors. These seemingly ‘ordinary’ activities can tell us much about children’s social worlds, and more importantly, the wider structural context within which these worlds sit.

At the conference we presented three unique papers, connected by two central themes. The first was an appreciation that the everyday is not simply a site where individuals are socialised and social practices reproduced. Rather, the everyday, as Beverley Skeggs has discussed, can be a space were norms and values are interpreted, navigated and potentially challenged. By acknowledging the role of agency, the everyday is a space in which children and young people can shape and make the social worlds around them.

The second theme around which our papers fell relates to the type of behaviour and actions the ‘everyday’ seeks to describe. Typically, the everyday has been conceptualised as that which is mundane or otherwise unimportant. What then of the everyday experiences of children and young people whose lives are characterised by issues far from mundane – such as violence, neglect and abuse?

Emma’s research into young men and violence found that in disadvantaged areas some young men not only normalised violence, but actively sought out a deviant identity as a means of escaping the structural inequalities they faced. Lisa and Emma’s project meanwhile spoke of the experiences of growing up in care, and the difficult transitions young people made into adulthood. Despite support, many of these young people’s pathways were beset by chaos and disorder, so much so it had become a predictable and expected part of everyday life. Finally, Fiona’s research explored children’s perspectives of contact with non-resident fathers when there is domestic abuse. She focused on how children spoke about their experiences of domestic abuse, how they made sense of abuse and how they navigated and responded to abuse in their everyday lives.

The finding that cut across the three papers was that while disorder and risk was not a welcome aspect of children and young people’s everyday lives, it became an all-consuming presence which was then reconstructed as normal, routine and ordinary. This response, the papers conclude, was a means through which they could give order and stability to aspects of their lives that were anything but. The papers all highlighted how children and young people continue to exercise agency and resist, even when their everyday lives are characterised by ‘disorder’ and ‘risk’. These emancipatory possibilities, however small, gave young people agency in circumstances over which they had very little control.

Contact Emma by email.

The impact of independence on the future of Scotland's children

 Last night, we were discussing ‘The Impact of independence on the future of Scotland’s children’, at the University of Dundee as part of the Five Million Questions platform. Organised by Lorraine van Blerk and colleagues, the panel involved Aileen Campbell Minister for Children and Young People and MSP, Kezia Dugdale MSP, John McKendrick (Glasgow Caledonian University) and Kay Tisdall (Co-Director of CRFR, University of Edinburgh). In this blog, Kay shares key points and questions that arose from the discussion. 

The biggest topic of the evening was child poverty and income inequality. With statistics showing that 20% of children in Scotland still living in poverty, and modelling forecasts showing a further 100,000 children will be pushed into poverty by 2020, the politicians debated about devolved and reserved powers, taxes and the potential impact (or not) of independence. But all could easily agree – as the audience applauded – that public will to address inequality was required: there is a lot of talking about addressing inequality and poverty in Scotland, in these times of discussing independence, but are we serious about redistribution?

Other questions from the audience ranged from: should cash benefits be replaced by vouchers? (no – stigmatising); will there be more money for schooling in an independent Scotland? (can we say for sure? But ongoing investment in prevention and beyond was essential); and what the ‘dream’ is for Scotland? As John McKendrick pointed out, the opportunity for 16 and 17 year olds to vote in September may open up even further possibilities to engage children and young people seriously.

Whatever the decision on the September referendum, these discussion are a refreshing and much needed opportunity to ‘think big’ and have participative, productive debates for the possibilities for Scotland. It allows us to realise what we can do under the existing devolved powers – and perhaps even more under ‘devo-max’ – as well as what an independent Scotland might do to further children’s human rights. Whatever decision, my suggestion is to keep that vision going and turn some of the best ideas into reality – can we truly make ‘Scotland the best place in the world to grow up in’?

Intersecting childhood identities, inequalities and social justice

Issues of identity and social justice have come to the fore of political, theoretical and practical discussions. Children and young people are at the heart of this debate, confronting researchers, practitioners and policy makers with challenges of how to address social inequalities and promote social justice for present and future generations. Marlies Kustatscher, co-organiser of the 'Children's rights, social justice and social identities in Scotland' seminar series updates us on the upcoming third seminar. 

Children and young people’s identities and inequalities are complex. A growing field of interdisciplinary research in the UK and beyond recognises that categories such as ethnicity, race, gender, social class, disability, sexuality and age intersect in intricate ways, shaping children’s social identities and impacting on their everyday life experiences.

The way in which such interlinking identities generate particular inequalities has been framed in theory and research through the concept of ‘intersectionality’. Intersectional perspectives recognise the diversity of different groups and examine how certain groups are silenced from and marginalised by dominant political debates. This seminar series is providing us with an opportunity to better understand what the concept of intersectionality means for those working with children or those who shape child-related policy.

