Posted in Attachment, Social services


I think it is absolutely essential that social workers have a basic understanding of attachment theory and the importance of the early relationship between baby and mother (again used as shorthand) from the first moments of birth, and even in utero as there is evidence that babies can be adversely affected if there is tension, hostility, domestic violence etc., and how this insecure attachment pattern will affect the children as they grow through the ages and stages of childhood. They need to understand that attachment patterns are secure or insecure/anxious, not “strong” or any of the other adjectives that are often used. However it is only by observing the interaction between the mother and child that can demonstrate the attachment pattern. Having said that, great care should be taken not to jump to conclusions, and indeed I don’t think it fair that social workers should be expected to determine the exact attachment pattern between mother and child. This is more the work of clinical psychologists and play therapists, often working collaboratively.

The other important point is that LAs should make it a priority to ensure that all prospective and approved foster carers and adopters are given the opportunity to learn about attachment theory and practice. These children with insecure attachment patterns, or an attachment disorder are going to be in their care, and it can only be positive for them to have an understanding of the reasons for the child’s often difficult and challenging behaviour.

Adopters need to know that “love is not enough” (a commonly held view, and not unreasonable) but the child who has an insecure/anxious attachment with his mother, or an attachment disorder is going to prove a huge challenge for the adopters, especially in the case of the attachment disordered child. Indeed these children should be able to receive play therapy and the adopters should be assisted/guided by the therapist as to the best way of caring for the child, to enable the adverse effects of his early life to be minimised, and for him to begin to feel loved and valued for who he is, and that love and care is not conditional. There is no “quick fix” and sadly LAs are so cash strapped that they are highly unlikely to pay for play therapists. Some LAs have clinical psychologists who are able to offer training on attachment to social workers, managers, foster carers and adopters.

Many foster carers and adopters in the LA in which I worked said that it was “like the scales falling from their eyes” as they recognised the child who was insecurely attached to his mother, and the behaviours that were manifested as a result. Many of them went on to read and study the topic further and in turn were able to share their knowledge with other foster carers and adopters.

Posted in Alienated children, Alienation, Parental Alienation PA, Social services

Child Welfare Reporters: a question of competence? –

There is a lack of knowledge around child development, attachment, domestic abuse, family dynamics, and little understanding of what might constitute a risk of harm to a child. There is often a lack of curiosity and over reliance on what seems, at first glance, most apparent. And where there is clear indication of likely harm – at times this is not identified, and rarely is a referral made to safeguarding services.

I am not alone in these concerns; they are not new. They go back more than 30 years. “The lack of understanding of child development and family dynamics can result in an adult view rather than a child-centred one.” Such concerns, in addition to others around the interviewing of children, determining “genuine” views and potential “severe consequences on the child’s psychological state and social environment” led to recommendations for improvements and reform234 . Nearly 10 years later, these concerns have yet to be addressed.

Posted in Alienated children, Alienation, Parental Alienation PA, Social services

Impact Statement –

It’s now clear the children have been scarred by this experience and especially by the long delays and the court’s failure to provide them with relief from what they were experiencing. So much then for the principle that the best interests of children must be the paramount consideration in these cases.

A Child Welfare Hearing is meant to provide the sheriff with an informal opportunity to settle a family case quickly for the benefit of and in the best interests of children. It is meant to avoid the need for a lengthy and expensive proof (a proof, I understand now, is the Scottish equivalent of a trial in England; a hearing on evidence in a civil matter.) In my experience – and largely, I think, because the private practice solicitor appointed was unqualified, untrained and unskilled in assessing welfare and risk – the Child Welfare Reporter’s involvement actually exacerbated, inflamed and confused the matter, causing years of delay.

Posted in Alienated children, Alienation, Parental Alienation PA, Social services


Training for Lawyers

Lawyers here means solicitors, barristers and Legal Executives.  We have already highlighted the appalling level of ignorance amongst lawyers about PA.  As with CAFCASS officers, UKAP recommends a compulsory PA training module in the CPD (Continuing Professional Development) of all family lawyers.  Use our questionnaire when talking to lawyers.

Posted in Alienated children, Alienation, Parental Alienation PA, Social services

Health Education continued………………………


CAFCASS is a major source of injustice for children and APs.  Make no mistake about that.

The reasons are these.

