Research Note: An Attempt to Classify Adolescent Parasuicide Attempters

Correspondence to David Gilliland, Principal Social Worker, The Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast BT12 6BE. Summary This paper examines some of the literature available on thesubject of adolescent suicide attempts. It discusses the extentto which it is possible to identify sub-groupings within groupingsof young people who took overdoses. It suggests on the basisof the study undertaken (and in reference to other studies)that it may be possible to identify sub-groupings. The paperalso discusses in detail a study carried out examining characteristicsof two groups of young people—one who had been admittedto hospital following a single overdose attempt, and a secondgroup who had several admissions to hospital following repeatedoverdose attempts. The implications of these findings are discussedin terms of the possibilities of identifying young people whoare at an increased risk of repeating an overdose attempt, andthe issues for practitioners and service managers are identified.     

Do Nothing but Do Something: the Effect of Human Contact with the Parent on Abusive Behaviour

Summary This study examines whether a mere human contact, which is notaccompanied with any definite treatment goal or technique, canbring about a change in the behaviour of abusing mothers. Resultsindicated that after three months of social contact betweenthe layman, intervening woman and 40 abusive mothers, significantchange could be seen in the abusive behaviour. This change didnot last when the contact with the mother was terminated. Threeelements inherent in the contact were mentioned by the mothersas an explanation; social control, attention, and easing theburden. The paper ends with a discussion of the use of humancontact as a method of treatment, its advantages and disadvantages.     

An Innovative Project for Young People in Care Who have been Sexually Abused

Correspondence to Willm Mistral, The Mental Health Research and Development Unit, 3 East, 2.10, University of Bath, Bath BA2 7AY,UK. E-mail W.Mistral{at}bath.ac.uk Summary Professional awareness of child mental health problems and sexualabuse has increased greatly over the past 20 years, and thisis especially true for young people under the care of socialservices. The current paper provides an overview of the researchliterature on needs and service provision in this area. It goeson to describe an innovative interagency project in Dorset whichoffers flexible, fast track intervention packages to lookedafter young people with a profile indicating sexual abuse, whohave been reluctant to engage with conventional child and adolescentmental health services. The paper includes preliminary resultsfrom an evaluation of this project and discusses the implicationfor future service provision.     

Children and young people with a hidden disability: an examination of the social work role

Summary There has been little research attention paid to the natureand extent of social work intervention with children and youngpeople with invisible impairments. The recent study describedhere found that children and young people with a hidden andstigmatizing impairment received a social work service whichwas at a minimal level. The children and young people were affectedby physically induced incontinence, and described how they facedan environment which created particular tensions. Their parentsconcurred with this overall picture and reported unmet needs.Recommendations are made about social services input, but itis recognized that the level of social services interventionavailable to these families may, in part, be a reflection ofa low priority assigned to disabled children generally. It isargued that, although such an assignment is a common picturein recent research about social services provision to disabledchildren, a change in priorities is needed which recognizesthe importance of coherent support to disabled children as ameans of improving their environment and thereby reducing families'stress levels and the likelihood of abuse or rejection.     

Gender, Ethnicity and Vulnerability in Young Women in Local Authority Care

Correspondence to Sue Lees, University of North London, 9 Northolme Road, London N2 2VZ, UK. E-mail: S.Lees{at}unl.ac.uk Summary This paper analyses the impact of gender and ethnicity, takentogether, on the experience of being looked after away fromhome. It presents the findings from a study of young women,aged over 12, who came into care in one local authority between1990 and 1999. It reports that the over-representation of youngblack women in care is associated with the greater tendencyof African-Caribbean and mixed heritage young women to run awayfrom home rather than put up with abusive relationships; thelack of cross-generational support resulting from migrationand the effects of poverty and racism which place added strainon family relationships. The implications of these findingsfor social work practice are considered.     

