John Triseliotis, Moira Borland, Malcolm Hill and Lydia Lambert (1995) Teenagers and the social work services London: Her Majesty’s Stationery Office 0 11 701970 4This study, undertaken for the Department of Health by the Universities of Glasgow and Edinburgh, broke new ground in looking at the provision of a range of social work services to a sample of young people. Stein and Carey (1986) had highlighted the situation of young people leaving care and Rowe et al. (1989) had documented the extent to which residential care had become a short-term placement for young people but no-one had looked at the range of interventions available for young people throughout their teenage years.
- Social workers were only aware of about half the issues in young people’s families.
- Though many more girls than boys reported having been abused, it was an issue for only a few at the point of intervention.
- Young people with family problems were more likely to end up in care, those with community problems under supervision and those with school problems to come from intact families.
- While parents stressed family problems and social workers personal development, these had the lowest priority for young people whose first priority was to remain at or return home.
- Young people with school, offending or family problems tended to end up in residential schools and those with family or behavioural problems in other residential units and were less likely to return home than the few placed in foster care.
- Parents may prefer residential care for a variety of reasons, including the feeling that foster care is a criticism of themselves.
- Young people on supervision received a similar number of visits to those in care with the focus on their current living situation.
- Two thirds of young people moved at least once in the year and 30% three or more times; placement related reasons tended to influence first moves and court/hearings later moves.
- Young people and their parents were equally positive about social workers with the young people appreciating those who did practical things or undertook advocacy on their behalf and parents appreciating those who allowed them to unburden themselves.
- Young people were critical of social workers who broke confidences, didn’t listen or did nothing; parents were critical of social workers who failed to keep promises, could not control the young person or focused too much on the young person.
- Few of the participants thought that young people had benefited from supervision and then mostly those who had a good relationship with each other; both social workers and parents tended to attribute any failings to others, with only the young people acknowledging any failings themselves.
- While groupwork and befriending were viewed positively, referrals to psychiatrists and psychologists were viewed negatively.
- Three quarters of participants agreed on the success or otherwise of residential placements, with parents who disagreed more likely to see them less positively.
- Proportionately more foster placements were rated very positively and very negatively.
- Young people in residential schools were assessed as having had more problems and as having made more progress.
- Young people were equally split in their preferences for residential and foster care and, while most of those in foster care wanted another foster care placement, those who had suffered a foster home breakdown tended to be more negative about foster care than other young people.
- Young people who had left care tended to evaluate the preparation they had had and their level of coping less favourably than social workers did.
- Young people tended to recall only those decisions about which they had had strong feelings.
- Parents’ satisfaction with their involvement in decision-making declined over the year.
- Those living at home or in foster care were most likely to evaluate the year positively and those in independent living least positively; these estimations were more strongly associated with the young person’s sense of self-esteem and their parents’ estimation of the situation than with any of the interventions.
- Young people and their parents were more positive in their evaluation of changes in family functioning, offending and schooling than were social workers.
- Young people’s confidence about the future bore no relationship to anything that had happened in the previous year.
- The small proportion of placements judged successful were more likely to involve an admission to care, family conflict and access to an individual relationship with an adult, whether a family member, carer or social worker.
- Foster placements were more likely to be very successful or very unsuccessful, whereas residential school placements were less likely to be very successful but even less likely to be very unsuccessful; apart from family placements, all other placements were more likely to be unsuccessful.
In Chapter 1 Introduction to the study, they point out that, though there have been studies of particular interventions with teenagers, there has been no study of those actually offered to teenagers. They therefore set out to study the services offered in five local authorities in England and Wales, the views of key participants and the outcomes of the interventions.
Following Parker et al. (1991) they studied both outcomes in a broad sense and developmental progress. When the study started in January 1991, local authorities in England and Wales were preparing for the implementation of the Children Act 1989, while Scottish authorities were awaiting proposals for similar legislation. Local authorities in England and Wales were also affected by the Criminal Justice Act 1991 and those in Scotland by changes in the funding of criminal justice services for over 16s. All social welfare departments were affected by the introduction of purchaser/provider arrangements.
