Exploring parents’ concerns about children’s mental health and wellbeing
16 November 2022, 01:00PM to 02:00PM
Emi A, Jamie Lee, Joanne Donne, Chris Dolman
About the webinar
This webinar was held on Wednesday, 16 November 2022.
By engaging parents in conversations about their children’s mental health, practitioners are more likely to achieve positive outcomes for parents and children. The focus of the webinar is on practice skills for working with parents who have concerns about their child’s mental health and wellbeing.
The webinar discussion will include:
- Ways to respond to parents’ concerns about their child’s mental health and wellbeing when the child is not physically present.
- Inviting parents to reflect on their understanding of their child’s perspective.
- Enabling parents to identify and speak about what is important to them as a parent.
- Discussing and exploring ways to involve the child in consultations.
This webinar will be of interest to practitioners for whom working with children is not a regular focus but is within their scope of practice. This includes professionals working in health, education and social and community service settings with children and their families.
A related online course developed by Emerging Minds entitled ‘Engaging children: Paving the way with parents’ will be released in late November 2022.
This webinar is co-produced by CFCA and Emerging Minds in a series focusing on children’s mental health. They are working together as part of the Emerging Minds: National Workforce Centre for Child Mental Health, which is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.
Audio transcript (edited)
CHRIS DOLMAN: Good afternoon everyone, and welcome to this webinar, co-produced by CFCA and Emerging Minds, exploring parents’ concerns about children’s mental health and wellbeing. My name’s Chris Dolman and I work with Emerging Minds, and I’m really delighted to be joining you this afternoon to accompany some really experienced and skilled practitioners, and also a parent who has lived experience of consulting with practitioners about children’s mental health and wellbeing. So, thanks very much for joining us.
In today’s presentation we will be exploring practices for working with parents who are concerned about their children’s mental health and wellbeing. Working with parents, either prior to working with their children, or in those early stages of working with their children, and really seeking to explore some of the key ideas and practices that can support us to work well with parents in a way that paves the way for working effectively and helpfully with their children, with the whole family.
I’ll just proceed now to have a look at the learning outcomes. You’ve seen these, but just to reiterate that this webinar will be supporting practitioners to respond to parent’s concerns about their child’s mental health and wellbeing when the child isn’t physically present in the conversation; ways of inviting parents to reflect on their understanding of their child’s perspective; enabling parents to identify and speak about what’s important to them, as a parent; and also be thinking about way to invite and involve children in consultations. So, that’s what’s ahead for the next hour. Again, thank you for joining us, thanks for setting aside the time today, or as you listen to this recording.
As we proceed, CFCA and Emerging Minds would also like to recognise and pay respect to Aboriginal and Torres Strait Islander peoples, the traditional owners of the lands on which we work and play and walk on throughout this country. We acknowledge and respect their traditional connections to their land and waters, and to spirituality and family and community for the wellbeing of all Aboriginal and Torres Strait Islander children and their families, and acknowledge too the many skills and knowhow that Aboriginal families and communities continue to hold on to and nurture and grow; skills and knowhow about what it takes to be looking after kids; skills and knowhow that the rest of us are all very much benefitting from.
This webinar is part of a broader series offered by Emerging Minds and CFCA around infant/child mental health. There’s some other webinars coming up in this series around the themes of engaging fathers, child mental health in culturally and linguistically diverse communities, and also child mental health in Aboriginal and Torres Strait Islander communities as well. There’s been some other webinars already this year in this series. Back in October there was one: How infant-led practice in family violence settings can nurture infants and families; Working with children who are experiencing or engaging in bullying behaviour in August; and then a few months ago in June, Supporting children who have disclosed trauma. All of those previous webinars are available on the CFCA website or through the Emerging Minds website. So if those topics interest you, please have a look at those.
So, it’s my pleasure to be joined today by our other presenters for this webinar. I’d like to welcome Joanne Donne, Jamie Lee and Emi to the panel. You’ve already had a chance to read a bit about their backgrounds, their bios – that was available before today. Thanks to each of you for joining us. Rather than restating the bio, I’m just going to ask them each a bit of a question, to help us understand their position in relation to this work, really. And so, Joanne, if I could ask you first. Firstly, welcome once again, and what is it that continues to interest you in this area of practice, working with children and families. What continues to draw you to this area of practice?
JOANNE DONNE: Thanks, Chris, and hello to everyone out there in the universe, cyberverse, whatever we call it. This is a really lovely question, because it stops me in my tracks now and again. I think what keeps me focused is this fabulous opportunity to be part of just witnessing change and facilitating change, and fostering hope. We have families who come to us who sometimes feel hopeless. I was thinking about this question and that lovely quote from Leonard Cohen: There is a crack in everything, that’s how the light gets in. And I think for me, focusing not just on the crack but on the light also gives me hope. But I just see the sense of struggle that the families come to us with, but behind that struggle is a real desire to change. So, just the privilege of being part of that change helps me maintain interest.
CHRIS DOLMAN: Thanks, Joanne, a privilege indeed, and we’re very much looking forward to your contribution over this next hour or so. Hi Jamie, welcome to you as well, to this panel. Great to have you joining us. What about for you? A similar sort of question in terms of, you’ve been working in this area for some time, in a few different contexts. What is it that continues to draw you to this area of practice?
JAMIE LEE: Thanks, Chris. I also acknowledge land. Joanne and I are on Kaurna land, and certainly working on Kaurna land is very enjoyable for me, continues to be enjoyable, working with children and their families for a number of different reasons. And so that sustains me as a practitioner. I think listening to parents talk about being a parent and the hopes they’ve got is very enriching. And often those conversations don’t happen very often. So, to have someone, as a parent, talk about their hopes for their children and to create a space for them to really explore that, it’s very enjoyable, and sometimes exciting to hear them voice those hopes. And of course, in working with children and young people, they do see the world very differently, and that continues to interest me, intrigue me, amaze me, surprise me and so it’s very enjoyable work for me to do this. And that’s what really sustains me and keeps me going with this work.
