Family trauma and children’s services: Co-designing support to reduce the impact of parental conflict
Andrea King is Director of Clinical Services at the Anna Freud Centre. She has worked as a senior leader in a local authority, for central government, for NHS England and NHS Improvement, specialising in mental health for vulnerable children and young people. In this blog, she looks at the opportunities for early intervention services presented by the new government funding for family trauma services.
Children’s services have been struggling in the shadow of austerity for over a decade. Funding for services has fallen and costs have risen. One of the themes that has emerged from the conversations we’ve had with children’s services is how can additional funding be best used to make a difference and benefit the most vulnerable children and their families, rather than being spent on filling the growing budget deficits that so many services are experiencing.
This question is brought into light this week as the Government has announced some very welcome additional funding for local authorities working with families experiencing parental conflict.
The Relationship Foundation puts the national economic cost of family breakdown at £48bn. As the Early Intervention Foundation has shown, where children are exposed to parental conflict the impact on their lives can be measured in increased levels of anxiety and depression and behavioural difficulties, including aggressive and hostile behaviours.[i] Children are also likely to experience more significant difficulties in their own interpersonal relationships. Those who experience trauma may have difficulty regulating their emotions, including, anger, anxiety and shame, especially if the trauma occurred at a younger age.[ii] They may also be vulnerable to high risk behaviours, or self-harm, and substance use. Both the immediate and the long-term benefits of breaking the cycle of this behaviour are apparent.
In February, the Anna Freud Centre launched its clinical offer based on our conversations with children’s services. The aim is to start a national conversation with children’s services’ leaders to enable us to identify how best we can harness our combined skills and expertise to co-design interventions and support for the most vulnerable children and families and ensure that funds are used as effectively as possible.
The difficult position that children’s services find themselves in is best illustrated by looking at the annual cost of supporting a child in care, many of whom have experienced parental and family conflict in their young lives. These costs have increased by more than 20% over the last decade to £64,000 while the number of looked after children has increased by 21%.[iii]
Children’s services are caught in a vicious circle. Local authorities have to prioritise short-term statutory responsibilities which leads to a focus on emergency support. This means reducing spending on early intervention services. As needs are not picked up early, the demand for crisis and statutory intervention grows. Because some of these services are provided by the private sector, as demand rises, so does price, which then increases pressure on statutory budgets.
One of the five areas of intervention we have identified in our clinical offer is support for family trauma, and specifically support to reduce the impact of parental conflict. This includes dedicated clinical support to parents and carers experiencing relational conflict and training and workforce development support for social care, CAMHS professionals and the wider workforce.
These interventions aim to address issues that children’s services have identified as growing concerns. In February 2019, the LGA carried out a survey of lead members of children’s services which found that only 24% of respondents were ‘very’ or ‘fairly’ confident that their budgets could meet their demand on spending for 2021/22, a decline from 61% in the previous year. In the same survey, 81 per cent of lead members who reported a ‘great’ or ‘moderate’ increase in the number or complexity of children and young people receiving child protection or looked after children services attributed this rise to an ‘increase in family conflict’ such as domestic abuse, substance misuse and offending.
In this context, the Government announcement of additional funds for local authorities is a very welcome development. The funding won’t cover the shortfall identified by children’s services, but it may provide an opportunity to start to reverse the trend from investing in early to late intervention services.
Over the years, our specialist Family Trauma team have been developing highly specialist skills in this area. As a multi-disciplinary team of mental health professionals, they work with families where children are on the edge of care. They provide therapy packages for families who have experienced trauma including physical, sexual and emotional abuse, domestic abuse and homicide, as well as those who have experienced neglect, traumatic loss or separation. Our team works with families where there is high conflict between parents and families with adopted children; the team has developed a therapeutic assessment model to support families where there is parental conflict and on averting the damage caused in contact and residence disputes to protect children.
The new Government funding is not a magic wand. It is only a start, but it could provide an opening for a new way of working. Perhaps the funds can create a space for a new type of collaboration, co-design and skills sharing, and if we can make this work together, we can start the process of developing earlier interventions so that children and the families can get the support they need, when they need it.
If you are interested in co-designing family trauma work, please contact email@example.com
[i] For further information, Pote I, Ghiara G, Cooper E, Stock L & McBride T. Measuring parental conflict and its impact on child outcomes, Early Intervention Foundation; March 2020.
[ii] van der Kolk B, Roth S, Pelcovitz D, Mandel F. Complex PTSD: Results of the PTSD field trials for DSM-IV. Washington, DC: American Psychiatric Association; 1993.
[iii] Department for Education (2021): Statistics: looked after children and Department for Education (2021): Statistics: children in need and child protection.