Sarah asked
I have just had a meeting pitching Cedar to the children and families social work team and a need has been highlighted surrounding adolescent boys who have experienced domestic abuse and are now being aggressive or violent towards their mother. In some of these high-tariff cases the boys have been relocated because their mother does not feel safe living with them. It is clear that this would be a guaranteed source of referral for Cedar as there is little provision offered to this group of service users at the moment. I wondered if you could ask the Cedar network whether they have experience of working with this kind of group, and if they have any advice surrounding the wisdom of working with this group as our first session of Cedar? Although it would certainly “sell” Cedar to agencies in our area, I am unsure whether it is too much to take on at an early stage.
If anyone from the network has any feedback regarding this that’d be great.
Cedar Boders says
November 8, 2013 at 10:51 amFrom Elizabeth
Thanks for your email, I had some of these concerns also and the following are some thoughts I had about Cedar in the Borders and how I work with young people here.
I have been working with a teenage group of boys and am now on session 10. One of the boys could be as you describe, he now lives with foster carers and his mother could no longer cope with his violent and aggressive behaviour towards her. All but one of the 5 teen boys in group is displaying aggressive and violent behaviour towards their mothers but only one of the boys has been accommodated.
We are now on our second group, totally different experience as the first group were younger so couldn’t compare groups but at least I knew by the second group exactly how Cedar would work. This has been a really positive experience for the boys – they have peers that support them and are sympathetic towards one another as they have shared experiences. they have their experience validated in group, have a voice, sometimes for the first time and are listened to. They can talk openly about their feelings thoughts and actions and I believe really take the activities seriously. To do this work we have a really robust set of groundrules, determined by the young people and we refer them back to these if they go off track, we have one young person with ADHD also but the rules work pretty well for him.
Things we have learned – expectations placed upon Cedar can be too high for this group, have had comments such as “I need this to fix my son, I want my baby boy back” from mothers. From professionals there can be a sense of the family has suffered Domestic Abuse so Cedar must be the intervention used. This will not work for everyone and I feel that this is an early intervention but for this one young person it would have been helpful if Cedar had been around for him when he was 11 and not 14.
One mother has described things as getting worse before they get better as the young people start to open up about their experiences this can be really difficult for them so I work very closely with education and ensure the young person is supported if they need it when they return to school after the session.
I also work with mother’s after the sessions, I cant tell them what the young person has said but we talk about likely impacts and look at the Cedar tools to use between sessions. I will also give Social Workers feedback of likely impacts – I am often asked to go to MAC meetings and lots of other meetings but have to exercise caution here as this could damage the relationship between myself and the youg person, again here I would report on levels of engagement and the outcomes, impact and benefits of Cedar. I don’t know if you are in this position but I am Co-ordinator for women and young people and it is a balance as they both know I am working with the other and are curious about this, but I need to maintain confidentiality for both.
There has been difficulty with mother using the tools or speaking about the sessions if the young person is not living with them so they would need this time and space to do this work with each other and this time needs to be agreed in advance.
From young people in this age group I have had them respond with aggression towards me when Cedar was suggested at a meeting so if you are going for this age group – meet on neutral territory and let young people know that it is their decision to attend Cedar and not social work, spend at least 3 visits if you can and also spend time with Young person on their own.
SW should not sell Cedar to the Young People and tell them they are doing it as they will just see this as another intervention in their plan – they need to want to do this for themselves. It took me 3 months of engagement with the young person who was accommodated as he didn’t trust that his confidentiality would be protected at first (he does now). I think at times a lengthy assessment period does no harm to build up trust, I sometimes leave the initial meeting venue to be chosen by the young person and their mum and I keep this as informal as possible.
Have really good food in the group as this helps create the nurturing environment and we have a light meal with young people and let them snack during the group. The environment has been so important and the young people feel relaxed enough to behave like children – making badges, making masks etc – They all just say the same thing “don’t tell anyone I did this in here”
What has worked well for us is having young people that have diverse circumstances and living arrangements, I would always look at the individual as am sure you know that people are very different on paper. You might well have difficulties in group if you have all “high tariff” young people but I always look at the individual’s circumstances first. I was worried that after a female dropped out and I had all males this would not work but it totally does. I was also concerned about the levels of aggression the young people were displaying but having them in the group we were able to give them tools and clear messages.