CHRIS DOLMAN: Thanks, Jamie. I think you’ve really highlighted something, haven’t you, in terms of the contribution that the families we meet with can make to our practice, can make to our lives indeed. And that’s perhaps often not spoken about. So, thanks for bringing that to this forum, and again, really looking forward to your contributions over this next hour. Hi Emi, great to have you as part of this panel as well. Thanks so much. For you, as a parent who’s consulted with practitioners in relation to your children’s wellbeing over time, how come you’ve decided to contribute to this kind of forum, where there’s an audience of practitioners and professionals tuning in. How come that’s been something that’s interested you?
EMI A: Thanks, Chris. I think having my voice rounds out the information. It gives an authenticity from this hands on experience that I have. And it’s also fantastic to be able to share my experience in a useful way. I really enjoy being able to do that.
CHRIS DOLMAN: Thanks, Emi. We really value the lived experience expertise, that realm of knowledge that only people with lived experience can contribute. So, thank you for that. Looking forward to your contribution as well. Certainly this topic, we know that parents significantly shape their children’s wellbeing, don’t they? And so therefore it makes sense to involve them in consultations. Indeed – and this is supported by research as well, that shows that parents’ participation in services for their children can significantly add to, significantly enhance outcomes for children and their families as well. In fact, research also shows that effective outcomes are more likely when parents are invested and involved, engaged in those services, in those conversations alongside of their children.
Of course, we know that many practitioners, many of you listening in to this webinar, work in very diverse contexts where, for some, you may be required, as part of agency policy, to meet with parents beforehand, before meeting with children. We know for others that meeting with parents and children together is a regular part of the work together. And some of you may just only meet with children as well. But regardless of those scenarios, conversations with parents, as a precursor to meeting with children, or alongside of, or concurrent with meeting with children can be very significant in shaping parents’ views and understandings of their children, of the problems the child and the family are facing, and indeed of the child’s relationship with the problem as well.
So these are potentially quite significant conversations we can be having with parents. We’re going to move in now to a conversation, a discussion about some of these themes. So I’ll just move on to asking about the first question. As we were preparing for today’s webinar, we were talking a bit about how sometimes practitioners may feel a bit uncertain or less than confident in working with children and families, particularly if working with children and families is a less significant or less prominent part of their work. I’d like to start by asking Jamie and Joanne first – perhaps firstly to you, Jamie – what do you think can help practitioners to not let that lack of confidence, if you like, get in the way of their work with children and families?
JAMIE LEE: Thanks, Chris. I also heard that lack of confidence can really hold back practitioners from working in this area. In terms of what might support practitioners with that feeling of lack of confidence, certainly the work is quite different, working with children, as opposed to adults. But it’s not a completely different kettle of fish. It’s not an absolutely, completely different endeavour. Children are still human beings, they have rights, parents have responsibilities towards them. So, many of the issues, the things that they want to work on are similar to what adults would want to work on, if they were adults working not as parents, but just phrased differently. So, similarly, the work that we do just needs to be phrased differently.
Whereas the fallback position for a lot of therapists with adults is talk therapy. That still is very relevant and important and influential for children. But often the talk therapy happens while something else is happening, such as doing a drawing, or doing an activity, or scribbling on the board. Because I know children and young people are very, very skilled at multitasking. I know the parents will sometimes say, “Please sit still. Listen to what Jamie’s saying”. I’m okay with them – really okay with them scribbling away or doing something on the board or stroking the little stuffed dog that we have in the room downstairs.
So, I hope that’s one reminder for practitioners that you can still use your main tool in your belt, to use that metaphor of talk therapy, but just also be aware that that will often happen while something is happening for the child, and really making space and signalling, it’s okay if you draw or we draw. We can do something on the board together while we’re talking about what Mum said earlier on when she was in the room. So I hope that’s one practice that helps with confidence. But also, for practitioners to remember that, especially children, younger children, will give you a lot of feedback about how they’re going. So you can be confident and somewhat secure that if the topic is not of interest to them, then they’ll start looking out the window; they’ll start wanting to go to the bathroom; can I have some biscuits, please; what time do we finish. So, if you can just tune into those signals, all right, okay. And then just of course ask, “How is this going for you, because I’ve noticed you’re looking at the clock several times.”
So I hope those reminders for practitioners can help them with practice just around the talk therapy. It’s still talk therapy, but often they might be busy doing something else. And also, to check in quite frequently with children, young people, how is it going for you? Because you’ll get that very instant feedback about whether they think this is influential in the problem or not. They’ll tell you.
CHRIS DOLMAN: Great. Thanks for those, Jamie. What about for you, Joanne? What is it, do you think, that can help practitioners kick those less than confident feelings that they have in working with kids and families, if they’re not so familiar with that?
JOANNE DONNE: I think at some level, Chris, we have to remember, we were all children once. For some of us that was a long time ago. So, remember, some of what Jamie was saying, there’s certain developmental stages where children will like to be maybe looking at the bear cards or drawing or something like that. But basically, I think that sometimes practitioners might feel a greater sense of expectation when they are in the room with parents and children. They might feel that they have to have a lot of answers, and they have to give a lot of information, when really, what we have to do is relieve ourselves of that expectation, and to just really simply be curious. If we’ve got lots of people in the room, and we’ve got the child there, what a great opportunity to just be curious and ask lots of questions to the child about what do they think is going on.
I think we also have to remember that children are often more aware of what is going on in terms of the problem than what a lot of parents might say to us. We know in, say domestic violence situations, for example, we know that children are a lot more attuned to what’s happening with the parent and caregivers; even when there’s no physical violence there, they’re attuned to that ongoing conflict. I know some practitioners might feel protective of children, but I think I would also encourage practitioners to know, these children probably know a lot more than what we think they might. And so, I’d like to encourage practitioners to, after engaging well, maybe having a few games, to give themselves permission to ask into some of the harder questions about what we’re all doing here. Having everyone in the room, what a great opportunity to just ask questions of, who agrees with this problem? Who doesn’t agree with this problem? So, staying in that position of curiosity, I think, can relieve practitioners of their own expectations of having to deliver a solution.
