This study from New Zealand looks at how young people who have been exposed to very harmful environments and experiences, such as abuse, violence, addictions, disengagement from school and mental health issues, then go on to engage with services.

The study emerged from a need identified by social workers and policy makers, to provide services that are responsive to need, targeted and that ultimately lead to positive outcomes for the young people concerned.

In particular this wide ranging study looked at:

• How young people made sense of their engagement with these services,
• What was positive about their encounters with services and barriers to successful service engagement,
• The resources and strategies young people employ to overcome their experiences and achieve their goals.

The study unearths and underlines the need for social workers to take the time to understand young people’s lives and their previous experiences and help them make sense of what has gone before. This is as much a challenge for social work practice in the UK as it is in New Zealand, particularly in a climate of cuts to services such as child and adolescent mental health services (CAMHS), and increasing caseloads.

Service commissioners and practitioners alike will find this article insightful to reflect on what makes an effective service for young people and to consider how stretched time and resources can be used to best effect.

Method

The study surveyed 605 young people aged 13-17 years, who were using two or more either statutory or non-governmental services, such as: child-welfare, juvenile justice, remedial education and mental health services.

Typically, young people entered these services through referral to one of the statutory organisations.

The survey was used to capture the demographics of the young people, their patterns of service use, relationships with their family and friends and factors which came in to play to help them achieve positive outcomes.

One hundred and nine young people participated in the qualitative semi-structured interviews, which were conducted confidentially by the research team, at a time and location suitable for the young people.

The young people selected to take part in interviews were the ones facing the highest levels of harm and those with both the most and least resources and strategies to guard against harmful environments.

The young people also gave permission for their case files to be reviewed.

Findings

Results showed that where young people could exercise some choice over service engagement and where service providers were respectful in their interactions the service quality score given by the young people increased, although it was noted that for young people engaging in youth justice and child protection services, often choice in service engagement is taken out of their hands (due to offending behaviour or as a result of them becoming children in need).

The study also found that:

[T]he greater the exposure to harm the less likely it was that services would be delivered in ways that were empowering, respectful and responsive; young people facing the highest experiences of harm had the fewest opportunities to engage with services that provide them with opportunities to exercise agency and to build trust in providers who might assist them to embark upon change

Where services did work in empowering and enabling ways with young people, better outcomes were achieved. These included:

• involvement in school,
• social participation,
• pro-social behaviour,
• forming positive peer groups and
• developing positive future aspirations.

The amount of contact young people had with services over their lifetime had little impact on their levels of resilience. This appears to point towards the conclusion that the high quality, rather than high quantity, service provision is key to harnessing and promoting resilience in young people.

These conclusions were supported by the qualitative interviews which also highlighted the important role that empowering and respectful practice plays in successful service delivery, where three key themes emerged from the data:

‘Why am I here?’

Young people’s confusion about service encounters came out strongly in the interviews. Including confusion about who would be caring for them and what would happen next. For example, inadequate explanation about key events and meetings. This was interpreted by young people showing them a lack of respect. There was also inadequate explanation as to why particular programmes were seen as appropriate for the young person and the young person could not explain why they were involved.

Ask us what we want.

Ask us how we are feeling and what we think needs to happen.

Starting and stopping

The unevenness and messiness of service delivery impacted on young people’s ability to engage with services and made it difficult for them to exercise control over their circumstances and address their challenges in the short and long term, with young people reporting that they lived life waiting for one referral or another or for workers to be in touch.

Also young people reported on the momentum and optimism that is lost when a promised referral does not happen or when resources cannot be delivered. Young people also reported that they were not well prepared for transition and independence, leaving them open to harmful situations on leaving care.

‘They are still here’

The social workers who made a difference provided supportive relationships that were empowering and respectful, taking account of young people’s beliefs and cultural values and their own unique circumstances, and involving them in decision making. Behaviours that were particularly valued were:

• active listening and direct responses to young people’s concerns,
• reliability,
• availability and
• advocacy.

Emotional connection was also very important, coupled with practical strategies to help them address issues, keep them engaged with programmes and help build confidence to achieve their goals. In essence, predictability, persistence, routine and structure were all important – the things often lacking in these young people’s lives.

Young people respected the difficult decisions social workers had to make if they felt they had been listened to.

They were also grateful to social workers who advocated for support services, even at times when the young person themselves didn’t want to engage, as these actions showed to the young person that they were important and valued.

Conclusion

The authors conclude that

The findings underline the importance of the relationship between social workers and their clients as a foundation for successful interventions. It reiterates the need for social workers to take the time to understand young people’s contexts and how young people make sense of these contexts.

Strengths and limitations

The focus of the study was on users of multiple services who are therefore likely to be facing more adversity, than young people receiving lower levels of service intervention.

Summing up

Relationship-driven social work is key to successful outcomes for young people. The social workers who made the biggest difference understood the complexity of young people’s lives and the potential that services could have in providing that young person with a new direction.

The service encounter opens up new spaces where a worker can address immediate issues while holding the dreams of the young person, actively supporting them to seek their own desired outcomes.

Link

Munford, R. and Sanders, J. (2015) Understanding service engagement: Young people’s experience of service use Journal of Social Work January 29, 2015, doi: 10.1177/1468017315569676 [Abstract]

Photo Credits

Francisco Osorio CC BY 2.0

Francisco Osorio CC BY 2.0

Francisco Osorio CC BY 2.0