105 young people and 78 parents were initially interviewed for the study, with seven more young people and nine more parents taking part in the second interview. 116 social workers were initially interviewed and all but seven a second time.
None of the agencies had a specific or comprehensive policy for teenagers though all discouraged the use of secure accommodation and most were reviewing different aspects of their provision, often without reference to other aspects.
They then summarise the existing research on development, family and social circumstances and particular forms of intervention, pointing out some of the inherent conflicts between particular approaches.
In Chapter 2 Characteristics of the sample, they say there were 73 males and 43 females in the sample of 13–17 year olds who agreed to participate following a major change in their care situation; 56 declined and some had already left care when the interview was undertaken but that was important in order to take account of unexpected moves and changes of plan. There were no significant differences between the sample and the samples in other studies. Around three-quarters were or had been in care, two thirds only once before, and social workers had previously worked with over half of the others. Girls were more likely to be in care and boys on supervision.
They note that the way in which young people were selected for the study meant the sample was not wholly representative of the issues that young people in contact with social work services might encounter before going on the describe the baseline information they obtained. This showed that a high proportion had behaviour or school problems, often associated with low esteem. Though social workers’ assessments of the young people’s health and family and social relationships tended to be similar to the young people’s, social workers were only aware of around half the issues raised by young people relating to their family situations.
In Chapter 3 Problem definition and the setting of expectations, they recount how participants identified problems in community relationships, such as offending, in the family and at school; parents tended to identify more of these problems and social workers fewer but the young people identified more problems outside these areas than did parents or social workers. Offending was more likely to be a problem for boys and sexual or physical abuse had been a problem for many more girls than boys, but at the time only six of the young people mentioned it. Interestingly school problems were more likely to affect those from intact families.
While family problems followed by community relationships came ahead of school problems as reasons for care, community relationships followed by school problems were the main reasons for supervision.
Parents found the stress of dealing with family relationships very difficult, tending to see themselves as victims and the young person as needing to change, whereas the young people tended to see themselves as willing to make compromises which were not forthcoming from their parents. Social workers tended to take a much more multi-faceted view but in some cases then appeared to lack the confidence to address the problems.
Parents tended to blame ‘bad company’ for offending whereas young people tended to accept personal responsibility for their offending, while not seeing it as a problem that needed to be dealt with. Social workers tended to underplay offending, stressing the young person’s needs, but this could be misunderstood by both parents and young people.
Parents tended to be exasperated by school problems which they sometimes blamed on pressures on schools but there appeared to be no early warnings of, or constructive attempts to deal with, these problems, which meant that they had often grown serious before anything was done. Young people saw the solution in the ways schools dealt with them while social workers’ views tended to be influenced by the theoretical model they adopted of young people’s problems. Parents used a variety of approaches to encourage or enforce school attendance but were frustrated that, when their efforts were unsuccessful, social workers were unable to provide or suggest anything more effective, not least because preventive work with teenagers takes a low priority.
While good practice suggests that interventions should be based on a shared understanding of where each party is coming from, the priorities of each party were significantly different, with social workers stressing personal development, the lowest priority for young people, and parents family relations, the second lowest for young people. Young people’s priority of remaining at or returning home was second lowest for social workers and not on the parents’ radar.
Social workers tended therefore to see the carers as having a primary role and they gave offending a low priority even though it was often the reason for a supervision order. Even where it was given priority, this was far more likely to be the case for male than for female offenders. Young people’s expectations were much more focused on their immediate situation whether that involved remaining at home or school or moving into independence. Where there was some measure of agreement among the parties, it tended to be around schooling before family relationships and offending.
Young people were overwhelmingly optimistic about how things would work out, with two thirds of parents and just over half of social workers also optimistic.
In Chapter 4 Service provision through the year, they describe how the social workers, mostly qualified with up to four years experience though some had more, saw most young people twice a month, usually at a location away from the office. Social workers were more successful in advocacy roles, in keeping young people out of care/custody and in improving general social relationships than in other areas. Though social workers recalled discussing family relationships more than schooling, the young people recalled schooling and future plans.