CHRIS DOLMAN: Thank you. Thanks, Joanne. I’d love to hear some more about what you’ve got to say about when parents have concerns – sorry, when practitioners have concerns about children’s wellbeing, or that sense of protectiveness. We might be able to get on to that a bit later as well. So, thank you for that. Emi, what about for you? What is it you’d like practitioners to be understanding about children and families when they first present, when they first come into the service, the counselling room?
EMI A: I guess I’ve got similar things to what’s already been said. One is that it’s okay to make mistakes and put your foot in it; that’s all right. As a parent, I understand that if you’re meeting someone for the first time it can be really challenging for everyone. And that, like you said, Joanne, just ask lots of questions, because that shows me that the practitioner is open, and it gives a sense that there’s – when the questions are asked with that sense of curiosity, it gives a sense that there’s a lack of judgement; there’s an open-mindedness and a willingness to hear. The family’s in there for a reason, and it’s a good opportunity to have that come out in a rounded discussion, and I think curiosity is such a good one because it brings that sense of lightness, but also depth, into a room.
CHRIS DOLMAN: Thanks, Emi. I also think about how practitioners often, at times, have children in their lives, in their social lives as well, and there’s a whole lot of skills that practitioners as adults in kids’ lives bring to those relationships, aren’t there? Engaging with kids in those social settings – and I know it’s a different context – but I’m also wondering about how those commitments to be with children a certain way, in other settings, can be brought into those counselling sessions as well.
JOANNE DONNE: Can I just comment on that, Chris?
CHRIS DOLMAN: Yes, sure.
JOANNE DONNE: It just reminds me when you said that, I was involved in a family this morning, and one of the – actually, both of the children were involved in different sports. And in spite of – there were big feelings in this family for these children – and in spite of these big feelings, which led to a lot of physical behaviours, hurting behaviours, when they were in their respective sports, they played really well. And one of the parents was the referee in one of these sports, and so it just reminds me that there is always a little pocket, even if it’s a tiny pocket, of when things are going okay, and when family members are experiencing themselves differently to when the problem is there. And using that sport analogy, looking at how they can work as a team, off field, so to speak, and who’s going to be the referee, I think is both light hearted, but very relevant. So it just reminds me of how we can draw on our own lives, but also the lives outside of the problem.
CHRIS DOLMAN: Yes. Just further – Jamie, did you want to add something to that, sorry?
JAMIE LEE: It was something that Emi said, just around it’s okay to make mistakes. I’ve certainly heard from children in my life, a phrase used in schools, mistakes are evidence of trying. So, Let’s make some here. Thank you.
CHRIS DOLMAN: Yes. And Emi, if I could just ask you, further to what Joanne was saying about – because I’m interested in – and perhaps I was talking a bit about some of the initial intentions around when we’re first starting to meet with families. I guess Joanne, the fact that you heard a bit about, this morning, these children’s sport playing is not by chance. There might have been particular things that accompanied, particular intentions that accompanied those conversations. But for you, Emi, for parents, when they’re first coming in to consult with practitioners, what are perhaps some of the hopes that parents bring with them in those initial consultations, do you think?
EMI A: I think broadly, you’d have a hope that whatever the issue is that has brought you there, you’re going to make some kind of inroads into solving it or getting some kind of solution. But that’s a long-term hope. I think the initial hope is that you’re going to be in a space which is safe and respectful, and one in which you’re heard. To me, those kinds of ideas are just central to having a good working relationship with yourself, your practitioner and your children. If I find myself in a space where I feel like I’m not listened to, or my children aren’t heard, or their voice isn’t important, I’m not going to feel comfortable there. So, in a sense, my initial hope is that the scene will be set in a way that works with me and my family.
CHRIS DOLMAN: Thanks, Emi. Joanne and Jamie, what about for you? Maybe Joanne, for you, what are some of your initial intentions in meeting with families in those very early stages? What is it that we can be talking about there that would help practitioners to get clear about their initial intentions?
JOANNE DONNE: I think in a first – or at the end of a first session with the parent or parents, I would like them to leave with a lot of what you, Emi, have said. I’d like them to leave knowing that I was really interested in all of the attempts that they have already tried, and knowing that I’ve acknowledged those attempts. Even if they describe those attempts as failures, it doesn’t matter; to me, they’re attempts, and they’re attempts in trying to reconnect with the child, attempts in trying to find some solutions, attempts in trying to make a difference. So I’d like to leave them knowing that I’ve acknowledged that.
And I also would like them to know that underneath those attempts is a lot of love and a lot of care for their child, despite what the presenting issue is, whether it’s gaming addiction, whether it’s an out of control child, whatever it is, that you are here. You picked up the phone, you made the time to come here. So to me, that shows that you really want to have something different, and that you love your child in some way; I’m really interested in what your thoughts are on how we’ve got to this point and how it’s affected everyone. And most importantly, I would like them to leave knowing, hey, I think we might have a bit of hope here; I think we’ve had a conversation that can lead us to some sort of solution. There’s that lovely quote from a family therapist, Alison Elliott: They have the map, we have the torch. So families know themselves best. Our job is to shine a light, not just on what’s going wrong, but what’s also going okay, or what they have tried. So they’re some of the things that I’d like them to think.
CHRIS DOLMAN: And are they three things that you really orient yourself to in those early conversations? What have they tried, and finding a way to acknowledge that; how they figure they’ve got to where they are; and also, letting them know something about hope. Those three – there might be more – but they’re three key things.
JOANNE DONNE: Yes, they’re the three key things. And those sorts of questions like – once again, being curious – who else might have noticed these attempts? And I might also take it further and ask into, do you think that your child, in their own way, has started to make attempts? Now, those attempts might be some of the problematic behaviours, as a way of getting attention, but is there a way – you’ve noticed your child then making some attempts as well, either at home, in the school. So, really trying to invite people to step into the shoes of other family members and just have a think of, maybe it’s a little bit different to them. How are they seeing it? What sort of efforts have they tried? So, just introducing that, looking through this through the child’s eyes in that session is really important.
