2.13 Disguised compliance, coercive control and families who are hostile or resistant to change

This guidance addresses issues that arise when professionals are working with families who they have been unable to engage with.

‘Disguised compliance’ was first coined by Reder, Duncan and Gray, a psychiatrist, psychologist and social worker, who reviewed 35 serious child abuse inquiries in England (Reder and colleagues, 1993). They found that parents appeared cooperative to neutralise a professional’s authority and reduce statutory involvement, ultimately delaying an accurate assessment of risk for the often unseen and unheard child (Brandon and colleagues, 2008).  As a result, the term ‘disguised non-compliance’ was introduced to describe the behaviours of adults responsible for the care of their child who appeared to undermine child protection procedures and who sought to reduce professional involvement. Reder and colleagues (1993) also found that disguised non-compliance was commonly shown by parents who had a poor sense of control over difficulties impacting their quality of life and had an apparent urge to regain some control within the parent-professional relationship.

Coercive Control - In December 2015, a new offence of Controlling and Coercive Behaviour in an Intimate or Family Relationship was brought into law under the Serious Crime Act (2015). The law recognises that a pattern of coercive control lies at the root of domestic abuse.  Coercive and controlling behaviours are a form of gender-based violence used by perpetrators to limit another person’s freedom by making them subordinate via the use of humiliation and threats. They do not relate to a single incident but rather a purposeful pattern of behaviours carried out over a period of time.

Controlling behaviour is a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour. 

Coercive behaviour is a continuing act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim (Home Office, 2015).

Hostile and Resistant relationships in social work practice may be expressed in aggression, in open refusal to cooperate, or in missed appointments and other forms of avoidance, or it may be masked by superficial cooperation. The common feature in all cases is failure to change, and a refusal or inability to acknowledge or address the risk to the child’s welfare.

Key Messages:

• Resistance, non-engagement, and non-compliance can contribute to children being unseen and unheard.
• The complexities of adults’ problems can eclipse children’s needs.
• Overly optimistic views on small improvements and not always keeping history in mind are common pitfalls in child protection work.
• Practitioners must ensure they are not unwilling to make critical judgements; underestimating harm to children; or developing fixed views of families that are not updated in light of contrary evidence.
• Respect the right of parents/carers to challenge any professional’s interpretation of events, assessment of their child’s needs or assessment of risk to the child. Challenge is not necessarily resistance.
• Confirm that the parents/carers understand the concerns and what is expected of them.
• Assess what, if any, contribution the service approach and/or interventions may be making to the resistance.

Disguised Compliance

The techniques by which parents/carers resist change tend to draw attention toward their needs and away from the child’s needs, and to draw the focus of work toward achieving their cooperation rather than ensuring that the child receives adequate care. The consequential effect of this is to create a situation in which the child remains at risk of significant harm and there is no sustained improvement in his/her care. Ultimately the child/ren will fail to thrive in this environment.

It can be more difficult for professionals to identify the challenges in working with parents who appear pleasant and amenable, agree with the need for change, but who are unable or unwilling, despite interventions, to bring this about satisfactorily.  The term 'highly resistant' sits on a continuum.  At one end a certain degree of reluctance on the part of parents who know they need help but find it hard to accept can be predicted.  At the other end are a small number of highly manipulative parents who are very accomplished at misleading professionals.  This is referred to as 'disguised compliance'.

Coercive Control

In some family relationships there can be a strong element of 'coercive control' occurring.  Coercive control describes a range of patterns of behaviour that enable a parent/carer to retain or regain control of a partner, ex-partner or children.  The impact of coercive control within families can have a significant effect on how family members respond to professionals, even when they are highly motivated to change their situation.  In such situations victims may feel it impossible to talk openly and honestly with professionals despite a desire to do so. 

