By Sheila Wilson
Date Posted: 14 December 2010
Sheila Wilson has been a residential child care worker in the south east of England for five years. She is now searching out a Masters degree course which will qualify her as a social worker and allow her to continue her interest in residential child care.
The damaging effects of poor communication in child care
As a residential child care worker I have come to know that good communication within a children’s home is essential and I have also learnt that being able to communicate clearly with as little blurring of the information you are trying to pass on is an essential attribute in work with children. I say this especially because the young people I worked with had emotional problems which they found difficult to talk about. For this reason I believe that a residential child care worker needs an understanding of communication in all its forms, whether it is verbal, non- verbal and written and it remains important whether the communication is in person, by email or by telephone. Any breakdown of the communication cycle of a children’s home which involves a child in residential care invariably leads to a worsening in the child’s situation.
First of all I’d like to look at the problems staff encounter in communicating with external agencies and the difficulties these cause for young people I look after and care for. Later I will consider communication problems which are present within the home between staff members as well as staff’s communication with the young people. It saddens me that a child’s placement at a children’s home can get off to a bad start at the stage of initial referral of the child to the home. This is usually caused by the incomplete and inaccurate nature of the information about a child communicated by the referring social worker to the staff of the children’s home. This usually occurs when the placement is an emergency one, and the referral is made by a duty social worker who has little or no knowledge of the child, and doesn’t know what the care plan is for the child. At the time of such an admission the residential child care staff at the children’s home are left with a new child (of whom they know very little) who is joining a group of residents who may be very settled. In my view this is a recipe that can have disastrous effect on the resident group. I have also observed how a child’s situation is made much worse by poor communication between agencies when a young person experiencing an emotional crisis has behaved aggressively is moved in an emergency from one placement to another. In the incident I will recount it has to be accepted that a seemingly irreversible breakdown in communication between the young person and the residential staff has occurred but it is the aftermath that I want to consider first.
Last year a young man named Sam who was 13 years of age was placed in the children’s home where I worked. He was brought in an emergency to the home by a duty social worker who informed us that Sam’s last placement at another children’s home had broken down. On his arrival at the children’s home it became immediately apparent that Sam found it difficult to sleep at night and he behaved disruptively every night and was “acting like a 6 years old”. His behaviour kept all the other children in the home awake, and another resident decided to join forces with him. They continued to disturb the other children by running around the house and shouting to the early hours. This created an management problem for the staff who were also having to stay up very late in order to try to settle Sam and the other resident. One night the problems came to a head when Ben seriously assaulted a member of staff and then began to destroy furniture and damage the fabric of the interior of the home.
Since the staff were unable to contain Ben’s behaviour, a decision was made to move him immediately to a safer place. The incident and the decision were communicated to the duty social work team of Sam’s local authority, and they were asked to find an alternative emergency placement for him immediately. After about an hour during which Sam continued to act out, the duty team informed us that they had found him a placement at a large regional secure residential resource centre near London. In order to take Sam there I was required to accompany him to this resource in a taxi. The driver was not a member of staff. En route Ben told me he did not want to go to this new placement and he jumped out of the car while it was stationary. I followed him and by pointing out to him how late it was and how cold it was, I managed to persuade him to get back into the car and go to the centre to spend the night where he would at least be warm and safe. On our arrival at the resource centre, Sam refused to get out of the car but when a member of staff from the centre came to assist me to get Jeff out of the car, Sam picked up his bag and went into the centre. When Sam realised that there was an intention to place him in the centre’s secure facility he was angry. Even after the member of staff from the centre and I suggested he should consider it as shelter for the night, Sam remained adamant that he would not stay there. Since there was no secure order placed on him Sam of course had the right to leave. The fact that Sam was to be placed in the secure facility came about as a consequence of poor communication between the duty social worker and the resource centre’s staff. The duty social worker had presumed that Ben was to be placed in their open facility, but this had been closed because it was being renovated. Somehow this did not come up when the duty social worker first contacted the resource. So Sam was able to leave with no place having been found for him to stay overnight. I can accept that my concern about this incident may in part be fed by my own feeling that I might have had some responsibility for Sam’s unhappy situation and although I can acknowledge that our decision to move Ben immediately placed the duty social work team under a great deal of pressure, in my view the duty social worker and the colleagues in his team should have researched in more detail the place where they were intending that Sam should stay that night. If the duty team had been more informed about the current situation at the resource centre and if the duty social worker had discussed the case in more detail with the resource centre then the true situation at the centre would have been established. Sam would not have been taken to what was at that time purely a secure unit. Without the secure order there was no legal authority to prevent him from leaving the centre, which he did, a 13 years old boy out in London after midnight in the freezing cold. We heard later on during that day that Ben had been found by the police and had been placed in another children’s home. Sam’s removal immediately solved our management problem at the children’s home but this situation made me aware that poor communications between agencies about a young person who has been placed in the care system for his own protection can result in him finding himself in an even more vulnerable situation.
