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The New Deadly Sins: Resistance & Compliance

May 10, 2012

On the 29th May this year, a community care conference is taking place, entitled “Working With Highly Resistant Parents”. the sub-title to the event is: “Practical strategies to tackle obstructive behaviour and disguised compliance”. For more details of the event, see here:

My apologies if it’s difficult to think straight after reading that but your thought process is probably being drowned out by an orchestra of alarm bells.

Before we go into any observations, let me just point out a few items included in the programme for this day. At 11.45, a child protection consultant will deliver a lecture on: “Identifying indicators of disguised compliance”. As a tasty appetizer before the lunch, the presentation includes, “How some parents mislead workers through passive, covert manipulation”. After lunch, the delegates will enter the “virtual world” to see how game technology can help practitioners “manage situations where parents or carers are resistant, obstructive, deceptive or un-cooperative”. And the big finale examines “where un-cooperative or deceitful behaviour may be as a result of a parental mental health problem” and alarmingly, “Parental grooming of professionals”.

Where has this language and ideas come from? What robust thesis is it based on? Is there a justifiable reason for such an adversarial position? Why are the parents and carers cast as the dangerous enemy?

Court judgement after court judgement, after court judgement, repeatedly take the position that in the vast majority of cases, the parent/carer are the experts on the client’s needs. It is the parents/carers who are most likely to genuinely know what is in the client’s best interests. And out of old-fashioned concepts like love and duty, it is the parents/ carers who are most likely to genuinely fight for their children’s best interests. Sadly, even the most committed professional with the upmost integrity cannot always do this as there will be other agendas at play, like budget cuts (or this week’s latest Cameron word – “efficiencies”), political decisions or ignorance of the law etc. The often quoted judgement of Justice Munby in Re:S, sums it up for me perfectly:

“115] I am not saying that there is in law any presumption that mentally incapacitated adults are better off with their families: often they will be; sometimes they will not be. But respect for our human condition, regard for the realities of our society and the common sense to which Lord Oliver of Aylmerton referred in In re KD

…, surely indicate that the starting point should be the normal assumption that mentally incapacitated adults will be better off if they live with a family rather than in an institution – however benign and enlightened the institution may be, and however well integrated into the community – and that mentally incapacitated adults who have been looked after within their family will be better off if they continue to be looked after within the family rather than by the State.

[116] We have to be conscious of the limited ability of public authorities to improve on nature. We need to be careful not to embark upon ‘social engineering’. And we should not lightly interfere with family life. If the State – typically, as here, in the guise of a local authority – is to say that it is the more appropriate person to look after a mentally incapacitated adult than her own partner or family, it assumes, as it seems to me, the burden – not the legal burden but the practical and evidential burden – of establishing that this is indeed so. And common sense surely indicates that the longer a vulnerable adult’s partner, family or carer have looked after her without the State having perceived the need for its intervention, the more carefully must any proposals for intervention be scrutinised and the more cautious the court should be before accepting too readily the assertion that the State can do better than the partner, family or carer.

[117] At the end of the day, the simple point, surely, is this: the quality of public care must be at least as good as that from which the child or vulnerable adult has been rescued. Indeed that sets the requirement too low. If the State is to justify removing children from their parents or vulnerable adults from their relatives, partners, friends or carers it can only be on the basis that the State is going to provide a better quality of care than that which they have hitherto been receiving: see Re F; F v Lambeth London Borough Council [2002] 1 FLR 217, at para [43].”

However, despite a huge body of case-law supporting the above, rather than opening up a more collaborative way of working between parents and professionals, it seems to have driven the profession into a deeper bunker position, that quite frankly, can be frighteningly hostile. Umbrage is taken at the parents/carers view, and the idea of care goes for a burton as battle lines are drawn and weapons are employed. This is an arsenal of psychological weapons that can be terrifying for the parent/carer to face.

