The Social Worker's Guide to Child and Adolescent Mental Health

Steven Walker

• Publisher: Jessica Kingsley Publishers
• Year: 2011
• Print ISBN: 9781849051224
• eBook ISBN: 9780857002266
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

The Social Worker's Guide to Child and Adolescent Mental Health provides a comprehensive guide to working with children and young people who are experiencing mental health problems, and equips the reader with the knowledge and skills to provide the best service to these vulnerable young people.

The first part of the book considers what role social work can play in child and adolescent mental health, and explores key ideas related to mental health and young people, including attachment issues, children's emotional development and common and complex mental health problems. The author then covers how social work skills and methods can be applied to working with children and young people with mental health problems, including guidance on assessment tools, intervention, and multi-disciplinary working. The final section focuses on the wider context, such as legislative and policy frameworks and the importance of considering cultural, spiritual and religious identity. Case examples, reflective activities and practical exercises are included to underpin theory and knowledge.

This book will be essential reading for all pre- and post-qualifying social work practitioners involved with children, adolescents and families, in particular those working in mental health settings, as well as approved mental health professionals.

Part I

Social Work Assessment and Intervention

Chapter 1

The Social Work Role in CAMHS

Learning objectives

»Describe and define modern social work practice in the context of constant social, economic and political change.

»Understand the challenges and dilemmas of social work practice with children at risk of developing mental health problems.

»Develop knowledge and skills to help safeguard and promote the development of children with additional or complex needs.

»Articulate the social work contribution to multi-agency work in children’s services and CAMHS.

Introduction

The code of ethics for social workers (British Association of Social Workers [BASW] 2005) under the section on human dignity and worth makes explicit the expectation that professional social workers will:

•respect human dignity, individual and cultural diversity

•value every human being, their beliefs, goals, preferences and needs

•respect human rights and self determination

•seek partnership and empowerment with service users and with carers

•ensure protection for vulnerable people.

Contemporary social work practice continues to define itself in a changing legal, professional and organisational context within which social care staff are expected to safeguard the welfare and meet the increasingly complex needs of modern children and young people with fewer resources, increasing provision by the voluntary and private sectors and a retrenchment of the welfare state.

Social work is a part of the wider children’s workforce and all programmes of post-qualifying education and training in social work with children and young people, their families and carers need to demonstrate they are enhancing competent and effective practice (General Social Care Council [GSCC] 2005a). Good continuous professional development and pre-qualifying training needs to be developed in relation to ‘outcomes for children’ as defined in the Government Green Paper Every Child Matters (2002) and described in more detail in the national framework for local change programmes published by the Department for Education and Skills (DfES) as Every Child Matters: Change for Children (DfES 2003).

Programmes must also provide evidence that they are developing practice and assessing outcomes in accordance with the National Service Framework for Children, Young People and Maternity Services (DfES and Department of Health [DoH] 2004). One of the fundamental aims of these specialist requirements is to ensure that social workers, wherever they are employed and whatever their specific roles and responsibilities, are able to promote and protect the well-being and welfare of children and young people.

This is part of the historical evolution of social work, which has included debates about the merits of generic versus specialist practice and the creation of false dichotomies between radicals citing the economic and political context as the locus for addressing social and psychological problems, and others proposing a psychosocial model seeking to address the internal psychological resources and resistance within clients. This chapter examines the developing role and nature of social work practice and articulates a modern, progressive model of practice in child and adolescent mental health (Walker 2001b).

Children and young people with mental health difficulties are increasingly coming to the attention of social workers practising in a variety of contexts such as: Adoption and Fostering, Child Protection, Care Proceedings, Mediation, Drug and Alcohol misuse services, Adult Mental Health services, Youth Justice, Family Support, and Education Welfare. National and international research demonstrates an increase in the number, range and the complexity of emotional and behavioural disturbance in children and adolescents (Audit Commission 1998; Mental Health Foundation 1999; Micklewright and Stewart 2000; Office for National Statistics 2006; Rutter and Smith 1995; Singh, Leung and Singh 2000; Walker 2001a). It is estimated that one in five children and young people under the age of 20 will experience psychological problems (World Health Organization [WHO] 2005).

