Six ways to support child-focused practice in adult services

‘Children’s wellbeing as everyone’s business’ is a common mantra in health and social services. Most practitioners in adult-focused services recognise the need to identify the effects of adult adversity on children, particularly where there are immediate threats to health and safety. Despite this, many adult practitioners are challenged to ask questions about children because of time, priorities and confidence (Emerging Minds Needs Assessment, 2017). If children’s safety and care is truly to become everyone’s business, organisational mechanisms which plan, monitor and evaluate the effectiveness of child-focused practice are essential. Without these processes, services may continue to leave child-aware practice to chance.

This paper provides examples of the system used in adult-focused organisations to plan, monitor and evaluate child-focused practice.

The opportunity to provide key messages to potential staff begins at recruitment. Position descriptions, job advertisements and interviews can create the expectation that staff will develop skills for assessing children’s wellbeing while working with adults.

This doesn’t necessarily mean that the successful applicant will already have highly developed child-aware skills. An organisational commitment to supervision and reflective practice should also be part of the position description. This tells applicants that the organisation will help them to develop these skills, and that systems will be put in place to track this development.

Job advertisement example:

Our organisation is committed to the social and emotional wellbeing of children. As part of this commitment we support all staff to demonstrate child-focused and parent-sensitive practice. This includes being curious about parents’ relationships with their children and identifying children’s social and emotional wellbeing needs in assessments and case management plans. We support this practice through reflective supervision and professional development practices.

Frontline Staff

Position description example:

Major challenges associated with the role include:

• developing skills and confidence in child-focused practice by asking all adult clients whether they have children, and what the strengths and vulnerabilities in their relationships with their children are.

Successful applicants must have:

• experience in the provision of child-focused and parent-sensitive practice or the willingness to develop these skills
• experience in and a commitment to supervision and reflective practice
• knowledge of children’s mental health and wellbeing, and the impact of trauma.

Supervisor/Manager:

Position description example:

Major challenges associated with the role include:

• developing capability and confidence in staff to ensure child-focused practice is embedded throughout the organisation
• implementing and monitoring service data that shows child-aware practice within the service.

Successful applicants must have:

• experience of child-focused and parent-sensitive practice and how this is implemented through policy, supervision and practice
• experience in providing reflective supervision to staff
• knowledge of children’s mental health and wellbeing, and the impact of trauma
• commitment to early intervention and prevention strategies for children’s mental health and wellbeing.

New staff members’ first days in your organisation provide the opportunity to further clarify the job role and expectations. In adult-focused services, this can involve a discussion about the development of child-focused practice and how new staff will be supported to develop competencies and confidence. Child-focused discussions form an integral part of induction checklists in adult-focused services and provide the beginning of an agreement that child-focused and parent-sensitive practice will occur.

Frontline staff

Induction checklist example:

As part of their role, the staff member agrees to:

• use child-focused and parent-sensitive practice
• use eco-mapping or genograms to help parents consider the key relationships in their children’s lives
• follow service intake/assessment procedures, to ask all adults about their relationships with children and to demonstrate curiosity regarding these relationships
• apply existing knowledge of child developmental stages to their work, and to develop a plan to acquire knowledge and skills where appropriate
• apply understandings of the effects of childhood trauma to their work, and to develop a plan to acquire knowledge and skill where appropriate
• participate in a training and development plan to improve child-focused and parent-sensitive practice
• participate in a supervision/mentoring/co-work plan to support the development of child-aware practice
• participate in discussions regarding KPIs for child-aware client case file reviews
• comply with supervision policy/procedure.

Induction discussion example:

‘Jack, the answers you gave during your interview provided us with a good understanding of your practice with adults. Your answer to the question about child-focused practice showed that this area of your work needs some further development. There are numerous ways that our organisation supports practitioners to develop confidence in this area. We will make this a regular agenda item for your supervision. We will also offer some training and co-work opportunities to support your development.’

Supervisor/Manager

As part of their role, the supervisor/manager agrees to:

• lead discussions regarding organisational child-focused policy and procedure, and the expectations of all staff to demonstrate curiosity about parents’ relationships with their children and the children’s social and emotional wellbeing
• lead discussions regarding KPIs for child-focused assessments in the service, and organisational requirements regarding the reporting of this data
• lead discussions regarding KPIs for child-focused client case file reviews
• lead the use of eco-mapping or genograms in service delivery and develop plans to help staff acquire knowledge and skills where appropriate
• support the application of service practice informed by child development stages, and develop plans to acquire knowledge and skills in child-development informed supervision where appropriate
• support the application of service practice informed by the effects of childhood trauma, and develop plans to acquire knowledge and skills in child-development informed supervision where appropriate
• follow supervision/co-work/mentoring mechanisms that support staff to develop skills and confidence in the application of child-focused interventions
• comply with supervision policy/procedure.

Induction discussion example:

‘Jack, the answers you gave during your interview provided us with a good understanding of your staff supervision skills. We are confident in your ability to develop staff confidence and skills in many aspects of the role. However, your answer to the question about child-focused supervision showed that this area of your work needs some further development.

There are numerous ways that our organisation supports supervisors to develop confidence in this area. We will make this a regular agenda item for your supervision with your manager. We will also provide some training on child-focused supervision, which we have scheduled for your first week in the new role.’