Of course the language and content at this conference exposes the massive divide between the professionals and the carers. The professional view seems to be that the position taken by parents/carers is because they have something untoward to hide; something dangerous and destructive to the client is being hidden. The carers position, nine times out of ten, is that they are scared shitless about the enormous amount of power the professional holds. The carer is aware of countless stories of families being torn apart, by at best, ignorance, or at worst, unfortunately because of a vindictive, punitive individual or system. And if there is a difference of view between the carer and the professional, woe betide the carer if they chose to assert their view or challenge the alternative opinion. That is the reality for many many carers when complicated needs assessments are taking place and care plans are being drawn up. The carer has to be pretty sharp-witted to sift through the many agendas that are informing the process.

Lets examine some of the language of this conference: “Highly resistant parents” and “obstructive behaviour”. In my counselling experience, people aren’t resistant and obstructive for no reason. We resist something that doesn’t feel right; something we feel isn’t going to do us any good and may actually, cause us some harm. We may have smelled a rat and don’t fancy entertaining that rat. We become obstructive when something we don’t want or feel is no good for us, is being forced upon us. We feel backed into a corner. But the inference of this language is that the parent’s behaviour is pathological; we are the rat that has been cornered. In my case, the council wanted to send my son to a hospital/care home 200 miles away, probably permanently. Was I highly resistant to this plan? YES. Was my behaviour obstructive? Probably, from the professional’s perspective, by going to court and going public, I was obstructing their plan. Did I have any other choice? Well, that leads us on to the next succulent course on the conferences’ menu: “Disguised Compliance”.

I’m not entirely sure what that phrase means but I’m guessing that it means to pretend to be compliant, whilst behind the scenes, being anything but compliant. This is the professionals equivalent of wanting their cake and eating it. Even when it goes against your better judgement, we cannot be resistant and obstructive; we cannot fake compliance. We have to be wholeheartedly compliant, with no reservations or misgivings. The professional always knows best, and my God, have we got to be grateful for that. I’ve written many times that I regularly attended meetings where there were 8 professionals present and me. It was very intimidating. Nearly all of the plans proposed at these meetings, I was uneasy with. But, I learned to choose my battles, so with some of the less life threatening plans, I probably fell into “disguised compliance”. And then went straight home and phoned the solicitor. Or Private Eye. All fueled by nothing other than desperation on my part to avert a catastrophe but galling for the professionals because I wasn’t playing ball, although it may have looked like I was in the team.

I love the quote from Judge Endersligh in the judgement A London Authority V JH. In this case, the LA were furious that the man wanted to care for his wife at home and not be placed in a care home. They got round the wife’s views by classifying her as lacking mental capacity. One of the professional’s weapons at the hearing was the assertion of the husband’s “repeated un-cooperation”. Fortunately the judge had their number and gave them very shirt shrift:

“On many occasions (in the local authority statements and submissions, and in court) it has been asserted by the local authority that Mr H is unable to compromise or to reach a reasonable compromise and, by implication, that trying further to enlist his support and co-operation would be a fruitless exercise.

Mr H is a devoted husband, and I think a proud man, who finds it difficult to accept anything but the best for his wife, and this forms part of the picture.

However, I also find that Mr H has compromised his position since these proceedings begun in various important ways. He has compromised on the number of carer hours he seeks; he has agreed to occupational therapy and carer’s assessments; he has agreed to proposals for GP, District Nurse, community matron visits; he has agreed to abide by a review of Mrs H’s Linkline needs; he has put forward a constructive proposal in relation to the deployment of carers.

It is not only Mr H who at times has been unwilling to compromise a strongly-held opinion about the care and treatment which Mrs H must receive in her best interests. Since the start of these proceedings the local authority has not compromised any of its demands.

When significant issues have been raised in court, time and again the local authority has told me that Mr H is not willing to compromise, rather than that neither of us will compromise. Of course, what they mean is that he is not willing to concede the relevant point and neither are they. Compromise, as opposed to concession or surrender, is an agreement that involves both parties giving up part of their preferred position in order to reach a working agreement.

