Supporting children and young people after abuse and neglect

Featured article - 24 October 2018
By Corinne May-Chahal and Hannah Roscoe

Head-shot of the author, Corinne May-Chahal and Hannah Roscoe

A new quick guide for practitioners and managers who work with children, young people and families

It is hard to imagine a more traumatic experience than being abused or neglected, possibly by someone you know and trust. But this is the experience of 58,000 children substantiated as victims by UK authorities each year, with potentially many more who are not known to the authorities.

Once a child or young person is out of immediate danger of harm, for example on a child protection plan or care order, there is a tendency to think that they are ‘safe now’. But that is not the end of the story. In order to prevent further harm, such as mental distress, children must get help and support to recover from their experience. The emphasis in our child protections system is too often on ‘rescue’ and much less on the medium and longer-term interventions that children need.

‘Therapeutic interventions after abuse and neglect’, the new quick guide from NICE (National Institute for Health and Care Excellence) and SCIE, is based on the recommendations of the NICE guideline on child abuse and neglect. The guide reflects the long-lasting impact that maltreatment can have on the health and wellbeing of children. The guide, which is for practitioners and managers working with children, young people and families, looks at what works when supporting abused and neglected children and young people.

This is important. One young person from our guideline reference group told us: 'Things were hard at home for a long time. I remember being scared all the time, and then I just kind of started to feel numb to everything. I skipped school, hung around with mates who were a bit older than me, anything to avoid being at home'.

Others talked about how abuse and neglect had affected them – 'being afraid', 'hurting yourself', 'feeling very angry' or 'crying a lot'. For some, abuse and neglect can lead to further abuse, for example, through exploitation; difficulties at school, or even involvement in the criminal justice system.

A key message is the importance of choice and involving children and families in discussions about what interventions you think will help, and why. Young people told us that not all types of help worked for them – so it is important to have different options and choices if possible.

The guide sets out the interventions which our review of the evidence found to be effective. For young children, interventions that help to rebuild attachments with caregivers have been shown to be helpful. For older children effective interventions involved addressing trauma, managing behaviour and crisis support. The guide also recommends specific interventions for addressing difficulties following sexual abuse.

A separate quick guide for children and young people highlights some key principles, such as keeping children involved in decision making and being clear about information sharing, as well as giving young people advice about where to find help and support.

As one young person said: 'Abuse can make you feel helpless and as though you are totally under the control of another person. It’s really important that any help or support doesn’t take even more control away from you, but empowers you and helps you to make choices as well as helping other people to understand what you have been through'.

We hope that managers and practitioners will use these guides to continue to support and empower children and young people affected by abuse and neglect.

Corinne May-Chahal is Professor of Applied Social Science at Lancaster University and chaired NICE’s guideline committee on Child abuse and neglect. Hannah Roscoe is Senior Research Analyst at SCIE.

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