5 essential tips for toilet training children on the autism spectrum

MacAlister-Flem_Toilet-Training_978-1-84905-603-8_colourjpg-printThe authors of the new book Toilet Training and the Autism Spectrum (ASD): A Guide for Professionals Eve Fleming and Lorraine MacAlister, share with us their top tips for practitioners training children with an ASD to appropriately use the toilet.

Learning to use the toilet is one of the most important life skills to teach a child with autism. It is necessary to create independence and allows opportunities for other activities, including those that help to develop socialisation. It is also important to remember that for older children it is never too late to start toilet training, or to address any problems with independent toilet skills that are occurring. So here are our top 5 things to consider as a professional working in this area with children on the spectrum.

Firstly – familiarise the child with the language of using the toilet
Preparation for helping children with autism learn to use the toilet is essential. One of the first things you should do is to familiarise the child with the correct vocabulary and steps to using the toilet safely. This includes learning the words for wee and poo, understanding what toilets are for and where the wee and poo should go. This can be done before starting formal toilet training and leaving off nappies. For children with delays in language and understanding, pictures, signs and objects may be used to help them understand and communicate.

Next – try to make the bathroom fun
For many children with autism, toilet training can be a challenge and may take some time. Families will need ongoing support through this process. Often children with autism have become comfortable with using a nappy, they may dislike the idea of change, feel uncomfortable in underwear and thus resist doing their wee and poo in the toilet. The result is that they find the toilet to be a frightening place to go to, this is not good for anyone. It is important to try your best to cultivate the bathroom environment as an area where they can enjoy themselves or at the very least not feel frightened. Think of it as a place where they can play with bathwater and perhaps the interesting smelling bathroom products and try to transmit that across to them while at the same time remembering the importance of the language you use to describe going to the toilet.

Thirdly – time it right
It is important to choose the right time to start learning to use the toilet. This needs to be best for the child and the family. Consideration may need to include careful thought about what things are impacting on the family. If there are changes occurring such as starting school or changing class it may good to let the child settle before starting to help them learn a new skill.

Never forget – the physical developments concerning bowel control
It is essential to consider the physical development of the bowel and bladder as well as that of the child’s autism spectrum condition. Problems with bladder control, especially immaturity of control, are common in all young children including those with autism. Difficulties such as constipation are also common, especially for children who have rigid diets, and for those who sometimes learn to hold on to their poo. These factors need to be assessed and treated, as problems with bladder and bowel control can create significant difficulties with toilet training.

Always ensure – that you have broken down all the tasks clearly enough so that everyone is on the same page
Employing a step by step approach to developing the skills to use the toilet is undoubtedly the best way to learn, but it is crucial to ensure that everyone involved with this part of the child’s development is providing them with the same messages as well as using the same strategies. It is essential to make sure the parents, siblings, family members, carers and teachers are as clear as they need be about the targets you are setting and the methods being used to achieve them. This will ensure that learning is consistent and that the child becomes used to developing the skill in different settings.


Eve Fleming and Lorraine MacAlister are the authors of Toilet Training and the Autism Spectrum (ASD): A Guide for Professionals which is now available from Jessica Kingsley Publishers

Fight, flight or freeze; your body’s alarm system – author interview

K. L. Aspden has worked as a therapist with both children and adults since 1998. She has particular interest in the areas of trauma and anxiety, and she has experience working in both mainstream and special schools. She currently works in a school for children with emotional and behavioural difficulty, and is the author of Help! I’ve Got an Alarm Bell Going Off in My Head!: How Panic, Anxiety and Stress Affect Your Body.

1) What inspired you to write this book?
I work with some amazing children and teenagers, many of whom are frequently triggered into the fight/flight/freeze response. This can result in upsetting behaviours such as shouting, crying, hitting etc. They have no idea what is happening in their bodies and often feel too ashamed to talk about it, even when they are calmer. This is very sad. Having seen and heard what they go through, I wanted to write something to assure them that it is not their fault. I wanted to teach them about the physiology behind their feelings and show that there are things we can do to help ourselves.Aspden_Help-Ive-Got-an_978-1-84905-704-2_colourjpg-print
Above all I wanted to normalise this experience. Whilst we may not all react with the same intensity, everyone has an in-built ‘alarm bell’ (known as the amygdala) which can trigger powerful responses. An understanding of this can help anyone when they are going through periods of stress or anxiety.

2) Why did you decide to use the metaphor of an alarm bell?
I heard the panic response described as a ‘false alarm’ and decided to develop the idea. Alarms are so intrusive and distressing when they go off too frequently and at the wrong times – just like the overpowering feelings that can take over our bodies, minds and emotions when we are stressed. I wanted to communicate something of the jarring and disruptive effect of this through the alarm bell metaphor. I also thought it would be a non- threatening way to approach this tricky subject with my young clients.

