2.13 Families who resist change (including disguised compliance)
- Practice implications
- Protection and action to be taken
- Further information
This guidance addresses issues that arise when working with families who are difficult to engage. Resistance 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 refusal to acknowledge or address the risk to the child’s welfare.
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 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.
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’.
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.
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.
Protection and action to be taken
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
- consult other professionals
- revisit the causes for concern
- weigh the level of resistance and the seriousness of the concerns
- ensure that agencies coordinate their efforts
- arrange a review of the risk assessment including the impact of delay on the child’s development
- confirm parent/carer understanding of what is expected from them.
The professional should check the records of contact with the family and estimate the size of the problem:
- 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, 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 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 the delay in change being achieved impacts on the child’s development.
- 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?
Any professional who identifies resistance 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 informally, as part of the Early Help Plan, through a Child in Need meeting, through the core group, or by reconvening the 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
- 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 seek legal advice) has been passed. Where there is resistance to change, the risks to the child may not reduce, and in fact may increase. Action and decisions should manage any drift and delay in meeting the child’s needs.
If it has been agreed that change is necessary to safeguard the child’s welfare, the agreed plan has not been effective unless there is progress in achieving that change.
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.
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 do not experience resistance in their relationship with the family, this may balance the difficulties experienced by other agencies, provided that appropriate progress is being made as set out in the plan.
Effective practice to protect children living in ‘highly resistant’ families (British Association of Social Workers)