Firstly, the training of CAFCASS officers is woeful.  Courses in PA are only optional.  And the uptake of these courses is lamentable – only 2% of caseworkers take this course (  Well, Mr Douglas of CAFCASS says that CAFCASS officers are very busy – but not too busy to attend courses on reclaiming their expenses – the uptake for those courses is rather better [link to]

Second, CAFCASS is institutionally gender-biased.  In July 2017, CAFCASS produced a report

.  Leaving aside a critique for the moment, it is deeply concerning that CAFCASS chose to involve Women’s Aid, but not one group that represents men.  The problem is not just the report itself, but in the narrowness of the consultation.

Third, CAFCASS are only now waking up to PA, despite it having been around for thirty years in its current form.

Fourth – Wishes and Feelings Reports

These are a waste of time and money in PA cases, for the reasons we describe in our case law introduction page, and should be abandoned.  We should judge a child’s capacity to consent to their estrangement from you using something like the Gillick test of competence.

Here is a useful quote from Judge Wildblood in re A 2019:

ix)                There is an obvious difficulty about how to approach the expressed wishes and feelings of children who are living in an alienating environment such as this. If children who have been alienated are asked whether they wish to have a relationship with the non-resident parent there is a likelihood that the alienation they have experienced will lead them to say ‘no.’ Therefore, in this type of case, the approach to the wishes and feelings of children has had to be approached with considerable care and professionalism. To respond simply on the basis of what children say in this type of situation is manifestly superficial and naive. The children in this case have been expressing wishes that they should not see their father for many years now…

Fifth, when there are (and this is very common) false allegations against the target parent then, According to Anthony Douglas of CAFCASS

“you can’t oversimplify it into punish one parent because generally the punishment of a parent rebounds on a child”

There are several problems with this.

Firstly, the use of ‘oversimplify’ implies a value-judgement that has not been proven.  If one parent makes false allegations against the other, that is simple, isn’t it?   False allegations loom large in most PA cases.  AP alleges that TP has assaulted AP.  Or the child.  This is simple.  It is either true or false. The onus, as with all allegations, is, or ought to be, on the party making the allegations to prove the allegations.  As soon as it is clear that the allegations are false, they should be withdrawn, and some kind of sanction levied against AP.

Next, ‘the punishment of a parent rebounds on a child’.  

This is an argument adopted by some judges too, when deciding not to send APs to prison for contempt when then ignore court orders.  It is a nonsensical argument, for the following reasons:

  1. It is probably true that punishment of any parent for any offence will rebound on the child, isn’t it?  If mum or dad is sent to prison for murder, for twenty years, this will affect the children;
  • So perhaps no parent should ever be punished for any crime for fear of the effect on the children – that is obviously an untenable position;
  • If prison must be an option for parents if they murder, or rape, steal, or commit fraud, then prison should be an option for all imprisonable offences including contempt of court (lying to the court or ignoring court orders).  
  • Therefore these things should be punished like any other offence.  Nobody considers the effects on a bank robber’s child of the bank robber going to prison…

Anything less than prison would mean that we regard the psychological abuse of children as less serious than physical or sexual abuse or other criminal offences.  Or perhaps just not serious at all…Worth noting too is that a judge has many other options at her disposal for punishing parties that do not obey the court.

But of course that is EXACTLY why it is not punished.  Nobody seems bothered about psychological abuse of children.  Social workers, including (and especially) CAFCASS, can’t even recognise it! 

We thought CAFCASS might be changing their ways:

But in their blog a few weeks later, Anthony Douglas says this:

Posted in Social services

Health Education England

“e-Learning for Healthcare (e-LfH) is a Health Education England (HEE) Programme working in partnership with the NHS and professional bodies to support patient care by providing e-learning to educate and train the health and social care workforce.”

Am I missing something here? I have searched the complete hub for any modules covering Parental Alienation, I have even search the new planned programmes.

I have found nothing covering PA.

Posted in Social services

Narcissistic Personality Disorder and the Social Work Exam

For details on all of these, take a look at PsychCentral’s summaries. But first, let’s zoom in on Cluster B and a recently much-discussed diagnosis: NPD.

A woman tells a social worker that she believes her husband, a successful businessman, is “a clinical narcissist.” She says he’s “completely obsessed with himself.” Which of the following can the social worker tell the woman is a common symptom of narcissistic personality disorder?

A. Discomfort in situations in which he or she is not the center of attention.

B. Is unwilling to recognize or identify with the feelings or needs of others.

C. Inappropriate, intense anger or difficulty controlling anger.

D. Repeated lying, use of aliases, or conning others for personal profit or pleasure.

What do you say?

