Transcript for
Child-focused approaches to complex problems – part one
Kirsty Lowe (00:00): Acknowledging with families the amazing things they’re doing despite these challenges in their lives, that they’re still fighting for their children, that they still have a hope that their children can have amazing things in their life. It changes the way you see people when you acknowledge that they’re doing their best despite what else is happening around them.
Narrator (00:19): Welcome to the Emerging Minds Podcast.
Dan Moss (00:25): Hi everybody, and welcome to this Emerging Minds Podcast. My name’s Dan Moss. As part of our work in Emerging Minds, we are privileged to engage in partnerships with a range of leaders from research and practice around the mental health of Australia’s infants and children. One such partnership for the last four years has been with Professor Sarah Wendt and the team at the Social Work Innovation Research Living Space, or SWIRLS at Flinders University. Sarah and her team have recently written a paper with Emerging Minds called ‘Child-focused practice competencies: Structural approaches to complex problems. This paper examines intersectional and structural responses to the interconnecting issues of intergenerational disadvantage, parental mental illness, substance use, violence, and trauma. In part one of these two-part podcasts, titled, ‘Child-focused approaches to complex problems’, we speak with Sarah and the team about intergenerational disadvantage and substance use, how these adversities can affect parents, and how they can affect children’s safety and wellbeing.
(01:30): We take a structural lens to child-focused practice, which can help think about children’s needs, while also acknowledging how inequality can affect parents. Throughout this podcast, you’ll be hearing from Professor Sarah Wendt, who is the director of the Social Work Innovation Research Living Space or SWIRLS at Flinders University, Dr Kate Seymour, who is a social worker and criminologist, and currently employed as a senior lecturer in social worker at Flinders Uni, Nicola Trenorden, who is an associate lecturer teaching specialist in social work at Flinders Uni, and Kirsty Lowe, who has over 20 years experience as a clinician of the field in work with infant mental health and is currently an associate lecturer at Flinders University. So to start with, I ask Sarah, as someone who’s been responsible for cultivating curriculum that shapes social worker practise about what skills she wanted social workers and practitioners to be developing in providing child-focused responses.
Professor Sarah Wendt (02:36): It’s important to social workers that we take away some key messages in how we practise and work with children. Firstly, in being child-centred, we want to encourage you to think about walking in children’s shoes, putting children at the centre of our thinking, our actions, and at what we are going to do That might be being present with them in a space, looking at them, interacting with them, but it also might mean being curious and asking questions about their lives with others who surround them in their important environments. That’s the second message we want you to take away, is to be aware of their family context and to ask and engage with their parents and their extended family. And one of the most important questions you can ask in the context of complexity, whether that’s trauma, violence, mental health or substance in alcohol and misuse, is to ask the important question, how does this impact on the child and their safety and wellbeing?
(03:35): Thirdly, as social workers, we also want you to think critically and structurally. So, what do I mean by that? I want to encourage you to think about the environments in which families and children are growing up in. I want you to think about intersectionality in how poverty, race, class, ethnicity, sexuality, and gender might influence an impact on children and family circumstances. We hope that you take away these three messages. Enjoy listening to social workers, talk about their practise, but be child-centred by always focusing on the child, balance that with being interested in the family’s safety and wellbeing and how that impacts on the child. And I want to encourage you think structurally, what is the environment in which children and families are living?
Dan Moss (04:22): One of the challenges in this work that is discussed is the balance between being curious about a parent’s experience of adversity while also ensuring a focus on what the child needs, particularly around safety. I asked Kirsty Lowe about her thoughts on this, particularly when working with parents who have infants.
Kirsty Lowe (04:44): Things that we used to really do was focus on three core areas, and which was what was happening for the infant or the child themselves, what was happening for the parent and around parenting, and then what was in happening between them, so the relationship, and then obviously taking into account the context that they were in as well. And so that would be things like we would, through assessment, have conversations and really explore those different elements. And I guess that was a way of being able to hear parent stories, the sense they were making of their experiences and the impact it was having for them, but also with an eye to the child and what those things then currently meant for the child. Many parents thought that they were alone in feeling a particular thing. For example, the myths around that you just automatically fall in love with your baby.
(05:29): And so by being really upfront and asking about those sorts of things, it gave permission for parents to actually share some of their struggles and to talk about how difficult it was and the things that might have been contributing to that. Sometimes they examined their own relationships and came to different understandings, and sometimes that might even lead to different compassion for themselves or their parents or what they might have experienced as a child. The notion of underutilised capacity, and that we see people and the families that we’re working with as having capacities and strengths. And so we often used to use video, or even just in the moment observing where a parent might say, “I can’t respond to my infant,” but even momentarily, you can catch them actually, with a smile on their face or being sensitive to their infant, and being able to lift that up and show them that there’s probably… They have got more capacity than they think they do.
