The MICE Hub (Mental Health in Childhood & Education Hub) conference on Trauma, Mental Health and Wellbeing in Childhood – Historic and Contemporary Perspectives

In support of narrative

In the interest of supporting the theme of narrative I have decided to tell the story of my experience at the recent The MICE Hub (Mental Health in Childhood & Education Hub) conference on Trauma, Mental Health and Wellbeing in Childhood  – Historic and Contemporary Perspectives, which took place on Wednesday 20th November 2019 at the Old Customs House at Gunwharf Quays.

What’s Changed?

I arrived to a warm room filled with people sat on rustic chairs, mostly women, all entranced by Dr Sims-Schouten’s talk on Trauma & Mental Health in Childhood describing accounts of her recent archival and contemporary research into the deserving/undeserving paradigm around the provision of support for young people and how this impacts their mental health and wellbeing. It was especially intriguing to listen to her account of how the conceptualisation and treatment of children based on their behaviour, has changed so little in over one hundred years.

“Bad Blood” and Criminalising Children

Leading on from this inspiring introduction, the distinct and pleasant accent of Professor Hendrikus Stam from the Department of Psychology, University of Calgary (Canada) captivated the room with his talk, “We need more of our own blood” – Home Children as Conduits for Maintaining an Empire or Building a Nation?This told the story of the horrific treatment of some of the migrant children shipped to Canada by so called ‘Child Protection Agencies’ leading up to, and at the turn of the 20th century, as part of the migrant movement. He described some truly terrible tales. It was hard to believe that anyone could treat children this way, especially the treatment of girls and links to prostitution and the general criminalising of the children’s behaviour. It was shocking to hear the strong views expressed by the Canadians that the children sent to them were, ‘not of good stock and expressed evil and immoral tendencies.’ Linking to the rise of eugenics and fear of the defective working class.

The Impact on Identity

Dr Annie Skinner, School of History, Philosophy and Culture, Oxford Brookes University, then took us through a series of in-depth narrative accounts with her talk, ‘I don’t know what they took me away for … I didn’t think I had done anything wrong’: Narratives from committed children on the experiences and impact of being in the care of the Waifs and Strays Society in the late nineteenth century. These paint a vivid picture of the impact that being taken into care and/or committed had on these poor children. Stories tell of care leavers, now adults of middle or old age, looking back at their experiences, still traumatised by how they were treated (many were criminalised) and their sense of a lack of identity and connection to who they are. It is clear that this had a significant impact on how they view themselves.

Position and Power

Professor Helen Haste, Professor emerita in Psychology, University of Bath, shared with us the power and importance of narrative in her talk, “The Power of Story in Making Change through the use of the voice and how perspective plays its part.” I learnt that how the authors positions a person in the context of the story is just as important as the plot and protagonist, and indeed, how the audience perceives all of this all depends on how the author positions them. I experienced the power of telling a story from different perspectives through the words of those from various cultures so different to my own. It was empowering to listen to such articulate accounts of various injustice told through a variety of voices.

Parents Perspectives

Dr Emma Maynard Senior Lecturer in Education, University of Portsmouth, shared some heart felt stories in her talk, Family Complexity; Trauma, Change, and Recovery, many of which have a personal connection to members of the audience. In particular, the launch GEMS, a pilot intervention programme in Portsmouth. She told these stories from the perspective of parents with children in the care system who fear being judged and do not always understand the perspectives of so-called ‘normality’ inflicted upon them. They fear a system that is judgemental and seeks to enforce conformity, without really taking the time to understand who they are or how they can best provide them with the help they so desperately need.

So Much More to Offer

And last but not least, care leaver and final year undergraduate student in Childhood Studies, University of Portsmouth, Claire Thomas, highlighted the gaps that urgently need to be addressed in her presentation, “Outcomes for Care Leavers.” It was clear that these people have a plethora of untapped potential yet to be utilised despite often experiencing a myriad of ACE’s (adverse childhood experiences) at an early age many have an amazing capacity for resilience and wellbeing.

Systems and Shaping Society

The conference paints a picture of a system that, while expressing the best intentions, remains flawed and unfit for purpose in many contexts for the children and families it serves. Who often go unheard and unnoticed. The tales tell of a need to hear and listen to the forgotten voices of the past, so that we might make their future, a better place.

Bibliography

Skinner, A. and Thomas, N. (2017) ‘A Pest to Society’: The Charity Organisation Society’s Domiciliary Assessments into the Circumstances of Poor Families and Children, Children & Society, 32(2), 133144. DOI: 10.1111/chso.12237. Sohasky, K.E. (2015), Safeguarding the interests of the State from defective delinquent girls. Journal of the History of Behavioral Sciences, 52(1), 20-40. DOI: 10.1002/jhbs.21765.

Sims-Schouten, W., Skinner, A and Rivett, K. (2019). Child Safeguarding Practices in Light of the Deserving/Undeserving Paradigm: A Historical & Contemporary Analysis, Child Abuse & Neglect.

Sims-Schouten, W., and Riley, S. (2018), Presenting critical realist discourse analysis as a tool for making sense of service users’ accounts of their mental health problems. Qualitative Health Research.