3) You have worked as a therapist and at schools with children who have emotional and behavioural difficulties. What insight has that given you into how different people’s alarm bells work?
I think the alarm bell works in the same way for all of us, though it may affect us in different ways – could be trembling, feeling sick, withdrawing, tears, swearing…
For some people the alarm bell is set off more frequently because there are more triggers; this is especially true when trauma has occurred early in life or someone has high anxiety (for example, in autism). Children who have emotional/behavioural issues often live in a state of hyper-arousal – the alarm system is on red alert. In addition to this, they may lack the maturity or capacity to process their emotions which makes life even harder.
Those who have a stable background and an ability to reflect, often find it easier to learn to manage their responses. However, even the most vulnerable can benefit from being understood and supported by people who have an appreciation of the alarm system .

4) What triggers your alarm bell, and how do you take control back when you are feeling anxious or stressed?
Aspden - help i've got an alarm bell - pg 23 -imageOver the years I have carefully considered my own triggers and where they come from.
When I was a teenager life was much harder than it is now. Like many young people I wanted to be liked and didn’t understand that sometimes others can put you down to make themselves feel better. I was often bullied. This affected my confidence and I became reluctant to speak in groups, preferring not to be noticed. When put on the spot in a group setting, my internal alarm bell would ring loudly and I would experience a sense of wanting to disappear; lots of thoughts would rush round my head about how bad the situation was, and of course, this made me feel worse. There are occasions even now when I can revisit those feelings, but I am much more equipped to deal with them.
The thing that most often sets my alarm ringing these days is ‘technology’ – when my laptop goes wrong or I don’t know how to do something because everything changes so fast and it’s hard to keep up.
If this happens, I remind myself that I am having a ‘false alarm’. It is not a real emergency.
I also use two suggestions from the book that work quickly in any situation:

  • breathing more slowly
  •  doing a simple exercise like counting things to turn the thinking part of my brain back on.

In addition, I use Mindfulness in my everyday life (a discipline which helps to bring us back to the present moment), as well as a variety of creative activities. I find these tools are very soothing for the nervous system especially in times of stress or busyness.

5) Finally, what is the most important thing you would like readers to take away from your book?
I hope that an understanding of ‘the alarm system’ will help readers to feel more in control and more able to ask for help if they need it, without feeling embarrassed. I think a lot of people struggle because they don’’t know their difficulties are physiological.
Perhaps some readers will go further and become motivated to learn more about themselves. I would be especially pleased if they were to find the benefits of creativity in calming the nervous system, but that may be a subject for a whole new book.

You can find out more about the book, read reviews or order your copy here.

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Putting restorative theory into practice

Belinda Hopkins, author of Restorative Theory in Practice, provides her unique insight into what works in restorative practice and why.


Facilitating restorative conferences is one of the most rewarding things I do.

I can remember one of the first conferences that I facilitated on my own – many years ago now. It involved two young boys who had been playing outside their village community centre. They had been experimenting with a box of matches, some cloth and a jam jar. Young scientists at work! Suddenly they realised that it was tea-time, chucked their experiment into a nearby wheelie bin and rushed off home to tea.

A little while later, after tea, they went out to play again and noticed a kerfuffle outside the community centre. There was smoke coming from the building, sirens were heard as the fire engines arrived and a crowd was gathering. Curious to know what was happening the boys ran over and pushed their way to the front of the crowd, just opposite a window at the far end of the building – the bit furthest from the fire.

Inside was the neighbourhood police officer looking at the footage from the CCTV cameras. He glanced out of the window – and then looked back at his screen. He could hardly believe his eyes. There on the screen , he could see, crouching near the wheelie bins from which flames were to leap several minutes later and set fire to the building, huddled over something he could not make out, were the same boys whom he now saw at the front of the crowd! What luck. He went out, arrested them and they were driven away to the nearest police station – many miles away!

By the time I met the boys many months later they had had quite an adventure. Those were the days when there was no pre-meeting preparation so I met them for the first time sitting in a room with their parents, a fire officer and two members of the parish council who were responsible for the upkeep of the community centre.

The boys were timid and very remorseful – hunched like little frightened mice, the parents were tight-lipped and distressed ; suppressing a huge bundle of emotions – embarrassment, anxiety, anger, and fear. The parish councillors were incandescent and maybe also a little surprised to see that the arsonists they expected to confront were two tearful little boys of about 10.

