Case Studies

Taken from the original Pause pilot in Hackney.

Chloe is 24 years old and has had 2 children removed from her care.

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Background

Chloe was removed from her mother’s care around the age of 5 due to neglect and her mother’s substance misuse. She spent a brief period in care and was then placed with her father and paternal grandparents.  Both grandparents and her father died within 4 years of each other. When Chloe was aged 10 she went to live with her paternal great grandmother. Chloe started a relationship with the father of her children when she was around 15 and first became pregnant at 16. Her education in secondary school was disrupted by her challenging behaviour and she spent some time in a Pupil Referral Unit. She was also arrested for robbery and common assault when she was a teenager. Chloe’s two children were removed primarily due to concerns around domestic violence. Chloe has reported physical and psychological abuse by her ex-partner and the father of her two children. Chloe’s children were placed with their paternal grandmother under a Special Guardianship Order (SGO) with the recommendation that contact between Chloe and the children be supervised and at the discretion of their grandmother. Chloe’s relationship with their grandmother been quite tense for the majority of the time the children have been placed with her.

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At the Start of Pause

Chloe was introduced to Pause by another Pause client. She stated that her primary support need was around her experience of domestic violence. Chloe indicated that she wanted to understand how to recognise the signs of an abusive relationship so as to avoid a similar situation to the one that she was in with her ex-partner. Chloe was very reluctant to meet one on one with her practitioner and the first few times they met she was with her friend and fellow Pause client. It took about 3 months for Chloe to become comfortable meeting her practitioner alone. Chloe has engaged consistently with Pause for the last 8 months and although there are times that she is avoidant or dishonest with her practitioner, she is often able to admit this and discuss it.

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Challenges

Chloe has struggled finding housing options due to her housing history and a previous ‘intentionally homeless’ decision. She has found it very difficult to speak about her own childhood and it has taken her about a year to begin spontaneously speaking about her experiences as a child. Chloe has consistently suffered from anxiety in group settings due to limited negotiation skills, resulting in her becoming frustrated and losing her temper easily. She has a history of deep mistrust of services and poor engagement with support. She finds it difficult to be alone and is easily ‘bored’ and she finds thoughts or emotions that come up when she is on her own intolerable. Chloe has a long history of offending behaviour including credit card fraud and drug dealing. In addition, she has a fear of therapeutic support and a history of mental health issues including personality disorder, anxiety and depression and at least one overdose. She also has difficulty with developing and maintaining relationships with females.

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Progress to Date

Chloe has taken a Long Acting Reversible Contraception (LARC), and has developed insight into her parenting capacity and self-referred to a parenting course. She has accessed support from the Learning Trust around further education and training. Chloe used to smoke cannabis a few times a day when she first began working with Pause but has now reduced this to 4 or 5 times a week. She has effectively been able to engage with Pause for an extended period and engage with Children’s Social Care in a positive way for the first time. She has an improved understanding of healthy relationships and recognises her past tendency to look for a father figure. She has also succeeded in identifying intergenerational patterns within her family. Chloe is now open to therapeutic support and has made significant progress in terms of her ‘stage of change’ around this. She has also made substantial improvements in her ability to manage conflict without losing her temper and in working within a group setting. Chloe has considerably reduced her offending behaviour (drug dealing, credit card fraud) and has started part-time employment in a retail shop. In addition to this, she has developed an interest in new activities such as art museums and theatre.

Becky is 27 years old and has three children in total. The oldest two children are placed with their paternal grandmother under a Special Guardianship Order (SGO).  The youngest child was adopted earlier this year.

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Background

Becky’s childhood was very difficult, with inter-generational dynamics of poor mental health and drug use, stemming from her own mother’s difficult and neglected childhood. As a child, Becky witnessed domestic violence and alcohol addiction within her family and was sexually abused at 8 years of age.  Becky first smoked cannabis at age 9 and tried heroin aged 14.  Inevitably, her secondary school education was disrupted due to her challenging behaviour. She has a history of criminal involvement and has spent multiple periods in prison. Further to this, Becky has a history of sex working and has been the victim of domestic violence.

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At the start of Pause

When Becky attended her first Pause appointment, she presented with a bruised eye but did not disclose domestic violence.  Becky had been given the date of the final contact with her youngest child and over time was able to describe to her practitioner, feelings of shame and guilt for her increasing drug use and the domestic violence she had experienced, both of which were at the root of care proceedings. Becky’s mental health was very poor and she described suicidal thoughts and self-harming. Becky indicated that she wanted to stop the cycle of repeat pregnancies, and removals and also expressed a desire to recognise the signs of an abusive relationship in order to avoid similar experiences.

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Challenges

Becky struggled greatly with having to see her child in a contact centre environment and understandably the final contact meeting was incredibly traumatic.  Her ongoing substance use, problems with her housing (including rent arrears), prospective eviction and threats from her ex-partner posed particular challenges.  Becky had been diagnosed with an ‘unstable emotional personality disorder’, as well as anxiety and post-traumatic stress disorder, (PTSD).

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Progress to Date

Becky has successfully taken a Long Acting Reversible Contraception (LARC) and has developed an insight into her parenting capacity. She has started a short course at a local college and begun to address her housing issues. Becky has agreed to be referred to a Multi-Agency Risk Assessment Conference (MARAC) for assistance around the violent partner. Becky now has an improved understanding of healthy relationships with different individuals including partners, family members, professionals etc. She has also been able to identify various intergenerational patterns within her family and wants to ‘break the cycle’. Becky is not currently involved in sex work and has openly discussed the idea of therapy, stating that she is open to therapeutic support. She has significantly reduced her substance intake and is successfully engaging with support services, whilst also receiving support around health (including sexual health checks), nutrition and diet. She has also had access to personal training and self defence lessons.