Though social workers often starting seeing parents as often as the young people, this had tailed off by the end of the year. Joint meetings with the young person tended to be accidental and the focus for social workers in their meetings tended to be on getting the family to change, though parents also raised issues unconnected with the case.
Young people tended to be admitted to residential schools because of school problems, offending or family problems but to other residential units because of family or behaviour problems. Most children who spent a period in residential care did not return home, with those in residential schools more likely to spend longer in a residential placement. Though fewer young people were placed in foster care, nearly half of these placements ended with a return home.
Young people on supervision and their parents tended to receive as many visits from social workers as those in care but the focus in the meetings tended to be on school and living situation issues rather than issues individual to the young person. They might also be offered groupwork, participation in particular projects, befriending, psychiatric or psychological support or educational support, depending on the agency responsible for them.
Around a third of the young people had some time in care during the year, half of these in residential care, a sixth in foster care and the rest in both, while over a third only had supervision; however, the group who received the widest range of services were those who had experienced supervision and then care or vice versa.
Two thirds of young people moved at least once during the year and 30% three or more times. Those living the community were most likely to move but only a sixth of those in residential care remained in the same unit throughout; these were more likely to be those in residential schools with frequent home leave; slightly more remained in the same foster home throughout. While moves for positive or negative reasons related to the placement characterised first moves, court proceedings were more likely to influence subsequent moves.
Residential school placements planned to last for the whole year were more likely to do so and more likely to result in a return home. Moves home were more likely to be planned than moves within care. Young people tended to agree with social workers who said that moves had been related to relationship difficulties with carers but not where the social workers said it was the young person’s behaviour. Young people initiated some of the moves but sometimes regretted the decision later.
Young people were less likely to believe that they needed preparation for independence than social workers were and even less likely to recognise that any steps had been taken to prepare them. About a third of young people expecting to live independently expected the social worker would help them in this, though in practice most preparation for independence was carried out by carers. Social work support for those already living independently varied widely, unlike most other forms of support.
Availability of resources had limited the options for those on supervision and tended to extend the distance from home for those in care.
In Chapter 5 Participants’ views of social workers and their activities, they report that, while social workers tended to attribute success to the responsiveness of the young people or their parents, the young people evaluated the social workers’ interventions particularly in their counselling role as significantly more successful, even though relatively few thought the social workers had addressed the original problem. They were also more likely to blame factors other than the social worker for any failures. Parents evaluated social workers as positively as the young people though some thought they had not been given the attention or the support they deserved.
Though there were variations, overall social workers and young people rated the quality of their relationships similarly and those who had the better relationships tended to do better over the year. Young people particularly appreciated the practical things or the things social workers did on their behalf. They appreciated social workers who could see things from their point of view and there was a general increase in those willing to confide in a social worker over the year. Young people complained most about breaking confidences, not listening, talking and doing nothing and nagging. Some also would have preferred someone of the same gender.
In relation to other professionals, young people were more likely to confide in residential staff than social workers and in some cases in teachers but less likely to confide in group or project workers and least in psychiatrists and psychologists.
However, slightly different results were obtained from a group feedback exercise with social workers getting more negative ratings, particularly from young people in residential schools, Intermediate Treatment workers getting ratings on a par with keyworkers in residential care and teachers poorer ratings.
Though social workers saw their relationships with parents relatively positively, parents largely perceived the relationships as having declined over the year but there was no correlation between parents’ and young people’s views of particular social workers. Parents were most positive about social workers who offered a supportive relationship within which parents were able to unburden themselves and most critical of social workers who failed to keep promises, who could not exercise control over the young person, who focused too much on the young person or who appeared unwilling to help.