Everyone had long and tearful stories to tell. The parents re-lived the experience of not knowing where their sons had been taken on that fateful day – only hearing from neighbours that they had been arrested – something that neither family had ever experienced before. The parish councillors shared their anger and distress at the damage to a well-loved and well-used Centre. And the boys – the boys told their story about matches, a piece of cloth and a jam jar …

And the conference worked its magic – because it felt like magic by the end – when everyone was smiling;  the parish councillors were offering ways for the boys to make amends – picking litter up around the skateboard park, helping at the local village fete – jobs the boys were only too pleased to agree to – desperate as they were to put things right and show how sorry they were.

And the Chair of the Parish council leaned forward at the end and reassured the boys that she was willing to spread the word that they were certainly not arsonists but they had been a bit silly. A message re-inforced by the fireman – playing with fire can have serious consequences – a lesson the boys were unlikely to forget.

So what was this magic that had moved people from a place of  anger, fear, shame and guilt to one of open-heartedness, collaborative problem-solving and celebration, from tears to smiles?

I simply stuck to my brief – I followed the framework I had been taught, blended with experience from having been a community mediator. I left the room metaphorically punching the air.

“It works” I crowed… And it really had felt like magic.

So now – many years later, I have had the chance to delve deeper into the magic of restorative encounters. I have invited 10 practitioners to reflect on what they think is happening as people are supported through the process to find mutually acceptable ways forward when a harmful incident has put such distance between them.

Each practitioner sees the restorative process through their own unique theoretical lens – that of Transactional Analysis, of Social Constructionism, of Constructivism, of Resonant Empathy – to name but a few of these lenses. There is no one definitive theory that explains the magic of the restorative process  but I hope people will deepen their understanding of what may be going on – as I have as editor of the book.

Learn more about Restorative Theory into Practice

Belinda Hopkins is Founder and Director of Transforming Conflict, the National Centre for Restorative Approaches in Youth Settings. She has been pioneering restorative approaches in youth settings across the UK and beyond for over 18 years. She regularly runs training courses, writes books and articles, develops training materials and speaks at conferences nationally and internationally. Belinda is the author of Just Care: Restorative Justice Approaches to Working with Children in Public Care and Just Schools: A Whole School Approach to Restorative Justice, also published by Jessica Kingsley Publishers.

Your Role as Your Child’s Advocate

Judith Canty Graves and Carson Graves are co-authors of Parents Have the Power to Make Special Education Work: An Insider Guide, and are the parents of a son with learning disabilities who is about to graduate from college. They live in Massachusetts.

As the parent of a child with special needs, one of your most9781849059701 important jobs is to be an advocate for your child in the school setting. You are vital to the success of your child’s education. You cannot be a passive observer; you need to be involved.

Here are some reasons why:

You Are the Only Permanent Member of Your Child’s Team

You are the only permanent member of the Team that decides what services and accommodations go into your child’s Individualized Education Program (IEP). New people who do not know you or your child will join the Team each fall and leave it the following spring. Occasionally a Team member might stay on for more than one school year, but most do not.

Schools Think Short Term, You Think Long Term

You and the school see your child’s education from different perspectives. In a way, this is natural since school personnel are focused on the current school year. You, on the other hand, are looking ahead to when your child becomes an adult. These different timelines can result in a source of conflict as you may want services that will help your child acquire skills needed in later years, but the school may only want to provide services that will meet more immediate needs.

As an example, students today are not given much instruction in handwriting and instead are taught keyboarding. But functional handwriting has not disappeared from the adult world. Our adult children will still have to fill out job applications or medical forms legibly by hand. Most of us are aware of other basic skills that may not have an immediate application in the classroom but which we know our children will need in later life. We have to be patient but persistent advocates for teaching these skills.

Skills Not Learned in School Have a Lasting Effect

Take the role as your child’s advocate seriously, because eventually your child will leave the public school. If he or she does not receive an appropriate education, who will help your child in a post-high school setting to balance a checkbook or fill out a job application? Many children who do not receive an appropriate education will need to take remedial courses after high school to learn skills they missed when they were younger.

What Parents Can Do

To become a better advocate for your child’s education, we recommend the following:

  • Periodically study your child’s special education documents in chronological order to better understand the progression of your child’s education. Trends will become apparent as you study the details and analyze the data over time. You must do this since Team members are transient and they don’t see the “big picture” that you can see. This exercise will show you the areas where your child has made progress or areas where he or she hasn’t.
  • Compare your child’s goals from year to year. If some goals never change, that means that either the goals aren’t appropriate or that your child isn’t making effective progress. Also compare the service delivery grid for each goal. Are the frequency and duration of services adequate to achieve the goal? If you notice that services are being decreased and the goal hasn’t been accomplished, you will want to discuss this with your Team.
  • Keep a notebook in which you record the important details of conversations you have with school personnel. If there are any action items, make them the subject of a follow-up letter or email to that person. If there are any misunderstandings about what was agreed to, this will help correct them before too much time and too many opportunities have passed. This improves positive communication with the school.
  • Keep a parent journal of your observations of your child’s experience. Record details about progress or lack of progress, and be sure to date your entries. Write in this journal on a regular basis and review it periodically. Progress almost always happens gradually, and you will only begin to see it when reviewing entries from past weeks, months, or even years.
  • Review your child’s IEP progress reports as you receive them. Compare the reports with the IEP goals and make sure these progress reports reflect your own observations as recorded in your parent journal. If these reports do not accurately describe your own observations, be sure to question these reports in writing to your child’s special education liaison. This will document your concerns.
  • Realize that every year of your child’s education matters. Time is essential in special education. If there are too many delays getting services, your child may fall behind. Each new year builds on the skills learned the previous year. It is remarkable how quickly a school year can go by and how the academic demands intensify as students advance in the grades.

