Monday 9 March 2015

Hurt: Part 2

I didn't anticipate the reaction people had to my last blog. I'd written it in a fit of pique after what is becoming a regular bust up at the weekends. The usual argy bargy leading us down a path we all regret. I spewed it into the drafts folder of my blog account and laughed to Mrs C that I'd just written a blog I couldn't publish.
She read it, insisted and after some thoughtful editing I posted it.*

Before I'd even Tweeted that I'd posted it or linked it up I started to get a few notifications, initially telling me to tweet a link then, after posting, the few became a torrent. Conversations snowballed and before I knew it I had only a thin grasp of what was going on. I was included in conversations that spiralled around the subject of holding, restraint, Social Workers and child violence.

Hundreds of notifications universally positive** and thankfully none of a sympathetic 'ah, hun you ok' type. Comments coming thick and fast all expressing the varied approaches and policies that Foster Carers, Social Workers, Therapists and Local Authorities had.

Parents and carers, some behind veils of anonymity, talked of holding their children to keep families safe without permission from the powers that be. Others told of pragmatic advice to just do it. Others of being instructed to not do it in any circumstance.
Encouragingly there were stories of people finding support and training, enabling them to therapeutically protect themselves and their child. Knowledge of de escalation techniques, backed up by sensitive and proven methods of control, safe holding.
Helping children to keep their inside and outside worlds safe.
Helping children and parents regulate.
Helping families to stay together.

Trying to make sense of it now I believe the crux of the issue remains that the risk of not using safe holding to keep my child, and others, safe is lesser than the risk of letting the behaviour run its course.
Professionals need to have a nuanced and long sighted perspective. Weighing cost and risk now against the potential long term consequences for parents and children. And dare I say it the stability of the family unit.

Amongst the notifications were some quiet voices, messages from scared, weary parents not knowing where to turn. Trapped between the policy decisions, short sighted risk aversion and the violence they were living with. People struggling not knowing where to turn.
Distressing to hear, not knowing how to affect actual help from a virtual place. Some still lingering with me now.

Was this just a Twitter storm in a teacup one weekend in March? Others have blogged, written and Tweeted before so I don't know. In the midsts of the notifications a swell of proposed actions was suggested, a gathering of voices to raise speak out and make this plight known, a 'flash mob' of blogs, or  'blog bomb', a gathering of experience and knowledge.
All to try and affect a change to a more informed model of practice for professionals, empowering, equipping and enabling the many carers and parents who live and love children who sometimes are unable to control their hands and feet.

So watch this space.

If you are struggling and are looking for support or advice I can recommend
The Open Nest who are able to offer advice, insight and support
or DM me on Twitter if you want or through the blog.

*I took out the sweary words and toned down my critical tone (come on I have my HCPC registration to think of).
** one comment accused me of being an angry foster parent, I invited them to look closer. They did and bravely apologised.


  1. So glad you did publish that post. This is another helpful and insightful one. I especially appreciate the way you have summarised the responses - so many of us are having similar experiences and you've articulated it brilliantly. Thanks.
    P.S. The tag 'airy fairy social worky' nearly made me spit out my coffee. Marvellous! :)

    1. Thank you for commenting. I passed with flying colours the 'airy fairy' module on my degree course.

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  4. Thanks for raising this important issue.. I absolutely agree with you that this is an area that needs some careful reflection and thought about how to better support parents/carers. In helping to raise these issues it may useful to reflect on the reasons for resistance to holding. Forgive me if you know all of this already, but for what it is worth: One main reason LA/CAMHS are resistant to advocating a holding approach, especially in the context of attachment related difficulties, is the result of some high profile child deaths a few years ago at some dubious 'attachment therapy centres' in the USA. This highly inappropriate use of holding/restraint during therapy & the catastrophic consequences led to the denouncement of holding as a therapeutic strategy by prominent regulating organisations in the US & UK. Since then, everyone has been twitchy about advocating holding. Another reason is that it's difficult for authorities to monitor the use of holding that they have advocated/provided training for. To use safe holding effectively, the adult needs to be able to stay very well regulated themselves during the process. This is important to avoid the hold being used inappropriately as control or domination rather than for safety. Some folks will find this easier than others depending on their knowledge, skills, available support etc, but that has to be factored in as a potential risk. A 3rd factor is that you have to be careful using holding as a strategy depending on the child's trauma history, as you may actually be inadvertently reinforcing or exacerbating the very behaviours you are trying to stop. Therefore, holding is best done, and is most effective, in the context of a broader package of support, rather than in isolation. Having said all that, I agree with you whole heartedly that there is a need for a re-think about how we support families who are facing these challenges. We need not throw the baby out with the bath water so to speak when it comes to holding. Sometimes, safe holding from a parent/carer with a loving heart and loving arms is the only thing you can do when all else has failed, & a child/YP is hurting themselves or others. Providing physical safety and containment is just as important as providing emotional safety and containment. We need to think how and when to support parents/carers to ensure they are holding safely when it is absolutely necessary, & as part of a broader support package/care plan; rather than leaving them languishing & running the risk of inadvertently exacerbating or reinforcing the underlying difficulty through inappropriate holding. One last thought reflecting on the fears of parents in case they inadvertently hurt or let a mark as a result of holding..... This must be every parents worst nightmare!!! My only advice would be that if you are finding that you are regularly needing to use holding to keep safe, particularly where the young person is actively resisting, you need to be raising this with your support agency. I know this may feel like a fruitless task for those of you who struggle to access appropriate support in your area, but even if you can't actually get the support you need (though the ASF may help?) at least you can try to safeguard yourself, and the young person, by have raised the needs with your local agency, made them aware of your concerns, the risks, and the reasons why you feel you need to use holding, and ask for this to be documented. I look forward to hearing how this debate continues, and wish you all the very best in raising it as an area for further discussion. I will take it back to my area of work for further reflection. If you become aware of any pockets of good practice please do share them, or post a link as It is always good to learn from the experiences of others who are doing it well.

    1. Your post is well worth the effort I know it took to get it posted. You've given a fantastic overview of safe holding and have highlighted issues that need to be considered before embarking down this path..
      I do appreciate your professional input as I do worry that relying on anecdotes and other people's experience, whilst good, is only part of the jigsaw.
      Many thanks for the comment.

  5. Apparently we use approach called 'team teach' in our locality... Training for foster carers, residential unit staff etc, but not routinely to adopters as far as I can tell. I don't know anything about the approach, as I haven't used it myself, but it involves safe holding & might be worth looking into.