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Social injustice and inequality in the care system Part 1: How professionals can inadvertently make things worse (www.psychchange.org)

 

Cissy's note: One of the best blogs I've read recently and describes why I am passionate about sharing information about ACEs/Pair of ACEs personally and professionally but don't support universal #ACEs screening of adults or children, particularly parents and survivors of ACEs. I still worry that ACE scores will be used to further marginalize, shame, and other individuals and families.

We know, thankfully, that #ACEs happen to all people, regardless of class, race, gender, etc. which is wonderful. It's twenty years after the original ACEs study and so many are still learning about it and ACEs every single day. But, how we with ACEs are treated by system, especially when we have high ACEs is not at all the same. It's not the same in educational systems, healthcare systems, law enforcement systems, justice systems, child welfare systems, medical settings, or any of the sectors.

Equity issues are not even on the radar for a lot of organizations, even those doing #traumainformed care or work, though it is central, first and foremost to many. However, until #traumainformed routinely addresses historical trauma and structural oppression and supports trauma-informed change in all of us and all of our systems, I worry that universal screenings might hurt more than help.

I remain passionate about widespread sharing of #ACEs/Pair of ACEs work though as it inspires improves, energizes, motivates, validates and inspires parenting, health and social change among us all in our own lives, families and communities. and look forward to the day when we don't talk only about "at risk" or resiliency as though those can happen outside of a social context. There's so much to sift through and sort and how we use #ACEsScience in our lives and work and I love being part of a social network where all members can share, debate, discuss, and learn from one another. 

Excerpts from a recent Psychologist for Social Change blog.

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Professor Anna Gupta discussed her research, alongside that of Paul Bywaters, Andy Bilson and Michal Krumer-Nevo. Professor Gupta explained that a child is ten times more likely to be taken into care if they come from an area of high deprivation compared to an area of low deprivation. (Deprivation refers to a community's access, or lack of access, to important resources such as income, education, employment or health). This is also the case for children on a child protection plan, which is drawn up by the local authority and the family after an investigation to keep a child safe or improve their living conditions.

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Professor Gupta talked about the direct and indirect impacts of poverty on children and families – both of which play a role. A direct impact would be the inability to buy food for your family if you do not have access to money. An indirect impact would be the lack of power that people living in poverty hold, blocking their access to roles, rights and opportunities as well as having an impact on the way professionals interact with them.
Poverty was also talked about as a human rights issue, which has a symbolic as well as a concrete impact. As a psychologist, talking about poverty’s symbolic impact was helpful. It gave us space to consider the roles of stigma, discrimination and the “othering” process which takes place between professionals and families living in poverty. Othering is the tendency for humans to believe that the group that they are a part of (this could be any kind of social group from Manchester City supporters to working mothers to practising Christians) is inherently living the “right” way. Practising in a way that does not other families in the care system can be a challenge for professionals. Whether or not individuals consciously other on a personal level, it is inevitable on a structural level - the fact that families are on the radar of the care system communicates that their parenting has been judged and found not to be “right”. 

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In practice, this culture of parent blame and child rescue can present itself in the attitudes of people working in family services. Parents are labelled as “uncommitted” when they are unable to attend appointments due to travel costs. Parents become fearful of asking for help, aware that they will be labelled “high risk” or “neglectful”. This is also something psychologists are guilty of, said Dr Christina Trigeorgis, clinical psychologist and PSC member. She reiterated the importance of acknowledging social context in formal reports and ensuring that parental or familial “need” is not constructed as “risk”. Dr Trigeorgis warned of de-contextualizing people’s lives when drawing only from Western, individualised theories of psychology and said that even therapists who work with the relationships between people, groups and organisations can inadvertently narrow their lens to the family level, and fail to consider the wider social and political factors shaping the child or family.

Read more on the Psychologist for Social Change blog.

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