Being your child’s special education advocate is an additional job for you on top of all the other things you are already doing. But it can be one of the most rewarding jobs you will ever have. Giving your child an appropriate education is an essential foundation for a productive future.

Learn more strategies for success in the Graves’ book, Parents Have the Power to Make Special Education Work: An Insider Guide. You can also discover more resources and check out their blog at their website.

Personality disorder: What about recovery?

Exploring the process of recovery from personality disorder, and how this can be achieved, Heather Castillo, author of The Reality of Recovery in Personality Disorder, provides some insight about the concept of recovery in relation to personality disorder.

Castillo-Realityof Recovery-C2W
Twenty years ago, personality disorder was defined as enduring and inflexible and was usually considered untreatable.   If I had moments of doubt, regarding embarking on a study of this human puzzle, they weren’t many.  The adversity experienced by those who had attracted the diagnosis was too compelling.  The assumption that professionals know best how conditions should be defined, and how services should be configured, was a similarly popular perception at that time.

My subsequent twenty-year journey concerned research with people diagnosed with personality disorder.  Driven by the ideas and needs of service users, our ensuing service developments aimed to build a new model of understanding and progress, one which could even make the old ways obsolete.  The early 2000s proved to be a fertile time for innovation when the Department of Health invested in pilot services which allowed a kind of exploratory latitude that I have not experienced before or since.  This gave us heaven-sent liberty to create a new and very different kind of service and a golden opportunity to extend our research studies.  At this time there was no agreed rationale of recovery for those diagnosed with personality disorder and few researchers had sought the views of service users regarding this.  We wished to continue to explore research methods that incorporated subjective accounts of recovery because we believed that professionals would find little guidance about what might help recovery from a medically-oriented randomized controlled trial.

The concept of recovery essentially arose in the service user movement, however, it was an idea which was soon hijacked by mainstream services becoming a clinical concept concerned with cure.  This was experienced as an unrealistic expectation and a burden to get well.  The word recovery has different meanings suggesting that conceptual clarity is necessary.  First is the traditional concept of recovery as cure which is located within an illness framework.  Second is the personal definition of recovery which has emerged from service user narratives.  These accounts emphasize the understanding of recovery as a process that can still take place in the presence of symptoms and disability.  Recovery is about finding abilities, possibilities, interests and dreams.  This was a crucial concern for our research group members and they set out to define recovery in their own terms.  They believed that the term recovery implied returning to a previous state of being, whereas members were seeking to create a new future, the future they wanted.  Standing on the firm foundations of a clearly defined concept of personal recovery, by 2004 we had established our new service.  I have long believed that, as human beings, thriving is our default setting.  Up to now this had not proven to be the case for our service users, however, the homeliness and peacefulness of the new service and the sense of hope that permeated the air had an effect on all of us.

Living too long with untenable emotions and in a state of chronic hyper-arousal, people with a personality disorder diagnosis frequently adopt dysfunctional behaviors to numb unbearable feelings and to swiftly bring their mood down to a manageable level.  Hurting the body can create temporary calm because of endorphin release.  Such behaviors include self-harm and substance misuse.  This is how people have coped and, for many, they become deeply ingrained coping strategies.  The damaging expression of pain needs containing measures, therefore, to create psychological safety at the new service these self-destructive behaviours needed to be actively challenged.  An Acceptable Behaviour Policy was created in collaboration with service users and administered by them.  If someone broke the rules laid out in this policy there were consequences, and that person would be invited to a community discussion with peers.  During the course of our research 51 (85% of participants) discussed the use of negative coping strategies and 46 (over 76% of participants) reported a dramatic reduction in their use, suggesting that the concept of boundaries had become internalized.