Professionals need to be aware of the impact on the behaviour of victims where there are high levels of fear and difficulties articulating the abuse and what makes them afraid.  It is possible for professionals to unwittingly collude with the perpetrator, further isolating the victims within the family.  Evidence suggests that perpetrators of coercive control do not easily cease their abusive behaviour, often seeking to manipulate and control professionals or making allegations about the victims. Often victims of control and coercion do not recognise that they are victims which makes engagement problematic for professionals.

Professional Curiosity

In such cases it is important that practitioners are professionally curious.  Professional curiosity is a combination of looking, listening, asking direct questions, checking out and reflecting on information received.  It means not taking a single source of information and accepting it at face value.  It means testing out your professional assumptions about different types of families.  It means triangulating information from different sources to gain a better understanding of family functioning which, in turn, helps to make predictions about what is likely to happen in the future.  It means seeing past the obvious.

Working Together to Safeguard Children 2023 makes it clear that no single practitioner can have a full picture of a child’s needs and circumstances and, if children and families are to receive the right help at the right time, everyone who comes into contact with them has a role to play in identifying concerns, sharing information, and taking prompt action.  It is the sharing of information with other agencies that can help identify the truth or otherwise of a situation.

If criminal offences are identified, support for reporting to authorities including the Police should be encouraged as this can provide intervention to disrupt the coercive control by the perpetrator. If children are identified as victims safeguarding procedures should be followed in line with ‘Working Together 2023’.

Resistance may be expressed in overt refusal to cooperate with services to protect children at risk of harm.

Resistance may be masked by outward compliance, which is not carried through in practice, for example when parents/carers fail to carry out agreed tasks, or where there are repeated missed appointments. This is often referred to as disguised compliance.

Indicators of disguised compliance or resistance might include:

• No significant change at reviews despite significant input
• Persistent or intermittent failure to keep appointments
• Parents/carers agreeing with professionals regarding required changes but put little effort into making changes work
• Change occurs but as a result of external agencies/resources, not parent/carer efforts
• Parents/carers engaging with certain aspects of a plan only
• Change in one area of functioning is not matched by change in other areas
• Parents/carers splitting or allying themselves with certain professionals by  seeking to blame other professionals for things not happening.
• Parents/carers attempting to refocus the attention of professionals by presenting a pattern of crises which detract from planned interventions
• Child's report of the situation is in conflict with report from parent/carer

The possibility of resistance to change should be considered when interventions fail to provide timely improved outcomes for the child. However, before concluding that a family is resistant to change, the professional should consider whether the parents/carers understand what is expected of them and why it is necessary. Capacity to change has two elements: motivation and ability. A parent may have the knowledge and ability to change, but not the motivation; or have the motivation, but not the ability e.g., they may not understand what is being asked of them. It is therefore important that professionals assess a parent’s capacity to change.

When practitioners use the term disguised compliance in case notes, examples or evidence of the behaviour and implication on the child should be provided to support this.

Professionals should be conscious of the right of parents/carers to challenge any professional’s interpretation of events, assessment of their child’s needs, or assessment of risk to the child. This does not constitute resistance, provided that the child’s safety and welfare is safeguarded.

Examples of coercive and controlling behaviours might include:

• Controlling or observing victim's daily activities, including being made to account for their time, restricting access to money, restricting their movements
• Isolating the victim from family/friends; intercepting messages or phone calls
• Constant criticism of victim
• Threats of suicide, homicide or familicide
• Preventing the victim from taking medication or accessing care
• Using children to control a partner
• Extreme dominance
• Extreme jealousy
• Damage to property, including pets
• Threats to expose sensitive information (e.g. sexual activity) or make false allegations
• Involvement of wider family members/community; crimes in the name of 'honour'
• Manipulation of information given to professionals

Impact on Children & Young People

Where a child lives with their parent(s) or carer(s), risk and needs cannot be optimally assessed and managed without the co-operation and involvement of parents. Parental resistance, non-engagement and disguised compliance when there are child protection concerns can therefore result in the following negative outcomes for the child: 

• A child may remain in a high-risk situation and potentially come to significant harm
• Wellbeing does not improve and may deteriorate
• A child becomes subject to a compulsory supervision order or accommodated where these interventions may not have been necessary if there had been effective engagement.