In Chapter 6 Participants’ views of supervision, group work and specialist services, they report that, though young people tended to like supervision, few thought they had benefited from it, mostly those with a good relationship with their social worker. They were critical of social workers who only talked, who gave no opportunity for private conversations, who showed little concern or who just nagged. Overall, the assessments of benefit by social workers were similar but there was almost no match between the young people who thought they had benefited and the young people whom the social workers thought had benefited. Parents’ assessments were similar but closer to those of the social workers’ than the young people’s and, like the young people, they tended to associate benefit with a good relationship with the social worker.
Practical help and third party advocacy were valued and young people also valued social workers who tried to exercise a restraining influence. Both social workers and parents tended to attribute failures to others with only the young people recognising failings in themselves as well as in others. Social workers greatly overestimated their help in dealing with family tensions compared with the assessments by young people and their parents but all three parties were in closer agreement over their help in other areas. This applied whether the area had been identified as a focus of intervention or not. Interestingly there was no change in young people’s self-esteem as a result of supervision.
Groupwork tended to be evaluated positively by both young people and their parents but social workers tended to think it had not achieved much perhaps because it had not been part of a clear plan. All parties tended to view befriending positively; however, referrals to psychiatrists or psychologists tended to be viewed negatively with few referrals thought to have brought any benefit.
In Chapter 7 Views of services for young people living apart from their families, they say that they were unable to examine every placement in detail and they did not try to break them down into successful or unsuccessful placements; rather they asked all parties whether the placement had achieved its aims as far as they were concerned and found agreement among all three parties in nearly three quarters of placements. Where there were disagreements, parents always had less positive views of the outcome of the placement, sometimes because they thought it had ended too soon.
Residential placements tended to be viewed favourably, with few considered very unsatisfactory but higher proportions of foster placements were rated very satisfactory and very unsatisfactory. There was complete agreement between social workers and young people that three residential school and three foster home placements had been positive, three of which were ongoing, and that five residential unit and three foster home placements had been negative, all of which had ended. Positive outcomes were associated with high self-esteem at the outset but there was no change in the level of self-esteem as a result of a positive placement. Yet three young people who had substantial difficulties and who might not have been expected to benefit from a placement also had very positive placements.
Parents were most positive about residential care, particular where they saw it offering discipline, while social workers were more likely to have preferred an alternative placement; half of the young people in children’s homes and three quarters of those in residential schools were satisfied with the placement, many of those who were dissatisfied wanting one closer to home. Over the year young people’s views polarised slightly with some, particularly those in residential schools, becoming more positive and some becoming less positive.
Social workers considered that all the residential schools had achieved positive outcomes and, though focusing on different things, the young people tended to agree, pointing to things they had had to do which they would not otherwise have done and the space to work out things with their parents. Young people identified being away from home, being stigmatised for being in care and being bullied, which had affected one in six, as disadvantages of residential care.
The young people who went to residential schools were assessed as having more problems than those who went to other residential units but appeared to make more progress perhaps because they tended to have more family support. Those in residential units appreciated the staff, the other residents and a good physical environment but disliked the rules. One in five complained about the way they had been treated but young people in residential schools were less likely than those in other units to be given information on how to complain.
Absconders, whether occasional or habitual, tended to be running away from a situation where they felt powerless and habitual absconders tended to come from families with more problems. Some absconding was just to see friends.
Parents’ views of what constituted good residential care did not change over the year while social workers highlighted lack of resources, such as educational support in the residential units and supported accommodation for those moving on.
Young people were split evenly in their preferences for residential and foster care; while those in foster care were positive about their placements at the outset, by the end of the year, those whose placement had ended tended to have more negative views. While social workers identified a range of benefits from foster care, the young people mostly focused on the family nature of the placement as did the parents.
Some parents saw fostering as a criticism of themselves and half the young people reported difficulties, including abuse; they were critical of rules and restrictions which they did not see applying in other homes. However even where a placement ended, more young people wanted another foster placement. A key factor in foster care was the quality of the relationships the young people were able to make both with the foster carers and with other children in the family.