Initially we were engaged in developing healthy attachment in terms of safety and trust, feeling cared for, a sense of belonging, and learning acceptable boundaries.  Next we discovered that only when this was sufficiently consolidated did service users begin to learn to contain their past experiences and build necessary skills to progress.  Meaningful therapy cannot take place, no matter how desperately it is needed, if trust does not exist and if behaviour is chaotic, risky and destructive.  Healing is about integrating experience by making sense of what has happened.  Prior to this stage, reality often proved to be unbearable and making sense out of traumatic experiences and child abuse is a difficult thing to do.  This marked the long process of beginning to re-frame traumatic experience.   However, a focus on a deficit in skills, and all that has gone wrong in the past, can create a sense of hopelessness.  Therefore, the fostering of hope and the building of confidence became vitally important in activating the internal resources necessary to conceive of and pursue dreams and goals.

Supporting recovery is about helping people to build self-esteem and identity and to find valued roles in society.  This began to translate into internal changes concerning sense of self and external achievements in the various domains of social inclusion.  However, despite progress, significant fears and barriers to the concept of recovery were also highlighted in relation to risking what progress had been made.  Because the word recovery could potentially become synonymous with the idea of loss of support, it became essential to further define it in a tenable way.  As a result, the concept of Transitional Recovery was born, meaning that progress would be defined as an ongoing journey of small steps, involving the retention of new-found healthy attachment, and new structures were incorporated into the service to help build confidence with outdoor-well-being pursuits and social inclusion initiatives.

Developments which stemmed from the  unique knowledge of service users, about what would best support them and help them to progress, shows that it is possible to work effectively with a relatively large number of people with a personality disorder diagnosis, well in excess of a hundred at one time, at different stages in their journey of recovery, many of whom had not made progress in other service settings, resulting in significant financial savings to the health, social care and the criminal justice system.

Dr Heather Castillo worked for many years in Mind organisations in Essex, developing advocacy for people with mental health problems. She has worked with service users, training and supporting them to become legitimate researchers in the field of mental health. In 2004 she helped to set up, and became the Chief Executive of The Haven Project, which began as a Department of Health National Innovation Site for the support and treatment of personality disorder. In 2011 she completed a doctorate at Anglia Ruskin University, UK, about the process of recovery in personality disorder. She lives in Essex, UK.

Learn more about The Reality of Recovery in Personality Disorder

Research, innovation and social work education

Co-editor of Innovations in Social Work Research, Aidan Worsley, offers some reflections on the function of research in the development of social work education.

Hardwick-Innovaations in SW-C2W

Having recently completed my role as co-editor of Innovations in Social Work Research, it seems like a useful time to offer some reflections on where research features in the development of social work education. The chapters of the book have identified innovative research practices around areas as diverse as new technologies, visual methods, dissemination and user involvement – amongst a range of wonderful and inspiring contributions. The whole presents a lively and creative sector containing what I believe to be the vanguard of a golden generation of social work researchers thinking imaginatively about how to explore the social world around them and influence policy and practice.

And yet, there are also elements that are less encouraging. There is a growing concern with the disconnect between professional education and research. On the one hand we have social work academics who, as evidence sadly demonstrates, are finding it easier to be successful in their research careers when they are not engaged in direct teaching. This has to be understood in an open way – universities, of course, value high quality publications in journals and high yields on grant capture projects – and no one can be in two places at once. Indeed, funding and league tables are dominant forces in Higher Education. And whilst a wide variety of practices exist across the sector and ‘full time’ researchers are indeed just that – a slow but steady drift away from the lecture theatre can be observed. This can be coupled with what appears to be an orientation away from pedagogic research related to the professional area. Funders and academics are looking less often at what makes social work education effective. This vacuum has, and will continue to be, filled by untried and misunderstood approaches. We all need to understand these conflicting demands – but try to redress that balance.

On the other hand we also need to consider the narratives that surround policy development of social work education. Croisdale –Appleby in his 2014 report on social work education talked of the social worker as a ‘practitioner, professional and social scientist’ – such an imaginative and forward thinking notion. But the resolution of the contradictions of his and Narey’s reports remains – 18 months later – a forlorn hope. Policy makers appear to have lost (by carelessness or design) the awareness that research belongs in social work education. The recent development of Teaching Partnerships simply didn’t engage with the notion- despite its avowed intent to be about quality. Research as a word didn’t appear in the guidance. How can a high quality professional education not be concerned with research? Its emphasis was on academics being qualified as social workers to the exclusion of the range of knowledge (or indeed teaching ability) they might present. And knowledge appears to be only valued in so far as it relates to the practice of a (Local Authority) social worker.

And this, in turn, does the greatest disservice to the profession. Surely we know that high quality professional practice requires the practitioner to generate new knowledge and understanding in the myriad of complex scenarios they encounter. Connections should be made between the shared experiences they encounter of the users of the service they provide and those communities with which they interact. These connections form new understandings and, in turn, improve delivery. And yes, this also requires the support of the research community to reach out and work with practitioners on these lines of thinking – and that this is valued by all stakeholders – I’m looking at you middle managers! But this has to start with an awareness that new knowledge matters as much as received knowledge – and social work education needs to ensure it captures this spark of the professional role in its delivery of teaching- because the light is going out.

