Dealing with Aggression and Violence

Contents

1. Aggression and Violence in the Children
2. Assessment and Monitoring
3. The Staff Role
4. Using Transference; Supervision
5. Community Culture and Boundaries
6. Staff Violence and Aggression

1. Aggression and Violence in the Children

Many children and young people who come to Childhood First communities are referred with problems of aggression or violence. Children may have been aggressive to those they live with, adults and children, and also to those outside the home; it is likely that other interventions have been tried unsuccessfully to help them with these problems. The treatment model at Childhood First, Integrated Systemic Therapy (IST), seeks to understand precisely what each violent child is communicating about their early life experience as a way of beginning to understand and treat them.

The children who come to Childhood First have often not had an early life where adults have been able help them to process their experiences. This leaves them with many complex emotions which they are unable to process which can lead to frustration, aggression and violence. In addition the actual experiences, often of severe abuse and neglect, leave the children feeling very angry.

2. Assessment and Monitoring

Close consideration of a child's propensity for violence will be given at referral stage and monitored using the placement plan and restraint review meetings. Social workers and parents will be kept informed about violent incidents. An unacceptable level of violence may lead to a Planning Meeting being convened to discuss the security and continued viability of the placement. This should never be a surprise to the child or the social worker as violent incidents should be discussed regularly within the community and with the placing authority. In making these decisions the effect of the individual on the whole will also be taken into consideration. In the longer term a placement could not be justified if it were perceived to be having a dangerous or de-stabilising effect on the whole.

3. Staff Role

It is a fundamental part of the staff's role to do everything possible to protect the children's group from coming to harm or harming others and to remain constantly mindful of issues relating to group and personal safety.

As part of the treatment model, it is the job of the staff to establish and model relationships which are based on trust and respect, and within these to help the children understand their feelings so that interactions can be based on reasoned discussion. In order to do this well, the staff, like capable parents, must be willing to accept and be interested in the detail of the children's emotional experience. The Childhood First model of treatment seeks to understand the legitimacy of children's strong feelings while stopping them hurting themselves or others, and helping them to feel as safe as possible. This profound treatment method means that it is important that staff are able to use the supervision and consultancy to think about and express their own full range of emotions - without this ability staff will not be able to really help children to process their own strong feelings.

Whilst modelling conversation and reasoned discussion, the staff group also needs to help children to begin to express their feelings as much as they are able. This is to be encouraged by all staff using everyday opportunities but mindful also of the need for daily activities and the structure of community life to continue. The daily group meeting is another formal arena which IST uses to express and contain these feelings. The staff role is to help children to discuss their feelings in these groups.

In considering the children's early experience in terms of exposure to violence and aggression it is recognised that there is individual potential for children to develop the same patterns of behaviour and therefore evolve from the position of victim to that of aggressor. It is the staff responsibility to attempt an effective intervention in this potential process. Physical restraint should be kept to a minimum and the maintenance of a culture where constant adult intervention is needed must be avoided.

4. Using Transference; Supervision

Often, children have become stuck and cannot find ways to communicate their intense feelings without using violence. The Childhood First methodology also uses transference to understand how the violence is being used, and the network of meetings which make up IST enables those adults working with the child to understand and express how the violence makes them feel. For example: violence may have the effect of making others feel frightened and anxious, or submissive, perhaps bullied or abused etc. Experienced staff help more junior staff to express these feelings and to understand that they are being conveyed to others by the violent child, in order that the adults can process them on behalf of the child. The adults' first response then, if they are able, can be to assume the violent child is also a frightened one and to reassure them and help make them feel safe. This can have the effect of stopping the violence. It is vital that staff do not feel isolated from their peers and they retain an ability to respond appropriately in any given situation rather than react to the anxiety generated in situations of potential violence.

In dealing directly with any situation which staff judge is likely to escalate into violence staff are advised to seek immediate advice and assistance.

Using the transference should help staff avoid getting caught up in a situation where they feel shamed or where they allow themselves to be provoked into an unreasonable response or into acquiescing to a child's unreasonable demands out of fear that the child may become angry.

The adult-only dynamic forums which are part of IST are essential to the process of understanding transference. These are not an optional part of the support and supervision structure. It is recognised that very personal responses and experiences may well be triggered by violent situations; these can only be dealt with for the safety and good of the whole community if they are talked about in the appropriate forum, and it is expected that staff engage openly and reflectively in this process.

5. Community Culture and Boundaries

Effective intervention in cycles of violence cannot be achieved if children remain exposed to a culture of violence and it is essential that children who have been frightened know clearly that violence is unacceptable. The way staff set limits and say 'no' are ways of helping to give the child a means of protecting themselves and saying 'no'. In many cases children have previously been subjected to ill-treatment because they were less powerful than those hurting them. It is important that they do not have to re-experience this when they come to live in a Childhood First community.

The whole community must become a place where everyone knows that any violence will be promptly dealt with and discussed in a thoughtful way. This is often in contrast with the children's prior experiences where there may well have been no response, unpredictable or disproportionate responses to difficulties, or where violence was to be kept a secret. Gradually the children come to know that these matters can and will be talked about calmly and kindly, and that the staff will not become so full of unprocessed emotion that they cannot think. Repeated experience of this equips children to become more able to help others to talk and think about their violence, and to express honestly their responses and fear of violence so that others learn about the impact of their behaviour. These regular dynamic forums ensure that all incidents are swiftly available for group discussion and offer the opportunity to constantly reinforce the experience of issues being addressed and resolved without the need to resort to violence. Objects which could be used as weapons need to be swiftly removed from the confrontational space.

6. Staff Violence and Aggression

Staff who cannot admit, understand, manage and process their own aggression are not suitable to work with aggressive children using the iST methodology. Whilst it is important for staff to be genuinely in touch with their own feelings (otherwise they can emerge in dangerous ways) it is not acceptable for adults to show or act out their aggression in the presence of children. However, adults may need occasionally to raise their voice in the presence of children - the guiding principle must be that the adult is in control and the intervention is based on a mindfulness of the child's experience and needs. This fine balance is managed through the individual and group supervisions and consultations which are part of IST. Staff are expected to develop their understanding of themselves as part of a process and to thereby recognise that their actions and comments play a vital role in escalating or diffusing situations.