CHRIS DOLMAN: Thanks, Joanne. Jamie, for you, what are some of the – can I say the go-to practices, the things you really – those practices you really draw on initially with families that stand you in good stead with the parents?
JAMIE LEE: Certainly, because of the context in which I work, we will often be using Relationships Australia and many other places as well, a series of risk screening questions. So, also questions around – so this would involve questions around domestic violence, around parental mental health, alcohol, drug issues that are affecting the family, outside the family, within the family. So there are a lot of questions there that we can then springboard into the work with the parents, and certainly the conversations do need to pause. Okay, I know you’re here to talk about your son, but I’m also hearing from the form here that – the form is trying to tell me that things are really unsafe for you right now at home. Let’s just talk about this bit first of all, and then we can talk about your child, maybe later on.
So, certainly that is one of my intentions, just to check people are safe and well enough right now, to have those conversations about children’s mental health. So, assuming we can move on to talk about children’s mental health, as you said earlier on, Chris, the link between children’s mental health and wellbeing and parents’ mental health and wellbeing is very strong, very, very strong. People affect each other in families, we know that. We know that sometimes it can be because of these upstream issues like domestic violence or racism, or disadvantage, economic, poverty. So these are really important factors just to tune into. But once we’ve done that, certainly for me, I’m very interested in how this is affecting the relationship between the parent and the child, and how we can bring the child into the room emotionally through a series of questions which are about an attachment orientation.
So we’re thinking about questions like, give me five words to describe the relationship you’ve got with your child, and then I’ll ask you to give me some examples of those times when the relationship feels like that for you. What are your hopes in being a parent to blah, your child? What brings you most pain being a parent to your child? What’s your biggest regret being a parent? So these are very powerful questions, and really make the child really come alive in the room. And it’s not a test; this one genuinely is no right or wrong answers. But certainly, that really, I think, very powerfully starts to zone in on what is absent but implicit for you with your child; what is going on for you, and how is it affecting you; and what are you hoping to be different. We can just use Joanne’s quote back there, start to really focus the torch on, if this is how it is right now, how do you hope things will be in the future? And why is that? Is this the first time you’ve felt those feeling What do you think
CHRIS DOLMAN: A number of things stood out to me from what you’ve said, but also really understanding the impact on the – paying attention to the relationship between the parent and the child, and how that might be affected by whatever the problem is. That’s one of the significant enquiries for you as well. Actually, folks, we’ve been having quite a few questions come through from the participants, so thank you everyone for submitting those questions. We’ll try and get to – we will be getting to some of those. There’s a question about actually – and also, some have submitted questions prior to today, so thank you for those that have already done that. A question about – if it’s clear from your early consultations with a parent, say, that a child might be experiencing some mental health difficulties to the extent that you become a bit concerned about that, but the parent has a different view to that. They’re not so concerned.
How do we go about responding to parents when that’s the case; when they’re not perhaps seeing some of this? Joanne, do you have some initial questions? Perhaps I could ask Emi for your comments about that.
JOANNE DONNE: Me, did you say? Or Emi?
CHRIS DOLMAN: Yes, sure, sorry Joanne. Joanne, yes, perhaps for you. What comes to mind for you about that?
JOANNE DONNE: I think if we’re getting information from parents that leaves us concerned, and the parents are not concerned, I would be once again, just being really curious and asking into that: Can you tell me a little bit more about that behaviour? Does that surprise you? Who else notices that? How long has that been going on? Do you think if Bobby was sitting here that he’d say that things are okay, or do you think he might say something differently? So once again, trying to position the parent, or to invite them into seeing things through the eyes of the child. But we’re also having to, at the same time, assess the level or the ability of the parent to be able to do that reflection. And some of the questions that Jamie posed in the previous question helps us understand how quickly or how slowly to go when we’re in that situation.
I’d also be asking the parent – if maybe I’m speaking to a dad: If Bobby’s mother was sitting here, or if Bobby’s teacher was sitting here, do you think they might have any questions about this sort of behaviour? So once again, getting them to think about other people’s – what they’ve noticed, rather than me coming in and saying, “Hey, this is a problem. I think we need to deal with it”, because I think that’s disconnecting rather than connecting with the –
CHRIS DOLMAN: Okay. So one way you’d open space for perhaps those considerations is asking those questions about the others’ view of the situation, to help the parent think, rather than your own take on it.
JOANNE DONNE: Yes, it is. I’d also introduce some ideas around what hopes the parent has for their child as they’re growing up, depending on what the situation is. What are the values that you hope that your child can fall back upon when they’re in their teenage years, or when they’re in a relationship themselves? What does that look like to you? What sort of hopes do you have for them? When are the times when you think those values and hopes are alive and kicking in the family, and when are the times when you think those values and hopes are really hard to dig out because of all of the pressures that you’re under? When are the times when it’s really hard for you to hold on to those values? So once again, not pointing the finger, but acknowledging that sometimes I know that it’s really hard for you to be the parent that you want to be. Those sort of questions that, I suppose, acknowledge but invite, Yes, sometimes it really is hard, Joanne.
CHRIS DOLMAN: So that can then open up the conversation for perhaps times when the parents aren’t being the kind of parent they want to be, say, or are struggling with ways the child might be being. Yes, okay, great.
JOANNE DONNE: I think after that soft introduction and that acknowledging, I think sometimes there can be times when maybe a little bit of information about the situation can be offered. But if it’s offered too soon, I think we risk coming from a position of judging.
CHRIS DOLMAN: Thank you, Joanne. Emi, for you, from a parent’s perspective, do you have guesses or ideas from your own experience, or understandings about ways practitioners can respond, say, if they have concerns about a child’s wellbeing that the parent isn’t noticing, or sees differently?
EMI A: Yes, I guess I’d be finding out why that is. It could be that the parent’s own idea of okay behaviour is very different to what standards, regular standards might be. A particular kind of behaviour might be normalised in that parent’s life, and so they might not be able to see problematic things arise, because of their own situation. Maybe their childhood situation, or their current situation. And as you were saying before, Jamie, that conversation around safety and so on, that might bring up some of that stuff. And also, like you were saying, Joanne, about the hopes and values. I think that’s such a good strategy, having a talk about hopes and values, to find out where the parent’s idea of the child sits, and how it sits within their own hopes and values for their child and for themselves. And maybe finding out, when you’re talking about that parent’s hopes and values for their family life, for their children, where it misaligns with what’s actually happening.