Professional Advocacy as a Force for Resistance in Child Welfare

Correspondence to Jane Dalrymple, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton, Bristol BS16 1DD, UK Summary The development of child and youth advocacy is a relativelyrecent phenomenon, increasingly recognized by both practitionersand politicians as a way of establishing communication spacesfor young people who are looked after in state care. Literatureto date has focused on the development and underpinning principlesof child and youth advocacy, which is a necessary starting pointfor establishing good practice. However, while policy and legislationpromote the view that young people are actively involved indecision making, their advocates can be placed in a passiveposition, effectively denying young people a position as socialactors. This paper argues that the problemitizing of independentadvocacy as unprofessional can serve to further marginalizeyoung people and render advocates impotent. It suggests thatwhile it is structurally necessary for adults to take on theadvocacy role, this must be undertaken in a way that activelyresists the oppression of young people. Through considerationof accounts of advocacy activity, by way of illustration, thepaper takes the debate beyond the principles of participation,empowerment and rights to a consideration of strategies thattake into account the complexities of advocacy practice in childwelfare.     

Betrayal of Trust: A Feminist Analysis of Power Relationships in Incest Abuse and its Relevance for Social Work Practice

Correspondence to Dr Lena Dominelli, Department of Applied Social Studies, The University of Warwick, Coventry CV4 7AL. Summary Feminist analyses of incest have revealed that this is a highlyprevalent form of sexual abuse which is perpetrated primarilyby male assailants against young girls. Feminists have focusedon incest as the expression of unequal power relations withinthe family, and demonstrated that it is more than the genitalpenetration of a young girl by her father or step-father. Thispaper examines incest from a feminist perspective and highlightsthe significance for the incest victim/survivor of the abuseof power taking place within intimate ‘family’ relationships.This abuse of power cannot be seen as anything other than abetrayal of trust which undermines the young girl's view ofherself as a sexual being and reinforces her feelings of powerlessnessand subordination. These feelings are very difficult to overcomeeven after disclosure, though dealing with them provides a cornerstonefor feminist work with incest victims/survivors. Moreover, workfeminists have already undertaken in this area holds significantlessons for practitioners wishing to improve their practicewith those experiencing incest abuse.     

Abuse of Elderly Men and Women among Clients of a Community Psychogeriatric Service

Correspondence to Gail Wilson, Department of Social Science and Administration, London School of Economics, Houghton Street, London WC2A 2AE. Summary This paper reports on a study of elder abuse among clients ofan outer London community psychogeriatric service. Staff reportedelder abuse in their caseloads over a period of one year. Reportedcases were linked with referrals. Rates of abuse for differentstaff and for different age and ethnic groups were calculated.Women were very much more likely to be abused than men and wereless likely to be abusers. Clients were frequently reportedas abusing their carers. Staff reporting rates varied widely.Training and the time available to win the trust of clientsappeared to be important variables. The staff response was limitedby lack of managerial support and by lack of developed strategiesfor dealing with abusive situations. Separation was the mostcommon response to physical violence in the home. Financialabuse was mainly dealt with by social services. Staff abusewas largely ignored.     

Are Young People in Correctional Institutions Different from Community Students Who Have Never Been Convicted?: Differences in Internalizing and Externalizing Behaviours

Correspondence to Byoungduk Sohn, Department of Social Policy and Social Work, University of Oxford, Barnett House, 32 Wellington Square, Oxford OX1 2ER, UK. E-mail: byoungduk.sohn{at}linacre.ox.ac.uk Summary By comparing the prevalence of emotional and behaviour healthproblems among institutionalized juvenile offenders with thatamongst a non-offending sample of adolescents, this study indicatescommon characteristics of the perceived emotional and behaviouralproblems, and describes risk factors pertinent to persistentjuvenile offending. Familial backgrounds, behavioural and emotionalmeasures were collected through self-report surveys. Resultsshowed that young people in secure units claimed significanthigh levels of emotional and behavioural problems and that thoseproblems were associated with their disadvantaged familial socio-economicbackgrounds and perceived parenting factors. Various policyimplications are recommended to tackle problems amongst thesedisadvantaged young people in correctional institutions in Korea.In particular, for those working with young people in correctionalinstitutions in the UK, the findings highlight the importanceof culturally relevant programmes.     