I do have to say that I have been very impressed by how articulate, reflective and engaged all of those young people have been so give them an environment they feel safe in and you will see the true person come through, and these are all young people who have been aggressive towards their mother’s, teachers and siblings.
For the other 3 young people their relationships could be regarded as close to breaking down but the mother’s who continue to come to group are seeing improvements in their relationships with their sons.Mothers of these boys should where possible commit to coming to group as it works so much better,boys often ask what their mothers did at group and they are more likely to talk to their mother after group.
If this is going to be the first group you run ensure that some of your facilitators in that group have plenty experience of working with young people with complex needs ( young people will often come out with parts of a story and need to be supported sensitively to put the story together and make sense of this) They will also ask you if it is adolescence or the Domestic Abuse that has made them feel this way, so it is important they know the answer to this
All young people say that they feel better for coming to Cedar but it is important to let them and everyone else know that 12 weeks wont “fix them”. I think young people should feel in a good place to complete Cedar and it should absolutely be their choice.
Cedar West Dunbartonshire says
November 8, 2013 at 10:55 amFrom Dominique
I read the proposal of work that has been request with young males who are accommodated in residential setting. I have raised a few issues for your consideration.
· Firstly what are the referrers looking for by engaging the young people with CEDAR; are they looking for you to work in a therapeutic way to help them with recovery and rehabilitation to the family or are they looking for you to work with them on their aggressive and violent behaviour ( in terms of being a perpetrator of domestic abuse)and the impact that this has on their relationship with their mothers. I would suspect that they would perhaps want you to fill this dual role and this goes way beyond the scope of CEADR and into the realms of a perpetrator programme. You also have to consider if rehabilitation is a factor is mum able to engage with group or is the perpetrator still living in the family home? Will the young person return to an environment where they have contact with the perpetrator if so what are the safety implications?
· Are the young people accepting that they are perpetrators of domestic abuse – do they identify with this – especially when we use this language openly, what would be the impact of the language we use?.
· You mentioned ‘high tariff’ young people. I would suspect that there is currently lots going on for the young people and you would have to consider each child’s previous and current needs on top of the trauma they have experienced as a result of the abuse i.e. age and stage of development, do they have a spectrum diagnosis, is there evidence of conduct disorder, learning difficulties, literacy and numeracy skills, impulsive behaviours, risk-taking behaviours, addiction issues, self-harming behaviour and perhaps above all their understanding of and desire to be in group.
· With consideration to the above issues I can tell you that the current model cannot be used for children with the above issues. I am running a group with 2 young people who have very complex issues (most of the above are a feature) and the programme has had to be practically re-written to be delivered to this group. They are very challenging and at this stage it is unclear exactly what they are getting from group. This group has to be delivered on a 1:1 ratio to meet the needs of both children and even this can be a struggle at times. I will let you know the outcomes for this group once it has been fully evaluated in the new year.
· How are you going to evaluate you and your co-facilitators safety in terms of the risk taking and violent and aggressive behaviour that may be a feature of this group. Who is going to take responsibility for undertaking a risk assessment/risk management and crisis management plan for each individual young person attending group and also a group risk assessment/risk management plan in terms of the young people at group and also being transported to group?
· How many young people will attend the group – this will have implications if there are only a maximum of three facilitators. My advice would be that you would need practically a 1:1 ratio of staff to young people. This ratio may also have implications for the efficacy of the group in terms of the therapeutic element.
· Running a group where young people come from the one establishment would undermine the confidentiality of the group and giving each child a safe place to share their story – this would prove to be a mine field with children who are accommodated alongside one another with far reaching risks and negative implications. The world of LAAC is also very small so if you were planning to do this across different residential setting again the problem would be the same; accommodated children always know of each other or someone who knows of someone else it would be very difficult to ensure the confidentiality of each child.
· You would also have to be very careful about the sharing of stories in terms of perpetrator behaviour. You may end up inadvertently facilitating an opportunity for young people to discuss their abusive behaviours and share ‘ideas’ that may contribute to the shaping of aggressive/violent behaviour – again this would require a thorough risk assessment.
· You would also need to consider the location of group and the individual ability of a young person to be transported using taxis (again this risk would need assessing). Furthermore young people may see group time as an opportunity to abscond from their accommodation to engage with risk taking and thrill seeking behaviour – have you considered them perhaps coming to group under the influence and the implications of this?
· Have residential staff been part of the conversation about involving CEDAR? Is there any potential duplication of work? What other interventions or support services are currently part of the child’s plan?