Some examples of the mechanisms through which parental resistance, non-engagement and disguised compliance can be associated with poorer outcomes for children are described below.

• An incomplete assessment may result in significant needs and risks being unrecognised and therefore not taken into account in decision making and planning to support the child
• If the impact of parental resistance, non-engagement and disguised compliance on the workers ability to undertake an assessment of the circumstances of the child and on the likelihood of co-operation and compliance with the child protection plan is not recognised, these will not be considered additional risk factors and taken into account when making decisions to protect the child
• If parents are resistant to the implementation of a child protection plan (for example by not engaging or by deliberately sabotaging the plan) this is likely to undermine the effectiveness of the plan in achieving the objectives of making and keeping the child safe and promoting their wellbeing
• Where the time and emotional energy of staff who are supporting the child is diverted to overcoming parental resistance, they have less capacity to focus directly meeting the needs of the child
• Where the time and emotional energy of parents/carers is focussed on avoidance or hostility towards services then they may be less emotionally available for their child than would otherwise be the case
• Children who are aware of hostility and distrust of support services by their parents/carers may themselves adopt this pattern of behaviour and miss opportunities to benefit from working with support services

Engaging Hostile and Resistant Families - Tools and Tips

There are a number of common strategies that could be used to address and improve engagement. 

• Re-evaluating your engagement strategy and communication techniques
• Identifying how engagement could be improved, by reflecting on what has not worked and what might instead work
• Using strengths-based approaches to identify even small signs of positive engagement with a view to building “successes”
• Discussing the issues/concerns with the child, young person and/or family and identifying solutions together
• Meeting families in a different environment outside the family home
• Discussing the issues/concerns with a supervisor, manager or colleagues
• Consider underlying factors – could these be alleviated? There are some particular tools that may be useful when working with resistance, non - engagement and non - compliance:

Assessing need and risk

Assessment of need and risk in a child protection context must always be undertaken on a multi-agency basis.  It requires workers to gather all relevant information, analyse this in terms of impact on the child, identify any needs and risks that require action and plan the action required to address the needs and risks. There are obstacles immediately apparent when considering the impact of non-engagement and resistance on the process of assessing risk and need.

There may be difficulties in gaining access to the child and/or their parent/carer. Where access is possible, it may be very limited. For example, the parent may not allow the child to be seen alone, the parent may refuse to share background information or the resistance by the parent may mean particular assessment tools routinely used to gather and analyse information are not able to be used/effective.

Many parents/carers have their own legitimate needs, experienced trauma from poor parenting and their own adverse childhood experiences (ACES) impacting on their ability/capacity to parent, poor housing), homelessness, poor mental health, experiencing loss and bereavement etc, and may seek to raise several such issues during the assessment process. Professionals can become focused on addressing these needs sometimes with a sense that if they can resolve some of the parent’s/carer’s issues it might be easier to focus the parent on the needs of the child. But for the parents/carers who deliberately seek to deflect from the concerns for the child through non- engagement and resistance, there will be no end to their demands and professionals can become caught up in a cycle of crisis perpetuated by parents/carers.

Issues which impact on parents and carers will often impact on children and professionals may well have the view that such intervention is aimed at improving outcomes for children.

However, without a clear professional analysis of the needs and risks for each child, which informs the child’s plan, intervention will instead be driven by the needs of parents and carers.

