Atta c hme nt & Adole sc e nt Ha rmful Se xua l Be ha viour Be - - PowerPoint PPT Presentation

Atta c hme nt & Adole sc e nt Ha rmful Se xua l Be ha viour

Be x Da r by NSPCC (UK) Na tiona l Clinic a l Asse ssme nt & T r e a tme nt Se r vic e

Intr

• duc tion
• Ac tivity - A pilo t in the use o f AAI

, pa re nts’ inte rvie w a nd T AAI in a sse ssme nt o f a do le sc e nts who displa y ha rmful se xua l b e ha vio ur.

Se tting - A spe c ia list ha rmful se xua l

b e ha vio ur se rvic e within a na tio na l UK c hild pro te c tio n c ha rity (the NSPCC).

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Pur pose

• As the ne w ma na g e r o f this multi-disc iplina ry

te a m, whic h de sc rib e s itse lf a s a tta c hme nt info rme d, I wa nte d to se e ho w the DMM mo de l o f a tta c hme nt a nd F a mily F unc tio na l F

• rmula tio n c o uld impa c t upo n the

a sse ssme nts c urre ntly pro duc e d a nd inte rve ntio ns c urre ntly o ffe re d/ re c o mme nde d b y this te a m.

• My te a m is c o mprise d o f fo ur so c ia l wo rke rs, a

fa mily syste mic psyc ho the ra pist, a c o nsulta nt c linic a l psyc ho lo g ist, a psyc hia trist – a nd me !

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Pr

• ble m

I n the c o urse o f the pilo t I wa nte d to unde rsta nd:

• Ho w we ll fa milie s wo uld e ng a g e with the a dditio na l

me e ting s a nd the pa rtic ula r style o f the inte rvie w/ s

• Whe the r re fe rre rs to o ur se rvic e wo uld b e willing to pa y

the a dditio na l c o st/ e sta b lish the ir fina nc ia l thre sho ld

• Ho w c o uld the c o nc e pts a nd c o nstruc ts o f the AAI

/ T AAI a nd DMM b e sha re d me a ning fully with a te a m no t ye t tra ine d in the mo de l?

• Ho w c o uld the F

F F b e inte g ra te d in to o ur c urre nt a sse ssme nt re po rts?

• Whe the r the ne w info rma tio n wa s use ful to re fe rre rs

(usua lly so c ia l wo rke rs) a nd b e ne fic ia l to fa milie s.

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Me thod

• One c a se / fa mily wa s se le c te d a s a

pilo t whe re b y a n AAI fo r e a c h pa re nt, a T

AAI fo r the a do le sc e nt

a nd the par

e nts inte r vie w wo uld b e

c o nduc te d, c o de d a nd inte g ra te d in to o ur multi-disc iplina ry re po rt a s a F

amily F unc tional F

• r

mulation.

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Me thod

• All inte r

vie ws a re c o nduc te d b y me a s a sta nda lo ne

pie c e o f wo rk (i.e . no ne o f the fa mily me t me in a ny

• the r c o nte xt).
• Coding o f the tra nsc ripts is pro vide d b y the DMM

c o mmunity via Pa t Critte nde n (b y Pa t he rse lf in this c a se !)

• Inte r

pr e tation o f individua l c la ssific a tio ns a nd F

a mily F unc tio na l F

• rmula tio n is unde rta ke n b y the a utho rize d

c o de r a nd sha re d with NSPCC re po rt a utho rs a nd wide r te a m in o ur c linic a l me e ting prio r to inc lusio n in the writte n a sse ssme nt.

• F

e e dba c k is o b ta ine d fro m the fa mily a nd re fe rring

se rvic e o nc e the multi-disc iplina ry re po rt ha s b e e n sha re d.

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

T he family

• 16 ye a r o ld b o y
• De c e a se d
• lde r b ro the r
• Mo the r a g e d 42
• F

a the r a g e d 48

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

F amily histor y

Childr e n’s se r vic e s pr

• c e sse s
• F

irst re fe rra l to c hildre n’ s se rvic e s whe n T urb o is 6 we e ks o ld

• F

ive e piso de s unde r a Child Pro te c tio n Pla n fro m a g e 1y9m to 15 yrs

• L

e g a l pro c e e ding s (i.e . re mo va l) c o nside re d twic e a t a g e 9y7m a nd 14y 8m

• Multi-Syste mic T

he ra py fo r Child Ab use a nd Ne g le c t (MST

• CAN)

de live re d a g e 10y6m to 11y7m; pe rio d spa ns de a th o f e lde st c hild

• Re fe rra l to NSPCC a g e d 15y 10m

Ke y c onc e rns/ e ve nts

• PND, ma te rna l se lf-ha rm & a tte mpte d
• ve rdo se
• Do me stic dispute s, pa te rna l a lc o ho l

misuse , lo w inc o me , ? de pre ssio n, NAI s

• Child a g g re ssio n, so iling , spe e c h de la y

se xua lise d b e ha vio ur a t sc ho o l, po o r pe rso na l hyg ie ne

• E

lde st c hild dro wns a g e d 15 (T urb o is 11y4m). T urb o thre a te ns to se t se lf a lig ht sho rtly a fte rwa rds

• Vio le nt a nd se xua lise d b e ha vio ur pe rsists

a t sc ho o l

• Ra pe a lle g a tio n whe n T

urb o a g e d 14y5m (NF Ad due to unre lia b le witne ss a nd T urb o ’ s ina b ility to unde rsta nd c o nse nt)

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

F rankfurt, 2012 Camb ridg e , 2010 Be rtino ro , 2008 Miami, 2015

Re sults?

