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We catch up with Consultant Clinical and Forensic Psychologist  and author of the book 'Child Protection and Parents with a Learning Disability', Penny Morgan.

With research indicating that parents with a learning disability are over-represented in child protection investigations, we talk with author, Penny Morgan, about the potential emotional and mental health issues in the context of a person’s parental role.

What inspired you to write your book? 

Having specialised in working with parents who had a learning disability or difficulty as well as co-existing emotional or mental health problems, I became aware that social workers and other support staff had limited access to training opportunities. Staff would be expected to work with a generic caseload and, at the same time, be able to complete specialised assessments on parents with complex presentations, including learning problems. 

Much of the literature in this area focuses on planning and philosophical issues; whilst these are essential discussions, they do not necessarily inform the detail of everyday case work. My book, Child Protection and Parents with a Learning Disability, is a response to these concerns.

How does it bridge psychology and social work?

I offer a psychological perspective on the assessment process, explaining the relevant psychological models (intelligence, mental health and attachment), showing how they are used in relation to people who have a learning disability and how they align with and complement the social work assessment process. I also highlight constructive ways of working with families which can be readily incorporated into routine practice.

How important is engagement?

Engagement is a fundamental issue with families where one or both parents have a learning disability. Social workers have to negotiate the dual role of supporter and assessor, which affects the nature of the relationship formed with the family. Yet a parent’s understanding of the reasons for the assessment and the need for support or change may be limited.  

Here are a few pointers to help establish a positive, contained relationship allowing parents to say when  they do not understand or need help: 

• Use straightforward explanations and simple  language structures 

• Allow the expression of strong emotions such as confusion, fear and anger but seek to contain these emotions 

• Be sensitive to known vulnerabilities (history of   abuse, social exclusion and mental health issues) 

• Work collaboratively on goals and tasks to diffuse imbalance in power with parents

• Include extended family members within the assessment process 

How important is a cognitive assessment?

It should be commissioned as early as possible. Tests of cognitive functioning and IQ scores give an idea of thinking and learning style, speed and capacity. It will not only help your assessment if you have a clearer idea of a parent’s strengths, but family courts will be looking to see if you have worked appropriately to their individual strengths and needs. 

However, any cognitive assessment must be set within a wider context. After all, each person will have a mix of inherited familial characteristics, their own personality, environment and upbringing as well as any identified learning disability. 

Where does mental health factor?

It may be more complex for parents who experience mental health issues as their learning disability may interact with their mental health difficulties.

Take post-traumatic stress disorder (PTSD), for example. A high proportion of parents with a learning disability where child protection is an issue have a history of trauma. Research shows that the interaction between the parent’s cognitive difficulties and emotional or mental health problems (resulting from trauma) can limit the parent’s capacity to prioritise their child’s needs, leading to child protection concerns.

Parents themselves, lacking a clear frame of reference, may not recognise past experiences as traumatic or have the language to describe what happened. Friends and relatives may have dismissed their symptoms. Past abusers could still be present and powerful within the family structure. 

Helping a parent to build their personal story, and within this, recognise traumatic events and the role that effective treatment could play, are helpful first steps in working with parents with PTSD. Early referral to skilled support is essential, as waiting times for treatment may be lengthy. It is also important to recognise the demands that the treatment process places on the individual and to support this process in order for it to be successful. 

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