The explanations offered for this contemporary phenomenon are as diverse as the methods and models of assessment and intervention employed to tackle the problem (Carr 2000). The following are all cited in the literature as risk factors (Cooper 1999 and Sutton 2000; NCH Action for Children 2007; Richardson and Joughin 2000):

•social exclusion

•parental separation and divorce

•rise in lone parent households

•racial discrimination

•child abuse

•increase in alcohol and substance misuse

•widening of the gap between rich and poor

•genetic predisposition

•retrenchment of the welfare state

•parental mental illness

•intimate partner abuse.

Equally, there is interesting research examining the circumstances, characteristics and dynamics of children and young people from high risk groups who do not develop mental health problems (Dulmus and Rapp-Paglicci 2000; Rutter 1999; Vostanis 2007). It is as important to determine the reasons for such resilience and protective factors, if social workers are to contribute fully to enhancing the mental health prospects of children and young people, and prevent problems rather than constantly reacting to difficulties (Walker 2004).

Workforce development

Recent government research illustrates the contemporary context of modern family life with one million children growing up with alcohol-addicted parents; 350,000 with at least one parent dependent on drugs; 140,000 families experiencing multiple and serious deprivations, with children more likely than others to be involved in crime, fail at school, be bullied or run away from home. One in eight children is considered to be growing up in a situation where they may be at risk (Home Office 2008). These features of family life today have endured for decades in some communities but are no less a shocking indictment of government social policies. They emphasise the critically important contribution social workers have to make.

The role and function of the social care workforce in social policy has been the subject of much discussion throughout the relatively short history of the social work profession (Adams, Dominelli and Payne 1998; Barclay 1982; Butrym 1976; Central Council for the Education and Training of Social Workers [CCETSW] 1989; Davies 1981; Giddings 1898; Kemshall 1993; O’Hagan 1996; Payne 2002; Richmond 1922; Titmuss 1958). The specific manifestation of that role and function in work with children and young people with mental health problems continues to receive little attention in the context of multi-disciplinary working, child protection, methods and models of therapeutic intervention and post-qualifying training (Adams, Dominelli and Payne 2002; Brearley 1995; Copley and Forryan 1997; Davies 1997; Higham 2009; Howe et al. 1999; Ruch 2009; Tovey 2007; Trevithick 2000).

Even the new Approved Mental Health Practitioner (AMHP) role replacing (and some argue subverting) the old Approved Social Worker role is focused on adult mental illness rather than child and adolescent mental health. The training requirements for the duties of an AMHP under the Mental Health Act 2007 specify that they play a key role in the care and protection of people with mental disorders and are expected to be accountable for the decisions they make. Children are hardly mentioned at all in the Specialist Standards for post-qualifying social work education and training for social work in mental health services (GSCC 2007a). The assumption is that mental health social work is about adults for adults with adults.

Under section 18 of the Mental Health Act local social services authorities are required to approve professionals as AMHPs, who may be social workers, nurses, occupational therapists or psychologists, to discharge the functions conferred on them by the Act. The Act stipulates that ‘no person shall be approved by a local social services authority as having appropriate competence in dealing with persons who experience mental disorder unless he/she is approved by the local social services authority as having appropriate competence in dealing with such persons’. Under the Mental Health (Approval of Persons to be Approved Mental Health Professionals) (England) Regulations (2007) local social services authorities can only approve professionals who have successfully completed AMHP training approved by the GSCC. The problem is that former Approved Social Workers (ASWs) are being redesignated as AMHPs, thus perpetuating the adult focus of their training and practice.

The arguments for a stronger social work role in CAMHS can be traced back to the emergence of the child guidance movement in the 1920s which led to the development of specialist clinics staffed by psychiatrists, psychologists and social workers. This inter-disciplinary model was based on assumptions about the totality of needs of children and young people referred due to concerns about their emotional and behavioural development. Neverthel...

Table of contents

• Cover
• Of Related Interest
• Title Page
• Copyright
• Dedication
• Acknowledgements
• Contents
• List of Tables and Figures
• Foreword by Stephen Briggs
• Introduction
• Part I Social Work Assessment and Intervention
• Part II Applying the Skills of Social Work
• Part III The Context of Social Work with Children and Young People
• Conclusion
• References
• Subject Index
• Author Index