Dendy Platt examines the potential for the C-Change approach
Social workers’ assessments of parental capacity to change are becoming increasingly important when working with children in need and children who may be at risk of maltreatment. Expectations from the courts regarding care proceedings in England have increased in the last couple of years, focusing particularly on better analysis in social work assessments, and better exploration of alternative courses of action for the child in question. Assessing the likelihood of a parent being able to make sufficient changes in their lives to ensure the child’s safety and wellbeing is a part of this analysis. And capacity to change is now included in the court report template from the Association of Directors of Children’s Services – requiring assessment of whether a parental capability gap can be bridged (http://adcs.org.uk/care/article/SWET).
Fulfilling these requirements, however, presents some problems. One view of court decision-making suggests that the key evidence the courts need to make a decision is:
- Whether harm has occurred to the child;
- What caused that harm, and whether it can be attributable to the parent(s);
- What can be done about the situation – and in particularly, whether the parent(s) can change things sufficiently to ensure that the child is well cared for into the future.
A brief look at the history of child protection work shows that there has been a great deal of research into the first point. Child maltreatment is well-understood. Research has helped us develop and improve methods of identifying it, investigating it, utilising medical expertise to arrive at satisfactory diagnoses, and so forth. Similarly, on the second point, a variety of assessment approaches have been developed over the years to give us ways of exploring the context of the harm, the contributory or causal factors, and to help us understand the parents’ roles. Examples include the Framework for the Assessment of Children in Need and their Families, and the Signs of Safety approach, but there are many others. All these developments have been backed up by theory and research.
The third element of the decision, the potential for changes that benefit the child, has received much less attention. In terms of assessing parents, there are methods that support parents to make changes, and the impact of this can be measured using before and after measures. Examples include the work of Paul Harnett, but few such approaches are widely used, despite their underpinning research. In terms of theory related to behaviour change, the only theoretical approach that has had a significant impact in the context of UK social work practice is the Transtheoretical or Stages of Change model. This model is useful in drawing the practitioner’s attention to the idea that individuals approach change in different ways, and that relapse is a regular part of most attempts to change. However, the model itself has been widely criticised, particularly in the child welfare field. The stages themselves have not proved detectable in significant empirical studies, and individuals’ progress from one stage to the next has not been demonstrated at all clearly.
The key point is that theory and research, to date, have not offered very much help to social work practitioners in relation to understanding and assessing capacity to change.
The C-Change approach, developed by Katie Riches and myself at the University of Bristol aims to fill this gap. Its central principle is that there are two parts to an assessment of capacity to change. The first involves understanding what helps and hinders change in individual parents. The second involves creating an opportunity for change and assessing progress. C-Change brings both of these elements together into one systematic approach.
The first part of the approach draws on behaviour change theories. It can be seen that capacity to change is affected by a variety of factors, ranging from social and contextual circumstances to individual motivations and intentions. These factors interact, and practitioners should avoid relying for their assessment on isolated elements – such as whether a parent has ‘owned up’ to actions that have harmed their child. Some factors may help change, and others may hinder it. The social work assessment should weigh up barriers and facilitators in the individual situation.
The second aspect of the C-Change approach involves creating an opportunity for change, with appropriate support and help, and assessing the success or otherwise of achieving the necessary changes. In this, we have drawn on the work of Paul Harnett in particular, including his use of Goal Attainment Scaling.
These two parts have been combined into a single approach, under the name C-Change, and are supported by a practitioner-friendly manual. The double meaning of “C-“ in the name refers not simply to “capacity” but also indicates our view that a “sea change” is needed in the importance of capacity to change assessment. Whereas at present this part of the assessment can be a bit of an afterthought, our view is that it should be have a central role in the assessment process in recognition of its real importance in decision-making.
Further information, about the C-Change approach and the ideas put forward here, is available from our website, www.capacitytochange.org.uk and the practice manual can be downloaded free of charge by following the links on the site.
See also: Platt D. & Riches K. (2016), Assessing Parental Capacity to Change: The missing jigsaw piece in the assessment of a child’s welfare? Children and Youth Services Review, vol 61, pp. 141–148.