So this blog ends with a plea to all those reading this: research matters, research improves people’s lives. Managers in services – make sure your staff have opportunities to hear about and engage with research. Policy makers – don’t lose sight of the role research plays in professional education. Academics – reach out to practitioners and students alike with your research and make sure it gets heard in the lecture theatres of universities and the staff meetings of practitioners. And students reading this blog – find out who is doing interesting research in your institution, or beyond, and ask your programme to invite them along. Ask to learn more! In the meantime, the chapters of this book will hopefully be one offering of dissemination so that readers from across all these groups can see what there is on offer here – and what we must ensure the profession and its users doesn’t miss out on.

Aidan Worsley BA, MA, MPhil, FRSA is a Professor of Social Work and Executive Dean of the College of Business, Law and Social Sciences at the University of Central Lancashire and. He is a qualified, registered social worker, with a background in criminal justice work and wide experience as an academic manager, external examiner and active researcher in areas of social work education, social work and service user led research, practice learning and interprofessional learning and teaching. He has provided training and consultancy to a wide range of organisations across the health and social care sectors.

Learn more about Innovations in Social Work Research

Young People and Drugs – What can adoptive parents do?

Julian Cohen, author of All About Drugs and Young People, is a writer, educator, counsellor and consultant who has specialised in drug and sex education work with children, young people, parents, carers and professionals for nearly 30 years. In this blog post he covers tips and advice for adoptive parents who may be concerned about their child and drugs, and there is a free extract from the book for you to read at the end of the post. 

National Adoption Week is highlighting the fact that over 4,000 children in England are waiting for adoptive parents. A significant number of these children are older, have had particularly distressing childhood experiences and have additional and complex needs. They need adoptive parents who will help them overcome their troubled backgrounds. This means consistently sticking by them through the good times and the bad, helping them to make sense of who they are and to grow up feeling safe and secure.
These children may use a range of drugs not just to have fun but in an attempt to escape from unpleasant feelings they have about themselves, past experiences and anxieties about their futures.
Adoptive parents need to be drug aware and sensitive and relaxed about how they deal with young people’s involvement with drugs. How can they go about doing this? Here are 10 suggestions to help you be prepared.

1. Be aware that we are all drug users and have a lifetime drug career. If we think of drugs as mood altering substances they include alcohol, tobacco, caffeine and medicines, as well as illegal drugs, ‘legal highs’ and other socially taboo substances such as solvents. We all self- medicate throughout our lives. The key is to promote a relatively healthy and safe drug career, rather than a damaging one. Cohen_All-About-Drugs_978-1-84905-427-0_colourjpg-web

2. Be informed – learn about drugs and their use. You don’t need an encyclopedic knowledge but you do need to know something about various drugs, the different ways they are used, possible effects and dangers. At the same time you need to avoid the many myths that often surround discussion of drugs. Read books, look on the internet and talk to other adults and to young people.

3. Be aware of your own use of drugs, both past and current, and your particular feelings about drug use. What messages is your use giving your child, why do you feel as you do and how do your views compare with and other adults you know and with young people?

4. Be realistic. Be clear about what you can expect of children of a particular age, development and background. Drug use can be dangerous but avoid exaggerating the risks. Going over the top about dangers is a sure way of closing down communication with young people. And don’t think that they always will be deterred by risky behaviours. Risk can be attractive to them. Rather than expecting they will never use drugs adopt a harm reduction approach where you can have an honest dialogue with them about what they are up to and help to ensure their safety.

5. Talk with young people and make drug use a normal topic of conversation. Use opportunities that arise from watching TV and films. Don’t rush in and tell them what to feel, think or do. Take it gently and listen to what they have to say. You may sometimes need to bite your tongue and agree to disagree.

6. Know how to assess the risks involved with young people using drugs. Take into account the particular drug they may be using, how much and how often, how they are feeling in themslef and also who they may be using with, when and where. Don’t assume the worst and be aware that heavy, regular drug use is often motivated by a desire to blank out painful emotions.

7. Negotiate sensible, age appropriate drug rules. Rather than impose rules discuss with young people what they think might be best. Start with alcohol, cigarettes, caffeine and medicines. If, what, how much and often, when, where and who with can be discussed. You can consider sanctions for breaking the rules and might also put the spotlight on your own drug use as well as theirs.

8. Educate young people about drugs. Learn together by talking and looking at drug pamphlets, books and the internet. Include learning about basic first aid so they can help other people in any emergency situations. Support their school to deliver relevant drug education.

9. Respond to situations where young people become involved with drugs without panicking, being aggressive or overly draconian. Rather than rushing to act, whenever possible create time to think carefully and find out more before responding.

