FromDifficultConversationstoDifferentConversations:TheSafety

inPartnershipApproachJenniferMcKinneyNatashaDuddy

SignsofSafetyGathering2016

Summaryofpresentation• AviewofthesafetyinpartnershipapproachinIreland

• CaseexamplefromtheWesternHealth&SocialCareTrust– theprocess.

• Linkstoevaluationoftheapproach.

Irelandfromspace

FourProvincesWesternHealth&SocialCareTrust

IrishMythology- TheFifthprovince• Hederman&Kearney(1977-1985)- Irishphilosophers- aprovinceofimagination.

• Aforumwherepeopleofdifferencemightpeacefullyco-exist,interactandco-create.

• Aforumforviewingoneselfandoneanotherdifferently- ‘inter-viewing’(McCarthy,2010)

• Aplacewhereanythingispossible!!

DifficultconversationswithfamiliesReachingAcrosstheDivide

HandsacrosstheDivideDerry,N.Ireland

ThepeaceBridgeDerry,N.Ireland- Bridgingthedivide

UsingSafetyinPartnershipasaCompass

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CaseExample“I’mrightandyou’rewrong”

• Judicialreview• Childwithlifelimitingcondition• Differentpositionsoffamilyandprofessionalsaboutwhatisrightforthechild

• Difficultrelationships• Engagement- Anongoingrelationalprocessofsocialwork

• Takingasystemicview

Beforemeeting• Differentpossibilities

- Icanjustaccepttheprofessionalstoriesaboutthisdifficultwomanwhowon’tlistentotheexperts.Howmightthispositionme?MaybeIwillaskmumquestionstoprovetheirpoint?MaybeIwillaskdeficitquestions?MaybeIwillmeetherforthefirsttimeatthemapping?

Beforemeeting• Differentpossibilities

- maybeIwilldecidethattheprofessionalsaremakinglifedifficultforthismother?

-maybeIwilltrytoprovethemotherrightandtheseexpertswrong?

-maybeIwillignoretherisksintakingthisposition?

Beforemeeting• Anotherpossibility- thechosenroute

- totakeaboth/andposition-meetwiththefamily-meetwiththeprofessionals-starttoseemultipleperspectives-activelisteningbegins

Meetingthefamily• Mumtellsherstory- shedoesn’tfeellistenedto,shefeels

disrespected,sheisangrythatanyonecouldthinkshewouldhurtherchild.

• Emotionswithintheprocess- howdowedealwiththeseassocialworkers?Whatthingsresonatewithusandhowdowerespond?

• Mumhashadotherexpertadvicethatsheisfollowing.• Mumtellsthestoryofthe“bucketlist”andthelostbabies.• Imeetthechildinherenvironment.

Meetingtheprofessionals• Amirroringofmum’sstory.• Theprofessionalstellmethattheydon’tfeellistenedto,feeldisrespectedandworrythatthischildwilldie.

• Emotionsasasocialworker- howdowedealwiththese?

• Theydonotknowthestoryofthelostbabies• Theytellthestoryabouthowmumhasmadeaprofessionalcry.

InsearchoftheFifthProvince• Allagreethattheywillmeettomapthecase.

• Mumwantsthechildren’scommissionertoattend!!!

• Holdinghope

Mappingtheterritory• ArrivingintheFifthProvince• Preparation

-explainingtheprocess-whoneedstobeinvited?-Howlongwillthemeetinglast?-introductions-noticingthetension-theuseofquestioningandexplorationtowork

towardsnegotiation

Danger/Harm

Risk Statements

Safety

Strengths/ Protective Factors

Building Safety & Strengthening Families Practice Framework

GENOGRAM/ECOMAP

Client Name: UNOCINI Ref No: DATE:

Purpose/Focus of Consultation

Complicating Factors

Next Steps

(Immediate Progress)Safety/Protection

Required

Current Ranking

GreyArea

NavigatingourWaythrough

Theimportantroleofthefacilitator-positioning/repositioning

• Doublelistening(narrativeapproach)- hearingtheproblembutlisteningoutforstrengths/possibilities

• Curiosity(Cecchin)

• Co-creatingintheroom

• Aquestioningapproach

Theimportantroleofthefacilitator-positioning/repositioning

• PastandworryQuestions- Whathashappenedsofarthathasimpactedonthechild?+veand–ve

- Howhavetheseincidentsimpactedonthechild?- Whatistheevidencetosupportthestatements?