Dan Moss (06:18): I ask Kirsty about this notion of underutilised capacity and noticing the stories of strength or resilience that parents so often bring to professional engagements.
Kirsty Lowe (06:31): Yeah. I think one thing is really important is the way we see people in the first place. And so as a social worker, the way you see people and understand people and what they’re going through. I mean, most of the families and the mothers that we are working with are there voluntarily. And so even the fact that they’re engaging and willing to have a conversation is an act of resilience and standing up for their children and fighting for what they want. And so really acknowledging that and noticing the things that they’ve done, the attempts that they’ve made to do things differently, really focusing on those, and acknowledging, I guess, that times can be challenging and that things can be uncomfortable and those sorts of things, whether they’re having a go and finding that there is that shared or that they want something different for their children, that they’re really fighting for their children to have the best start in life that they can.
Dan Moss (07:19): I asked Kirsty a little bit more about this openness to parenting capacity, what it might mean for a professional engagement, and what impact this approach might have on the social and emotional wellbeing of infants and children.
Kirsty Lowe (07:33): I think there’s two things that come to mind. One is around, I guess, the notion of hope and acknowledging with families the amazing things they’re doing despite these challenges in their lives, that they’re still fighting for their children, that they still have a hope that their children can have amazing things in their life. And so I guess there’s hope in that sense of, yeah, recognising that despite all of this that’s going on around them, they’re still doing in there and being resilient and doing that. The other thing that comes to mind is it just what offers workers. And I guess if we don’t see and recognise those structural issues, then we can get into blaming families as well and seeing that it’s all about individuals rather than… I think it’s just… Yeah, it changes the way you see people when you acknowledge that they’re doing their best despite what else is happening around them.
(08:19): I think for me, one is examining my own values and what I am really committed to and almost maintaining that eye to the structural helps me be almost a bit resistant to, or maybe resistant to being part of then the system that also then blames people. And so you’re very much wanting that to be part of what informs my work. And then I also have, throughout my career, have found processes like supervision, reflective practice, and not necessarily what’s given to me, but finding people who I can have those conversations with, who will challenge my thinking, will challenge my language, those sorts of things to keeping me on my toes and to keep me examining the way I see people and going about my work a real commitment to children, and that we are there and the work that I was doing because there are children present.
(09:07): And so it’s always the questions. The exploration is always about, yes, understanding the parent’s experience, but then taking it to that next level about what does that mean for the child? What’s the child’s experience? Sometimes it might even mean speaking for the child, if it’s an infant, to lift up that experience for a parent to hear it differently, to wonder about what a parent’s noticed about what might be happening for a child in that instance. Even with a lot of the time, I would be with a parent who may be finding it really hard to regulate their child when they were distressed. And so just even being able to wonder with that parent about what the child might be experiencing in that moment would be a way of lifting up that with the parent. So, I’m always really conscious of how I am with the infant as well, because I don’t want the mom to have the experience, well, you can do this, but I can’t.
(09:56): And so wherever possible, it would be about supporting the mom to respond to the infant and me supporting mom, versus me was necessarily responding directly and meeting the needs of the infant. So, that’s one way of not, I guess not showing parents up, but also then again, coming back to that idea of the underutilised capacity to show them that they can actually do it.
Dan Moss (10:13): I asked Dr Kate Seymour about how newly graduated practitioners or social workers can hang on to this idea of parenting capacity in ways that help maintain a focus on the child while also maintaining a respectful and engaging relationship with parents.
Dr Kate Seymour (10:31): Look, I think my message to social work students is quite simple, and that is probably too simple, but seems like a good place to start, is around just those very basic things around being honest, being open, not seeing people as problems, but seeing them as people with just like your or I, and thinking about even how you or I might cope with that particular situation. So, really trying to strip away some of that stigmatising and focusing on how people might be behaving in front of you. So the harder we can work to get young social workers to connect with the humanity of the people they’re working with and to just interact with them as in all the kind of things that we need from relationships, so being honest, being respectful, being not over promising, just telling people what your role is, what you’re there to do, what you can do and what you can’t do. Just being upfront in itself goes a really long way towards being able to engage with people in a way that’s useful.
(11:40): So, I guess my message to social workers is not to get too caught up in what theory they’re using or what practice model. That’s important, but it’s not as important as just connecting with the people in front of you. Basically, what we have as social workers is that human connection. That’s what we work with. That’s the heart of our practice. Those basic human skills are just absolutely at the core. And also, that kind of ethical stance about a vision of society that’s not built on inequality where there isn’t huge gaps between the richest and the poorest just allows you to see people differently and interact with them differently.