If you know the cluster B diagnoses in some detail, the answer comes much more easily. All but one of the listed symptoms come from other cluster B disorders. Let’s take them one at a time:

A. sounds a lot like NPD. Needing to be the center of attention. But it’s not. It’s a criteria for histrionic personality disorder. Wait, really? Yep. Histrionic personality disorder is characterized by “a pervasive pattern of excessive emotionality and attention seeking…” It’s attention-focused, not self-importance focused.

D., repeated lying for profit or pleasure, sounds like NPD too, but, this one is a criterion for antisocial personality disorder (“A pervasive pattern of disregard for and violation of the rights of others…”). NPD can include taking advantage of others, but not necessarily outright, repeated lying, conning, or using aliases.

C., anger problems, sounds a little like NPD too. But it’s more indicative of BPD (“a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity”)–and that’s where that criterion comes form.

Which leaves…the correct answer! B., lack of empathy.  For diagnosis of NPD, five of nine possible criteria have to be exhibited. Here are the full nine:

Posted in Alienation, Social services

Stepping forward to 2020/21: The mental health workforce plan for England

Following graduation from undergraduate medical school, there are a number of points along the ‘pipeline’ for psychiatrists where potential supply can be lost:
• Not enough newly qualified doctors choosing/able to train in psychiatry. In 2016, only
349 of the advertised 417 Core Psychiatry Training places were filled by a trainee (83%). The percentage of unfilled training posts in psychiatry is consistently higher than any other specialty. Doctors in postgraduate training programmes contribute significantly to the service by delivering care, as well as getting trained. The impact of poorly filled training programmes therefore directly affects care today as well as risking care tomorrow if too few consultants are produced.
• Low direct transition rates from Core to Higher Specialty Training. Historically, for every 100 psychiatrists recruited into core psychiatry, 60 will complete core training and then proceed directly to complete higher psychiatry training. For UK medical graduates, the figure is significantly higher than overseas medical graduates. Trainees may temporarily or permanently step out of training at this transition point to work as locum or nonconsultant, non-training grade doctors.
• Recruitment into higher psychiatry is therefore reliant on non-UK doctors in training
and augmentation from beyond the pool of former core trainees. As many as 48% of
higher specialty trainees in psychiatry have non-UK Primary Medical Qualifications. 67% of our medical staff in mental health services are British (10% EU, 17% non-EU) compared to 75% of all medical staff (9% EU, 16% non-EU). The contribution of overseas doctors to the NHS is highly valued and it is essential that we retain their skills whilst also ensuring we have a sustainable ’homegrown‘ future workforce.
• A quarter of recently qualified consultant psychiatrists do not go on to be employed
substantively by the NHS (although they may be providing NHS-funded services in other settings or working as a locum for the NHS). This figure rises to a third within five years of registering. The GMC annual report2 shows over 8000 psychiatrists on the Specialist Register (across the whole of the UK), but the NHS in England employs fewer than 5000

• The psychiatric workforce also relies heavily on non-consultant, non-training grade
(SASG) doctors (24% of the psychiatric workforce). This staff group is unplanned and
therefore does not have a secure supply pipeline, but are a vital and valued part of
specialist medical care. The Five Year Forward View for Mental Health and this Workforce Plan identify the need for significant additional psychiatrists to be employed, if these services are delivered using current service models. This is in addition to filling the high levels of vacancies in current services.

Stepping forward to 202021 – The mental health workforce plan for england

Posted in Alienation, Social services

E-learning programmes on the e-LfH Hub

A comprehensive list of proposed e programmes offered by Health Education England

Not one mention of anything relating to Parental Alienation, have we really moved any further forward???