That would be a really good way, I think to have that really open, ongoing conversation, and would really allow the parent then to be able to speak about what they think the problem is with their child or not. And find out again where the two don’t match. And also, don’t give up. Some ideas are really ingrained. Maybe if you didn’t have a lot of knowledge about particular issues, or maybe you have a different cultural understanding, or just your own conditions of being a parent are really different, it can take a while to shift that. But if that needs to be shifted, it will eventually, because, as has already been said, the parent is there because they love and have concerns for their child. And so, that already lays the groundwork for things to shift and move as they should.
CHRIS DOLMAN: Thanks, Emi. Just to extend that a bit further, actually, I might ask you afterwards as well, Jamie, about this. But I’m just thinking of where a practitioner is concerned to the extent that perhaps they’d be thinking that they need to make some sort of notification, child protection notification. This can be tricky, can’t it, for practitioners in working with parents, where they’re knowing or feeling that’s what needs to happen. Again, from your perspective, Emi, what’s the best way practitioners can approach those conversations where they are concerned about children’s safety even with parents. How to go about that.
EMI A: I think something like that, just be frank and direct. There’s no point working your way around it. Me as a parent, if there was a child protection issue, I’d want to know about it. I’d want to know straight away. And I’d want to know why, and what I can do about it, and have some tools to manage it, because it’s serious. And I’d also want to know how it was that I was missing that. I’d really want to get some understanding around the issue. I guess that would be a time for just an open and frank conversation. Knowledge is better than ignorance, isn’t it?
CHRIS DOLMAN: Sure. What do you think would help you, or help any parent be open to that frank discussion though? What needs to precede that, do you think, for that to land with a parent?
EMI A: I would hope that there’d already been some of that setting up that I was talking about, where I already knew that I was in a space of respect and a space where my own ideas and viewpoints were acknowledged and taken into account. And so, in that sense, that creates the avenue for then this more serious issue to arise. And I think also – again, hopes and values, particularly the values conversation, allows the parent to get more into the child’s shoes and into the child’s perspective. And just shifting that perspective from where the parent might be at, to where the child is, and where the practitioner is. Just working around that.
CHRIS DOLMAN: Thanks Emi. Actually, Jamie, perhaps I’ll ask you for a reflection on what Emi said in terms of what that might link with, in terms of what’s important to you in those situations, where you’re wanting to raise concerns, safety concerns with parents.
JAMIE LEE: Thanks Chris. I do think we need to have those frank conversations, as Emi says, and to remind parents or carers of our responsibilities, which we would have already spoken about when we’re talking about the service and the limits of the confidentiality. But also – and this is a phrase from Joanne – there’s love behind the concern. So, where we hear child protection concerns, as a practitioner, it’s not because I’m being punitive or I want to get you in trouble, it’s because I’m also concerned and committed – this is what we can say as parents – I’m concerned about what’s been going on, and I’m committed for things to be different for you and for your children. So, as part of that commitment I’m going to need to do this, which is the child protection notification; but I’m also going to do that, which is to stay with you and to keep working on this, hard work.
Even though you know I will have made this notification, I’m still going to be there with you to work on this. I’m not going to leave you; this is not the end of us, this is just the beginning of a new phase of us, but I do need to be really honest with you as a parent, that I’ve got a responsibility here. And then, once I’ve met that responsibility, we’ll carry on with what we need to do. So I’m hoping – interested to hear what Emi thinks – but part of the – I guess it’s reassurance, Chris, giving a sense of reassurance that this isn’t the end of it, and that I know, certainly from a child protection angle, a family, parents, carers, remaining engaged with services actually is a protective factor, to use that phrase, protective factors for making things safer for the family and for the children. That’s what I would say.
EMI A: Can I just say, being told that there’s a child protection issue brings in a lot of fear and shame for a parent. But knowing that the practitioner, like you were saying, Jamie, is there for the long run, it then allows that blame and shame to be shifted and spread out a bit. So you’re not on your own. You hear this news, but then you also know that you don’t have to solve this by yourself. You’ve got a practitioner who, one, has cared enough and is knowledgeable enough to recognise that a notification or whatever it is has to be made; but also that they’re there with you to help you through this. That’s so important, because if you’re there and it’s to a point that a notification or a child protection issue comes up, already I would assume that you’d be in a situation which is challenging, to get to that point. And so you want people in your corner; you want people to be there for you. Ultimately, it can only be a good thing, just knowing that that problem is out there in the open and it’s going to be worked on.
CHRIS DOLMAN: And I guess bringing that problem in the open, being frank about that, another foundation you’ve already spoken about in terms of that trust and those other conversations about values, Emi. I’m thinking about – that’s a practice of being accountable to the kids in the situation, isn’t it, by bringing their perspectives in. I’d like to ask you to just extend on that theme, in a way, around children’s perspectives, since we’re on to that, and Joanne, I was wondering, again, whether you could say – you started to touch on this earlier – but just ways that you found helpful when working with parents, to bring children’s perspectives into the room, perspectives perhaps in relation to the problem, or other parts of the conversation. Firstly, how significant is that, and are there some ways that you go about doing that, that you’ve found really useful?
JOANNE DONNE: There’s a couple of different ways, depending on if I’ve got the parents and the children in the room, all together, or whether we are working in post-separation, when we are maybe seeing the parent and then seeing the children, and then maybe sharing some feedback back to the parent. So when we’re in the room with the children, the way we work is that we have already invited the children to write down or draw what some of the things are that is not making them very happy. So the children have an invitation and have actually got something to share before they actually come to the session. That’s certainly one very practical way that invites children’s voices into the session, and once they are there, we ask into that.
CHRIS DOLMAN: And what are you interested in asking about in relation to whatever it is they’ve drawn or produced in some way?
