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Experts Corner: Interview with Helen Johnson

ISW Helen Johnson talks to Clare Jerrom about sibling assessments

Siblings should always be placed together wherever possible and where it is in all the children’s best interests, an expert in sibling assessments has stated.

Helen Johnson, who has been carrying out sibling assessments for the past 10 years, said placing siblings together should be the “default position” as per legislation which is set out in The Children Act 1989.

“It is absolutely beneficial on every level and separating siblings risks breaching their human rights. It is beyond question that this should be the default position,” said Helen. “The problem is if we don’t understand each individual child’s needs within a sibling group and what that means going forward for the children and the parent.”

‘A piece missing’

Helen studied for the Diploma in Social Work on an Open University course in 1998 after graduating in history at the University of Sheffield. She spent her first years working in children’s services in a children with disabilities team in Sheffield followed by a looked-after children team in Derbyshire and has been carrying out sibling assessments since 2008.

When working with looked after children she began to realise that, if she wanted to really help support vulnerable children and their families, then she needed to heavily invest in her own continuous professional development and went on to deepen her knowledge through various training courses, particularly around trauma and attachment.

However, the more she learnt, the less of a fit she was within a social services setting and in 2009, she moved into Independent Social Work. In 2011 she came across the work of Dr Patricia Crittenden. “While I had done a lot of work around attachment, there was always a piece missing in my mind. Once I came across DMM I found this to be a much better tool to understand children and families,” she said.

Dynamic-Maturational Model of Attachment and Adaptation (DMM) began under Mary Ainsworth's guidance, with input from John Bowlby and E. Mavis Hetherington. The DMM focuses on the ways in which danger organises attachment behaviour and looks beyond the surface of behaviour; instead examining how behaviour functions within relationships. In the DMM, neurological maturation interacting with experience is central to the self‐protective strategies that individuals develop to regulate familial attachments. When the relationships fail to protect child (or parent), more extreme strategies are organised to wrest some measure of safety and comfort from an otherwise threatening environment.

 ‘Happy’ children are often the ones we need to worry about the most

“I use it very much in my work to get a deeper understanding of a child’s behaviour and their individual organisation. There may be a child presenting as being bright and happy in order to make themselves more acceptable and maximise the degree of care their parents will provide, when they are actually hiding anxieties and feelings of vulnerability and anger. Unless we understand that, their behaviour can be misinterpreted,” said Helen.

She highlights the case of Victoria Cimbie who died aged eight years old with 128 separate injuries on her body. Victoria had been burnt with cigarettes, tied up for periods of longer than 24 hours, and hit with bike chains, hammers and wires as well as being forced to sleep in a bin liner in a bath tub. Yet in pictures and to professionals, Victoria appeared a smiley, happy child as she presented a false self to her carers and abusers, her aunt Marie-Thérèse Kouao and her boyfriend Carl Manning.

“Her safety mechanism was dismissing her own needs within the situation. If she had recognised the danger of the situation, it would have been overwhelming and she would not have been able to function, which could have placed her in more danger,” explains Helen.

She highlights work she carried out with a family with three siblings, two of whom – a girl and a boy -  were in a placement. The girl was functioning well, however, the boy was less able to inhibit his feelings and comply with others expectations of him. Professionals first felt that he had an attachment to his sister, as he repeatedly asked how she was and what she was doing. Yet, it emerged that he recognised his sister was managing better than he was and he was trying to live up to that. His questions about how she was doing were related to his anxiety about this and poor self-image. “He seemed interested in his sister, and he was, but why?” said Helen, explaining that DMM is particularly helpful at unravelling behaviour in this type of scenario.

Helen may also use the Marschak Interaction Method (MIM), often used in Theraplay, which can be useful to see how a child responds to an adult in a play setting. The MIM is a structured technique for observing and assessing the overall quality and nature of relationships between caregivers and children. It consists of a series of simple tasks designed to elicit behaviours in order to evaluate the caregivers’ parenting capacity. The primary carer is given a list of 10 play scenarios to carry out in order and the activities are filmed.

While formal measures require Helen to film proceedings, she said it has been vital in her picking up behaviours after the session.

“When that boy was asking questions about his sister, I would never have realised the situation at the time as there is too much happening at once. It is only watching the film in hindsight that I could see what was happening,” she explains.

Scrutiny from the courts

While siblings may refer to full siblings, half-brothers and sisters or families where children have been living together for significant lengths of time, Helen says her work is usually with full or half siblings. She says she “cannot think of an example” when her work has involved siblings that are not blood related.

While a local authority may have concerns about one particular child within a sibling group, Helen says that is not the way the case is presented to her and she is asked to look at a whole sibling group and come to a conclusion. Helen may be brought in at various stages during proceedings from assessing children who are at home with their birth parents to children who are placed under an Interim Care Order and the local authority want plans in place if the children do not return to their parents. Sometimes the sibling assessment comes some time after the conclusion of proceedings.