(12:21): And so I would always say to a social worker who’s going on their first placement or graduating, just be honest and open and upfront. And even if you’ve got bad news, or even if your role is one that is quite like a child protection role where everybody in the room knows that you’ve actually got a whole lot of power, that can be removing a child, that you still need to be upfront about that and not try to pretend to be something that you’re not or to not try to cosy up or be friends with people, and then suddenly rip this out of your bag and say, “Oh actually, now you’ve said that, I have to…” So, always being upfront. I think they’re the kind of absolute fundamentals of social work practice that enables you to connect with people, but also enables you to get to sleep at night.
Dan Moss (13:11): I was interested to know a little bit more about the challenges in maintaining curiosity in parenting capacity, particularly where parents were engaging in behaviours that are not always conducive to children’s social and emotional wellbeing or indeed their safety. I asked Nicola Trenorden about her work in connecting with parents who were engaging in harmful substance use.
Nicola Trenorden (13:34): Some of the challenges I think in working in their drug and alcohol space is that you’re often in programmes that are mainly focused just on that. Yeah, when somebody comes to you, they’re not just coming with their drug and alcohol issues. So as a practitioner, we’ve often got that brief and we’ve got the training. We might have motivational interviewing, training and a whole lot of tech techniques around harm reduction and those kind of knowledges, but the person coming to us, if it’s voluntarily, has a bigger story to tell. So in that space, it’s about, I think, being open to that broader story and understanding a lot more about them, being interested in their story and not… I guess it’s also a reframe around why they might be using certain substances or alcohol. Again, if we look at a trauma-informed lens, using alcohol excessively or a range of drugs is often a self-medicating response to much more overwhelming trauma and adversity experiences.
(14:29): If you’ve got that relationship, you’ve made the time, you’ve spent quality time with a parent or parents, then you can have those conversations, and then you can also have some permissioning around, “Hey, we’ve talked about this. Can I have your permission to follow up on that?” And to see when you’re next going to see this person to really start looking at your drug and alcohol use, because you’ve got that relationship to do that. And I’ve found, in my experience, often once you’ve established that and there’s that safe trusting relationship, that they’ll often come back, connecting with you. With some families there’s quite a lot of isolation and loneliness, so the fact you’ve taken the time to build that relationship and connection, they can see some safety in that. That speaks great. It’s gold, and it means that families are often, or parents are quite often to come back, meet with you again.
(15:17): It’s interesting in those conversations, because often you’ll start talking about childhood development and what’s happening a certain time in a child’s age. And where there is complexity and maybe childhood adverse experiences of the parent, it brings up their own experiences of their own childhood. So, it is a conversation that absolutely needs to happen, but there’s a delicacy around the trauma that might come up for the parent as well, but that can also be done very safe. And in that, you can… I talk about kind of containment or hold that parent… And you are almost doing this kind of parallel work with the board of the child, but also with the parent and their own experiences around that. So, I think it’s very important work. It’s complex to a level, but it’s being mindful that when you go there that the parent that you’re working with will have their own stories and need to be held in a respectful space.
Dan Moss (16:07): I asked Kirsty about how she approaches difficult conversations with parents where the exploration of their stories uncovers some safety or wellbeing concerns for the practitioner.
Kirsty Lowe (16:18): There has to be still conversations around safety for the children. And so, especially I guess for younger children and infants, there comes a time where you have to have very explicit conversations about the impact on the child or how they’re managing their drug and alcohol use and still keeping an eye on the child. Whether it’s hungover the next day and they’re not caring for the infant, that needs to be named and discussed. You can’t always scoot around them. Seeing the humanity in everybody and that relationship and that connection and trust you have with the parent that you’ve established is not a conversation you’re going to have right off the bat when you walk through the door. But over time, it’s about if you’ve established trust. It’s about… I mean, I guess I’ve got, over time, better at having the conversations about this is going to be a tricky conversation for us to have, but I feel like we really need to have it, and in being more explicit and trying to be relational and do it in a way that’s about helping them to achieve their goals for what they want for their children.
(17:14): And I think, again, it comes back to how you see people. If you come from a position of people are capable, then you see them and you really are about respect for people, then it’s like well, you add respect for them. I need to have this conversation, add respect for them and their children. We need to at least have a goal at having this conversation and being explicit with them about my concerns. I can’t expect them to address this issue if I’ve not even been up upfront with them about, I’ve got concerns here. When you are with a parent and you’re seeing the impact of their behaviour on a child and that sort of stuff, it can be really hard to maintain that position of compassion and empathy for them, but I guess it’s challenging yourself that I actually can’t benefit the child if I can’t do this.