Closing the Circle: Social Workers' Responses to Multi-Agency Procedures on Older Age Abuse

Correspondence to Professor Michael Preston-Shoot, School of Law and Applied Social Studies, Liverpool John Moores University, Liverpool, L7 4DN, UK. E-mail: m.prestonshoot{at}livjm.ac.uk Summary This paper reports findings from a project which examined howinter-agency procedures on older age abuse in domestic settingswere used in one local authority. Observations about the useof procedures and about practice with older people who had beenabused are placed in the context of national policy developmentsand are reviewed alongside the available literature. The researchquestions the extent to which guidance is effective in providingdirection for practitioners who encounter older age abuse, andhow well guidance and practice combine to protect victims.     

Developmental markers of risk or vulnerability? Young females who sexually abuse – characteristics,backgrounds, behaviours and outcomes

This paper presents findings from a subsample of 24 young females aged 8–16 years who were referred to specialist services in England during the 1990s because of their abusive sexual behaviours. The characteristics, backgrounds and behaviours of the sample are summarized and compared both with the males in the total population studied and with findings from the limited international literature on young female sexual abusers. Key findings include the higher rates of sexual victimization amongst females, their lack of prior criminal convictions, their somewhat younger ages at referral and their fewer victims. A smaller selection of case studies is used to illustrate the range of circumstances and behaviours leading to referral. Follow‐up interviews with two female ex service users, who are now in young adulthood, indicate that their childhood sexually abusive behaviour is more a marker of vulnerability than of risk of abusive behaviour in adulthood. Their struggles now as parents, in adult relationships and their ongoing health difficulties are outlined.     

Independent Living Schemes: Organization, Resident Characteristics and Outcomes

Correspondence to David Phillips, Department of Sociological Studies, University of Sheffield, Sheffield S10 2TN. Summary This paper presents the findings of a major follow-up studyof independent living schemes (ILSs) for people with mentalhealth problems and people with learning difficulties. The surveywas undertaken in four local authority areas and covered 171schemes accommodating 481 residents. Information was gatheredon the characteristics of the schemes and their occupants, withparticular reference to the suitability of the ILSs in meetingresidents' needs. It was found that mixed-sex ILSs and ILSsrun by voluntary bodies in cooperation with statutory agencieshad higher than average success rates.     

Hard to reach and easy to ignore: the drinking careers of young people not in education,employment or training

Young people's drinking in the UK remains a matter of medical, social, media and political concern. The notion of transition and drinking styles in the move from childhood to adulthood and from education to employment has been central to understanding young people's drinking behaviour, but little is known about how the drinking patterns of those not in education or employment, both men and women, develop over time. This paper reports on research which aimed to examine the current drinking habits and drinking careers of young people not in education employment and training who are traditionally described as hard to reach. In‐depth qualitative interviews were undertaken with 23 young people: 15 women and 8 men aged between 14 and 23. The findings are presented with respect to three stages of drinking: starting, continuing or increasing, and decreasing or stopping. The conclusions indicate that for the majority of these young people, alcohol is a significant factor in their lives and that peers, gender, time and place combine to structure both their current alcohol use and drinking career. The paper argues that an understanding of young people's drinking career development and current alcohol use will help target effective social work and multi‐agency intervention.     

Understanding 'Going Missing': issues for social work and social services

Correspondence to Malcolm Payne, Professor of Applied Community Studies, The Manchester Metropolitan University, 799 Wilmslow Road, Didsbury, Manchester M20 8RR. Summary Recent research about young people and adults who ‘gomissing’ raises important issues for social work and thesocial services. Large numbers of young people go missing eachyear, becoming vulnerable to exploitation and at risk of committingcrime and suffering from other social difficulties. Adults leavebehind families with practical and emotional difficulties. Adefinition of ‘going missing’ should focus on absencefrom social expectations and responsibilities. Five groups ofmissing person are identified: runaways, pushaways, throwaways,fallaways and takeaways, reflecting different social situationsin which going missing occurs. It is argued that going missingis one of a range of choices which people in difficulties maymake, depending on their approach to problems in their livesand the availability of opportunities. Effective local co-ordinationto focus on reasons for going missing, on reunions and returnsto residential care or home, and to provide emotional and practicalhelp to people ‘left behind’, are required, providedthat care is taken to protect people who go missing becausethey are subject to abuse and violence.     

