Families at Risk of Breakdown

Beacon House (UK)

“If a community values its children, it must cherish their parents” – John Bowlby, 1951

At Beacon House, we are passionate about working with networks who are supporting families at risk of breakdown, where children are identified as being ‘In Need’ or meeting criteria for child protection procedures. We also sometimes work directly with families (or their professional networks) where care proceedings have been initiated, where the parties are open in principle to supporting therapeutic intervention prior to a final hearing. Please note that this sometimes requires an extension to standard timescales, as long as this is safe for the child.

The role that we take is somewhat different from that of an independent expert; we commence every piece of work with an overarching question of “What would need to be put in place for everyone in this family to be safe, and have their needs well met?”

Our work is inspired and shaped by the pioneering writing and research of Dr Patricia Crittenden. Crittenden’s key text, ‘Raising Parents’, shines a light on attachment throughout the lifespan, and the impact of parents’ own early years and developmental experiences on their capacity to safely parent their own children.

“Supporting – cherishing – parents is central to caring for their children. Doing so makes emotional sense, functional sense, and economic sense; parents are the only resource that is never cut back. Moreover, they are the architects of society; let’s value all parents and assist those that need help” 

Patricia Crittenden, 2008.

We offer three different pathways for families at risk of breakdown – all with a primary focus of meeting the emotional and psychological needs of the caregiver, and facilitating them to do the same for their children:

  • Case Consultation to the Allocated Social Worker
  • Case Consultation to the Professional Network
  • Parental Therapeutic Needs Assessment

Consultation to the Allocated Social Worker

Why choose this?

This option is useful when:

  • There are parts of a family’s situation that are difficult to understand
  • There are multiple significant needs, and it is difficult to know which to prioritise
  • Things feel ‘stuck’, or expected change is not happening
  • It is difficult to accurately assess risk
  • Aspects of the case are having a powerful impact upon the allocated worker

What is involved?

Key background reading is undertaken by the consulting Psychologist (e.g. chronology, PAMS assessment, assessments by other mental health professionals).

The Allocated Social Worker meets with the consulting Psychologist (either at one of our clinics, or the Social Worker’s usual base), and is guided through the process of developing a trauma and attachment informed, psychological formulation of the case.

The Social Worker is supported to connect with the emotional and psychological impact of the case for them, and thus, understand the ‘helping’ attachment relationship more deeply. This understanding is incorporated in to the formulation.

What happens next?

Initial recommendations are shared during the consultation session. Recommendations are likely to include:

  • Attachment and trauma informed strategies for working with the family
  • Priority needs to be addressed (i.e. those most likely to result in timely change)
  • How to sequence interventions
  • How to optimise the attachment relationship between parents and professionals

A written case formulation will be provided by the consulting Psychologist within two weeks of the consultation.

Case Consultation to the Professional Network

Why choose this?

This is a useful option when:

  • A case is complex, with the potential for risk of harm to children or young people is significant, and a number of different agencies are involved
  • There are parts of a case that are difficult to understand, and there is a lack of consensus within the professional network
  • There are multiple significant needs that require the input of a large number of professionals, and it is difficult to know which to prioritise
  • The professional network is not working as effectively together as everyone would like
  • Professionals, and the family, feel stuck and frustrated
  • Aspects of the case are having a powerful impact upon the all of the professionals involved, which may be manifesting as difficulties in relationships between professionals

What is involved?

Key background reading is undertaken by the consulting Psychologist (e.g. chronology, PAMS assessment, assessments by other mental health professionals)

The entire professional network meets with the consulting Psychologist (either at one of our clinics, or a convenient location for the network), and is guided through the process of developing a trauma and attachment informed, psychological formulation of the case.

Considerable time is dedicated to supporting the entire professional network to connect with the emotional and psychological impact of the case for each individual, and the network as a whole. The patterns of survival, defence, attachment, resilience and compassion within the team will be ‘brought to life’ in the room, and the network will be supported to observe these patterns with acceptance, curiosity and respect. This understanding is incorporated into the formulation.

What happens next?

We ask professional networks to approach these consultations with openness, honesty and self-reflection. Therefore, we do not minute or record what is shared.

In the final part of the meeting, the consulting Psychologist will facilitate the network to bring their reflections together in to a clear and concise plan for future working.

Parental Therapeutic Needs Assessment

Why choose this?

Empirical evidence tells us that the most powerful way to meet the emotional and psychological needs of a child is to meet the emotional and psychological needs of their caregiver. Creating a safe and secure care environment in the home has more profound and long-lasting impact than any individual therapy provision or even a number of discrete therapies.

Working alongside West Sussex County Council, we have developed a specialism in meeting the therapeutic needs of vulnerable parents. Often, parents come to us with a history of significant adversity, disruption, loss and trauma. They may have been removed from their own birth family. They may have insecure and mistrustful attachments with professional caregivers. They may find it difficult to relate openly to ‘help’, as help may feel threatening, overwhelming, or confusing.