In his statement of 5 May 2011, the social worker Mr C says that the respite issue “has proved to be a long standing stumbling block that Mr H has always consistently felt unable to compromise on.”

The way that sentence is phrased is illuminating. Mr C does not say “which the parties have felt unable to compromise” or “which the local authority has felt unable to compromise on.” Here, the local authority did not offer any increase of respite hours. They were not asking Mr H to compromise but to concede. In short, they were not willing to compromise their position.”

What happened to the idea of public service? In the not too distant past, the idea was that the professionals were meant to serve us; they were meant to cooperate with us – the customers. It’s a shame but in the social care world that idea has been flipped on its head to such an extent that the idea of service is now laughable. It is never about the service user or the carers anymore – their needs come secondary (if at all) to the needs of the service. Do you read the agenda for the conference and get any sense that the end result, the driving force is about service? My sense was it was all about self-serving; fueling a distrustful state that has completely lost sight of its basic function. Justice Peter Jackson made the following statement about the role of the state in Neary Vs Hillingdon:

“Nonetheless, two central principles are clear.

21. The first is that it is undoubtedly lawful for actions to be taken by families and local authorities, acting together on the basis of a careful assessment of the best interests of incapacitated persons. The vast majority of arrangements are made in this way and involve no breach of the rights of the persons concerned. Where there is a deprivation of liberty (referred to as a “DOL”) a specific statutory code exists to provide safeguards.

22. The second central principle concerns cases of disagreement. The ordinary powers of a local authority are limited to investigating, providing support services, and where appropriate referring the matter to the court. If a local authority seeks to regulate, control, compel, restrain, confine or coerce it must, except in an emergency, point to specific statutory authority for what it is doing or else obtain the appropriate sanction of the court: again see Re A and C (above) and the authorities referred to therein”.

The finale is the really scary part. I have this awful picture of the audience being whipped into a frenzy by this juncture and the icing on the cake is to diagnose the parent/carer as mentally ill, or that they are engaged in grooming. Lets up the ante at the final knockings with two of the, still, biggest taboos in our society. A mental health diagnosis in the hands of a non mental health clinician leads us into very murky waters indeed. All sorts of plans can be railroaded through if we can show that the carer isn’t mentally capable of caring, or of making an informed decision about the person they care for. Mental Health = Risk, so therefore the professional with their craving for risk management plans will be galvanised into action and the carer is put firmly in their mentally ill or incapable place.

Grooming is quite a disgusting insinuation. These days, that word is used solely in connection with paedophilia and involves the psychological and physical intrusion of an innocent, vulnerable party. Now, that concept is being used by casting the carer as the groomer and the professional as the innocent child. I don’t believe that idea stands up to any scrutiny whatsoever but the scare mongering language will chill the blood of anyone presented with that accusation. And the inference is obvious: if the parent can groom an adult professional, just think what they are doing to the person they are caring for. these are the heavy weapons of the war but to quote Basil Fawlty: “Who started the war?”.

I work on the basic operating principle that if what I am being presented with feels totally at odds with my experience of the situation, then probably, the opposite of what is being presented is true. To that end, I’d like to propose an alternative conference on 29th May, called “Working With Highly Resistant Professionals”. Is anyone compliant with this idea?


From → Social Care

  1. Couldn’t agree more! I am the parent/carer who is highly resistant to the harassment, bullying and wilful neglect that we have experienced at the hands of the NHS and SS – not resisting would have been criminal as it would have put my daughter at risk.

    My daughter has been refused health care and when we dared to complain the nasty little gang that attacked us as a result were all employed within the NHS and SS.

    Oh I know I can be a stubborn old goat but only when this is in my daughter’s best interest. Not so long back I asked an experienced NHS professional where my daughter would have been if I hadn’t been a stubborn old goat – the swift answer was ‘six feet under’!

    So with that in mind we will continue to resist the harassment, bullying and willful neglect. They will probably continue to resist our attempts to get health care but we are used to their obstructive and nasty behaviour and will not be bullied into accepting their intentions to prioritise their self superior attitudes above my daughter’s needs.