Checklist

When a professional feels that a family may be resisting change that is necessary to safeguard the child’s welfare, they should:

• Assess the evidence
• Inform their supervisor
• Consult other professionals and consider arranging a professional meeting
• Revisit the causes for concern with the family and confirm parent/carer understanding of what is expected from them
• Seek the views of the child(ren)/ assess lived experience
• Weigh the level of resistance and the seriousness of the concerns
• Ensure that agencies coordinate their efforts; and
• Arrange a review of the risk assessment including the assessment of impact of barriers and delay on the child’s development and safety

Any professional who identifies resistance or is concerned about whether there is a dynamic with a hostile family which is impacting on the assessment or intervention, should discuss this with their own supervisor before reporting it to the lead worker, who will consult all the professionals involved with the family. This may be done, as part of the Early Help Plan, through the Core Group, or by reconvening a strategy meeting to establish whether this requires a Sec 47 response which could lead to a  Child Protection Conference, depending on the level of concern and threshold at which the concerns are being monitored. It is important to identify whether the resistance relates to a single agency/professional or to several, and whether there are any professionals working with the family who do not experience resistance.

Professionals should consider the nature and seriousness of the current reasons for concern for the child’s welfare. These may not be immediately clear as:

• A family may avoid engagement by drawing attention away from the child’s needs and toward the needs of parents or other family members; and
• A family that avoids engagement may present as motivated to address their child’s needs but encountering difficulties in doing so.

Professionals should carefully reassess the seriousness of the concerns in the context of the evidence of resistance. When there is concern about a child’s welfare, and the family take positive action to conceal information, this is in itself a risk factor, but the total assessment of risk must be based on the evidence as to whether or not the child’s needs, including the need for protection, are being met.

When resistance is identified in a family it is essential that work remains focused on the child’s welfare. Agencies should coordinate their actions to take advantage of any good relationships the family may have with professionals.

Professionals must ensure that the aims and objectives of a plan (e.g. Early Help, Child in Need or Child Protection) are clear, and that each agency’s role in the plan is clear. It may be appropriate to reallocate responsibility for some tasks, but any change must be justified in terms of meeting the child’s needs.

If insufficient progress is made in achieving the tasks set out in the plan, the professionals must reconvene to reconsider the risk assessment. The meeting (e.g. core group) must consider whether the threshold for action to escalate concerns (e.g escalate to child protection or evoke PLO proceedings) has been passed - if there is resistance to change, the risk is not reducing, and it may be increasing. Action and decisions should be assessed by managers to prevent any drift and delay in meeting the child’s needs.

The professional should check the records of contact with the family and estimate the size of the problem:

• Consider any reasons the family give for their failure to progress. Are they plausible? What action can be taken to test whether the problems come from circumstances that are genuinely beyond their control or from a refusal to cooperate?

• If the family cooperate in keeping contact, but no progress is evident, check whether clear expectations were stated, what tasks were agreed and what proportion of them were completed.

• • Have certain tasks been completed satisfactorily?
  • Have some tasks been agreed repeatedly but not carried out?
  • What is the significance of the tasks that have and have not been addressed in terms of the child’s welfare?
  • Particular consideration should be given as to how any barriers to, and the delays in change being achieved, impacts on the child’s development.

• If the frequency of contact with the child is inadequate it is not possible to know whether the risk is increasing, reducing or staying the same, and the plan is unsafe. If concerns arise because of failed contact, professionals should analyse the risk to the child. 
  • One failed contact may require immediate action, such as making a referral to the MASH / Front Door, or if less urgent, may benefit from a discussion with other professionals to  identify how often the family allows other practitioners to see the child, talk to them alone or check their living conditions;

If any of the above is identified action should be taken without delay.

Where a decision is made that change is necessary to safeguard the child’s welfare, the plan will not be effective unless there is progress in achieving that change!

Impact on Professional Practice

Parents/carers who demonstrate resistance through aggression or open hostility towards professionals can be extremely intimidating.  Behaviours may be deliberately used to keep, or can have the effect of, keeping professionals at bay.  Professionals may find themselves seeking to avoid difficult or challenging interventions with the family, either consciously or unconsciously, and this dynamic must be addressed during supervision in order to ensure that the safeguarding needs of the children in the family are firmly kept in focus.