Sims-Schouten, W. and Hayden, C. (2017) Mental Health and Wellbeing of Care Leavers: Making Sense of their Perspectives, Child & Family Social Work, 22(4) 1480–1487. DOI: 10.1111/cfs.12370.

Sims-Schouten, W. and Riley, S.C.E., (2014), Employing a Form of Critical Realist Discourse Analysis for Identity Research: An Example from Women’s Talk of Motherhood, Childcare and Employment.  In: Edwards, P., O’Mahoney, J. and Steve Vincent (Eds.), Studying Organizations Using Critical Realism. (46-66), Oxford: Oxford University Press.

Sims-Schouten, W., Riley, S.C.E. & Willig, C. (2007) Critical Realism: A presentation of a systematic method of analysis using women’s talk of motherhood, childcare and female employment as an example. Theory & Psychology, 17(1),127-150. DOI:10.1177/0959354307073153 

Stein, M. (2006) Research Review: Young people leaving care, Child and Family Social Work, 11(2), 273–279.

Turner, J. Hayward, R. Angel, Fulford, B. Hall, J.,  Millard, C. and Thomson, M. (2015) The History of Mental Health Services in Modern England: Practitioner Memories and the Direction of Future Research, Medical History, 59(4), 599-624. DOI:10.1017/mdh.2015.48.

Blog post written by Kayleigh Rivett BSc (Hons), MA, PGCE (Twitter: @Klebee3), Research and Innovation Officer at the University of Portsmouth (Twitter: @uopresearch).

Family stories project: What does real change, really take?

Some good news – I am here to announce the launch of a the Family Stories project – a research and intervention project to help parents find solutions for their families, long term, in collaboration with Portsmouth City Council and as part of the MICE Hub. I am setting out to contribute some findings to the paradox of a revolving door. To address the question why do over half the families supported by social care return repeatedly for more help? A problem so significant, the Association of Directors of Children’s Services (2018) have termed it a national crisis. Think of the human suffering in children and adults needing specialist help time after time. Think of the money and resources occupied by that revolving door. Ask a single question; what does real change, really take?

As a former social care practitioner and manager, in my days before academia, I know the strain this puts a sector groaning with outstripped demand. I can still feel how demoralising it is for the media to overshadow the successes of safer children with the shortcomings of simply not having a magic wand. But through my doctoral research, I realised the paradox rests between the perceptions of parents through lived experience and the expectations for change placed upon them by agencies. Therein lies potential for a fresh approach.

It is a question of what is normal? Our perceptions of reality are subjective (Bruner, 2002), but every reality has a context (Bhaskar, 2010; Pycroft & Bartollas, 2014). Within professional practice, such questions of normality tend to be answered by established indicators, framed by the statutory responsibility to safeguard children from harm (Working Together, 2018). When we see improvement, it is measured by lessened risk for a child; the family has engaged and worked hard, children are in school, learning better and looking better. But what just happened? I have to question, how does it feel to a family when agencies arrive and explain that something is not right, and what if the concerns do not seem troubling to the family, but normal? (Hayden & Jenkins, 2012). Do we even have the language to identify, express, or contest dysfunction when it is the way things have always been; accepted, and unchallenged?

This indicates the sheer level of complexity we expect people to engage in when we ask them to change, and how obscure, confusing, and threatening that might be. I’m thinking here about the father I interviewed who sought his own father’s permission to stop hitting his child. Of the mother still deciding if husband was abusive when he locked her out of the house and threw her son out of the family home while she was in the supermarket – ten years after the event. And of the worried grandmother whose daughter’s drug problem had led her to phone social services, but still could not explain why her grandson was the way he [was]. She could explain however, that to her family, asking for help was a far bigger crime than leaving the children neglected. These points of utter confusion reflect disruption to the homeostasis of the family (Schneiderman et al., 2005) prompted by challenge, and usurping the ability for family members to navigate their own dynamics. Even if they were problematic before, at least it was possible to function through familiar patterns of behaviours (Pycroft & Bartollas, 2014).

I argue that the work of making change happen surrounds not just the behaviour we see, but the human psychological reaction to cognitive dissonance, where expectation jars with lived experience, and leaves us feeling so threatened that our drive to overcome it is as strong as hunger and thirst (Festinger, 1957; Calsmith, 2012; Cooper & Carlsmith, 2015). It is a primal response enabling us to reduce threat so that we can function effectively, and we all do it. A normal psychological drive to help us cope in a threatened state. Festinger’s theory (1957) suggests that hearing we have got it wrong by our children would force us to prioritise reducing this dissonance over anything else, by one of three routes. Firstly, we can learn and adapt to the new messages (cognitions). Secondly, we could play down the significance of these conflicting messages, realigning ourselves with what feels familiar. Thirdly, we fake it till we make it; enacting, but not embodying, those expectations of change. A false presentation of self, enabling us to fit for the time being, and avoid threat, stigma and embarrassment (Goffman, 1956). So I propose, that our success stories have taken route 1. Practitioners have worked with families to create meaningful and lasting change through learning and adaptation, so they are able to better support their children, now thriving. They walk through the door and do not return, because the change is theirs to keep. The revolving door, however, is full of those who take the downplayed second route, refusing to engage with uninvited ideas which threaten self-assured identity, and of those who take the third route; who enact, but do not embody, change. They have risen to the challenge of meeting expectations in the here and now – extrinsically motivated. They are richly rewarded by a reassured practitioner, and a case closed.