(17:53): And so I have to keep finding that spot to reconnect with that parent, to understand that they’re struggling too. And I think with both parenting and drug and alcohol use, all of it comes around to their ability to regulate themselves and their emotions. And often, they’re feeling overwhelmed and out of control, and I guess, in some ways, it might not feel necessarily a choice in the way they’re responding and managing in their life. There was a family that I was working with, and they couldn’t see the same concerns around their child’s development as I could. And so it is there position of we are both seeing this really, really differently. And it literally was conversations about, “I know that you don’t see this the same way as I do, but I need to talk to you about what I’m seeing when I interact with your child and what I’m observing.”
(18:35): So, prefacing it with almost like, “I know this is kind of a bit uncomfortable for both of us here, and it is for me as well, but let’s have this conversation anyway,” and then talked about, described what I’d seen in the infant, and I guess introduce maybe information around what I’ve noticed in other children of a similar age, those sorts of things.
Dan Moss (18:52): I ask Kate a little bit to describe the need to be open and upfront with parents where there are issues that need to be discussed regarding child safety or wellbeing.
Dr Kate Seymour (19:03): There sometimes will come a point where, as the person with the eyes on the child, whether or not you’re actually in a child protection role, even if you’re working in AOD services and your client is actually the adult, there nonetheless may come a time where you have to say, “Actually, the way that your substance use is right now, the child cannot be safe.” And so I think it’s also about being really brave around making those calls when you see it’s necessary and feeling like you can’t because of your loyalties to the parent or whatever. So, I think it’s both of those things, being really open and upfront always about what the nature of your involvement is and what your role is. And don’t pretend that it’s anything but what it is. Some of the biggest kerfuffles I got into in practice when I worked with adult offenders was when I was a younger social worker and trying to connect with people and be friendly, and they would just get…
(20:03): There were a number of times where that would get me into a real mess when I’d have to say, “Actually, you’ve crossed a line here.” And they would be like, “Well, where is this coming from?” And so, just being really upfront with that. But also, another example, when I did work in child protection and I had to remove a newborn baby, it was a week old, which is one of the hardest things I ever did. And when I knew I had to do that, I thought, how do I approach this? And I guess as is kind of my nature anyway, but I just thought the only way I can do this is to be absolutely open and to say to this mother, “I’m really sorry, but this is what has to happen.”
Dan Moss (20:43): It was really interesting to hear from Kirsty about how she used in her practise, a relational lens, which helped draw out some concerns that parents may already be having about their child’s wellbeing and how this can mean that conversations become more like a partnership, and co-research can happen rather than the sense that the practitioner is being didactic or just lecturing the parent.
Kirsty Lowe (21:09): That relational focus and building that trust with a mom or with a caregiver and really hearing their story, having compassion for it, understanding what all of it means for them and how they’re making sense out of it. I guess there is also that thinking about what was life like for them before they had this infant? What were their expectations, their hopes, I guess some of their fantasies or dreams about what this was all going to be like? But also normalising that it doesn’t always go smoothly for everybody. And I guess especially with parents with newborns, trying to establish what’s a kind of more normal reaction to childbirth and hormones and all of that sort of stuff versus actually there’s something more going on here that we need to be really concerned about. And I think trying to establish that is really, really important, so that we’re not adding to the stigma or we’re not pathologizing at experiences that are actually pretty normal.
(22:03): We’re probably just not very good at talking about how rough it can be for a lot of parents after they’ve had a baby come into their lives. So for some parents, they’ve survived with struggling with some of the way they’ve been feeling or the impact of their mental illness for a long time and being able to really recognise that they’ve got knowledge about this, they’ve had ways of coping and lifting up that, and then maybe exploring, well, how do you do that now with the presence of a baby in your life? How do we adjust those strategies that you’ve already got in order to make this manageable, now that there’s somebody else to think about as well, rather than imagining that they’re coming with nothing. They know their experience better than anybody and what works for them or doesn’t work for them.
Dan Moss (22:43): So, that concludes episode one in Child Focused Approaches to Complex Problems. In this episode, you heard Sarah, Kate, Kirsty, and Nicola discuss their views on parental adversity and how to use a structural and child-focused lens to develop safe, trusting and open relationships with parents, and relationships where concerns about children’s safety or wellbeing could be brought into focus without stigmatising or unfairly judging parents, conversations where parents could talk about their current adversities, but also the skills resilience and strengths they use to overcome these adversities in ways which help to protect their children, and in ways which ensure that they can plan for their long-term mental health of their children.
(23:33): So in a fortnight’s time, you can listen to the second episode in this two-part series where Sarah and the team will focus on the intersection between violence, trauma, and other disadvantages. They will describe some practise that will help you have conversations with parents who are currently experiencing domestic and family violence, either as victims of that violence or perpetrators, and also about how to have conversations with children, which bring into light their stories in safe and supportive ways. I really look forward to joining you then. Goodbye.
Narrator (24:10): Visit our website at www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health under the National Support for Child or Youth Mental Health Program.