Some coping strategies developed by professionals which can obstruct engagement with families are:

• Seeing each situation as a potential threat and developing a 'flight' response whereby the professional can be overly challenging, thus increasing the tension between him or herself and the family. This may protect the professional physically and emotionally but can lead to desensitisation to the child's pain and to the levels of aggression which exists within the home.  As a result the harm to the child can be under-estimated
• Colluding with parents/carers by accommodating and appeasing them in order to avoid provoking a reaction
• Becoming hyper alert to the personal threat so that the professional becomes less able to listen accurately to what is being said or is distracted from observing important responses by the child or interactions between the child and other family members
• 'Filtering out' negative information or minimising the extent or impact of the child's experiences in order to avoid having to challenge. At its extreme, this can result in professionals avoiding making difficult visits or avoiding meeting with those adults in their home, thus losing important information about the home environment
• Feeling helpless or professionally paralysedby the dilemma of deciding whether to 'go in heavy' or 'back off'. This may be either when faced with escalating concerns about a child or when the hostile barrier between the family and outside means that evidence about the child's situation appears minimal
• Confirmation Bias – is when we look for evidence that supports or confirms our pre-held view and ignores contrary information. Confirmation bias can impact judgement and action – it prevents practitioners from working in a child focused way or effectively assessing the risks that a child faces as they naturally seek to find evidence that supports the fixed view they hold 

Tips for self-reflection

If family members are hostile/aggressive assess how far their hostility is impacting on the assessment by considering the following questions:

• Am I colluding with parents/carers by avoiding conflict, e.g. focusing on less contentious issues, avoiding asking to look round the house, or not asking to see the child alone?
• Am I changing my behaviour to avoid conflict?
• Am I filtering out negative information or minimising?
• Am I afraid to confront family members?
• What message am I giving this family if I don't challenge?
• Am I relieved when there is no answer at the door/when I get back out of the door?
• Did I say, ask and do what I would usually say, ask and do when making a visit or assessment?
• Am I working with the key people or focussing on the less intimidating family members?

Tips for Managers to support Professionally Curious Practice

• Play ‘devil’s advocate’, asking ‘what if?’ questions to challenge and support practitioners. 
• Present alternative hypotheses about what could be happening.
• Provide opportunity for group supervision to stimulate debate and curious questioning. 
• Present cases from the perspective of other family members or professionals. 
• Ask practitioners what led them to arrive at their conclusion and support them to think through their evidence. 

It is important to recognise that where an individual is perceived as intimidating or dangerous to professionals, there is a strong possibility that they are also dangerous to the children and other members of the family.  If professionals are scared and intimidated, it is very likely that any children in that individual's care may be at risk.

The principles of good relationship building in child protection cases remain constant:

• Never underestimate the power of consistency, honesty and transparency
• Respect and be sensitive to other’s viewpoints, feelings and experiences
• Always keep the focus on the best interests of the child
• Listen actively to others and attempt to understand the world of the child and their parents/carers
• Work collectively with the other professionals involved with the family, following the agreed plans and decisions, presenting a united front
• Make use of supervision to reflect, avoid collusion, or allowing relationship issues to cloud your view of the best interests of the child
• Remain aware of the impact of the relationship on you as an individual and share this with your supervisor to ensure you receive effective support

Support for Teams Around the Child

When working as part of a team around the child, resistance should become central to ongoing information sharing, assessment, analysis, planning and review. Multi-agency plans for children will set out anticipated outcomes, with associated tasks, supports, timescales and responsibilities, but unless resistance is actively considered and explored at every opportunity, the team around the child will be unsuccessful in implementing the child’s plan effectively.

Use of Chronologies

Chronologies are effective tools in analysing a child’s circumstances and they can also help to identify both the existence of resistance, the nature of resistance and any patterns that help understand both how resistance manifests and how it might be addressed. It is therefore important that each service involved with the family maintains a single agency chronology which is shared across services in order to identify and agree significant events which would form an integrated chronology.

