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Safeguarding Children in Therapeutic Settings: Cultural Coercion in Assessing Risk

When does child safeguarding become a safeguarding issue in its own right? When child protection procedures are implemented without cultural competence, and without listening to the experiences of the children whose family roles and values are being pathologised. Gretchen Precey, independent social worker, draws therapists’ attention to the traumatising impact of some state interventions as she shares her encounter with one Eritrean teenager whose anxiety, depression and tics told a complex story.

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Sometimes I think I spend more time protecting children from the well-intentioned but misguided intervention of the state than from a shortcoming in the capacity of the parents to care for their children.

The impact of immigration in the UK has introduced to our previously largely monocultural society different ways of seeing the world, different understandings of how family life is conducted and different definitions of what is expected of children and what they can expect of adults.

Our society has become much more diverse and vibrant as a result. But it also finds itself having to cope with traditions and values that are not always a good ‘fit’ with how we operate procedures that are intended to keep children safe. Sometimes, in my work as a social worker and a trainer in safeguarding awareness for therapists and counsellors, I see the disastrous consequences for their mental health.

It often falls to social workers, especially those working in areas with high levels of cultural diversity, to apply policies and procedures to families for whom those concepts are alien and threatening and sometimes traumatising.

As an independent social worker undertaking parenting assessments I am often in the fortunate position of being able to spend extended periods of time with families trying to discover their cultural understanding of family values and practices and how that is sometimes at odds with the child protection system that operates in this country.

I recently worked with an Eritrean family whose children had been removed because of concerns about neglect and possible physical abuse. My role was to undertake a parenting assessment of the mother and the father. One of the older children, Haben (not her real name) was 13. She was a very bright girl with aspirations to read psychology at Cambridge, a goal her school thought was within her reach.

Haben was being seen weekly by CAMHS because of anxiety, depression and an inability to tolerate staying in class at times when her anxiety was heightened. She was also one of the cohort of children who made the huge transition from primary to secondary school during the height of the pandemic, and therefore without the normal support.

Another feature of her psychological presentation was a feeling of not fitting into adolescent life in west London. She came from a family of observant Muslims. Her father arrived in this country as a refugee and struggled to make a life for his family in the UK. Haben felt she could not confide in him about her alienation and isolation because of what her father had sacrificed.

One of the concerns that led to children’s services becoming involved was the frequency with which Haben collected the younger children from primary school. She was also sent to parent’s evenings to stand in for her parents who did not speak English, and for whom an interpreter was not provided as a matter of course.

Haben was identified as suffering significant harm at the hands of her parents. The court orders specified emotional abuse due to having to become a ‘parental child’ and take on family responsibilities beyond her years.

When I spoke to her about this, Haben’s fury was plain to see. She was adamant that she “was not doing my mum’s job for her”. She loved her younger siblings and wanted to help with their care. This was not a ‘burden’. It was part of her culture. Helping in this way made Haben feel anchored and useful in the traditional roles of her family Eritrean culture when many Western values felt alien to her.

Haben felt her family’s way of life was being misunderstood and pathologised. She also began to feel blamed for being complicit in behaviour that contributed to the state having cause to break up the family.

Her anxiety and depression worsened and her tics and inability to settle in class became more pronounced.

Because the family had experienced a series of social workers since care proceedings were issued, no one had an overview of how this family functioned and the cultural context that this was drawn from. Unfortunately, with the relentless churn of staff in social work departments, especially children and families, this is not unusual.

This kind of cultural coercion is, I feel, a safeguarding issue in its own right, and one therapists need to be more aware of in order to best support children like Haben. No one had spoken to Haben about what this experience meant to her, and her guilt at feeling responsible for contributing to the breakup of the family exacerbated the decline in her mental health.

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Gretchen Precey

Gretchen Precey is a qualified social worker who has worked with children and families for 40 years, in a number of local authorities across the country and, for the past 20 years, as an independent social worker. She undertakes parenting assessments as an expert witness in family court and consults to different agencies on various aspects of safeguarding and child protection. Gretchen also facilitates training courses for professionals involved in child welfare work. Among her clinical interests are safeguarding children about whom there are concerns regarding Fabricated or Induced Illness (formerly known as Munchausen Syndrome by Proxy) and working with inter-familial child sexual abuse. More information can be found on her website www.gpsocialwork.co.uk.

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