JOANNE DONNE: Well, I’d be asking about – first of all, this would be after we’ve engaged – what happens on a good day in your family. If I was a fly on the wall on a Saturday morning, what would I be noticing; what’s the best thing about having Mary as a sister, even if she has her music up loud all the time, and even if she does this, and even if she won’t play PlayStation with you, is there one good thing about that? Then, after that groundwork I’d be asking, if we could measure the problem in centimetres, how big is it? And who else do you think sees it this big? And how long has it been happening? Who do you think is worried about this problem the most? Who do you think isn’t worried about it at all? Who do you think agrees with you when we’re saying this? So once again, just getting a picture, how is everyone’s relationship with the problem, and once again, inviting people to be listening to the similarities and the differences, is one way of doing that. Yes, in the post-separation space, which I’ll leave Jamie to talk about, there’s different processes that we would use.
CHRIS DOLMAN: Jamie, would you like to complement what Joanne’s been saying, in terms of bringing children’s perspectives into the room when working with parents, for example?
JAMIE LEE: Thank you. I work mostly in the post-separation space, so I think that’s, Joanne, why you’re suggesting I would answer that question. I think one important practice point that I find really helpful is whenever we’re working with separated parents who may have very diverging, very different views of the children’s mental health, or whether there is a mental health concern or not – which touches on what we spoke about previously – we’re not about trying to find the truth, we’re not about trying to see which is the correct parent and to go, “Actually, you were correct because the child does have a mental .. It’s not about that.
So certainly, in terms of the work with different parents after separation, who have very diverging views and may be diverging from the child’s views of their own wellbeing and mental health, I think it’s still very helpful to try, with a parent who sees that there is no concern, that everything’s fine, child doesn’t do that with me, to really ask them, okay, even though this isn’t something that you’re concerned about, even though you’re saying this is something that happens in your house, it still seems to be affecting your child. I know you’re committed to your child, you love your child, you’ve told me about all these sorts of things previously, so setting aside your view of this, what can you do to support the other parent and your child with finding a different way of being? I’m not saying that you’re a better parent, it’s just about what can you do, what can you offer.
And I think – I’ve done a lot of parents who are able to do that, and sometimes, by doing that, they do start to then share the concern. So in other words, we don’t need to side with one parent or the other; we just need to have everyone siding against the problem. The problem is the problem, to use that phrase. So even if you don’t really – it’s a problem for you on a daily basis, let’s just see what can you bring to the party to work on the problem, even though it’s not a problem for you. So that’s how I would see things.
CHRIS DOLMAN: Thanks Jamie. Emi, I’d like to also ask you a question that’s come through again about – someone asking about how to work with parents who perhaps have had experience of services that have been less than useful, negative experiences of services, or who are not that keen to engage in services. What are your thoughts about that in terms of when a parent has had those experiences, how services can respond to that, or work with parents who have got that behind them?
EMI A: Yes, it’s a tricky one, because I was just reflecting that sometimes when the parents and children get into a practitioner’s room, they might already be quite jaded. Maybe they’ve had this issue come up and they’ve been to different places, and the kids think they already know what’s going to happen, yes, it can be tricky. At the outset, it’s just acknowledging that, that perhaps you’ve got a family that’s been through the wringer a bit. That definitely happens, and depending on their experience, if it’s been negative, there might be a lot of walls going up. It’s a self-protection thing, because if you’ve had a negative experience with services, that can have a huge impact, especially if you’re in a very vulnerable situation when you end up in those services.
So I guess just acknowledging that, maybe having a conversation around how that was negative, how we can do things differently. What are your needs, to be able to feel safe and to be able to feel that this is going to be helpful to you? Really bringing it back to the parent and to the children too, because the children would have some strong opinions on that as well, I’m sure. And also, finding out what the family themselves is doing around the issue, because it could be that they’ve just taken things into their own hands for a long time. Some of that might be useful and some of it might be not useful, but being able to bring that up and talk about it and unpick it a bit would be really helpful, and also would show me, as a parent, that having these open conversations where we’re acknowledging the past and the lack of service help, and the strategies that we’ve been using, shows that maybe this is a space where I’m going to be listened to and where our skills that we have and do put in place are going to be acknowledged a bit.
CHRIS DOLMAN: Thanks for those ideas, Emi, the ‘un-jading’ of families, I guess, what you’re describing. Thank you. I’d love to actually, Joanne, ask you a bit more about that, but I won’t because I’m aware of the time, but I’d like to ask you about another question, actually, which is around – a couple of people have mentioned about families facing quite long waiting periods at times, to access services. This might be something that families that access your services, Jamie, as well, face at times. How can parents support children’s mental health while they’re waiting to see a practitioner? Are there some things you want to let parents know about that can sustain them during that period in some way? Perhaps Joanne, to you.
JOANNE DONNE: Yes, everyone has long waiting lists, and so for some of our families we use a single session process so the waiting list is quite short, they might go back on the waiting list after we see them. But I think what we can do is, in an intake call, to certainly provide some ideas for parents to experiment with; maybe to practise. So, it’s not telling, it’s an offering to actually try and very briefly identify, who’s noticing what’s going well and talk with the parents about how to amplify that. Reminding parents that this is also about co-regulation. We talk a lot about self-regulation, but helping parents stay calm, so that they can help their child stay calm, so the focus shifts from the child to that of the relationship. And there’s lots of information and useful websites that we can share with the parents while they’re waiting.
CHRIS DOLMAN: Thanks, Joanne. Actually, we could perhaps make sure we share some of those websites that you and your teams have found helpful, on the webinar webpage when this is posted online. Thank you for that. Jamie, is there anything else that comes to mind for you in relation to that, that you had?
JAMIE LEE: Let me just remind – as if we need much reminding – but children also spend significant chunks of their time and their lives and their thoughts at school, so often there are school based services, school wellbeing officer, school counsellor, or just a class teacher, or last year’s teacher that a child feels especially close to that they can meet with from time to time while they’re being active on the waiting list. And again, reminding ourselves, and also parents, that you’re not just simply waiting and letting the problem do its thing; parents are still, and children, are very active in doing their own things to try to minimise the effects of the problem on their lives. So, while they’re being active on the waiting list, I’d consider speaking to the school, because often there are teachers that really do adore the kids, and other support services, Aboriginal liaison staff as well, cultural consultants, who can really help the child feel as though someone is listening to them at that moment in time.
