I had the honour of attending the Time In Not Time Out conference recently in Glasgow, invited by Dr Brodie Paterson. The topic of the conference – looking at the use of restraint and seclusion is one very close to my heart as many of you know.
Arriving at the venue in Glasgow, there was a positive vibe emanating from the many professionals and parents attending. People from all walks across Education, Health and Social Care had come together to share the reasons why we must change our perception of difference and how best to support everyone within life. The ethos of the day tied well to #flipthenarrative and the much needed move forwards with our view around the use of restraint and seclusion.
Kate Sanger, who I work with in the RRISC (Reducing Restrictive Interventions and Safeguarding Children) national steering group, opened the day with her positive and affirming stance that there is a better way, and we all owe our children, young people and adults, the commitment to ensuring that we collectively change the view – so that there is no need to utilise restrictive interventions. Kate shared the story of her daughter Laura, who experienced a negative impact upon her life because of the seclusion she experienced. It made me reflect upon the consequences of actions which so often we discuss in relation to children, and this has become a wide reaching and often heavily argued area of discussion. But we are still not discussing the consequences of the actions of the adults, upon the lives of those they are there to support.
The ACEs movement has brought about reflection about trauma that children experience in early life and how those adverse experiences affect them latterly. Professor Andy McDonnell and I discussed the concept of Institutional ACEs at the Great North East ACE Conference in April this year, and why we are not including the whole view. If we are to reflect upon, and ensure a better way for children with trauma in their life – then we must include Institutional ACEs as well, where the experience of trauma, occurred within settings outside of the home and parental care.
‘Whatever has been achieved through pressure and violence is unstable, unreliable and incorrect’
Our daughter’s experience has had a traumatic effect on her, the far-reaching consequences of adult actions have left a deep-rooted mark upon her life, in spite of any disability she has. One that daily, we are working to convert to a positive. We have been hugely successful in doing so, but often it is underestimated just how much work it takes to eradicate or ameliorate as much as you can, negative actions that have left deep seated trauma and broken trust. The work does not happen overnight and it is a lifelong commitment to a better way. There is no silver bullet for returning to how life was, before trauma hit. But there is a way through, and it is possible to change the way life can continue afterwards, with the trusted support of a consistent team, creating a feeling of safety and belonging, understanding and human empathy. We walk daily within a structured and human approach, personalised for Ella. One of the biggest factors of success? Our reflective daily practice, which incorporates many things – we are always reflecting and discussing how we can make things better – what we have missed, or indeed not considered. That practice doesn’t just support Ella, it has grown our team as a body of people who have learned a lot about themselves, their own stresses and how they can be in the world, in a more human and empathic state. We view any stress Ella may display as an indication that we have not understood, or missed something and we need to get better at understanding the why. We practice a Low Arousal approach that supports this. Because human beings are how we consider everyone first. Within our approach, we work to ensure everyone within the team has a low state of stress, so that transfers when working with Ella. People often don’t realise just how much our own pulse of intention is emitting stress, even if we are trying to disguise it. The team around a child or young person need to be in an optimum state themselves. There is no point in bringing our own stresses and angst to someone who is relying on us for support. That will only serve to make the experience negative for everyone. While no one can eliminate all stress within work or life, as Gareth Morewood has discussed, we can work together to ensure that stress is minimised for everyone. That much we are hard wired for, when we stop putting excess pressure on people and ourselves.
Listening to Jennifer Knussen on the day left me full of hope and the positive. A Headteacher who hasn’t excluded in over ten years. And no, she isn’t working within a privileged area, she is working within a real-life space and place that needs her and her team to provide a space to ‘be’. For the children and the families. A connected space that is central to their community – her school provides that. Jennifer advocates powerfully that belonging is critical for everyone. Finding ways around problems, so that we don’t turn from each other when we need one another and indeed work towards the path that includes everyone, whatever package they arrived in. It was an honour to hear Jennifer talk with such passion and humanity, it’s deeply rooted in her values and evident in her practice – I sat there wondering how many more Jennifers there are out there, and that we need them to share their work over and over – and loudly. We often hear a lot about what doesn’t work, and how things can end up in a damaging state for everyone, the children and young people often at the forefront. But this, this gave me hope and renewed my faith all over again that there are so many of us now willing the change.
Nick Hobbs, Head of Advice and Investigations from the Children and Young People’s Commissioner Scotland spoke about the commitment needed to ensure that all children have an education – and he reinforced the fact this is a right, for every child to achieve this, without reduction of their rights as per the UNCRC regardless of who they are. The report that CYPCS produced #NoSafePlace is an outstanding commitment from Scotland to herald the why around the use of restraint and seclusion within educational settings. In short, it is something that is no longer an acceptable human approach, in place of much more appropriate, human, relational and forward-thinking support. The report is a must read, and those supporting and driving the change forwards – Beth Morrison, Kate Sanger and many others must be followed in their lead around the open and transparent discussions they are bringing to the table.
The workshop I attended with A Life Explored was the next step in the conference to seal in my head that everyone is moving towards the same goal. A human, modern goal, based within rights that every single person has. Amy shared her poignant story of a life in the care system, where restraint was a routine part of her week, every week. Up until the time she moved into the A Life Explored setting, she had known that restraint would form part of her contact with adults supporting her. I was so moved by Amy’s honesty and her journey through a system that was supposed to care for and support her. Human contact – touch – is a sense that my daughter values immensely and uses consistently, not just in place of her eyes, but to ascertain that she is ok. Human contact is powerful and the sense of touch is not to be underplayed by anyone. Barbara Miles’ video on Hands and Touch is a must view for everyone. We all need positive human contact and touch in our lives, it’s part of our overall understanding of feeling safe, that we belong, we are respected, heard and held. Touch is like a fingerprint left on your soul, be it positive or negative. For my daughter, over manipulated hands had created the ‘tactile defensive’ narrative which in effect meant her hands had been over touched and not respected. Her experience of restrictive intervention meant that her trust had been shattered, when she was drowning in crisis and stress. Amy had not experienced positive touch until she became part of A Life Explored. They explained that restraint would not be part of her day or week and this, she said, was so perplexing to process. When you have been used to being treated a certain way, it embeds. And changing that takes time and a lot of support. It’s another journey taking you far away from the one you are used to grounded in renewing trust to heal. It was humbling to listen to Amy’s journey and how A Life Explored had changed her life for the better. It also reaffirmed that it can be done and there is a better way to treat our fellow humans.
Overall the whole conference was such a positive vibe of connected people who are willing this change that we all need to embrace is necessary for our development as humans. There is no evidence that supports the positives of restraint, restrictive interventions, or seclusion and there is a much-needed review of the long-term consequences that adult actions have upon young lives, when we know that there are so many better ways. The narrative that it is ok, is changing, it is becoming an obsolete narrative, that we will eventually look back upon and wonder why we ever allowed it to happen. Perhaps we still don’t fully understand that, simply put, every action creates a reaction – its science isn’t it? If we are going to affect how human lives are shaped, should we not be reaching for positive lives enhanced with our support, rather than lives changed or reduced negatively? If we wish to support children, young people and adults who have difference in their lives, it is our duty to them to do so with integrity, respect and humanity intact. Because the consequences of our actions can affect a life forever. It isn’t impossible to do, and it isn’t necessary to follow that path. Rather now, more than ever, with advances everywhere else in our lives we really need to embrace the move towards our humanity, towards one another, being just as advanced and whole view. Because yes, we are all different, but we are the same – we are all #human.
 McDonnell, A, ‘The Reflective Journey: A practitioner’s guide to the Low Arousal approach’ Janusz Korzcak quote, pg. 276