ReConnect is a service for vulnerable children from the unborn child to children under 2 years who are at risk of developing a disorganised attachment. The service works with high risk parents who are known to Social Care. Many of the parents referred into the service are living in poverty.
What We Did
ReConnect is a service for vulnerable children from the unborn child to children under 2 years who are at risk of developing a disorganised attachment. The service works with high risk parents who are known to Social Care. Many of the parents referred into the service are living in poverty. These parents often have complex presentations including, difficult and traumatic childhood backgrounds, experience of being in care themselves, mental health problems, history of substance misuse and domestic violence.
ReConnect works hard at engaging this often hard-to-reach population. Our service-users have had experiences of being discharged from other agencies when they fail to keep appointments. We will see clients in their homes, children’s centres or in the clinic. We encourage attendance through offering telephone support in between appointments, sending text reminders and spending time thinking with clients about the obstacles that may have got in the way of their attendance. The service offers long-term intensive therapy including a 6 month group therapy programme, individual mentalization-based treatment and Video Interaction Guidance. The service makes a real difference to both the parents and children using it.
We have managed to change outcomes for children in three-quarters of the client group we see. Children remain in their parent’s care and come off Child Protection Plans. From the parent’s perspective, parents are better able to think about their child’s needs and respond in a more sensitive way. Through the various therapeutic programmes, parents develop greater self-esteem, greater awareness of their child’s needs and children feel more secure in their attachment to their parent. We have video interviews with our parents illustrating how the service has made a difference to them. The service was evaluated by the Anna Freud Centre (report November 2015) and found significant changes in reduced parental stress, greater sensitivity and improved self-efficacy. Qualitative interviews with parents carried out by Anna Freud researchers have found that parents describe the service as “life-changing” and that in particular, the trustworthy relationship with the therapist was containing and for many an experience of being “re-parented”.
The Anna Freud are pursuing research funding to carry out a Randomised Controlled Trial feasibility study based on these findings. Positive comments about the service have also been made by professionals (Child Protection Conference Chairs, Social Work Managers and Judges). E.g. “I have no doubt that the intervention by ReConnect is beneficial to this mother and it is clear to me that ongoing work of this service with this mother is necessary and important”. (Judge Burgher)
Wider Active Support
We work closely with Social Care in identifying at-risk children. I receive regular notice of children under 2 years who are placed on Child Protection Plans. I work with Heads of Service and Practice Improvement Managers in Bucks Social Care to improve practice and offer earlier intervention to this client group. Social Care have involved me in their thinking in redesigning the way pre-birth assessments are being carried out by social care.
We also work closely with Health (Bucks Healthcare Trust). Safeguarding midwives will identify vulnerable parents through antenatal screening and will refer in. We also work closely with Family Nurse Partnership and will take on cases from them where there are concerns about a young parent’s background history or mental health presentation.
We involve service-users in staff interviews and selection as they are part of the interview panel. We encourage service-users to give feedback to commissioners and have set up focus groups for our parents to talk to commissioners about how early intervention services are essential in prevention. Service-users have contributed to the Tomorrow’s Child (1001 critical days) exhibition in Parliament and have made a video about their experiences and why it is important to invest in early intervention. Staff feedback is regularly gathered at away days, team meetings and anonymously through annual team temperature checks that are carried out by our Trust’s Improvement and Innovation team.
Looking Back/ Challenges Faced
Looking back, I think I would have involved service-users at a much earlier stage when presenting to professionals about the service. I have discovered that the service-user voice is much more powerful and meaningful than a professional talking about the service. I think if I had included service-users in talking to social workers and managers about their therapeutic journey, we could have arrived at a better understanding of the service and how it helps at a much earlier stage.
One of the main challenges has been getting referrals in from social workers at an earlier stage before care proceedings were instigated. In the earlier stages of the service, cases quickly escalated into proceedings without time given for the parents to benefit from therapeutic work. I overcame this challenge by meeting with the Head of Social Care to explain the rationale for the service. I was then supported by the Head of service to speak to county managers who then in turn invited me to come to unit meetings. It has been a big challenge as the social work practice at that time was reactionary rather than preventative. Through targeting the management system, the message about early intervention has got through to frontline social workers.
ReConnect has been re-commissioned as part of the CAMHS contract thereby guaranteeing its sustainability. Leadership opportunities are provided to staff within the service so that they can develop their skills in talking about the service to other agencies, learning to manage and co- ordinate referrals and evaluate treatments.
The service was evaluated by the Anna Freud Centre. Research team led by Professor Pasco Fearon and Michelle Sleed. The evaluation has encouraged the Anna Freud team to apply for funding for further research to carry out a randomised controlled trial. michelle.Sleed@annafreud.org pasco.FearonPhD@annafreud.org
The evaluation of ReConnect was shared with Social Work Managers and Children’s Commissioners. We are currently collecting data from our third cohort of parents but plan to publish our findings in academic journals.
Is there any other information you would like to add?
The parents we work with in ReConnect are often disadvantaged in terms of poverty, life experience and have experienced rejection or closed door from other agencies when they fail to attend appointments. We work hard at engaging this hard-to-reach population and spend considerable time building a parent’s trust. Our client group are complex and diverse presenting with a wide range of problems from mental health, personality disorder, childhood history of trauma, substance misuse or domestic violence. The feedback from our service-users is they worried about being judged by us because they have had previous children removed from their care and then were surprised when this was not the case. I have several video interviews with parents illustrating this.