HEE e-Learning for Healthcare: Planned Programmes to March 2021
List updated 11th August 2020
Programme name  No. of sessions (estimate)
Launch date
6  Autumn 2020
Emergency Medicine Leadership
3 November 2020
Freedom to Speak Up
3  Summer 2020
Healthier Weight Competency Framework
1  Summer 2020
Maximising Population Health and Prevention in curricula
1  Summer 2020
National Training for Continuity of Carers
1  Summer 2020

Online Safeguarding Conference
6  Autumn 2020
Preventing Cerebral Palsy in Preterm Babies (Precept)
Respiratory Physiotherapy
16 Autumn 2020
Supporting AHP Students
2  Summer 2020
Wound Care
3  Autumn 2020

Covid-19 Recovery and Rehabilitation
4 Summer 2020
Covid-19 IPC in Care Homes
4 Summer 2020

HEE e-Learning for Healthcare: Planned Programmes Updates to March 2021
Existing Programme Name  Updates  New content
Acute Medicine
Adolescent Health
All our Health
Yes  Yes
Yes  Yes
Antimicrobial Resistance and Infections
Breast Imaging Academy
Care Certificate
Continuing Health Care
Educator Training Resource: Clinical Educators
Education Training Resources: Pharmacy
End of Life Care
Yes  Yes
Flu Immunisations
Yes  Yes
General Practitioners
Yes  Yes
General Practitioners: Dementia
Yes  Yes
Healthy Child
Healthy School Child
Image Interpretation
Yes Yes
Intelligent Intermittent Auscultation (IIA)
Intensive Care Medicine
Yes  Yes
Medical Examiners
Yes  Yes
Mental Capacity Act
Yes  Yes
Yes  Yes
National Bereavement Care Pathway
NEWS and Deterioration

Yes  Yes
Oral and Maxillofacial Surgery
Pain Management
Yes  Yes
Yes  Yes
Plastic and Reconstructive Surgery
Yes Yes

Screening Newborn Hearing
Sexual and Reproductive Healthcare
Yes  Yes
Sexual Health and HIV
Statutory and Mandatory Training
Supporting a Smoke free Pregnancy (SCP) Yes

HEE e-Learning for Healthcare: External Programmes to March 2021
List updated 1st July 2020
Programme name No. of sessions Launch date Partner Organisation
Ambulance Services: Dementia
1 June 2020 SWAST
Autism Awareness
1 TBC HEE LD team
Delivering health services in special residential schools and colleges
1 TBC Health and Care Innovations
Genomics TBC TBC Liverpool Women’s Hospital
Hydration 1 TBC Wessex AHSN
Managing medicines for adults receiving social care in the community
TBC July 2020 PrescQuipp
Medical Schools TBC TBC Imperial College London
Mouth Care Matters TBC   Manchester University NHS Foundation Trust
National deterioration training for ambulance staff
1 TBC London Ambulance Service
National Literacy Foundation
TBC Summer 2020 National Literacy Foundation
NDTMS – National Drug Treatment Monitoring System
4 June 2020 PHE
NHS Blood and Transplant
3 June 2020 NHSBT
Perinatal Institute TBC TBC Perinatal Institute
PHE: Health and Work in Undergraduate Medical Education TBC TBC PHE
Post-Mortem Consent for Neonatal Deaths 1 TBC SSBC Operational Delivery Network
4 June 2020 Aquilant Services
Standards for Student Supervision and Assessment (SSSA)
2 July 2020 HEE Maternity team
Stroke Prevention in Atrial Fibrillation
1 TBC Oxford AHSN
The Healthcare Financial Management Association (HFMA) TBC   HFMA

See site for list of current programmes available in the UK.



Posted in Alienation, Social services

Expanding and enhancing the role of the mental health social worker

There are approximately 4,200 social workers (3,100 work in mental health and learning disability trusts), employed by the NHS, together with a larger number of local authority-employed staff working in partnership and based within the NHS.

In mental health, social workers often undertake intensive post-qualifying training to hold roles linked to the Mental Health Act 1983, such as Approved Mental Health Professional (AMHP), Best Interest Assessor and Non-Medical Approved/Responsible Clinician (AC/RC).

Social workers comprise 95 per cent of the 3,900 Approved Mental Health Professional (AMHPs), but less than five of the non-medical approved clinicians come from a social work background.

The New Roles Task and Finish Group recommended the inclusion of social workers as a core part of HEE’s mental health workforce plan as a key lever to achieving Long Term Plan ambitions and to alleviate workforce pressure. We are also exploring the possibility of expanding this workforce using Higher Education Institute pathways and fast-track models in specialist roles.

Mental health social work in the NHS – short films

HEE is creating a series of films to promote awareness and understanding of the crucial role that mental health social workers play in health and care systems.

This film, the first of its kind, includes a variety of voices from different areas of social work, including community work, approved mental health professionals, the family group conferencing approach and the social work consultant role highlighting how patients, service users and families benefit from their contribution to the NHS. Continue reading “Expanding and enhancing the role of the mental health social worker”