In the first two seminars we have addressed how intersectionality can help us to understand overlapping childhood identities, and how it can be put into practice by practitioners and policy makers. We have explored intersectionality from children and young people's perspectives and looked at how we can promote their participation in identifying, understanding and addressing these issues.

The third seminar takes place in Glasgow on 23 June to look specifically at the challenges of methods and research. We are interested in exploring:

• how research can help us to understand complex childhood identities and inequalities,
• what approaches are needed to enable academic work to contribute to processes that promote social justice and equality,
• what methods we should use to ensure that children's views, particularly from marginalised groups, are not silenced.

The seminar will include keynote presentations by Professor Floya Anthias, a leading expert in the field of intersectionality in the UK and worldwide, and Professor Peter Hopkins, who will talk about his extensive experience of doing research with young people. In the afternoon, delegates will be able to choose from a series of workshops on how to do intersectional research with children and young people in practice. The full programme is available on our website.

There are still a few final places available. Please be quick as registration closes on 6 June. The seminar is free to attend and is being held at Scottish Universities Insight Institute in Glasgow.

 

The seminar series is funded under the Scottish Universities Insight Institute 2013-14 programme.

Making children's rights real

Today, marks the launch of ‘Social Justice, The Common Weal and Children and Young People in Scotland’, with the Jimmy Reid Foundation. Authors John Davis, Louise Hill, Kay Tisdall , Liam Cairns and Selwyn McCausland consider how to make Scotland the best place to grow up in.

The themes of the paper arose out of our consideration of the recent legislation passed through the Scottish Parliament – The Children and Young People(Scotland) Act 2014. The rhetoric around the Bill was so promising, for those of us who support children’s rights and committed to improving children and young people’s lives in Scotland: the legislation was ‘landmark’ law, that would help ‘make rights real’ and make Scotland ‘the best place in the world to grow up’. But is the legisalation and accompanying policy radical enough to deliver on the promise?

We think we need to go further. It is welcome to have Scottish Ministers keeping ‘under consideration’ whether they can take further steps ‘to effect’ the UN Convention on the Rights of the Child – but why not incorporate children’s rights more systematically and directly? Public authorities will be reporting on what they are doing in relation to children’s rights – but they can report ‘nothing’ and pretty well meet the legal requirements. The duties in relation to children’s wellbeing are much stronger: plans for children’s services must be directed towards children’s well being; plans must be reviewed and should be implemented. For children’s wellbeing, public authorities cannot just report ‘nothing’ and meet their legal requirements.

A children’s rights approach marries a focus on children’s human dignity, recognition of their contributions now as well as in the future, as part of the broader society of human rights. Children’s rights set minimum thresholds and claims on all of us. For example, rights recognise that children can be discriminated against, simply in relation to their age. Why do we still have signs in our shops stating ‘no more than 2 children allowed in at any time’? Can you imagine that being acceptable under any other category, from cultural background to gender? But yet we accept that for children, solely on the basis of their age. Why do we allow the staggering amount of child poverty in our society, if we were serious about children’s wellbeing (1:5 children live in poverty, in Scotland – McKendrick et al. 2014)? Children’s wellbeing is aspirational and holistic – both aspects which are welcome. But you could maximise children’s wellbeing and ignore their human dignity, a typical utilitarian response of the ‘greatest happiness for the greatest number’. Rights are an important counterpart.

Social justice may well be able to reconcile these tensions – and bring together the advantages of both rights and wellbeing. Social justice is about entitlements, redistribution, recognition and respect. The Scottish idea of the Common Weal – equality, mutual work and wealth shared in common – fits well with these components of social justice. And we ask, in the report: Where are children and young people in this? What are their roles in defining, debating, delivering and expanding the idea of the Common Weal into reality? From our childhood studies and children’s rights perspectives, we suggest that they and their families are key to change and ensuring that all the current aspirational talk is actually translated into radical change. Let’s recognise children’s human dignity now and not just in the future. Let’s make ‘rights real’. Let’s make Scotland the best country to grow up in.

We suggest that, whatever one’s stance on the forthcoming independence referendum, it provides an opportunity to think what kind of Scotland we want.

The report can be found at: http://reidfoundation.org/portfolio/2295/

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Do you want to develop your skills in research and consultation with children and young people? Take a look at our Continuing Professional Development courses, delivered by Dr Susan Elsley and Professor Kay Tisdall:

10-11th March 2016: Involving children and young people in research and consultation
28-29th April 2016: Using creative methods in research with children and young people