Expert’s Corner with Mary Cullen

Mary Cullen is an Independent Social Worker who specialises in parenting assessments including PAMS assessments for vulnerable adults.

Court proceedings for families are undoubtedly daunting and stressful for any parent. But when that parent has learning difficulties and has been labelled as “stupid” throughout their lives, the stress levels rocket.

“Parents with learning difficulties tell me that they have been told they are stupid throughout their lives. There is definitely extra stress involved for parents with learning difficulties although having an advocate in court is very helpful,” says Mary Cullen who specialises in PAMS assessments.

PAMS assessments are a type of parenting assessment designed for vulnerable adults including parents with learning difficulties. While they have been around for a number of years, they have been recognised as the “gold standard” of assessment for parents with learning difficulties over the last three to four years with courts being in favour of their use.

“PAMS breaks down every element of parenting and covers birth to 18. So for new parents, I would assess their ability to sterilise feeding bottles, change nappies, bath and wean a baby whereas for parents of older children I would assess their ability to help a teenager be responsible when it comes to protection against sexually transmitted diseases, how to manage relationship, how to deal with bullying and other challenges that comes with being a parent to teenagers,” says Cullen.

Cullen is an Independent Social Worker who qualified 11 years ago. She has worked in children’s services throughout her career and spent six years working as a case manager at a residential family assessment unit in Peterborough. There, she worked intensively with families who were high risk for a period of 12 weeks, assessing them on everything before directing the work that needed to be carried out with the parents post-assessment.

PAMS gives parents a fair chance

In 2012, Cullen began working independently and local authorities will instruct her to carry out an independent assessment, often assessing parents on their abilities to safeguard children. Cullen uses a variety of techniques in her assessments including the Dynamic Maturational Model of Attachment (DMM) which she undertook intensive training in while at the assessment unit, CARE-Index Screen and Story Stem Assessment of Attachment, parent development interviews, Video Interaction Guidance and PAMS techniques to identify risks and the right intervention.

“A lot of the parents will then go back to the local authority who will put support in place such as CBT, although that is not effective in all cases. Given the complexities and risk, often intensive psychotherapy is needed over a number of years and that is not always in the child’s best interests, and therefore the child may be removed from the family,” said Cullen.

PAMS assessments, however, are far more likely to give parents with learning difficulties a fair chance and a fair assessment, says Cullen highlighting that authorities want to keep families together where possible. “PAMS assessments take longer to carry out. I would usually interview for no longer than two hours and have plenty of breaks as it is exhausting for anyone. Often I need to re-phrase things or be creative and allow extra time for things. I always carry out an introduction visit as I will have heard the local authority’s side of things but I then want to hear their story, their narrative with no questions to get an idea as to the whole picture,” she says adding that she often goes shopping with parents with learning difficulties to make observations and ensure that they are safe crossing the road and can manage money.

Horrendous childhoods

Attachment theory is a passion of Cullen’s and she says that PAMS assessments touch on attachment in terms of unresolved trauma and unresolved loss. While PAMS goes through childhood histories, Cullen says she would want to talk to the parents about whether they had someone to comfort them when they were a child, was there someone there to protect them?

“Often you look at the paper-work and their childhood was horrendous. But you ask them about it and they say everything was fine as they have blocked it out for survival. But if the parents have shut down their feelings of fear and anger they can’t help their children manage those feelings and that’s where the risk comes in. If I can explain that then I can recommend intensive psychotherapy,” says Cullen. “If both parents have shut down there could be significant problems but if there is some indication that they would work in therapy I would recommend systemic family therapy.”

By doing this, very highly trained and skilled therapists can work with the parents as a couple, individually and with the children which, Cullen says, “is much better than removing the children and placing them into foster care”.

PAMS techniques can also be used with other clients and Cullen says she has used it with a 16-year-old girl who is having a child. While she wouldn’t classify it as a “full PAMS”, the techniques could really benefit the girl, she explains.

She is also trained to use Video Interaction Guidance and uses video to film clients with their children. One mum could not get any joy from being with her child and said she didn’t know what her child was thinking. Using video to film activities and then playing back the positive interactions and talking through how the child might be feeling at certain points enabled the mum to learn, Cullen adds.

Drift is bad for the child

However, PAMS assessments are quite expensive and therefore Cullen finds that some London Boroughs they say they don’t need a PAMS assessment but will ask for “someone who is PAMS trained". The pressure on local authorities to complete care proceedings in 26 weeks is also a factor in decision making. “Local authorities are cash-strapped and so the cost does come into it but at the same time they want the best for the children they are responsible for,” says Cullen.

The 26 week rule applies to case involving parents with learning difficulties, there are no exceptions as the best interest of the child is paramount and the first two years from birth is key, explains Cullen. “The longer the case is allowed to drift, the worse it is for the child.”

Cullen carries out four to five PAMS assessments a month and sas she enjoys the flexibility that comes with being an ISW that enables her the luxury of spending time with families. “A common criticism from parents is that they only see a social worker for half an hour per fortnight which they know is not the social worker’s fault but it is good if we have the time to spend with the families as we are working in partnership,” she adds.

Cullen concludes that having patience is key to working with parents with learning difficulties as while you are working to tight time-scales, you have to be mindful that they may forget appointments or need more time. “You need to be curious, open-minded and extremely empathetic. Above all, you need to be a people-person,” she concluded.

Contact Mary Cullen through WillisPalmer

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