Shared Learning for Doctors and Social Workers: Evaluation of a Programme

Correspondence to John Carpenter, Tizard Centre, Institute of Social and Applied Psychology, University of Kent, Canterbury, CT2 7LZ Summary This paper reports a shared learning programme for final yearsocial work and medical students which was designed in the lightof social psychological studies of intergroup behaviour (theContact Hypothesis). Key features included institutional supportfor the programme and opportunities to work as equals in pairsand small groups on shared tasks in a cooperative atmosphere.Topics included alcohol abuse, dealing with psychiatric emergencies,deliberate self-harm and community senices for people with learningdisabilities. A comprehensive evaluation of the effects of the programme onone cohort of 85 participants revealed that overall attitudestowards the other profession had improved and that each sawthe other as more professionally competent at the end of theprogramme. Participants reported increased knowledge of theattitudes, skills, roles and duties of the other professionand of how to work together more effectively.     

The Association between Child Abuse and Attempted Suicide

Summary A recent survey by the authors has demonstrated that attemptedsuicide is common in parents, particularly mothers, who abusetheir children. However, the nature of the association betweenchild abuse and attempted suicide is complicated. Here somepossible types of association are suggested. In management ofchild abuse, special note should be taken of a history of attemptedsuicide in the parents because, in some cases, it suggests apoor prognosis. Similarly, young children of parents who attemptsuicide should be assessed in case they are at risk of abuse.     

Implementing the Power to Kids programme in home-based (foster) care: Identifying the SAFETY approach

Sexual abuse and dating violence are chronic problems for children and young people in out-of-home care. This study explored the impact of a prevention and response programme Power to Kids, which targets harmful sexual behaviour (HSB), child sexual exploitation (CSE) and dating violence (DV) for children and young people in home-based (foster) care. Twenty-eight case managers, 25 foster carers and 13 children and young people participated in a mixed methods study in Victoria, Australia informed by the research question: How does the Power to Kids programme impact the sexual health and safety of children and young people in home-based (foster) care? The data analysis revealed a SAFETY approach whereby the sexual health and safety knowledge of carers and case managers was enhanced, and carers were given permission to have Brave Conversations with children and young people, who could then apply the new knowledge to their lives. Case managers were upskilled in identifying indicators of sexual abuse and empowered to escalate stalled therapeutic and disruption practice when children and young people were identified as experiencing HSB, CSE or DV.     

Understanding Adolescent Female Prostitution: A Literature Review

Correspondence to Dr Jill Jesson. Aston Business School, Aston Triangle, Birmingham B47 7ET. Summary Sexual behaviour and sexuality are currently topical issuesof concern for child care social workers. Social workers arespending more and of more of their time with children who comeinto care because of sexual abuse, or who have an involvementin the ‘rent’ scene or Prostitution. In additionmany teenage young women come into care because of social orparental concern over their lsquo;promiscuous’ behaviour.The review of research on adolescent prostitution offers severalexplanations for involvement in prostitution. which vary accordingto the discipline of the author. Explanations vary from pathologicaland personal psychology factors to the wider social aspectsof the family and local environment. This literature reviewwas used as a basis for research which examined the incidenceof female prostitution for a social services department. Thisis a relatively new field of interest and consequently thereis very little British research published on the issue of adolescentprostitution, or on under age (16) prostitution. There is nopublished research on girls in care and prostitution. We needto know much more about the reality of young people's livesbefore social workers can offer a meaningful response.     

The extent and nature of known cases of institutional child sexual abuse

Summary The sexual abuse of children by persons who work with them -institutional abuse - is a focus of major concern among policymakers, practitioners and the public. Despite this, knowledgeabout it remains limited. This paper presents findings froma study of institutional abuse cases referred to social servicedepartments or the police in eight local authority areas. Whilesuch cases were relatively uncommon and constituted a smallproportion of all child protection referrals, some involvedlarge numbers of victims and abusers. Institutional abuse casesin the present study shared some characteristics with the majorityof (intrafamilial) abuse cases, but there were also importantdifferences, such as the proportion of male victims and theextent to which abuses used techniques of targeting and entrapment.Contrary to media representations, the institutional abuse reportedhere was not just a problem of children's homes, social workor the public sector, but occurred in a wide variety of settingsand sectors and was perpetrated by a range of occupational groups.If all children are to be protected, then policy and practicemeasures to prevent abuse need to be directed towards a muchwider range of institutions.