CHRIS DOLMAN: We’ve had another question as well about how can practitioners respond to parents who are expressing negative opinions about the child – when the child’s not in the room nonetheless – but when they are expressing negative views about a child. How do we respond to those, because this can be quite a tricky circumstance for practitioners to be in, and one they might be concerned about, prior to meeting with a parent, when talking about a child. Jamie, is there anything that comes to mind for you about that? Sorry Jamie, I think you’ve frozen.
JAMIE LEE: Yes, the screen’s gone blank for me as well. Is this – are you talking about when the child is in the room, or is not in the room?
CHRIS DOLMAN: No, when the child’s not in the room.
JAMIE LEE: Okay, so when the child’s not in the room and we’re starting to hear a parent talk about a child in a very negative way, then, just to use a phrase that I know Joanne used earlier on, just in terms of being curious with our questions: I’m just wondering what it would be like for Jayden, your son, to be in the room and hearing you say those things, and what would be feel or think about those things just said about him. Certainly you can be curious and ask the parent to imagine what it’s like, because the parent might then take the position, “Well obviously I wouldn’t say that when Jayden’s in the room”. And then again, you can be curious: Okay, how is it different now, compared to when Jayden’s in the room? Certainly we don’t need to tell the parent off, we can be curious and open to what’s going on there.
But certainly, if a parent is really expressing negative views and seems to be not interested, or feeling uncaring towards the child’s perspective, certainly we will need to manage that quite carefully so that we can make it clear, as practitioners, that we’re not participating in that, and starting to even name it or externalise it, that way of talking about Jayden, or the words that you’re using. So saying, “Well, I’m not going to be using those words about Jayden. The words that I prefer to use are these. I know they’re words that you’re using.” So I think it is possible to engage with that parent expressing those things and views without falling into a position of telling off the parent, which I think is going to be unhelpful for our process.
CHRIS DOLMAN: And Joanne, do you have something further to add to Jamie’s response, from your perspective?
JOANNE DONNE: I think it’s a hard position to be in, as a practitioner, when you hear that. I suppose my interest would be, first of all responding with something like, it sounds as though this is what’s happening with you, and your child is really hard for you at the moment. So, trying to get the parent into a position of understanding, something’s really hard for you at the moment to connect with your child. Because I’d be interested in looking at what’s happening for the parent; what’s the emotion that’s happening for the parent to feel this stuck in describing their child like that. So that would be my first response, to acknowledge and be true about that 'stuckness', and then start to move on and maybe integrate some of what Jamie was saying, but invite the parents to notice what it is that they’re saying, and to notice how these words and their descriptions might be affecting their relationship with their child.
CHRIS DOLMAN: Thanks, Joanne. Emi, I’d like to ask you another question to respond to others that are coming through, even though I’m sure you’ve got more to add to what’s been said, but there was a question about how do you engage with a child who doesn’t want to be involved in therapy, and they’re at an age where parents can’t force them to be there. Tough one, isn’t it. So, from a parent’s perspective, what is it that you might be hoping for, or looking for from a practitioner, when you know your child is very reluctant, or not keen to be in the room, that could perhaps support you as a parent in getting them along, or getting them back next time?
EMI A: I guess one, again, just acknowledging the difficulty of that situation. As a parent, trying to get your child to do something they don’t want to do, particularly when they’re at an age where they have some self-determination, is really, really hard. So just acknowledging that it’s hard, and it might not always work, but you’re doing your best. And I think just sitting down and talking about it with the parent, brainstorming strategies that you can use, looking back into the past, what’s worked, or what the child’s interests are – just really having a session where you and the parent are trying to work this out. Because it is a tricky one, it really is. If the parent really wants the child to be there and it’s obvious that the child should be there, then you’ve got to keep at it till you get some kind of solution. And maybe, if you can, look at alternatives. Try and go out of the box a little bit, if there’s scope to do that.
CHRIS DOLMAN: Thanks Emi. Jamie, what about for you, even to try and mitigate that or lessen the chances of that, or reduce that reluctance, perhaps I could say. Are there some things that you’ve found helpful perhaps, in meeting with parents prior to meeting with children, that help create a context for the child, to be meeting with the child?
JAMIE LEE: I think it is important to engage with the parent or carer around what they think their child is going to – the sense the child will make of attending these services, because I’d say 99% of the time, the person who says there’s a problem that we need to work on is the parent or carers. It’s really quite unusual for a child to say, I’d like to go and speak to a therapist or psychologist or social worker. So, just exploring with the parent about, how big is the problem for you on a scale from one to 10, and how big do you think the problem is for your child. Because the chances are they’re going to say that the child will probably say that the problem is smaller. So then we can start to say, what can you, as the grown up here, what can you do to make it easier for your child to see how it’s important for them to come along, even though it’s less important for them than it is for you.
And again, we can often find parents quite resourceful in that. There are a number of things that parents can do without them becoming punitive and saying, you’d better go and see that psychologist or else. We don’t need to ask parents to use threats to do that, because parents – as Emi said, parents can be creative in the way that they let the child know about their concerns, their worries and their hopes for things to be different for their family.
CHRIS DOLMAN: Your comments had me thinking how the meaning for the child of coming along to the consultation is up for grabs; it’s not set in stone, I suppose. And the practitioners, in meeting with the parents, can be influential in helping to shape the meaning the child might be making of coming along, in some way. Joanne?
JOANNE DONNE: Quite often we’ll write a letter to the child, first of all because it’s quite unusual to receive something in a letterbox. But a simple letter like, I’ve spoken to your mum; she’s told me a couple of things about you. And we’d write down some of those good things. Then about our role. I often talk to children about dah dah dah, and I might include some of the concerns that are happening at home. But most of all, I’m really interested to meet you and to have a chat. So, softening that introduction is quite often a helpful way to begin as well.