Young people in after-care situations tended to evaluate the preparation they had had and the extent to which they were coping less favourably than social workers did. Young people who had been placed away from home had often lost support networks and had housing and money problems as well as experiencing loneliness and boredom. The support of even one person, whether family, friend or social worker, was appreciated though it was rare for social workers to continue support and even rarer for residential workers. Half of social workers said they would have liked to give more help while half of young people said their families had helped and half that they had not; a third had had no help from friends.
In Chapter 8 Decision making and participation, they report that families had initiated 40% of admissions to care with social work services, the legal profession or the young person initiating the remainder; families initiated fewer of the supervisions but interventions initiated by families had the most positive outcomes and those by a multiplicity of agencies the worst.
Social workers thought most young people had had some input into the decision; interestingly young people who were most happy or most unhappy about a decision recalled some discussion whereas those who accepted it did not. Most parents had had some involvement in the initial decision. While social workers and young people generally agreed on who had made the decision to end their first placement, young people were less likely to agree with social workers about ending foster placements and more likely to regret the endings afterwards. Parents were less likely to be involved in later decisions which were more likely to be taken by social workers even where the young person had had a key role in ending the previous placement. Young people’s reasons for ending social work contact varied from it having achieved what was necessary to it being useless anyway.
In group discussions young people raised the difficulties in getting their views heard particularly in meetings. Only a third of those who had been at a Scottish Panel Hearing thought their views had been heard though some thought they could have been more forceful themselves. Though three quarters were satisfied with the eventual outcome, only a half had had any assistance to prepare for the meeting. Young people were also concerned that people were present whom they did not think should know about their private lives.
Around 60% of parents were satisfied with their involvement in the initial decision but only around a half with their involvement over the whole year.
While a majority of social workers thought that young people’s views should be taken into account in principle, they cited lack of resources and the demands of the justice system/Panel as well as the influence of parents as limiting the practicality of what some young people wanted. They tended to think that, while parents had been listened to, their views had not significantly influenced decisions. In practice, however, they could disrupt decisions by lack of co-operation.
Compared with younger children teenagers’ contact with families tended to be organised more informally rather than through specific access arrangements.
In Chapter 9 Progress during the year, they report that the young people had a range of health issues but that the majority of young people, their parents and their social workers rated their health positively and, though there was some confusion as to whether there had been changes for the better or worse over the year, boys were more likely to report an improvement.
Though parents thought a significant number of young people had shown improvements, others showed no change and, though some young people’s esteem went up and some went down over the year, for most it remained the same and there were no significant associations between self-esteem and what had happened over the year.
Just over half the young people had positive attitudes to school and these were more likely to stay on; only a quarter of those who had left had jobs. Those who had been to residential schools tended to stress their educational benefits.
Over half the young people said they got on well with their parents and, if there were any changes over the year, improvements were more likely with mothers and deteriorations with fathers, though this was reversed for step-mothers and fathers. Several young people had found out more about their own family and personal backgrounds, sometimes to their surprise, but none of this had been connected with a social work intervention.
Relatively few young people had actually sought help from their families over the year and were less likely to do so in reconstituted families. Nearly half of the young people lost a key contact over the year though three quarters, particularly those who had been in residential care, said they had added someone, usually a friend. Less than 40% recollected support from a friend over the year.
Taking the year as a whole young people living at home or in a foster home were most likely to be satisfied with their situations with those in independent living situations least likely. However, positive estimations were also associated with the young person’s sense of self-esteem and their parents’ estimation of their situation. There was only a weak association with the social work intervention, suggesting that other factors in a young person’s situation may have been more significant for the young person than the social work intervention. Nonetheless, regardless of whether they had positive or negative views of their progress, they tended to have positive views of their relationship with their social worker.
Interestingly the assessments by the young people and their parents of how far their expectations had been met were more positive in the areas of family functioning, offending and schooling than those of the social workers. Social workers’ assessments of their expectations being met for their living situations, the young people’s for their personal development and the parents for their independence were all less positive.
Young people and their parents credited the young person, the family situation and the social worker equally in their contributions to meeting expectations but parents gave more credit to residential care or a change of school and young people to foster placements.