Helen explains that she starts off by carrying out an assessment of each of the children in a sibling group. She looks at their needs, their attachment, and the relationship with their siblings, always keeping in mind BAAF guidance and legislation which recommends keeping children together where possible.

“There is an assumption and an underlying pressure to keep children together. There is a caveat, but it can vary across the country depending on an individual court’s stance. There are some local authorities where courts take a stronger position on placing children together. So social workers feel pressure in their assessment of siblings. There can be anxiety about providing sufficient evidence supporting separating siblings, even if they feel that is beneficial, as they know they will receive heavy scrutiny from the courts,” she said.

Hierarchy of need

Helen, as an expert, gets called in when the local authority feels it would be beneficial to have the expertise, experience and evidence-based practice provided by the use of formal attachment assessments to inform permanence plans for each child in a sibling group.

“Everybody is different. I use a full assessment of attachment with a child and, depending on their age, I do this with the primary carer where younger children are involved and with older children on their own,” Helen explains. “I also look at how they are interacting as a sibling group. I observe what they are doing to feel safe and comfortable, e.g. whether they are exaggerating their vulnerability and anger to pull parents in, or masking it to please their parents. If a child is acting in a certain way to get attention, we can look at healthier ways for them to behave. However, if they are using a more vulnerable child, for example by acting aggressively towards a baby to get attention, then the individual needs of each child can be incompatible.”

Helen looks at the hierarchy of need and what each child’s individual needs are and what that means in terms of the intensity of parenting required. Helen also carries out a lot of therapy work with adopters of sibling groups and their parents who might be struggling to meet their needs and she often sees sibling groups who should not have been placed together.

“Even when children have been placed early on, aged one or two, because of their individual needs, you can see the pressure on the placement and the cost to the children because of the dynamics and parents are struggling to meet their needs,” she said. “The parents can see this too, and it undermines their sense of competence as parents.”

Lack of understanding of the child’s needs

There are obvious situations where siblings should not be placed together, for example, where there is violence or sexual abuse between siblings, but a lot of the situations are less obvious. “Our job is grey, it is not black and white. I worked with a family where there were three brothers and the dynamic did not suggest that they should be separated. The way they worked together was not detrimental and did not suggest that it would undermine parenting,” said Helen. “However the individual needs of the three children were very difficult for two parents to meet.”

“The children were placed together but there were problems. The adoptive parents struggled for two-three years but they could not meet the intensity of two of the boys’ individual needs. In the end the local authority removed the older child. The parents were totally committed to the boy and were angry that they were put in that situation and things got acrimonious. The whole problem came down to a lack of understanding around the children’s individual needs,” she added.

So what happens when one child has a strong attachment to a sibling but that sibling would thrive if placed on their own? Helen says this is never easy and you have to weigh the situation up. “However, the bottom line needs to be that you cannot compromise one child’s needs to save the other child,” she said.

“If one child needs to be alone and that is your best judgement, then you cannot sacrifice that child’s needs for the sake of the other child. It will impact on the other child and it is not easy but there is guidance around these sorts of situations,” she adds.

Masked trauma and loss

Helen is quick to point out the stresses placed on foster parents and adopters saying: “Most adopters don’t come forward to be therapeutic adopters. You can never adequately prepare prospective adopters for the reality.”

Furthermore, Helen says there is a “massive over-representation of unresolved trauma and loss” identified through the adult attachment interviews and research confirms that 60% of adopters have unresolved trauma and loss. In fact, the more “balanced” adopters are the ones more likely to drop out of the adoption process. “The fact is, if we ruled out those adopters with trauma and loss issues, we wouldn’t have enough adopters. But they have their own needs and we need to take that into consideration.”

Helen also feels strongly that not enough is always done to keep children with their birth parents and provide them with support. Often local authorities have “their backs to the wall” and are reactive, less creative and that, Helen says, is an injustice. In fact, Helen was previously asked to do a lot of rehabilitation work with families, but this is much less frequent now which could be linked to the fact that children’s services budgets have been cut massively over the years forcing authorities to ditch early intervention and preventative work and focus resources on managing crises.

However Helen warns: “Often the rehabilitation work was no harder than the therapeutic work with adoptive families.”

And in the cases where siblings are separated, the priority is to find the children suitable placements that meet their needs, although that could mean they are placed geographically a long way away from each other. While contact with siblings may be set out at first, it frequently does not happen for a variety of reasons. It is then down to the foster carer or adoptive parent to deal with the issue of contact themselves which can be difficult and challenging. “Too often it is a case of best laid plans,” said Helen. She adds that there are exceptions and recalls a family she worked with where two younger siblings were adopted but their older sibling would go for overnight stays and the adoptive parents had the phone number for the older sibling and the situation worked really well.

“We do have a responsibility about what we can do to educate all parties about contact and how we can make it safe. However, social media changes the whole landscape and we are behind the curve with that,” she says.

“I know people say children are coming into care much more damaged and I assess a lot of children and the damage is huge. However, if we can get it right with these children, there is a huge amount that can be achieved,” she concludes.

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