- Dopeopleunderstandeachother’sworries?

Theimportantroleofthefacilitator-positioning/repositioning

• PredictionQuestions-Ifmumusestheadviceshehasbeengivenhowwillthisimpactonthechild?-Ifmumdoesn’tusetheadviceshehasbeengivenhowwillthisimpactonthechild?-Whatarepeople’sfearsandworriesaboutthefuture?-Whatistheworstthingthatcouldhappeniftheproblempersists?

StrengthsBasedQuestions- Whatisgoingwellinthechild’slife?- Whataretheprotectivefactorsaroundthechild?- Havetherebeentimeswhentheproblemhasnotbeenthereorhasbeenapproachedinadifferentway?

- Whoisinthesupportnetwork?- Howhavetheyhelpedorhowcantheyhelp?- Evidencethestatementsmade.

Examplesofstrengths• MumsaysS hasputon14lbsinlastthreemonths– Shasalsohadfewerepisodesofsicknessandhasmoreenergy.

• RichardsaystherehavebeennoconcernswithinChildren’sDisabilityTeamasthehomeiswarm,comfortableandloving.SspoketohersocialworkerAnninApril2014aboutherownfeelings(seeworkwithchild).

Exploringtherisks• Therewas1riskstatementwhereeveryonerealisedthattheywereallworriedaboutthesamething.

• Everybodyatthemeetingisworriedthatifthe****recommendationsarenotfollowedthroughbyall,whetherathome,school,hospitalorwhereverSis,thatthiscouldleaveS atriskofchoking,foodgoingintolungs,gettinginfectionthatmayleadtolungproblemsthatmayleadtodeath.

LandAhoy!!!Findingourdestination

• Agreeingaplan• Whatwillconvinceeveryonethatthechildissafe?

• Whowillreviewthis?• Howwillthisbereviewed?

Examplefromsafetyplan– Smallamountsoffoodtobegivenastastesforpleasureandnotasaregular

event.– WhenathomeonlymumwillfeedSandnototherfamilymembersbecause

thiscouldmakeSchokeandshecouldbecomeseriouslyill.– OnlytheagreedpeoplecanfeedSatschooloratthehospital.Thesepeople

areNthedieticianandCtheclassroomassistantwhohasbeentrained.– Foodshouldbecutinto2mmpiecesandgivenasrecommendedonpage2

ofthe***report.– Swillsitinherspecialchairforthissothatshehasthecorrectposturefor

swallowing.– SShouldbeinaquietenvironmentwhenfeedingforpleasuretakesplaceto

avoiddistractionsorincidentswhereScouldchoke.

Evaluation• “Idofindwe’rebetterunderstoodnow…Ididfeelwewereheard.Ididfeelitwasmoredemocratic…otherthanthatmeeting,they

neverfeeldemocratic,theyalwaysfeelthemandus…youalwaysfeelunderthemicroscope…Itwasallprepared…thatmakesyou

feelthoughtabouttoo…makesyoufeelvalued,youknow,thatyou’renotjustthenextontheconveyorbelt…everyonewaslooking

atthisthingratherthanatusandthat,initself,isamassiveshiftbecauseyoufeelthatscrutinyandwhenthey’realllookingatyou

it’sveryhardtobeempowered…ortofeelyouevenhaveavoice”

(Mother)

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Developments

PracticePrinciples DVD Manual

• Evaluation• ChangingProcesses/Structures• Transferabletodifferentserviceswithintheorganisation