Pr e liminar y findings 1

• F

a mily e ng a g e me nt:

• F

a mily (pa re nts) re fuse to tra ve l fo r me e ting s b ut pa rtic ipa te in AAI s a t lo c a l c hildre n’ s se rvic e s o ffic e

• T

urb o a vo ids b e ing se e n a t ho me ; pa re nts ‘ una b le ’ to pe rsua de him. ? Sa b o ta g e

• T

urb o se e n a t sc ho o l, suc c e ssfully

• PI

a rra ng e d a t sc ho o l ‘ fo rg o tte n’ ; q uic kly re sc he dule d a t ho me b ut T urb o re fuse s to b e in c a me ra sho t; he le a ve s ha lfwa y thro ug h

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Pr e liminar y findings 2

• Re fe r

r e r ’s inve stme nt

• F

a lse po sitive re . c o st – we o ffe r this a t no e xtra c o st due to pilo t sta tus

• Ve ry suppo rtive o f a nd a c tive in

lia ising with NSPCC, fa mily a nd sc ho o l to c o o rdina te a ppo intme nts

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Pr e liminar y findings 3

• F

amily attac hme nt str ate gie s:

• T

urb o :

Dp Ul(a )se lf l&tr(dp,dn)Bro(dn)PE

N A4/ 6

• F

a the r:

(Dp) Ul(dpl)son→F re j se lf (p)b la me o the rs We sle y (ds)ma ny tr(p)re j b y F A1C+

• Mo the r:

Dp Ul(a )se lf, T

urb o l&tr(dx,dp ,dn)We sle y tr(dp)b ully, F C (p&dp)CSA (dn)PE N A7F

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Pr e liminar y findings 4

• F

F F & c r itic a l c a use of dysfunc tion:

• Re je c tio n b y pa re nts le a ding to

de pre ssio n in a ll fa mily me mb e rs, de lusio na l ide a liza tio n b y mo the r o f he r ne g le c tful fa the r, fe ig ne d he lple ssne ss b y fa the r, a nd c o mpulsive c o mplia nc e a nd se lf-re lia nc e b y T urb o who se e ks to c a re fo r his dise ng a g e d mo the r.

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Pr e liminar y findings 5

• Unspoke n and unspe akable:
• I

c o nside r it po ssib le , e ve n like ly, tha t We sle y’ s de a th wa s fro m suic ide . I re c o g nize tha t no o ne ha s me ntio ne d suic ide (fro m so c ia l c a re o r the fa mily). T urb o sa ys no o ne ta lks a b o ut We sle y’ s de a th a t ho me . Sure ly no o ne did in the Pa re nts I nte rvie w with the so c ia l wo rke r. But e ve ryo ne spo ke o f it in the ir o wn pe rso na l inte rvie w. I f the re is an ide a that We sle y mig ht have c o mmitte d suic ide , it make s se nse in this family that no o ne wo uld disc uss it b e c ause it wo uld b e to o painful and it mig ht trig g e r the ne xt suic ide .

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Comme ntar y on c hildr e n’s se r vic e s involve me nt

• Ba se d o n the Pa re nts I

nte rvie w, the pa re nts a re c o mplia nt with So c ia l Se rvic e s, b ut ha ve no t impro ve d in the ir c hild-re a ring .

• …up to no w, e ithe r the pro b le m

ha s no t b e e n unde rsto o d pro pe rly

• r the se rvic e s o ffe re d we re

ina ppro pria te fo r the fa mily o r b o th.

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

Inte gr ation & F e e dbac k

• Gue ss wha t? T

hing s didn’t g o to pla n!

• Ca se disc ussio ns (inc luding DMM

ma te ria l) will ta ke pla c e e a rly July.

• I

nte g ra te d re po rt to b e pro duc e d mid- la te July

• F

e e db a c k to b e o b ta ine d in writing a nd in pe rso n fro m pro fe ssio na ls a nd fa mily a s pa rt o f fina l re vie w me e ting

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

What c an this pilot c ontr ibute to the DMM?

• Pro vide e vide nc e a s to ho w b e ne fic ia l the DMM

c a n b e in unde rsta nding the pa thwa y to a nd c o nte xt a ro und ha rmful se xua l b e ha vio ur

• Hig hlig ht whe re to fo c us inte rve ntio n fo r the yo ung

pe rso n a nd the ir fa mily

• I

ntro duc e a n a g re e d fo rm o f la ng ua g e fo r e a c h c a se ne two rk fo r de sc rib ing a nd func tio na lly a na lysing a tta c hme nt b e ha vio ur.

• I

ntro duc e multiple re fe rring a g e nc ie s to the DMM

• Pro vide a n e vide nc e b a se re lia b le e no ug h fo r sma ll

sc a le re se a rc h in the future …?

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

F rankfurt, 2012 Camb ridg e , 2010 Be rtino ro , 2008 Miami, 2015

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