10. Know where to get help, if needed. The Frank website – www.talktofrank.com – can point you to local drug services that offer information, advice and support for young people and for yourself. They also have a telephone helpline on 0300 123 6600. If you need help or advice also consider talking to your local adoption support groups and workers, other adoptive parents and your family and friends.

Remember, most young people who use drugs, including illegal and other socially taboo substances, do so without getting into serious problems. And many of those who do have problems with drugs will, in time, grow out of it. Supportive parenting can make a huge and positive difference to young people’s drug careers and their lives.

Julian Cohen

Read a free extract from Julian’s book here.

Find out more in Julian’s book All About Drugs & Young People – Essential Information and Advice for Parents and Professionals. Julian can also be contacted via his website www.juliancohen.org.uk

Using non-threatening direct work with children – an interview with Audrey Tait

With one bestselling direct work resource under her belt already, Audrey Tait, with Helen Wosu, has produced another must-have guide, full of creative ideas to engage the whole family and effect positive change through direct work. On the release of her second book, Direct Work with Family Groups, Audrey reveals how she developed her direct work activities, her experiences in the field, and her most cherished memories.

Tait and Wosu-Direct WorkFamilyGroups 1

Audrey, you have 20 years of experience working with children in social work settings, how do you feel that that experience has prepared you for the work you’re doing now?

I trained as a nursery nurse originally and this gave me a good understanding of child development, but also the importance of play. My career was based in children’s centres, nurseries run by social work which offer a package of care to the whole family, they offer a service to some of the most vulnerable children. It is no surprise then that many of these children had difficulties with speech and language and many of the children had issues with their wider development. They often had no reason to trust adults or expect adults to meet their needs – they were in essence ‘hard-to-reach children’. In communicating with them the workers needed to be very skilled and played a huge part in facilitating communication. This is where I learnt and developed my skills both with individual children, and working with family groups. When I moved to train as a social worker (approx. 12 years on), while doing the training I worked shifts in residential care with children aged 12-18, I realised that my skills were transferable. Arriving in practice teams doing child protection work I naturally used these skills, but I realised in the course of the job that I sometimes needed to be able to talk about difficult things more quickly than I would have liked (i.e. sometimes on first appointment in case of child protection, with really no time to establish a relationship, and in a critical position where not fully understanding the child’s situation could leave them at risk). How to do this in an as non-threatening and as gentle a way as possible was where many of the direct work activities came from.

Activities from Direct Work with Vulnerable Children have been adopted by a large number of social workers – what do you think it is about the activities that appeal to social workers and their service users?

Children respond well to non-threatening direct work, they need you to meet their needs, they need to feel relaxed and to get something out of the engagement with you – play is a common activity that children, and everyone else, is familiar with. It has potential, when used well, to help the participants feel safe and reassures that it can help facilitate communication, and ultimately it is rewarding for all parties. This doesn’t detract from the serious subjects we are often dealing with, adults who work with vulnerable children and adults do so because they care, they want to get it right, and in my experience most will do anything they can to extend this care, ease communication and ensure people get a good service. When professionals use direct work and see positive results, they are naturally motivated to develop their practice in this area.


Tell us about your new book – Direct Work with Family Groups. How is it different from Direct Work with Vulnerable Children?

Direct Work with Family Groups explores the challenges of working with families in the community and there’s a natural progression from Direct Work with Children. In reality, in my practice I will work with the child individually and with the family group. Other times the emphasis will be on working with the child, then the focus will shift to work with family group, then back again and so forth, depending on the needs of the child/family. Many of the activities can be transferable from one-to-one work to group work, and the second book focuses on activities and case studies. With regards to family groups, often people (including me) find this type of work challenging because you have to meet several people’s needs at once, have many stages of development to understand and respond to, not to mention different personalities and group dynamics! The book attempts to give some practical ideas on how not only to begin to offer this work, but also to demonstrate through the practice examples how powerful this work can be!


The activities you’ve developed were borne out of 20 years of experience. How did the activities come about, and was there a moment when the activities started to take shape as a collection?

The individual activities usually come about by thinking about a family/individual, knowing what I need to do with them, and trying to match that with something they will enjoy/respond to. Ultimately most activities are transferable to other children/parents with similar interests or situations.

Can you recall your most cherished memory with a service user?

I really don’t know – I make new ones every week! Today a mother whom I worked with a long time ago brought her little girl in to show me how smart she was in her new school uniform. The little girl was smiling, proudly showing me her new shoes and telling me happily about her new teacher. I was with them not more than five minutes but that meant so much. When I first met the family, the mum was very defensive and didn’t want to work in partnership. The little girl’s needs were not met on any level – poor hygiene, not enough food and poor school attendance to name but a few of the issues and now look! If you enjoy all the small achievements, and the not-so-small ones, your work brings constant rewards.