  2. llondel permalink

    Actually, I think you need to get someone to turn up to their conference on the 29th, learn what they’re doing and then hold your conference on the 30th.

  3. Karen Bartlett permalink

    As a home educating family we are very used to directives coming from on high from LAs. They really do believe they know best. Thank you for this article I’m feeling all fired up on this grey wet morning. Karen.

  4. mieke10ant permalink

    I think such an alternative conference would be great to boost the morale of those named as “highly resistant and obstructive parents or carers”. Such a conference would only really have a positive long term impact if the audience included judges and legislators, as well as employees from NHS, SS and LA’s with enough of an open mind to not see it as a confirmation of the theory that they are being manipulated and groomed.

  5. Clem Feeney permalink

    Looking at the conference details, it is clear to me it is aimed at the safeguarding children sector of social work – ie the people who work with the Baby Ps of this world. The profession took a hammering for trusting parents too much, and this is the government sponsored antidote.
    I don’t say this to deny anyones negative experience, my own family has been through the professional wringer over the last five years (CAHMS, SEN tribunals etc), but this conference is aimed at people at the sharper end of Social Work.

    • weary mother permalink

      I am a retired SW and the mother of a very vulnerable learning disabled man.

      The problem here is that Social Workers can be trained in a generic way, and some leave training poised to behave towards all families as though the issue is one of child protection.

      Especially when families challenge poor or dangerous decisions by the SW.

    • LizzieD permalink

      That may well be he case – but it doesn’t alter the basic point – that when people with LD reach 18, it is assumed on a very flimsy basis that families need to be marginalised, and a very spurious “independence” is he goal. In some cases that may be appropriate, and if a social worker is supporting the client, instead of just assuming that it is an ideal for everyone, and that ALL parents/families are a no-nothing irrelevance then it can be a real problem.

      Reading this, it is reassuring that SOME judges can see through this. But how many of us have any chance of finding a sympathetic hearing? You have to be a long way down a bad road, and it seems to me that a lot of judges still take social work certainties at face value.

  6. K.T. permalink

    I agree so much with Ilondil… I think that if other carers are willing I would like to suggest that there is a setting up of a “3rd sector” organisation, that could raise money and send a person who is closest to the various conferences, they happen all over the country and have been for 2 or 3 years now… I dont see any other way that parents could start to find out what we are up against here in exact terms… the whole thing reads as if your damned no matter whether you agree with them or don’t, theyve already got you painted as the type of person who grooms people, lies, and may turn agressive before they’ve stepped over the door…

  7. Pauline Thomas permalink

    A brilliant piece,

    So much of it most parents can relate to. If all the people who are tasked with helping our loved ones see us parents as the enemy then we are all fucked

    Trust is paramount. Not all parents are trustworthy and not professionals are trustworthy either.

    The blame game is not needed. Labelling caring parents as over protective is not helpful. Calling their loved ones spoilt or saying ‘they’ve won’ if you deem to put their interests first is not helpful either. I do not consider my son ‘has won’ if I put his best interests before my own.

    I had none of this fighting talk when raising my other two children. They had autonomy. They pursued their loves and interests without interference from anyone. That’s how it should be. Unfortunately my disabled son has not the luxury of autonomy. His life is being orchestrated by a myriad of professionals. All in his best interests they say. Some are just wonderful. Some are not.

  8. One of the most disturbing things you’ve ever written Mark – well done oh and by the way they have taken the link down – guess they will be holding these meetings in total secrecy in future

  9. Shonagh Mc Aulay permalink

    Brilliant citations. At least the judges are getting it right. Somebody should go to this conference and report on it. Do you know anybody?
    There must be a lot wrong with social work training but perhaps also with branches of academic psychology in the UK if professionals are getting away with this superficial, dangerous, supermarket psychology stuff.

  10. Shonagh Mc Aulay permalink

    The link failed. Removed?

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