A Parental Therapeutic Needs Assessment may be appropriate when there is a recognition that a parent’s own psychological and emotional vulnerabilities are serving to inhibit their capacity to parent their own children in the way that they would want to. We are very happy to work alongside statutory services to proactively engage parents who are anxious, ambivalent or unsure.

What is involved?

We commence all of our assessments with a professional network meeting. It is really important for parents to know that all of the professionals around them are working together in a joined-up way, and that there is an overall commitment to supporting them therapeutically. This meeting happens with the knowledge of the parent, but they would not usually be in attendance. This is an opportunity for professionals to share both their concerns and their hopes.

Following this, we would typically undertake any background reading, and meet with the parent over two to three hours to complete a clinical interview and administer psychological measures. Our aim is to develop a psychological ‘formulation’ of the parent’s difficulties, both as an adult in their own right, and as a parent. This involves developing an understanding of:

  • The parent’s own early years environment, early experiences of care, and developmental experiences.
  • The story of the parent’s key transitional stages (e.g. childhood to adolescence, adolescence to adulthood).
  • Understanding any significant life events, including the experience of becoming a parent.
  • A detailed picture of how difficulty and distress impact upon daily life, including the challenges of parenting.
  • The factors that seem to make things worse, or stop them from getting better.
  • How the parent experiences ‘help’, in the context of their own attachment pattern, and how they relate to professional caregivers.
  • The parent’s strengths, resources, skills and qualities.

All of this information is then brought together, underpinned by psychological theory and research evidence. We draw upon this understanding to generate our therapeutic recommendations for the parent.

What happens next?

Our assessment letter will be ready within three weeks of the last assessment appointment. This letter will include our formulation, and detailed recommendations for the type of therapeutic intervention that we think would be most helpful. We will invite the parent and allocated Social Worker to come back to meet with us face-to-face, to share our formulation and therapeutic recommendations. We usually conduct this meeting in two parts, allowing the parent to be the first person that our feedback is shared with.

Where therapeutic intervention is recommended, a phased programme will be devised, allowing the commissioning service to regularly review progress before commissioning the next phase. Please see ‘How will progress be reviewed?’

The psychological interventions that we use with vulnerable parents include:

  • Cognitive Analytic Therapy
  • Comprehensive Resource Model
  • Eye Movement Desensitisation and Reprocessing
  • Integrative Psychotherapy
  • Internal Family Systems Therapy
  • Mentalization Based Treatment
  • Schema Therapy
  • Sensorimotor Psychotherapy

If, as part of a Parental Therapeutic Needs Assessment, it becomes clear that the parent-child relationship could be further supported by a dyadic intervention, this will form part of our recommendations. Most often, individual intervention with parents will be sequenced to take place before their child is brought into a therapeutic space with them.

How will progress be reviewed?

Therapeutic progress is something which is continually reviewed throughout the intervention. During the feedback and treatment planning meeting with the parent and Social Worker, the intervals for review will be agreed. Review can take the form of a telephone call between therapist and Social Worker, a written report, or a professional’s review meeting.

Alongside this, we have three main ways that we evaluate therapeutic progress:

  1. During the Therapeutic Needs Assessment, the parent will be asked to fill out a number of questionnaires, which will be re-administered at the end of each piece of work.
  2. At the start of the therapeutic intervention, the parent will be asked to identify three therapeutic goals, and scale them to show how well they feel they are achieving those goals. We will review these goals and the scaling at the end of therapy.
  3. At the end of therapy, both parent and referrer will be asked to tell us how satisfied you feel with your experience of coming to Beacon House, and whether you feel the difficulties you have been working on have improved.

How do I make a referral?

You can request a referral form by contacting the clinic on 01444 413939. Alternatively, you can email admin@beaconhouse.org.uk. Please specify which service you are requesting: case consultation, professional network case consultation, or therapeutic needs assessment and your preference of whether the work should take place from our Cuckfield or Chichester clinic. If you are unsure of the right option, please feel free to request a free of charge initial telephone conversation with Dr Laura France, Adult Services Lead, to help you to select the most appropriate service.

Your referral form and supporting documentation will be reviewed by our Adult Services Lead, who will then provide an estimate within three working days. We are usually able to commence work immediately on the receipt of a Purchase Order number. We do not have a waiting list and can usually organise the first appointment within two weeks.

Safeguarding

Our commitment to working therapeutically with parents is rooted in our commitment to the safety, protection and well-being of children. Please see our Safeguarding Policy here.


Getting in Touch

If you have any questions about our services please feel free to pick up the phone to us on 01444 413 939 or send us an email on admin@beaconhouse.org.uk, we welcome informal conversations about whether we are the right service for you. To make a referral please click here.

(Please do not send Post or attend for Therapy)
Registered Name Beacon House Psychological Services Ltd
Registered in England and Wales.
Registered Address AD5 Littlehampton Marina, Ferry Road, Littlehampton BN17 5DS
Registered No: 09205920
Chichester 01243 219 900Cuckfield 01444 413 939Enquiry: Message Us

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RETRIEVED https://beaconhouse.org.uk/specialist-clinics/families-at-risk-of-breakdown/

Covid-19: Are you concerned about wearing a mask?