Professionals’ Meetings

It is important to work in a transparent way with families, in order to foster partnerships with parents/carers who are critical members of the team around the child. But there may be circumstances where professionals would benefit from meeting away from families to specifically discuss resistance behaviours being displayed by families. It is crucial that this is done in a safe and constructive manner.

In cases where a particular individual or service appears to be experiencing resistance from parents/carers, it is important to explore possible barriers to engagement that are specific to the worker or service, along with considering why the parent/carer might be choosing to target one particular service. While there is a need to consider how we might be contributing to resistance, individual staff or services should be supported with this type of reflection. Remember that some parents/carers deliberately select a service with whom to deploy resistance behaviours, with the sole purpose of encouraging focus to shift from their own behaviours to the individual service. If the team around the child falls into this trap, they could be colluding with a family’s resistance.

Shared Ownership

When parents/carers are challenged in respect of any resistant behaviour, it is important that there is shared ownership across all professionals working with the child or family  about why this behaviour is a concern. Services must be careful not to be drawn into discussions about individual services not present. Similarly, services should not act in isolation when planning strategies to address resistance. Actions such as:

• Changing worker
• Changing usual service delivery model
• Closing the case

These should all be discussed across the team around the child before the action is initiated. While changing a worker or barring a parent/carer from a particular office might well be actions that are decided as necessary in a particular case, it is important to have multi-agency discussion in order to test out any unforeseen consequences of such actions.

Effective Supervision

Managers and supervisors should consider how to facilitate working environments which ensure support for staff both in managing the individual impact of working with these types of behaviours, and in managing the impact on ongoing assessment and decision-making.

Managers and supervisors play a critical role in identifying resistant behaviour in families and its impact. The following are critical for managers in supporting staff:

• Provision of regular, effective supervision
• Clear messages to service users about acceptable/unacceptable behaviour towards staff
• Space to debrief
• Opportunities to reflect

Strategies to support particular aspects of the case – such as joint visits to volatile or aggressive families.

Tips for Effective Supervision

The following are questions helpful for managers to consider and explore in supervision:

1. Does the worker have experience of the parent/carer being hostile, intimidating, threatening or violent?
2. Does the worker have experience of the parent/carer displaying resistant behaviours?
3. 3. What is the view of the resistant behaviours when each individual incident is viewed collectively?
4. Is the worker intimidated or fearful?
5. Does the worker feel sorry for the parents/see the parents as victims?
6. Is the worker protective of the parents/minimising concerns expressed by others?
7. Is the worker effectively challenging of issues and behaviours when necessary?
8. Is the use of complaints or threats of complaints affecting the worker or the intervention?

When resistance is recognised in a family, attention may be diverted to the resistance itself, however focus should remain on whether the risk to the child is increasing or decreasing or has changed in nature.

If one or more agencies have established reasonable relationships with the family, these relationships should be identified and appointed to become the lead agencies to maintain communication to balance the difficulties experienced by other agencies, provided that appropriate progress is being made as set out in the plan.

Key Messages

• Working with resistance, non-engagement and non-compliance has an impact on individual workers as well as upon wider service intervention
• Individuals can feel isolated and vulnerable, and managers have a responsibility to support and protect their staff from the impact of their work
• Working environments must create safe spaces for staff to talk about how they feel in relation to the work they do
• Teams around the child should guard against inadvertently colluding with a family’s resistance
• Single services should not take action to address resistance without multi-agency discussion (unless immediate safety is compromised)
• The risks and benefits of strategies to address resistance should be explored on a multi-agency basis
• Staff need to be equipped with knowledge and skills when working with resistance, non-engagement and non-compliance.

• British Association of Social Workers: Effective practice to protect children living in ‘highly resistant’ families
• Summary of risk factors and learning for improved practice around families and disguised compliance
• Coercive control is now a criminal offence and statutory guidance has been produced for police and criminal justice agencies
• Findings in the latest National Panel CSPR report