So what does real change, really take?  My hypothesis is that we need to hold in mind the psychological stress taken by feeling threatened, in a life already threatened with violence, abuse, poverty and marginalisation. We need to give time and credit to the work within that space, and embrace the potential for meaningful change through making sense of experience in non-threatening environments in order to enable families to own their transformation; embodied and applied for their own lives.

Comments and contributions are welcome in forming this project; please contact emma.maynard@port.ac.uk, @maynard_emma.

Reference list

Association of the Directors of Children’s Services. (2018). Safeguarding Pressures phase 6; main report. Retrieved from https://adcs.org.uk/safeguarding/article/safeguarding-pressures-phase-6

Bhaskar, R. (2010). On the Ontological status of ideas. Journal for the Theory of Social Behaviour. 27 (2), 1-9. https://dx.doi.org/epdf/10.1111/1468-5914.00031

Bruner, J. (2002). The Narrative Construction of Reality. In M. Mateas, & P. Sengers, (Eds.) Narrative Intelligence. (pp41-62). Philadelphia, USA: John Benjamins.

Cooper, J. (2012). Cognitive dissonance theory. In T. Kruglanski., A.W. Lange., P. Van (Eds) The Handbook of theories of social psychology, Volume 1. (pp377-397). London: Sage.

Cooper, J., & Carlsmith, K. (2015) Cognitive dissonance. International Encyclopedia of the Social and Behavioural Sciences (2ndEd), 76-78 https://doi.org/10.1016/S0065-2601(08)60121-5

Festinger, L. (1957). A theory of cognitive dissonance. California: Stanford University Press.

Goffman, E. (1959). Embarrassment and social organisation. American Journal of Sociology. Retrieved from https://www.jstor.org/stable/pdf/2772920.pdf?refreqid=excelsior%3Afc90e2af9e437fec521c2d4b4aad79f1

Pycroft, A. & Bartollas, C. (2014). (Eds) Applying complexity theory; whole systems approaches to criminal justice and social work. Bristol, England: Policy Press

Schneiderman, N., Ironson, G., & Siegel, S. (2005). Stress and health; psychological, behavioural and biological determinants. Annual review of clinical psychology. https://dx.doi.org/10.1146/annurev.clinpsy.1.102803.144141

Photo by Timon Studler on Unsplash

Self-care strategies used by Children and Young People (CYP)

In August 2019, the Anna Freud Centre published a report (Garland, Dazell, & Wolpert, 2019) describing the experiences of CYP in their use of self-care strategies for their anxiety and/or depression, as well as the views of parents and carers. The report highlighted that there was a dearth of research into more widely available self-care strategies that were not delivered by mental health professionals. 

How did the researchers conduct the study?

Two anonymous online surveys were delivered – one for CYP between 11-25 years old who self-reported experiencing anxiety and/or depression, and another for parents and carers of a child who has experienced anxiety and/or depression. Respondents were asked whether they (or child of parent and/or carer) had used (or not) a list of 85 approaches to self-care, whether they would recommend them (or not), or to indicate that they (or their child) had not used a particular approach. The survey also collected qualitative responses. 

What were the results of the study?

Commonly used/recommended strategies

Both groups advocated use of strategies such as listening to music, watching TV or a film, and going outside, amongst others. CYP individually specified that they would use strategies such as maintaining personal hygiene and walking, whereas parents and carers specified strategies such as socialising and spending time outside in nature.

Not recommended/used again 

Both groups specified that they would not recommend/use eating more/a lot, spending time alone, and avoiding thinking about a difficult situation, amongst others as a strategy for managing their low mood and/or anxiety. CYP individually specified that they would not use strategies such as daydreaming and distraction, and parents and carers highlighted strategies such as avoiding conflict and gaming, amongst others. 

Qualitative responses

What is important to you when selecting a strategy?

All groups highlighted that freedom, support from others, as well as accessibility were important factors for consideration when selecting a self-care strategy. CYP also felt that they did not want to put any stress on others. 

Why do they work for you?

All groups highlighted that self-selection, distraction and support were key factors as to why the strategies selected worked. As a group, CYP also specified that being alone, routine, and no pressure were also factors. Parents and carers highlighted the increased confidence or enjoyment that the self-care strategies brought to their child.

Further research

Responses were varied and the groups felt that creative activities (e.g., art), sport and exercise (e.g., dance), as well as social strategies should be further investigated, amongst others.

Conclusions

The report concluded that further, detailed evaluations of self-care strategies were needed (what works, or does not, and why), as well as for the research agenda to be informed by the lived experience of CYP, parents and carers. The current work described is ongoing and feedback can be given here

Blog post written by Dr Rachel Moss, Research Associate for the Office for Students funded PGR Wellbeing project, based within the School of Education and Sociology (EDSOC) at the University of Portsmouth.