What do you feel has been the biggest achievement in your career thus far?

Still being in social work! Largely due to working in such a great team and getting to work with some of the bravest children you could imagine.


Audrey Tait is a Senior Practitioner with the Children and Families Practice Team, City of Edinburgh Council. She has over 20 years’ experience working with children in social work settings and for the last 6 years has been delivering a training course, Communicating with Children, for the City of Edinburgh Council’s Children and Families Department. Audrey also co-authored the bestselling Direct Work with Vulnerable Children with Helen Wosu.

Learn more about Direct Work with Family Groups








How do we respond to children we consider need protecting?

Informed by her many years on the frontline and subsequent experience writing serious case reviews, Joanna Nicolas has identified the most common pitfalls in child protection cases in her latest book Practical Guide to Child Protection. In this blog, Joanna explores what kind of issues frontline workers need to focus on when faced with a long list of case reviews.


It feels as though we as a country are at a crossroads as to what we consider to be child protection and how we respond to children we consider need protecting. There has also been seismic change in terms of the increasing recognition of child sexual exploitation and the impact that has on services. Child sexual exploitation usually involves victims who are teenagers – how do we work effectively with teenagers when they can just tell us to get stuffed – and is our child protection system as it stands effective for working with very vulnerable victims of child sexual exploitation? I remember a young person I was working with who would take part in a police video interview in the morning and talk about the abuse but then she would leave and later that day would be back with the gang. No one has all the answers and you cannot just lock these young people up.

There are those who are questioning whether our current system as a whole is fit for purpose. The Government is saying that there is to be an overhaul of how we protect our most vulnerable children. As well as this, at a time of great austerity, more and more children are living in poverty and there are those who are deeply concerned that the child protection system is being used in a wholly inappropriate way to deal with the consequences of austerity. On top of that, we have increasing obesity levels in children and so the debate goes about whether that should be dealt with in the child protection area and so it goes on.

While all of this goes on and cuts become greater and systems change and change again, those on the frontline have to keep their focus on the day-to-day job of protecting our most vulnerable children. In my professional lifetime I do not think there has been a harder time to do that, particularly as social workers can now be named by the media in some court cases, the Government is considering jail terms for professionals who do not report abuse, and almost daily you can read misleading and sometimes erroneous headlines about what social workers and other public sector workers have failed to do and how that has resulted in the death of, or serious injury to, a child.

With all of this in mind I wanted to write a book that focused purely on the practical. What do you do when faced with certain situations and what are the issues we need frontline workers to focus on?

For the last seven years I have been working on serious case reviews. There are common themes that arise from serious case reviews, such as agencies that have not worked well together, information that has not been shared, the parents/carers have issue around unmet mental health needs/substance misuse/domestic abuse, the child has become invisible, etc. I wanted to focus this book on those areas because what we learn from serious case reviews is that those are the areas we struggle with the most.

I am not an academic and this is not a textbook. I am a practitioner who has worked in the field of child protection for 20 years and so I wanted to write a practical guide. The aim of the book is to help frontline professionals with the work they are doing every single day.  My starting point is that when I qualified as a social worker, 20 years ago, no one ever told me what to do when you knock on someone’s door and they tell you to f*** off, and there have been so many situations over the years where I have asked myself ‘what on earth do I do now?’ The father answering the door in his Y-fronts was a dilemma. He insisted I come in and explained his near-nakedness by saying it was so hot, but I resisted and stood firmly on the doorstep. I had to make it very clear I was not going to enter the home until he was dressed – but you don’t learn that at university! I hope that is what this book will do, help you think about the practicalities.

We all need all the help we can get but there is never enough time to read everything we should, so I have created a book that you can dip in and out of, to help with the dilemma you are facing at the time. Just don’t make the mistake I did when a patronising father said to me many years ago, “Well how old are you, Missy?” and I heard myself reply, “I’m nearly 32…”

If this book helps one person it will be worth every hour I have worked on it and I hope that person will be you.

Joanna Nicolas has worked in social care for 23 years. She has worked as a residential social worker, a frontline child protection social worker and has been developing and delivering child protection training for her Local Safeguarding Children Board since 2006. She also develops and delivers training in the private and voluntary sector. She now leads on serious case reviews and works as an independent child protection consultant. She is an accredited lead reviewer in the Social Care Institute for Excellence (SCIE) Learning Together systems reviews model and has been leading these reviews since 2011, when the Government first piloted the model. Since 2008 Joanna has been a national commentator on issues around social work, child protection and serious case reviews. She is also the author of ‘Conducting The Home Visit In Child Protection’.

Learn more about Practical Guide to Child Protection.