CHRIS DOLMAN: Thank you, all three of you, for those responses. I think we’ve got time for one more question. It’s in relation to questions being asked about – what about if you’re meeting with parents and they have their own mental health concerns that they’re responding to, that they’re trying to find a way through. How do you work – what extent do you work with parents in relation to that, even though the presenting issue might be a concern about the child? They’re coming expecting to talk about the child, but this is discovered. So how do you work with parents in those circumstances? Again, Joanne, for you, is there something that’s important to you in those circumstances, in terms of practice?
JOANNE DONNE: Well, firstly, once again we go back to this notion of acknowledging a lot. But I think we go back to that notion because it’s so fundamental; it’s part of engagement; it’s part of ensuring the client feels understood. So I would acknowledge whatever the parent’s concerns are about the child, and I would ask into that. And then I might ask some invitational questions, like, I noticed this concern about your child, it’s a really deep concern, so is it okay if I ask how this concern is also affecting other members of the family? Can we start with you? So, a general invitational question, and acknowledging that, yes, no wonder you feel this way. So, trying to contextualise and normalise what we are noticing, to the parent, which I then think it might be easier for the parent to know that when we are asking them, would they like to talk about some of what we’re noticing, it’s coming from a position of wanting to work with, not a position of judgement.
CHRIS DOLMAN: Thank you. Emi, do you have some reflections around that for parents?
EMI A: Yes, I think there’s two avenues, really. One is if the parent is aware of their mental health state, and the other is if they’re not. I guess as a parent, if I was showing some problematic mental health signs and I wasn’t aware, I’d want to know. I’d want to know about it and I’d want to have something to do about it. Maybe be given some different strategies to try, or supports to call on, or services. On the other hand, if I was already aware that yes, my mental health isn’t that great at the moment, this or this or this is happening, I’d want to have the opportunity to talk, to say that; to say, yes, I understand that this is a problem, but I’m doing this about it. Or, I have this condition. Just really having it come into the open so the parent can talk about it, because it could be that they’re already aware, and they know they’re pretty messy, but they’re doing something about it.
CHRIS DOLMAN: Maybe we could just finish with a closing remark about what is it that you’re most hoping that practitioners understand, or take on board, or feel encouraged about in terms of working with parents in relation to their children. Joanne, could I start with you. What is it you’re wanting practitioners to most understand or feeling encouraged about?
JOANNE DONNE: I would really like practitioners to take the brave step and not just go into the wading pool, but go into the big persons’ pool, invite the children in when you’ve done some good foundational work with the parents, because when there’s more people in the room, the more questions you can ask, the more information you can get. And also, it’s actually quite fun. Give it a go.
CHRIS DOLMAN: Thank you. Jamie, for you, what is it you most want practitioners to know or understand or be encouraged about?
JAMIE LEE: Similar to Joanne, I really would hope practitioners to work with parents to bring the children into the room emotionally, and then physically into the room, or even with telehealth of course, that’s another option. Because children are not passive in this process. They’re not done to, they can be worked with, with families. They’ve got a massive stake in working on the problem, and so once practitioners can start to activate the resource, then they’ll find it, I hope, very invigorating as a practitioner, but also really helpful for the families to have a child’s voice heard, even if it’s just one session. That’s where it all begins. Give it a go.
CHRIS DOLMAN: Thanks Jamie. And for you, Emi, what would you like?
EMI A: I think be a colleague with the parent and the child. You’re there with your information in your field, and the parent and the child is there with their own information and wisdom about themselves and their lives. So, mainly that. And also, look for the love. If you get a bit lost, or the family is challenging – I know me and my kids would have been challenging at times – look for the love and that can pull you out a bit.
CHRIS DOLMAN: Thanks Emi. Thank you Jamie, thank you Joanne, and thanks everyone for joining us today for this discussion. We hope it’s sparked some ideas and encouraged you in this area of practice. So, thank you all very much for joining us today, and we look forward to seeing you again next time. Thank you.
Emerging Minds Child & Family Partner, South Australia
Emi is a current family partner with Emerging Minds and has worked with Emerging Minds on a number of projects for families. Emi sees great value in using her lived experience of navigating the role of parent and caregiver through challenges such as housing insecurity and escaping violence and seeking professional support for her children in different stages of their childhood.
Counselling Psychologist, Relationships Australia, South Australia
Dr Jamie Lee PhD, is Practice Manager for Family DOORS at Relationships Australia SA (RASA). He is also a Counselling Psychologist, working with children and their families affected by parental separation. He has also worked at the Child Protection Service of the Women’s and Children’s Hospital and the Federal Circuit and Family Court of Australia. In his time at RASA, Jamie has worked on many key initiatives around identifying and responding to violence, abuse and mental health.
Practice Manager Family and Relationship Counselling, Relationships Australia, South Australia
Joanne Donne works as the Practice Manager for Family and Relationship Counselling at Relationships Australia offering clinical supervision and training to RASA staff, as well as working within the reflective team in the family therapy clinic. She has worked for over 25 years in different organisations as a family therapist with children, couples and families who are struggling with a broad range of issues including the impact of family violence and separation.
Joanne is interested in questions and processes which invite parents to reflect on the experience of their child as well as offering ideas on the ways in which the whole family can be used as a resource for the child.
Joanne is looking forward to sharing the processes used when inviting parents to bring their children in to a family session and hearing insights from the rest of the panel.
Senior Practice Development Officer, Emerging Minds
Chris Dolman is a social worker who has been working for the past 15 years with individuals, couples and families facing a broad range of concerns in their lives and relationships. Chris currently works with Emerging Minds and the National Workforce Centre for Child Mental Health, as well as a narrative therapist with Country Health SA, providing consultations via video link to people living in rural and remote South Australia. Previously Chris has worked as a counsellor, supervisor and manager in a family and relationships counselling service with Uniting Communities with a particular focus around responding to family violence and the effects of childhood sexual abuse. He holds a Master of Narrative Therapy and Community Work and is a member of the Dulwich Centre Teaching Faculty.