However, when young people were asked how confident they were about the future, their answer bore no relationship to what had happened in the previous year while social workers’ estimations tended to be more positive for those in residential schools or at home but were also associated with their estimations of the young people’s sense of self-esteem. Less than half of parents were confident that their young people would do well.
In Chapter 10 Overall outcomes, they describe the scoring scheme they used to assess whether the outcome of the year had been successful, concluding that a significant minority had been unsuccessful and nearly as many had made no progress. Success was more likely to be associated with an admission to care than supervision or moving out of care and more likely to be associated with a referral for family conflict and less likely with a referral for offending. However, participants’ predictions of success at the outset were not associated with success.
A third of foster placements were very successful and a third unsuccessful while a fifth of residential school placements were very successful and only a tenth unsuccessful. All the custodial, nearly two thirds of the independent living and residential unit placements and nearly half of the family placements were unsuccessful. Success was also associated with a good relationship with the social worker.
The successful packages of service included single placements and various combinations and sequences of services, in some of which a young person had made a key decision to end a particular service. A key feature in successful placements was access to an individual relationship with an adult whether within the family, a carer or a social worker.
In Chapter 11 Summary and conclusions, they summarise the results of the research before moving on to its implications, namely, that there needs to be policy integration in work with young people along with horizontal integration of services; work with young people needs to be seen as an opportunity to be addressed by specialist teams with a particular focus on those young people who are likely to lack the family support that is available for others. They argue for greater involvement of young people in decisions and greater involvement of social workers in family mediation. This will have implications for training.
Excluding reports such as those into abuse and the Skinner report (Social Work Services Inspectorate for Scotland, 1992), this is one of the few reports like Who cares? (Page and Clark, 1977) and Stein and Carey (1986) where young people’s views form a key part of the research. It is also one of an even smaller group in which parents’ views are heard alongside those of their children and the social workers charged with offering them a service.
Each chapter provides a useful summary of relevant background legislation or guidance and previous research which has addressed the topic under consideration. This can be frustrating if you want to get to the research itself but makes the book a much more valuable document for the future than reports which take the current context for granted.
Many of its findings echo earlier findings which are shown to have wider application than just to the situation in which they were initially identified. For example, Trotzkey (1930) had shown that, while children in residential care had more problems than those in foster care, they made more progress in care than those in foster care; Brosse (1950) had identified that those children who had access to continuous adult support had best weathered the effects of war, just as those young people whose placements had been adjudged successful in this study were likely to have had access to an individual relationship with an adult in their lives.
Like their predecessors nearly two decades earlier (Page and Clark, 1977), young people do not regard residential care as negatively as many social workers do and their parents share the feeling, which children pointed to in Berridge (1985), that foster care is a criticism of them.
The weak relationship between success and social work intervention had been foreshadowed in Taylor and Alpert (1973), Fanshel and Shinn (1978), Rowe et al. (1989) andWiener and Wiener (1990) all of which had suggested little or no relationship; so the weak relationship identified in this research might have prompted further research.
On the one hand, the polarisation in the outcomes of foster placements may help to explain the poorer overall outcomes of foster care in Wiener and Wiener (1990) but, on the other, it may suggest that the lessons in how to create a successful foster placement set out in Trasler (1960), George (1970), Thorpe (1980) and Berridge and Cleaver (1987) were still being ignored.
However, the headline finding in this research was the success of residential schools — the form of intervention which many social workers and their managers had consistently sought to eradicate over the previous thirty years. Previous research demonstrating that residential care could be successful relative to other forms of intervention had tended to come from abroad (Wolins, 1974; Wiener and Wiener, 1990); here for the first time was some home grown research making very similar points.
In the end, this research was published at the wrong time; the Conservative government was on its last legs and the Labour government which took power in 1997 had no plans at all for child care. One of its first acts was to remove the presumption of doli incapax from young people, ushering in a decade of largely repressive measures aimed at young people, during which local authority neglect of young people was dealt with through increases in imprisonment (Gibbs and Hickson, 2009).
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