Milham et al (1981) demonstrated the value of good long term child care planning but this incident alerted me to the importance, even in an emergency, of taking time to plan. Had the adults involved that night spent even five minutes analysing Sam’s situation then there might have been a more satisfactory outcome for him. The incident itself could not have encouraged Ben to have any confidence in future communication with those adults entrusted with his care.
What else could have been done?
The events of that night haunted me for a good while. I realised Sam’s situation did not arise in a vacuum. How had we as a staff team allowed a situation to develop where we could only solve the problems he gave us by ejecting him in the middle of the night?
Were we more concerned about the difficulties he presented to us rather than thinking about the problems he was experiencing? Were we supporting him to deal with his problems? Were we communicating clearly with him and about him, in order to plan for him and give his stay with us a purpose or meaning?
The answer I eventually came up with was that we were failing to communicate clearly among ourselves because he made us so anxious about us not being able to help him with his problems. A total breakdown in communication had occurred. I decided I would try to avoid situations like the one involving Ben occurring again. Now my intention in my work with the children and with my colleagues is that my communication should be clearer, more engaged and be contained by some direction. It may be impossible entirely to avoid situations like the one involving Ben given the enormous emotional pressure child care work places on staff. As a residential child care worker I know that the pressure of work within a children’s home does affect my communication with my colleagues as well as the young people. It seems important for me to be on my guard in order to maintain the quality of my interpersonal communications. Carl Rogers suggests that it is often when we have a strong emotional involvement in any relationship that it can become tempting for us to block off communications. It is possible that in blaming poor communications between Sam’s duty social worker and the regional resource centre I was able to block my feelings of hopelessness in offering help to Sam. I have in the past experienced my own and a supervisor’s reluctance to engage with each other when we have both known that we have needed to discuss something which we believe will be painful for us. This kind of breakdown in communication may have concerning implications for young people if the painful issues we are avoiding in our discussion are related to their care. Supervision sessions can still be painful for me when I am trying to cope with the problems the young people and my colleagues throw up for me. For this reason I believe it is important that the managers in the staff group should be committed to clear communication within the team not only through staff meetings, handovers and training but also through a commitment to individual staff supervision. I now attempt to avoid the pitfalls which lead to my blocking communication and with this new insight In working with the children I have special responsibility for I try to understand and empathise when I sense that my child is blocking communication. It seems important to me that I should concentrate on listening to my child conscientiously. I try not to move in and out of listening mode, so that my eyes don’t glaze over because I have started to think about other unrelated things. I think it is often significant to hear what is not said, as much as what is. An awareness of body language seems to me to be needed to do this. I make an attempt to spend some time thinking about what my keychild has said before I make a response. I have in the past failed to engage with a young person because I assumed I knew what they were going to say, or I treated the session like a points scoring game, or I was trying to get through my own agenda. Sometimes I would block off communication myself because I did not think I was being heard. What happened then was that I found that my child became reluctant to join in one to one sessions or if they did attend them they tried to get them over with quickly by telling me what they thought I wanted to hear. In the short term this took a lot of pressure off me but it did not get the job done. For me, even worse than broken down communication (after all there is the possibilty of mending something which has broken down) is a situation where no communication has been attempted. I have learnt that good communication cannot always be established by conversation, so I have used my interest in music as a medium to make contact with a young person. When I thought about the breakdown of communication related to Sam’s situation and related to child care in a residential setting I have separated out two areas which I believe highlight the need for good communications in my work, and while there are many other areas I might have considered I think they are representative of a wider number of communications issues which arise in my work, and which can have an influence on how a young person like Ben may experience residential care.
Firstly, a failure in communication in residential child care can create a downward spiral from which it is difficult to escape. Broken communications have negative implications not just for the young people but also for the staff which in turn reduces their ability to work effectively with the young people.
Milham,S, Bullock,R, and Hosie,K and Haak, M. (1986) Lost in Care London, Gower
Rogers, C.R. (1961) On Becoming a Person : a therapist’s view of psychotherapy New York, Houghton Mifflin