Clearly defined, practical guidance is critical in supporting new staff members, supervisors and managers to practice in child-focused ways. Competency guidelines containing explicit instructions for expected practice are an important part of any organisation.

Frontline Staff

Trusting and supportive co-working, mentoring and supervision contexts are important for frontline staff members, especially during the early stages of their role. These processes are both accountable to clients and supportive of practitioners.

Co-work processes which make use of existing staff’s skills can support those new to child-focused practice. This strategy is best offered as part of a broader organisational commitment to child-aware practice and co-work. These commitments in turn should be clearly articulated in practice frameworks. As a staff member’s confidence improves, they can begin to develop their own examples of child-focused practice.

To embed child-focused practices within an organisation, supervisors must have a strong understanding of such practices and how they inform service delivery. They must also be skilled in providing supervision to staff that is reflective and encourages the principles of child-focused practice.

Practice framework example (applies to front-line staff, supervisors and managers):

Our organisation is committed to child-focused practice. This means every adult who presents at our service will be asked if they are a parent, and about their relationship with their child and the child’s social and emotional wellbeing.

As part of our commitment to child-focused practice:

• every adult assessment will include a question about children. Regular assessment audits ensure these questions are asked 100% of the time
• our organisation reports quarterly on the number and percentage of adult clients who have accessed support to improve their relationship with their child or to improve their child’s social and emotional wellbeing
• 100% of our staff have received training on child-focused practices, childhood development and child trauma and wellbeing
• 100% of our staff have received training in and participate in reflective supervision.

Child-aware competency examples:

As part of their role, the staff member/supervisor/manager has demonstrated:

• conversation with a parent regarding their relationship with their child
• the use of eco-mapping and/or genograms to facilitate understanding of a parent’s relationship with their child and that child’s social and emotional wellbeing
• collaborative case management with an adult that has had direct benefit to their child’s social and emotional wellbeing
• respectful practice with adults that has identified possible risks to a child’s social and emotional wellbeing at an early stage, through an understanding of child development stages
• child-focused practice that allows the parent to view their current circumstances from the point of view of their child
• understanding of the effects of trauma on children, through a conversation with a parent that encourages them to consider what is happening for their child.

Supervisor/Manager

Child-aware competency examples:

As part of their role, the supervisor/manager has demonstrated:

• a supervision session with a staff member regarding child-focused practice via supervision notes or in a practice meeting
• facilitation of a team practice session discussing practice that allows the parent to view their current circumstances from the point of view of their child
• facilitation of a team practice session where all staff contribute to discussion regarding developmental stages of children and the effects of trauma
• team case file reviews showing the regular use of eco-mapping and/or genograms to facilitate understanding of a parent’s relationship with their child and the child’s social and emotional wellbeing
• team case file reviews showing collaborative case management with adults that has had direct benefit to the social and emotional wellbeing of their child
• team case file reviews which detail conversations with parents that reference understandings of the effects of trauma and child development stages
• regular team assessment audits showing 100% of adults are asked whether they are a parent and if yes, about their relationship with their child
• 100% of staff in their team receive regular reflective supervision, with child-focus practice a regular agenda item
• supervision notes reflecting regular discussion about child-focus practice.

Supportive, accountable and reflective supervision processes are essential in supporting staff to develop child-focused competencies. Supervision contracts between staff and supervisor/manager are important in negotiating what both parties can expect from supervision. In the development of supervision contracts, child-focused practice should be a standing agenda item.

The ability of adult-focused services to collect child specific data is important in ensuring staff are supported in child-focused practice. This includes asking all adults if they are parents and regularly screening for risks for children. The services ability to know how many of their adult clients are parents, and quantitatively understand the most pressing risk and protective factors for their clients’ children, is paramount in supporting practitioners to ask the right questions of parents, and to maintain curiosity about the child’s social and emotional wellbeing.

The client case review process – along with co-work – provides supervisors/managers and frontline staff members with the opportunity to discuss entry points for child-focused conversations with parents. Case reviews are also a good way for staff to demonstrate their increased competency in child-focused practice, as well as discuss any challenges that are arising.

Example evidence of staff competencies in case reviews:

• Demonstration of 100% of adult clients being asked if they are parents.
• Demonstration of 100% of parents being asked about their relationships with their children and their children’s social and emotional wellbeing.
• Demonstration of collaborative case management with an adult that has directly benefited their child’s social and emotional wellbeing.
• Examples of eco-mapping and/or genograms being used to facilitate child-focused conversations.
• Demonstrated use of child development knowledge to support child-focused conversations with parents.
• Demonstrated use of trauma informed practice to support child-focused conversations with parents.

Qualitative and quantitative evaluations are crucial in understanding client experience and how individual staff and organisations can improve their practice. Quantitative evaluations can be completed by each client who accesses the service and can support the implementation of universal assessments regarding children. Qualitative evaluations can include more in-depth conversations with clients about which aspects of the service helped improve their relationships with their children, and which were less helpful. These qualitative evaluations can be performed regularly by staff to help them critically evaluate their practice.

The Emerging Minds: National Workforce Centre for Child Mental Health is committed to working with organisations to strengthen and collect examples of the implementation drivers for practice change. This paper provides a brief description of some of these drivers, but there are many other ways that organisations support consistent child-aware practice. We are always interested in hearing about how your organisation works, and encourage you to get in touch with us via email at [email protected].