Evaluating integrative services in edge-of-care work

ABSTRACT

Children living on ‘the edge-of-care’ are typically known to local safeguarding authorities and are considered likely to face risks to their safety. Many are subject to a child protection plan and/or involved in ‘pre-proceedings’ processes. A growing number of their parents face (un)diagnosed mental health difficulties as well as economic and social precarity. This article draws on a mixed methods evaluation of a pilot service in the East of England offering a therapeutically led attachment-based intervention for families. The service cross-cuts health and social care, allowing psychologists and psychotherapists to work alongside social workers and other practitioners. The evaluation examined psychological and safeguarding outcomes and explored practitioner perspectives. A key outcome was that 85.4% of families were enabled to remain, or reunite with their child, compared with an estimated 50% of ‘edge-of-care’ cases nationally. This supports the need for similarly oriented interventions that could help lower the incidence of child removals.

KEYWORDS:

• Attachment
• therapeutic intervention
• edge-of-care
• recurrent care proceedings
• parental mental health

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Transformational Challenge fund through the Department of Communities and Local Government.

Notes on contributors

Susan McPherson

Susan McPherson is a senior lecturer at the University of Essex. She teaches research methods on the Doctorate in Clinical Psychology programme and has research interests in psychotherapy outcome research, service user experience and involvement, methodologies and mental health care in NHS and social care settings.

Leanne Andrews

Leanne Andrews is a senior lecturer at the University of Essex and a chartered health psychologist. She teaches research methods across health professional training programmes and has research interests in trauma, psychometrics and measure development.

Danny Taggart

Danny Taggart is a clinical psychologist and the academic director of the Doctorate in Clinical Psychology programme at the University of Essex. He has research interests in attachment, trauma, parent-infant work and edge-of-care work.

Pamela Cox

Pamela Cox is a professor of sociology at the University of Essex. She teaches across social policy, socio-legal studies, social history and criminology. Her research spans modern social and cultural history, social policy, social justice, criminal justice, gender relations, youth justice, child rights and family law.

Richard Pratt

Richard Pratt is a Clinical Psychologist who specialises in the field of Attachment and Parent-Infant Mental Health and has a particular interest in supporting families where there is intergenerational trauma. Until May 2018 he was clinical lead for the Parent Infant Mental Health Attachment Team at Norfolk and Suffolk NHS Foundation Trust and has worked in a variety of child mental health settings. He is a senior associate member of the Association for Psychodynamic Practice and Counselling in Organisational Settings (APPCIOS).

Verity Smith

Verity Smith is an assistant psychologist currently based at the Psychosis Research Unit in Manchester. Verity worked as an assistant psychologist supporting the clinical and research work within the Parent Infant Mental Health Attachment Team at Norfolk and Suffolk NHS Foundation Trust for the duration of this project.

Jasmeet Thandi

Jasmeet Thandi is a clinical psychologist now working in the NHS. She completed her professional training at the University of Essex and contributed to this project during her time as a trainee clinical psychologist.