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Experienced Social workers

The following illustration may help:

I am a children's mental health social worker, working with children in the public care system who present with significant mental health problems. These issues affect their everyday ability to function and threaten placement stability (Ford, T et al (2007), Psychiatric disorder among British children looked after by local authorities: comparison with children living in private households, British Journal of Psychiatry 190, 319-325). I was recently consulted by a social worker about work with R, who has had a series of placement breakdowns in the past and whose current placement of three years has come to an end. From previous work with R I knew that, at age seven he had been described by school staff as behaviourally very challenging; they said he was a risk taker. He was described as numerically bright and quick witted, but unable to write well. At eight years old he was permanently excluded from school because he posed a risk to other children. At age nine, I assessed him as having below average verbal skills. He failed to meet any educational targets and was diagnosed with mild bilateral hearing impairment. Now at 13, the Statement of Special Educational Needs has noted that R's cognitive function is below average and that he has emotional and behavioural problems, poor social and peer relationships, deficits in his fine and gross motor skills, poor postural problems, and sensory difficulties. In short, R is likely to be exhibiting many of the symptoms of significant harm (Glaser, D (2000), Child Abuse and Neglect and the Brain: A Review, Journal of Child Psychology and Psychiatry, 41, 1, 97-116). R's current placement, which has just broken down, was the only one which provided him with any measure of security and it is my assessment that it is vital that attempts should be made to repair the placement. At the very least the relationship between R and the foster mother should be maintained so far as possible. I have provided the social worker with assistance as to how to encourage continued dialogue between them. I also think it is necessary to work separately with the foster mother to enable her to continue her parenting of Robert so far as possible.

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