Survivors on our helpline tell us that covering their own face or seeing the faces of others covered has been a triggering experience for them. From a small survey we conducted, we found that a third of survivors who responded confirmed this. With the Government’s announcement that face coverings will be mandatory in shops from Friday the 24th of July, this issue will only worsen for survivors affected by this.

Within the Government’s Guidelines for face coverings on public transport, it states that those who “cannot put on, wear, or remove a face covering without severe distress” will be exempt. Although technically this exemption includes survivors of sexual violence who are triggered by covering their face, asking a survivor to explain this to staff and security guards is a terrifying and humiliating prospect. Many survivors already carry a great deal of shame about what happened to them, making disclosing this to strangers an impossibility. There is also the worry as to how staff or other shoppers may react to them. We live in a society where members of the general public’s perception of survivors are still heavily clouded by rape myths and victim blaming. Survivors may not always receive an empathetic and compassionate response.

Although we strongly urge survivors to try to wear face coverings in order to protect themselves and the vulnerable members of our society, the guidelines state that those who “cannot put on, wear, or remove a face covering without severe distress” are exempt.

If wearing a face covering will be severely distressing for you, please download one or both of these images to your phone to present to staff when entering shops. These are NOT official Government documents but they may help you feel more comfortable when speaking with staff and security guards.

When viewing this web page on your phone, press the image above with your finger and hold down for a second or two. A box will pop up with a few options, select the option to download or save the image. The image should then appear in your photos ready for you to access.

Here are a number of alternative exemption cards that you can download, print and present:

Masks and face coverings can be triggering for a number of reasons. Wearing a face covering can trigger memories of abuse, such as the feeling of having a hand covering your mouth or your face pushed into a pillow. They can also make us feel claustrophobic which can trigger fears of having a panic attack or losing control of our breathing. Survivors have also reported that not being able to see the faces of those around them is intimidating and makes them feel worried. With the conditions of lockdown worsening pre-existing mental health issues and feelings of isolation for many people in the UK, survivors are particularly vulnerable at this time.

Here are some of our tips to consider for those who are worried about wearing a mask:

Practice wearing your face covering at home. If wearing a face covering or mask in public has been particularly triggering for you, try practicing wearing one at home or in environments where you already know you feel safe. Take the time to get used to how it feels on your face. This will make you feel more prepared and relaxed for when you might have to wear the face covering in less familiar or more stressful situations.

Find the right face covering. Some masks and face coverings fit better than others depending on the size and shape of your face. If you can find a face covering that is comfortable and doesn’t irritate you, this will help you stay relaxed in public. 

Get creative. If you feel uncomfortable wearing a mask, you could consider wearing a scarf or handkerchief over your mouth instead. Although the feeling is similar, it may be less restrictive and more familiar if it is an item you’ve owned for a long time. You could even make your own mask or face covering with fabric that makes you happy and feels comfortable on your skin. Here are some official tips on making effective face coveringsIf you like the idea of having a personalised mask but would find it difficult to make your own, you can find personalising options online, such as on Bags of Love.

Make it smell good. If there is a particular smell that you find relaxing, such as lavender, invest in a pillow spray that you can lightly spray a fabric mask with 20 minutes before you need to use it. That way, by the time you come to wear the face covering, the smell won’t be overpowering but just enough to relax your senses.

Ask for support. If you have trusted family and loved ones who know what you have been through, ask for their support. This might look like going for practice walks in the face covering with you, going with you to the shops to support you if it gets too much, or helping you to find the right covering for you.

If even after following these tips a mask is still causing you significant distress, you could consider a face shield instead. These still offer protection to the wearer and those around them without the same restrictive fabric covering the mouth. The Centres for Disease Control and Prevention (CDC) outlines on their website that they do not recommend the use of face shields as a substitute for face coverings, however, if they are used without a mask “they should wrap around the sides of the wearer’s face and extend to below the chin. Disposable face shields should only be worn for a single use. Reusable face shields should be cleaned and disinfected after each use.” You can find more information on this on the CDC’s website here. Face shields are also helpful for those who are hearing impaired or wear glasses (face masks are renowned for steaming up glasses.) You can find a variety of face shields onAmazon and other online retailers. 

If you lip-read as part of your communication, you may find an app such as Live Transcribe helpful when those around you are wearing a mask. The app will create live subtitles on screen as a person speaks. Simply search for this in your phone’s app store and click download.

If you feel triggered when you are out in public, whether this is due to face coverings or being overwhelmed by busy places, try considering grounding techniques. Grounding techniques can be very useful when we feel really distressed, particularly when the distress makes us feel very unreal or detached, or it feels like we are in a different situation to where we really are. You can find these here.


RETRIEVED https://www.thesurvivorstrust.org/covid-19-are-you-concerned-about-wearing-a-mask